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Medical Essays by Oliver Wendell Holmes, Sr. (The Physician and Poet)

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"not only as a Pastor, but as a Physician too, and this, not only in
his own town, but also in all those of the vicinity." Mather says of
the sons of Charles Chauncy, "All of these did, while they had
Opportunity, Preach the Gospel; and most, if not all of them, like
their excellent Father before them, had an eminent skill in physick
added unto their other accomplishments," etc. Roger Williams is said
to have saved many in a kind of pestilence which swept away many

To these names must be added, as sustaining a certain relation to the
healing art, that of the first Governor Winthrop, who is said by John
Cotton to have been "Help for our Bodies by Physick [and] for our
Estates by Law," and that of his son, the Governor of Connecticut,
who, as we shall see, was as much physician as magistrate.

I had submitted to me for examination, in 1862, a manuscript found
among the Winthrop Papers, marked with the superscription, "For my
worthy friend Mr. Wintrop," dated in 1643, London, signed Edward
Stafford, and containing medical directions and prescriptions. It
may be remembered by some present that I wrote a report on this
paper, which was published in the "Proceedings" of this Society.
Whether the paper was written for Governor John Winthrop of
Massachusetts, or for his son, Governor John of Connecticut, there is
no positive evidence that I have been able to obtain. It is very
interesting, however, as giving short and simple practical
directions, such as would be most like to be wanted and most useful,
in the opinion of a physician in repute of that day.

The diseases prescribed for are plague, small-pox, fevers, king's
evil, insanity, falling-sickness, and the like; with such injuries as
broken bones, dislocations, and burning with gunpowder. The remedies
are of three kinds: simples, such as St. John's wort, Clown's all-
heal, elder, parsley, maidenhair, mineral drugs, such as lime,
saltpetre, Armenian bole, crocus metallorum, or sulphuret of
antimony; and thaumaturgic or mystical, of which the chief is, "My
black powder against the plague, small-pox; purples, all sorts of
feavers; Poyson; either, by Way of Prevention or after Infection."
This marvellous remedy was made by putting live toads into an earthen
pot so as to half fill it, and baking and burning them "in the open
ayre, not in an house,"--concerning which latter possibility I
suspect Madam Winthrop would have had something to say,--until they
could be reduced by pounding, first into a brown, and then into a
black, powder. Blood-letting in some inflammations, fasting in the
early stage of fevers, and some of those peremptory drugs with which
most of us have been well acquainted in our time, the infragrant
memories of which I will not pursue beyond this slight allusion, are
among his remedies.

The Winthrops, to one of whom Dr. Stafford's directions were
addressed, were the medical as well as the political advisers of
their fellow-citizens for three or four successive generations. One
of them, Governor John of Connecticut, practised so extensively,
that, but for his more distinguished title in the State, he would
have been remembered as the Doctor. The fact that he practised in
another colony, for the most part, makes little difference in the
value of the records we have of his medical experience, which have
fortunately been preserved, and give a very fair idea, in all
probability, of the way in which patients were treated in
Massachusetts, when they fell into intelligent and somewhat educated
hands, a little after the middle of the seventeenth century:

I have before me, while writing, a manuscript collection of the
medical cases treated by him, and recorded at the time in his own
hand, which has been intrusted to me by our President, his

They are generally marked Hartford, and extend from the year 1657 to
1669. From these, manuscripts, and from the letters printed in the
Winthrop Papers published by our Society, I have endeavored to obtain
some idea of the practice of Governor John Winthrop, Junior. The
learned eye of Mr. Pulsifer would have helped me, no doubt, as it has
done in other cases; but I have ventured this time to attempt finding
my own way among the hieroglyphics of these old pages. By careful
comparison of many prescriptions, and by the aid of Schroder, Salmon,
Culpeper, and other old compilers, I have deciphered many of his
difficult paragraphs with their mysterious recipes.

The Governor employed a number of the simples dear to ancient women,
--elecampane and elder and wormwood and anise and the rest; but he
also employed certain mineral remedies, which he almost always
indicates by their ancient symbols, or by a name which should leave
them a mystery to the vulgar. I am now prepared to reveal the mystic
secrets of the Governor's beneficent art, which rendered so many good
and great as well as so many poor and dependent people his debtors,-
at least, in their simple belief,--for their health and their lives.

His great remedy, which he gave oftener than any other, was nitre;
which he ordered in doses of twenty or thirty grains to adults, and
of three grains to infants. Measles, colics, sciatica, headache,
giddiness, and many other ailments, all found themselves treated, and
I trust bettered, by nitre; a pretty safe medicine in moderate doses,
and one not likely to keep the good Governor awake at night, thinking
whether it might not kill, if it did not cure. We may say as much
for spermaceti, which he seems to have considered "the sovereign'st
thing on earth" for inward bruises, and often prescribes after falls
and similar injuries.

One of the next remedies, in point of frequency, which he was in the
habit of giving, was (probably diaphoretic) antimony; a mild form of
that very active metal, and which, mild as it was, left his patients
very commonly with a pretty strong conviction that they had been
taking something that did not exactly agree with them. Now and then
he gave a little iron or sulphur or calomel, but very rarely;
occasionally, a good, honest dose of rhubarb or jalap; a taste of
stinging horseradish, oftener of warming guiacum; sometimes an
anodyne, in the shape of mithridate,--the famous old farrago, which
owed its virtue to poppy juice; [This is the remedy which a Boston
divine tried to simplify. See Electuarium Novum Alexipharmacum, by
Rev. Thomas Harward, lecturer at the Royal Chappell. Boston, 1732.
This tract is in our Society's library.] very often, a harmless
powder of coral; less frequently, an inert prescription of pleasing
amber; and (let me say it softly within possible hearing of his
honored descendant), twice or oftener,--let us hope as a last
resort,--an electuary of millipedes,--sowbugs, if we must give them
their homely English name. One or two other prescriptions, of the
many unmentionable ones which disgraced the pharmacopoeia of the
seventeenth century, are to be found, but only in very rare
instances, in the faded characters of the manuscript.

The excellent Governor's accounts of diseases are so brief, that we
get only a very general notion of the complaints for which he
prescribed. Measles and their consequences are at first more
prominent than any other one affection, but the common infirmities of
both sexes and of all ages seem to have come under his healing hand.
Fever and ague appears to have been of frequent occurrence.

His published correspondence shows that many noted people were in
communication with him as his patients. Roger Williams wants a
little of his medicine for Mrs. Weekes's daughter; worshipful John
Haynes is in receipt of his powders; troublesome Captain Underhill
wants "a little white vitterall" for his wife, and something to cure
his wife's friend's neuralgia, (I think his wife's friend's husband
had a little rather have had it sent by the hands of Mrs. Underhill,
than by those of the gallant and discursive captain); and pious John
Davenport says, his wife "tooke but one halfe of one of the papers"
(which probably contained the medicine he called rubila), "but could
not beare the taste of it, and is discouraged from taking any more;"
and honored William Leete asks for more powders for his "poore little
daughter Graciana," though he found it "hard to make her take it,"
delicate, and of course sensitive, child as she was, languishing and
dying before her time, in spite of all the bitter things she
swallowed,--God help all little children in the hands of dosing
doctors and howling dervishes! Restless Samuel Gorton, now tamed by
the burden of fourscore and two years, writes so touching an account
of his infirmities, and expresses such overflowing gratitude for the
relief he has obtained from the Governor's prescriptions, wondering
how "a thing so little in quantity, so little in sent, so little in
taste, and so little to sence in operation, should beget and bring
forth such efects," that we repent our hasty exclamation, and bless
the memory of the good Governor, who gave relief to the worn-out
frame of our long-departed brother, the sturdy old heretic of Rhode

What was that medicine which so frequently occurs in the printed
letters under the name of "rubila"? It is evidently a secret remedy,
and, so far as I know, has not yet been made out. I had almost given
it up in despair, when I found what appears to be a key to the
mystery. In the vast multitude of prescriptions contained in the
manuscripts, most of them written in symbols, I find one which I thus

"Four grains of (diaphoretic) antimony, with twenty grains of nitre,
with a little salt of tin, making rubila." Perhaps something was
added to redden the powder, as he constantly speaks of "rubifying"
or "viridating" his prescriptions; a very common practice of
prescribers, when their powders look a little too much like plain
salt or sugar.

Waitstill Winthrop, the Governor's son, "was a skilful physician,"
says Mr. Sewall, in his funeral sermon; "and generously gave, not
only his advice, but also his Medicines, for the healing of the Sick,
which, by the Blessing of God, were made successful for the recovery
of many." "His son John, a member of the Royal Society, speaks of
himself as 'Dr. Winthrop,' and mentions one of his own prescriptions
in a letter to Cotton Mather." Our President tells me that there was
an heirloom of the ancient skill in his family, within his own
remembrance, in the form of a certain precious eye-water, to which
the late President John Quincy Adams ascribed rare virtue, and which
he used to obtain from the possessor of the ancient recipe.

These inherited prescriptions are often treasured in families, I do
not doubt, for many generations. When I was yet of trivial age, and
suffering occasionally, as many children do, from what one of my
Cambridgeport schoolmates used to call the "ager,"--meaning thereby
toothache or face-ache,--I used to get relief from a certain plaster
which never went by any other name in the family than "Dr. Oliver."

Dr. James Oliver was my great-great-grandfather, graduated in 1680,
and died in 1703. This was, no doubt, one of his nostrums; for
nostrum, as is well known, means nothing more than our own or my own
particular medicine, or other possession or secret, and physicians in
old times used to keep their choice recipes to themselves a good
deal, as we have had occasion to see.

Some years ago I found among my old books a small manuscript marked
"James Oliver. This Book Begun Aug. 12, 1685." It is a rough sort
of account-book, containing among other things prescriptions for
patients, and charges for the same, with counter-charges for the
purchase of medicines and other matters. Dr. Oliver practised in
Cambridge, where may be seen his tomb with inscriptions, and with
sculptured figures that look more like Diana of the Ephesians, as
given in Calmet's Dictionary, than like any angels admitted into good
society here or elsewhere.

I do not find any particular record of what his patients suffered
from, but I have carefully copied out the remedies he mentions, and
find that they form a very respectable catalogue. Besides the usual
simples, elder, parsley, fennel, saffron, snake-root, wormwood, I
find the Elixir Proprietatis, with other elixire and cordials, as if
he rather fancied warming medicines; but he called in the aid of some
of the more energetic remedies, including iron, and probably mercury,
as he bought two pounds of it at one time.

The most interesting item is his bill against the estate of Samuel
Pason of Roxbury, for services during his last illness. He attended
this gentleman,--for such he must have been, by the amount of physic
which he took, and which his heirs paid for,--from June 4th, 1696, to
September 3d of the same year, three months. I observe he charges
for visits as well as for medicines, which is not the case in most of
his bills. He opens the attack with a carminative appeal to the
visceral conscience, and follows it up with good hard-hitting
remedies for dropsy,--as I suppose the disease would have been
called,--and finishes off with a rallying dose of hartshorn and iron.

It is a source of honest pride to his descendant that his bill, which
was honestly paid, as it seems to have been honorably earned,
amounted to the handsome total of seven pounds and two shillings.
Let me add that he repeatedly prescribes plaster, one of which was
very probably the "Dr. Oliver" that soothed my infant griefs, and for
which I blush to say that my venerated ancestor received from Goodman
Hancock the painfully exiguous sum of no pounds, no shillings, and

I have illustrated the practice of the first century, from the two
manuscripts I have examined, as giving an impartial idea of its
every-day methods. The Governor, Johannes Secundus, it is fair to
remember, was an amateur practitioner, while my ancestor was a
professed physician. Comparing their modes of treatment with the
many scientific follies still prevailing in the Old World, and still
more with the extraordinary theological superstitions of the
community in which they lived, we shall find reason, I think, to
consider the art of healing as in a comparatively creditable state
during the first century of New England.

In addition to the evidence as to methods of treatment furnished by
the manuscripts I have cited, I subjoin the following document, to
which my attention was called by Dr. Shurtleff, our present Mayor.
This is a letter of which the original is to be found in vol. lxix.
page 10 of the "Archives" preserved at the State House in Boston. It
will be seen that what the surgeon wanted consisted chiefly of
opiates, stimulants, cathartics, plasters, and materials for
bandages. The complex and varied formulae have given place to
simpler and often more effective forms of the same remedies; but the
list and the manner in which it is made out are proofs of the good
sense and schooling of the surgeon, who, it may be noted, was in such
haste that he neglected all his stops. He might well be in a hurry,
as on the very day upon which he wrote, a great body of Indians--
supposed to be six or seven hundred--appeared before Hatfield; and
twenty-five resolute young men of Hadley, from which town he wrote,
crossed the river and drove them away.

HADLY May 30: 76


What we have recd by Tho: Houey the past month is not the cheifest of
our wants as you have love for poor wounded I pray let us not want
for these following medicines if you have not a speedy conveyance of
them I pray send on purpose they are those things mentioned in my
former letter but to prevent future mistakes I have wrote them att
large wee have great want with the greatest halt and speed let
us be supplyed.
Yr Sert


Mr. Lockes Letter Recd from the Governor 13 Jane & acquainted ye
Council with it but could not obtaine any thing to be sent in answer
thereto 13 June 1676

I have given some idea of the chief remedies used by our earlier
physicians, which were both Galenic and chemical; that is, vegetable
and mineral. They, of course, employed the usual perturbing
medicines which Montaigne says are the chief reliance of their craft.
There were, doubtless, individual practitioners who employed special
remedies with exceptional boldness and perhaps success. Mr. Eliot is
spoken of, in a letter of William Leete to Winthrop, Junior, as being
under Mr. Greenland's mercurial administrations. The latter was
probably enough one of these specialists.

There is another class of remedies which appears to have been
employed occasionally, but, on the whole, is so little prominent as
to imply a good deal of common sense among the medical practitioners,
as compared with the superstitions prevailing around them. I have
said that I have caught the good Governor, now and then, prescribing
the electuary of millipedes; but he is entirely excused by the almost
incredible fact that they were retained in the materia medica so late
as when Rees's Cyclopaedia was published, and we there find the
directions formerly given by the College of Edinburgh for their
preparation. Once or twice we have found him admitting still more
objectionable articles into his materia medica; in doing which, I am
sorry to say that he could plead grave and learned authority. But
these instances are very rare exceptions in a medical practice of
many years, which is, on the whole, very respectable, considering the
time and circumstances.

Some remedies of questionable though not odious character appear
occasionally to have been employed by the early practitioners, but
they were such as still had the support of the medical profession.
Governor John Winthrop, the first, sends for East Indian bezoar, with
other commodities he is writing for. Governor Endicott sends him one
he had of Mr. Humfrey. I hope it was genuine, for they cheated
infamously in the matter of this concretion, which ought to come out
of an animal's stomach, but the real history of which resembles what
is sometimes told of modern sausages.

There is a famous law-case of James the First's time, in which a
goldsmith sold a hundred pounds' worth of what he called bezoar,
which was proved to be false, and the purchaser got a verdict against
him. Governor Endicott also sends Winthrop a unicorn's horn, which
was the property of a certain Mrs. Beggarly, who, in spite of her
name, seems to have been rich in medical knowledge and possessions.
The famous Thomas Bartholinus wrote a treatise on the virtues of this
fabulous-sounding remedy, which was published in 1641, and
republished in 1678.

The "antimonial cup," a drinking vessel made of that metal, which,
like our quassia-wood cups, might be filled and emptied in saecula
saeculorum without exhausting its virtues, is mentioned by Matthew
Cradock, in a letter to the elder Winthrop, but in a doubtful way, as
it was thought, he says, to have shortened the days of Sir Nathaniel
Riche; and Winthrop himself, as I think, refers to its use, calling
it simply "the cup." An antimonial cup is included in the inventory
of Samuel Seabury, who died 1680, and is valued at five shillings.
There is a treatise entitled "The Universall Remedy, or the Vertues
of the Antimoniall Cup, By John Evans, Minister and Preacher of God's
Word, London, 1634," in our own Society's library.

One other special remedy deserves notice, because of native growth.
I do not know when Culver's root, Leptandra Virginica of our National
Pharmacopoeia, became noted, but Cotton Mather, writing in 1716 to
John Winthrop of New London, speaks of it as famous for the cure of
consumptions, and wishes to get some of it, through his mediation,
for Katharine, his eldest daughter. He gets it, and gives it to the
"poor damsel," who is languishing, as he says, and who dies the next
month,--all the sooner, I have little doubt, for this uncertain and
violent drug, with which the meddlesome pedant tormented her in that
spirit of well-meant but restless quackery, which could touch nothing
without making mischief, not even a quotation, and yet proved at
length the means of bringing a great blessing to our community, as we
shall see by and by; so does Providence use our very vanities and
infirmities for its wise purposes.

Externally, I find the practitioners on whom I have chiefly relied
used the plasters of Paracelsus, of melilot, diachylon, and probably
diaphoenicon, all well known to the old pharmacopoeias, and some of
them to the modern ones,--to say nothing of "my yellow salve," of
Governor John, the second, for the composition of which we must apply
to his respected descendant.

The authors I find quoted are Barbette's Surgery, Camerarius on Gout,
and Wecherus, of all whom notices may be found in the pages of Haller
and Vanderlinden; also, Reed's Surgery, and Nicholas Culpeper's
Practice of Physic and Anatomy, the last as belonging to Samuel
Seabury, chirurgeon, before mentioned. Nicholas Culpeper was a
shrewd charlatan, and as impudent a varlet as ever prescribed for a
colic; but knew very well what he was about, and badgers the College
with great vigor. A copy of Spigelius's famous Anatomy, in the
Boston Athenaeum, has the names of Increase and Samuel Mather written
in it, and was doubtless early overhauled by the youthful Cotton, who
refers to the great anatomist's singular death, among his curious
stories in the "Magnalia," and quotes him among nearly a hundred
authors whom he cites in his manuscript "The Angel of Bethesda." Dr.
John Clark's "books and instruments, with several chirurgery
materials in the closet," a were valued in his inventory at sixty
pounds; Dr. Matthew Fuller, who died in 1678, left a library valued
at ten pounds; and a surgeon's chest and drugs valued at sixteen

Here we leave the first century and all attempts at any further
detailed accounts of medicine and its practitioners. It is necessary
to show in a brief glance what had been going on in Europe during the
latter part of that century, the first quarter of which had been made
illustrious in the history of medical science by the discovery of the

Charles Barbeyrac, a Protestant in his religion, was a practitioner
and teacher of medicine at Montpellier. His creed was in the way of
his obtaining office; but the young men followed his instructions
with enthusiasm. Religious and scientific freedom breed in and in,
until it becomes hard to tell the family of one from that of the
other. Barbeyrac threw overboard the old complex medical farragos of
the pharmacopoeias, as his church had disburdened itself of the
popish ceremonies.

Among the students who followed his instructions were two Englishmen:
one of them, John Locke, afterwards author of an "Essay on the Human
Understanding," three years younger than his teacher; the other,
Thomas Sydenham, five years older. Both returned to England. Locke,
whose medical knowledge is borne witness to by Sydenham, had the good
fortune to form a correct opinion on a disease from which the Earl of
Shaftesbury was suffering, which led to an operation that saved his
life. Less felicitous was his experience with a certain ancilla
culinaria virgo,--which I am afraid would in those days have been
translated kitchen-wench, instead of lady of the culinary
department,--who turned him off after she had got tired of him, and
called in another practitioner. [Locke and Sydenham, p. 124. By John
Brown, M. D. Edinburgh, 1866.] This helped, perhaps, to spoil a
promising doctor, and make an immortal metaphysician. At any rate,
Locke laid down the professional wig and cane, and took to other

The name of Thomas Sydenham is as distinguished in the history of
medicine as that of John Locke in philosophy. As Barbeyrac was found
in opposition to the established religion, as Locke took the rational
side against orthodox Bishop Stillingfleet, so Sydenham went with
Parliament against Charles, and was never admitted a Fellow by the
College of Physicians, which, after he was dead, placed his bust in
their hall by the side of that of Harvey.

What Sydenham did for medicine was briefly this he studied the course
of diseases carefully, and especially as affected by the particular
season; to patients with fever he gave air and cooling drinks,
instead of smothering and heating them, with the idea of sweating out
their disease; he ordered horseback exercise to consumptives; he,
like his teacher, used few and comparatively simple remedies; he did
not give any drug at all, if he thought none was needed, but let well
enough alone. He was a sensible man, in short, who applied his
common sense to diseases which he had studied with the best light of
science that he could obtain.

The influence of the reform he introduced must have been more or less
felt in this country, but not much before the beginning of the
eighteenth century, as his great work was not published until 1675,
and then in Latin. I very strongly suspect that there was not so
much to reform in the simple practice of the physicians of the new
community, as there was in that of the learned big-wigs of the
"College," who valued their remedies too much in proportion to their
complexity, and the extravagant and fantastic ingredients which went
to their making.

During the memorable century which bred and bore the Revolution, the
medical profession gave great names to our history. But John Brooks
belonged to the State, and Joseph Warren belongs to the country and
mankind, and to speak of them would lead me beyond my limited--
subject. There would be little pleasure in dwelling on the name of
Benjamin Church; and as for the medical politicians, like Elisha
Cooke in the early part of the century, or Charles Jarvis, the bald
eagle of Boston, in its later years, whether their practice was
heroic or not, their patients were, for he is a bold man who trusts
one that is making speeches and coaxing voters, to meddle with the
internal politics of his corporeal republic.

One great event stands out in the medical history of this eighteenth
century; namely, the introduction of the practice of inoculation for
small-pox. Six epidemics of this complaint had visited Boston in the
course of a hundred years. Prayers had been asked in the churches
for more than a hundred sick in a single day, and this many times.
About a thousand persons had died in a twelvemonth, we are told, and,
as we may infer, chiefly from this cause.

In 1721, this disease, after a respite of nineteen years, again
appeared as an epidemic. In that year it was that Cotton Mather,
browsing, as was his wont, on all the printed fodder that came within
reach of his ever-grinding mandibles, came upon an account of
inoculation as practised in Turkey, contained in the "Philosophical
Transactions." He spoke of it to several physicians, who paid little
heed to his story; for they knew his medical whims, and had probably
been bored, as we say now-a-days, many of them, with listening to his
"Angel of Bethesda," and satiated with his speculations on the
Nishmath Chajim.

The Reverend Mather,--I use a mode of expression he often employed
when speaking of his honored brethren,--the Reverend Mather was right
this time, and the irreverent doctors who laughed at him were wrong.
One only of their number disputes his claim to giving the first
impulse to the practice, in Boston. This is what that person says:
"The Small-Pox spread in Boston, New England, A.1721, and the
Reverend Dr. Cotton Mather, having had the use of these
Communications from Dr. William Douglass (that is, the writer of
these words); surreptitiously, without the knowledge of his Informer,
that he might have the honour of a New fangled notion, sets an
Undaunted Operator to work, and in this Country about 290 were

All this has not deprived Cotton Mather of the credit of suggesting,
and a bold and intelligent physician of the honor of carrying out,
the new practice. On the twenty-seventh day of June, 1721, Zabdiel
Boylston of Boston inoculated his only son for smallpox,--the first
person ever submitted to the operation in the New World. The story
of the fierce resistance to the introduction of the practice; of how
Boylston was mobbed, and Mather had a hand-grenade thrown in at his
window; of how William Douglass, the Scotchman, "always positive, and
sometimes accurate," as was neatly said of him, at once depreciated
the practice and tried to get the credit of suggesting it, and how
Lawrence Dalhonde, the Frenchman, testified to its destructive
consequences; of how Edmund Massey, lecturer at St. Albans, preached
against sinfully endeavoring to alter the course of nature by
presumptuous interposition, which he would leave to the atheist and
the scoffer, the heathen and unbeliever, while in the face of his
sermon, afterwards reprinted in Boston, many of our New England
clergy stood up boldly in defence of the practice,--all this has been
told so well and so often that I spare you its details. Set this
good hint of Cotton Mather against that letter of his to John
Richards, recommending the search after witch-marks, and the
application of the water-ordeal, which means throw your grandmother
into the water, if she has a mole on her arm;--if she swims, she is a
witch and must be hanged; if she sinks, the Lord have mercy on her

Thus did America receive this great discovery, destined to save
thousands of lives, via Boston, from the hands of one of our own
Massachusetts physicians.

The year 1735 was rendered sadly memorable by the epidemic of the
terrible disease known as "throat distemper," and regarded by many as
the same as our "diphtheria." Dr. Holyoke thinks the more general
use of mercurials in inflammatory complaints dates from the time of
their employment in this disease, in which they were thought to have
proved specially useful.

At some time in the course of this century medical practice had
settled down on four remedies as its chief reliance. I must repeat
an incident which I have related in another of these Essays. When
Dr. Holyoke, nearly seventy years ago, received young Mr. James
Jackson as his student, he showed him the formidable array of
bottles, jars, and drawers around his office, and then named the four
remedies referred to as being of more importance than all the rest
put together. These were "Mercury, Antimony, Opium, and Peruvian
Bark." I doubt if either of them remembered that, nearly seventy
years before, in 1730, Dr. William Douglass, the disputatious
Scotchman, mentioned those same four remedies, in the dedication of
his quarrelsome essay on inoculation, as the most important ones in
the hands of the physicians of his time.

In the "Proceedings" of this Society for the year 1863 is a very
pleasant paper by the late Dr. Ephraim Eliot, giving an account of
the leading physicians of Boston during the last quarter of the last
century. The names of Lloyd, Gardiner, Welsh, Rand, Bulfinch,
Danforth, John Warren, Jeffries, are all famous in local history, and
are commemorated in our medical biographies. One of them, at least,
appears to have been more widely known, not only as one of the first
aerial voyagers, but as an explorer in the almost equally hazardous
realm of medical theory. Dr. John Jeffries, the first of that name,
is considered by Broussais as a leader of medical opinion in America,
and so referred to in his famous "Examen des Doctrines Medicales."

Two great movements took place in this eighteenth century, the effect
of which has been chiefly felt in our own time; namely, the
establishment of the Massachusetts Medical Society, and the founding
of the Medical School of Harvard University.

The third century of our medical history began with the introduction
of the second great medical discovery of modern times,--of all time
up to that date, I may say,--once more via Boston, if we count the
University village as its suburb, and once more by one of our
Massachusetts physicians. In the month of July, 1800, Dr. Benjamin
Waterhouse of Cambridge submitted four of his own children to the new
process of vaccination,--the first persons vaccinated, as Dr. Zabdiel
Boylston's son had been the first person inoculated in the New World.

A little before the first half of this century was completed, in the
autumn of 1846, the great discovery went forth from the Massachusetts
General Hospital, which repaid the debt of America to the science of
the Old World, and gave immortality to the place of its origin in the
memory and the heart of mankind. The production of temporary
insensibility at will--tuto, cito, jucunde, safely, quickly,
pleasantly--is one of those triumphs over the infirmities of our
mortal condition which change the aspect of life ever afterwards.
Rhetoric can add nothing to its glory; gratitude, and the pride
permitted to human weakness, that our Bethlehem should have been
chosen as the birthplace of this new embodiment of the divine mercy,
are all we can yet find room for.

The present century has seen the establishment of all those great
charitable institutions for the cure of diseases of the body and of
the mind, which our State and our city have a right to consider as
among the chief ornaments of their civilization.

The last century had very little to show, in our State, in the way of
medical literature. The worthies who took care of our grandfathers
and great-grandfathers, like the Revolutionary heroes, fought (with
disease) and bled (their patients) and died (in spite of their own
remedies); but their names, once familiar, are heard only at rare
intervals. Honored in their day, not unremembered by a few solitary
students of the past, their memories are going sweetly to sleep in
the arms of the patient old dry-nurse, whose "blackdrop" is the
never-failing anodyne of the restless generations of men. Except the
lively controversy on inoculation, and floating papers in journals,
we have not much of value for that long period, in the shape of
medical records.

But while the trouble with the last century is to find authors to
mention, the trouble of this would be to name all that we find. Of
these, a very few claim unquestioned preeminence.

Nathan Smith, born in Rehoboth, Mass., a graduate of the Medical
School of our University, did a great work for the advancement of
medicine and surgery in New England, by his labors as teacher and
author, greater, it is claimed by some, than was ever done by any
other man. The two Warrens, of our time, each left a large and
permanent record of a most extended surgical practice. James Jackson
not only educated a whole generation by his lessons of wisdom, but
bequeathed some of the most valuable results of his experience to
those who came after him, in a series of letters singularly pleasant
and kindly as well as instructive. John Ware, keen and cautious,
earnest and deliberate, wrote the two remarkable essays which have
identified his name, for all time, with two important diseases, on
which he has shed new light by his original observations.

I must do violence to the modesty of the living by referring to the
many important contributions to medical science by Dr. Jacob Bigelow,
and especially to his discourse on "Self-limited Diseases," an
address which can be read in a single hour, but the influence of
which will be felt for a century.

Nor would the profession forgive me if I forgot to mention the
admirable museum of pathological anatomy, created almost entirely by
the hands of Dr. John Barnard Swett Jackson, and illustrated by his
own printed descriptive catalogue, justly spoken of by a
distinguished professor in the University of Pennsylvania as the most
important contribution which had ever been made in this country to
the branch to which it relates.

When we look at the literature of mental disease, as seen in hospital
reports and special treatises, we can mention the names of Wyman,
Woodward, Brigham, Bell, and Ray, all either natives of Massachusetts
or placed at the head of her institutions for the treatment of the

We have a right to claim also one who is known all over the civilized
world as a philanthropist, to us as a townsman and a graduate of our
own Medical School, Dr. Samuel Gridley Howe, the guide and benefactor
of a great multitude who were born to a world of inward or of outward

I cannot pass over in silence the part taken by our own physicians in
those sanitary movements which are assuming every year greater
importance. Two diseases especially have attracted attention, above
all others, with reference to their causes and prevention; cholera,
the "black death" of the nineteenth century, and consumption, the
white plague of the North, both of which have been faithfully studied
and reported on by physicians of our own State and city. The
cultivation of medical and surgical specialties, which is fast
becoming prevalent, is beginning to show its effects in the
literature of the profession, which is every year growing richer in
original observations and investigations.

To these benefactors who have labored for us in their peaceful
vocation, we must add the noble army of surgeons, who went with the
soldiers who fought the battles of their country, sharing many of
their dangers, not rarely falling victims to fatigue, disease, or the
deadly volleys to which they often exposed themselves in the
discharge of their duties.

The pleasant biographies of the venerable Dr. Thacher, and the worthy
and kind-hearted gleaner, Dr. Stephen W. Williams, who came after
him, are filled with the names of men who served their generation
well, and rest from their labors, followed by the blessing of those
for whom they endured the toils and fatigues inseparable from their
calling. The hardworking, intelligent country physician more
especially deserves the gratitude of his own generation, for he
rarely leaves any permanent record in the literature of his
profession. Books are hard to obtain; hospitals, which are always
centres of intelligence, are remote; thoroughly educated and superior
men are separated by wide intervals; and long rides, though favorable
to reflection, take up much of the time which might otherwise be
given to the labors of the study. So it is that men of ability and
vast experience, like the late Dr. Twitchell, for instance, make a
great and deserved reputation, become the oracles of large districts,
and yet leave nothing, or next to nothing, by which their names shall
be preserved from blank oblivion.

One or two other facts deserve mention, as showing the readiness of
our medical community to receive and adopt any important idea or
discovery. The new science of Histology, as it is now called, was
first brought fully before the profession of this country by the
translation of Bichat's great work, "Anatomie Generale," by the late
Dr. George Hayward.

The first work printed in this country on Auscultation,--that
wonderful art of discovering disease, which, as it were, puts a
window in the breast, through which the vital organs can be seen, to
all intents and purposes, was the manual published anonymously by
"A Member of the Massachusetts Medical Society."

We are now in some slight measure prepared to weigh the record of the
medical profession in Massachusetts, and pass our judgment upon it.
But in-order to do justice to the first generation of practitioners,
we must compare what we know of their treatment of disease with the
state of the art in England, and the superstitions which they saw all
around them in other departments of knowledge or belief.

English medical literature must have been at a pretty low ebb when
Sydenham recommended Don Quixote to Sir Richard Blackmore for
professional reading. The College Pharmacopoeia was loaded with the
most absurd compound mixtures, one of the most complex of which (the
same which the Reverend Mr. Harward, "Lecturer at the Royal Chappel
in Boston," tried to simplify), was not dropped until the year 1801.
Sir Kenelm Digby was playing his fantastic tricks with the
Sympathetic powder, and teaching Governor Winthrop, the second, how
to cure fever and ague, which some may like to know. "Pare the
patient's nails; put the parings in a little bag, and hang the bag
round the neck of a live eel, and put him in a tub of water. The eel
will die, and the patient will recover."

Wiseman, the great surgeon, was discoursing eloquently on the
efficacy of the royal touch in scrofula. The founder of the
Ashmolean Museum at Oxford, consorting with alchemists and
astrologers, was treasuring the manuscripts of the late pious Dr.
Richard Napier, in which certain letters (Rx Ris) were understood to
mean Responsum Raphaelis,--the answer of the angel Raphael to the
good man's medical questions. The illustrious Robert Boyle was
making his collection of choice and safe remedies, including the sole
of an old shoe, the thigh bone of a hanged man, and things far worse
than these, as articles of his materia medica. Dr. Stafford, whose
paper of directions to his "friend, Mr. Wintrop," I cited, was
probably a man of standing in London; yet toad-powder was his
sovereign remedy.

See what was the state of belief in other matters among the most
intelligent persons of the colonies, magistrates and clergymen.
Jonathan Brewster, son of the church-elder, writes the wildest
letters to John Winthrop about alchemy,--"mad for making gold as the
Lynn rock-borers are for finding it."

Remember the theology and the diabology of the time. Mr. Cotton's
Theocracy was a royal government, with the King of kings as its
nominal head, but with an upper chamber of saints, and a tremendous
opposition in the lower house; the leader of which may have been
equalled, but cannot have been surpassed by any of our earth-born
politicians. The demons were prowling round the houses every night,
as the foxes were sneaking about the hen-roosts. The men of
Gloucester fired whole flasks of gunpowder at devils disguised as
Indians and Frenchmen.

How deeply the notion of miraculous interference with the course of
nature was rooted, is shown by the tenacity of the superstition about
earthquakes. We can hardly believe that our Professor Winthrop,
father of the old judge and the "squire," whom many of us Cambridge
people remember so well, had to defend himself against the learned
and excellent Dr. Prince, of the Old South Church, for discussing
their phenomena as if they belonged to the province of natural

Not for the sake of degrading the aspect of the noble men who founded
our State, do I refer to their idle beliefs and painful delusions,
but to show against what influences the common sense of the medical
profession had to assert itself.

Think, then, of the blazing stars, that shook their horrid hair in
the sky; the phantom ship, that brought its message direct from the
other world; the story of the mouse and the snake at Watertown; of
the mice and the prayer-book; of the snake in church; of the calf
with two heads; and of the cabbage in the perfect form of a cutlash,
--all which innocent occurrences were accepted or feared as alarming

We can smile at these: but we cannot smile at the account of unhappy
Mary Dyer's malformed offspring; or of Mrs. Hutchinson's domestic
misfortune of similar character, in the story of which the physician,
Dr. John Clark of Rhode Island, alone appears to advantage; or as we
read the Rev. Samuel Willard's fifteen alarming pages about an
unfortunate young woman suffering with hysteria. Or go a little
deeper into tragedy, and see poor Dorothy Talby, mad as Ophelia,
first admonished, then whipped; at last, taking her own little
daughter's life; put on trial, and standing mute, threatened to be
pressed to death, confessing, sentenced, praying to be beheaded; and
none the less pitilessly swung from the fatal ladder.

The cooper's crazy wife--crazy in the belief that she has committed
the unpardonable sin--tries to drown her child, to save it from
misery; and the poor lunatic, who would be tenderly cared for to-day
in a quiet asylum, is judged to be acting under the instigation of
Satan himself. Yet, after all, what can we say, who put Bunyan's
"Pilgrim's Progress," full of nightmare dreams of horror, into all
our children's hands; a story in which the awful image of the man in
the cage might well turn the nursery where it is read into a

The miserable delusion of witchcraft illustrates, in a still more
impressive way, the false ideas which governed the supposed relation
of men with the spiritual world. I have no doubt many physicians
shared in these superstitions. Mr. Upham says they--that is, some of
them--were in the habit of attributing their want of success to the
fact, that an "evil hand" was on their patient. The temptation was
strong, no doubt, when magistrates and ministers and all that
followed their lead were contented with such an explanation. But how
was it in Salem, according to Mr. Upham's own statement? Dr. John
Swinnerton was, he says, for many years the principal physician of
Salem. And he says, also, "The Swinnerton family were all along
opposed to Mr. Parris, and kept remarkably clear from the witchcraft
delusion." Dr. John Swinnerton--the same, by the way, whose memory
is illuminated by a ray from the genius of Hawthorne--died the very
year before the great witchcraft explosion took place. But who can
doubt that it was from him that the family had learned to despise and
to resist the base superstition; or that Bridget Bishop, whose house
he rented, as Mr. Upham tells me, the first person hanged in the time
of the delusion, would have found an efficient protector in her
tenant, had he been living, to head the opposition of his family to
the misguided clergymen and magistrates?

I cannot doubt that our early physicians brought with them many Old-
World medical superstitions, and I have no question that they were
more or less involved in the prevailing errors of the community in
which they lived. But, on the whole, their record is a clean one, so
far as we can get at it; and where it is questionable we must
remember that there must have been many little-educated persons among
them; and that all must have felt, to some extent, the influence of
those sincere and devoted but unsafe men, the physic-practising
clergymen, who often used spiritual means as a substitute for
temporal ones, who looked upon a hysteric patient as possessed by the
devil, and treated a fractured skull by prayers and plasters,
following the advice of a ruling elder in opposition to the "unanimous
opinion of seven surgeons."

To what results the union of the two professions was liable to lead,
may be seen by the example of a learned and famous person, who has
left on record the product of his labors in the double capacity of
clergyman and physician.

I have had the privilege of examining a manuscript of Cotton Mather's
relating to medicine, by the kindness of the librarian of the
American Antiquarian Society, to which society it belongs. A brief
notice of this curious document may prove not uninteresting.

It is entitled "The Angel of Bethesda: an Essay upon the Common
Maladies of Mankind, offering, first, the sentiments of Piety," etc.,
etc., and "a collection of plain but potent and Approved REMEDIES for
the Maladies." There are sixty-six "Capsula's," as he calls them, or
chapters, in his table of contents; of which, five--from the
fifteenth to the nineteenth, inclusive--are missing. This is a most
unfortunate loss, as the eighteenth capsula treated of agues, and we
could have learned from it something of their degree of frequency in
this part of New England. There is no date to the manuscript; which,
however, refers to a case observed Nov. 14, 1724.

The divine takes precedence of the physician in this extraordinary
production. He begins by preaching a sermon at his unfortunate
patient. Having thrown him into a cold sweat by his spiritual
sudorific, he attacks him with his material remedies, which are often
quite as unpalatable. The simple and cleanly practice of Sydenham,
with whose works he was acquainted, seems to have been thrown away
upon him. Everything he could find mentioned in the seventy or
eighty authors he cites, all that the old women of both sexes had
ever told him of, gets into his text, or squeezes itself into his

Evolving disease out of sin, he hates it, one would say, as he hates
its cause, and would drive it out of the body with all noisome
appliances. "Sickness is in Fact Flagellum Dei pro peccatis mundi."
So saying, he encourages the young mother whose babe is wasting away
upon her breast with these reflections:

"Think; oh the grievous Effects of Sin! This wretched Infant has not
arrived unto years of sense enough, to sin after the similitude of
the transgression committed by Adam. Nevertheless the Transgression
of Adam, who had all mankind Foederally, yea, Naturally, in him, has
involved this Infant in the guilt of it. And the poison of the old
serpent, which infected Adam when he fell into his Transgression, by
hearkening to the Tempter, has corrupted all mankind, and is a seed
unto such diseases as this Infant is now laboring under. Lord, what
are we, and what are our children, but a Generation of Vipers?"

Many of his remedies are at least harmless, but his pedantry and
utter want of judgment betray themselves everywhere. He piles his
prescriptions one upon another, without the least discrimination. He
is run away with by all sorts of fancies and superstitions. He
prescribes euphrasia, eye-bright, for disease of the eyes; appealing
confidently to the strange old doctrine of signatures, which inferred
its use from the resemblance of its flower to the organ of vision.
For the scattering of wens, the efficacy of a Dead Hand has been out
of measure wonderful. But when he once comes to the odious class of
remedies, he revels in them like a scarabeus. This allusion will
bring us quite near enough to the inconceivable abominations with
which he proposed to outrage the sinful stomachs of the unhappy
confederates and accomplices of Adam.

It is well that the treatise was never printed, yet there are
passages in it worth preserving. He speaks of some remedies which
have since become more universally known:

"Among the plants of our soyl, Sir William Temple singles out Five
[Six] as being of the greatest virtue and most friendly to health:
and his favorite plants, Sage, Rue, Saffron, Alehoof, Garlick, and

"But these Five [Six] plants may admitt of some competitors. The
QUINQUINA--How celebrated: Immoderately, Hyperbolically celebrated!"

Of Ipecacuanha, he says,--
"This is now in its reign; the most fashionable vomit."

"I am not sorry that antimonial emetics begin to be disused."

He quotes "Mr. Lock" as recommending red poppy-water and abstinence
from flesh as often useful in children's diseases.

One of his "Capsula's" is devoted to the animalcular origin of
diseases, at the end of which he says, speaking of remedies for this
supposed source of our distempers:

"Mercury we know thee: But we are afraid thou wilt kill us too, if we
employ thee to kill them that kill us.

"And yett, for the cleansing of the small Blood Vessels, and making
way for the free circulation of the Blood and Lymph--there is nothing
like Mercurial Deobstruents."

From this we learn that mercury was already in common use, and the
subject of the same popular prejudice as in our own time.

His poetical turn shows itself here and there:

"O Nightingale, with a Thorn at thy Breast; Under the trouble of a
Cough, what can be more proper than such thoughts as these?"...

If there is pathos in this, there is bathos in his apostrophe to the
millipede, beginning "Poor sowbug!" and eulogizing the healing
virtues of that odious little beast; of which he tells us to take
"half a pound, putt 'em alive into a quart or two of wine," with
saffron and other drugs, and take two ounces twice a day.

The "Capsula" entitled "Nishmath Chajim" was printed in 1722, at
New London, and is in the possession of our own Society. He means,
by these words, something like the Archxus of Van Helmont, of which
he discourses in a style wonderfully resembling that of Mr. Jenkinson
in the "Vicar of Wakefield." "Many of the Ancients thought there was
much of a Real History in the Parable, and their Opinion was that
there is, DIAPHORA KATA TAS MORPHAS, A Distinction (and so a
Resemblance) of men as to their Shapes after Death." And so on, with
Ireaeus, Tertullian, Thespesius, and "the TA TONE PSEUCONE CROMATA,"
in the place of "Sanconiathon, Manetho, Berosus," and "Anarchon ara
kai ateleutaion to pan."

One other passage deserves notice, as it relates to the single
medical suggestion which does honor to Cotton Mather's memory. It
does not appear that he availed himself of the information which he
says, he obtained from his slave, for such I suppose he was.

In his appendix to "Variolae Triumphatae," he says,--

"There has been a wonderful practice lately used in several parts of
the world, which indeed is not yet become common in our nation.

"I was first informed of it by a Garamantee servant of my own, long
before I knew that any Europeans or Asiaticks had the least
acquaintance with it, and some years before I was enriched with the
communications of the learned Foreigners, whose accounts I found
agreeing with what I received of my servant, when he shewed me the
Scar of the Wound made for the operation; and said, That no person
ever died of the smallpox, in their countrey, that had the courage to
use it.

"I have since met with a considerable Number of these Africans, who
all agree in one story; That in their countrey grandy-many dy of the
small-pox: But now they learn this way: people take juice of smallpox
and cutty-skin and put in a Drop; then by'nd by a little sicky,
sicky: then very few little things like small-pox; and nobody dy of
it; and nobody have small-pox any more. Thus, in Africa, where the
poor creatures dy of the smallpox like Rotten Sheep, a merciful God
has taught them an Infallible preservative. 'T is a common practice,
and is attended with a constant success."

What has come down to us of the first century of medical practice, in
the hands of Winthrop and Oliver, is comparatively simple and
reasonable. I suspect that the conditions of rude, stern life, in
which the colonists found themselves in the wilderness, took the
nonsense out of them, as the exigencies of a campaign did out of our
physicians and surgeons in the late war. Good food and enough of it,
pure air and water, cleanliness, good attendance, an anaesthetic, an
opiate, a stimulant, quinine, and two or three common drugs, proved
to be the marrow of medical treatment; and the fopperies of the
pharmacopoeia went the way of embroidered shirts and white kid gloves
and malacca joints, in their time of need. "Good wine is the best
cordiall for her," said Governor John Winthrop, Junior, to Samuel
Symonds, speaking of that gentleman's wife,--just as Sydenham,
instead of physic, once ordered a roast chicken and a pint of canary
for his patient in male hysterics.

But the profession of medicine never could reach its full development
until it became entirely separated from that of divinity. The
spiritual guide, the consoler in afliction, the confessor who is
admitted into the secrets of our souls, has his own noble sphere of
duties; but the healer of men must confine himself solely to the
revelations of God in nature, as he sees their miracles with his own
eyes. No doctrine of prayer or special providence is to be his
excuse for not looking straight at secondary causes, and acting,
exactly so far as experience justifies him, as if he were himself the
divine agent which antiquity fabled him to be. While pious men were
praying--humbly, sincerely, rightly, according to their knowledge--
over the endless succession of little children dying of spasms in the
great Dublin Hospital, a sagacious physician knocked some holes in
the walls of the ward, let God's blessed air in on the little
creatures, and so had already saved in that single hospital, as it
was soberly calculated thirty years ago, more than sixteen thousand
lives of these infant heirs of immortality. [Collins's Midwifery, p.
312. Published by order of the Massachusetts Medical Society.
Boston, 1841.]

Let it be, if you will, that the wise inspiration of the physician
was granted in virtue of the clergyman's supplications. Still, the
habit of dealing with things seen generates another kind of
knowledge, and another way of thought, from that of dealing with
things unseen; which knowledge and way of thought are special means
granted by Providence, and to be thankfully accepted.

The mediaeval ecclesiastics expressed a great truth in that saying,
so often quoted, as carrying a reproach with it: "Ubi tres medici,
duo athei,"--"Where there are three physicians, there are two

It was true then, it is true to-day, that the physician very
commonly, if not very generally, denies and repudiates the deity of
ecclesiastical commerce. The Being whom Ambroise Pare meant when he
spoke those memorable words, which you may read over the professor's
chair in the French School of Medicine, "Te le pensay, et Dieu le
guarit," "I dressed his wound, and God healed it,"--is a different
being from the God that scholastic theologians have projected from
their consciousness, or shaped even from the sacred pages which have
proved so plastic in their hands. He is a God who never leaves
himself without witness, who repenteth him of the evil, who never
allows a disease or an injury, compatible with the enjoyment of life,
to take its course without establishing an effort, limited by certain
fixed conditions, it is true, but an effort, always, to restore the
broken body or the shattered mind. In the perpetual presence of this
great Healing Agent, who stays the bleeding of wounds, who knits the
fractured bone, who expels the splinter by a gentle natural process,
who walls in the inflammation that might involve the vital organs,
who draws a cordon to separate the dead part from the living, who
sends his three natural anaesthetics to the over-tasked frame in due
order, according to its need,--sleep, fainting, death; in this
perpetual presence, it is doubtless hard for the physician to realize
the theological fact of a vast and permanent sphere of the universe,
where no organ finds itself in its natural medium, where no wound
heals kindly, where the executive has abrogated the pardoning power,
and mercy forgets its errand; where the omnipotent is unfelt save in
malignant agencies, and the omnipresent is unseen and unrepresented;
hard to accept the God of Dante's "Inferno," and of Bunyan's caged
lunatic. If this is atheism, call three, instead of two of the trio,
atheists, and it will probably come nearer the truth.

I am not disposed to deny the occasional injurious effect of the
materializing influences to which the physician is subjected.
A spiritual guild is absolutely necessary to keep him, to keep us
all, from becoming the "fingering slaves" that Wordsworth treats with
such shrivelling scorn. But it is well that the two callings have
been separated, and it is fitting that they remain apart. In
settling the affairs of the late concern, I am afraid our good
friends remain a little in our debt. We lent them our physician
Michael Servetus in fair condition, and they returned him so damaged
by fire as to be quite useless for our purposes. Their Reverend
Samuel Willard wrote us a not over-wise report of a case of hysteria;
and our Jean Astruc gave them (if we may trust Dr. Smith's Dictionary
of the Bible) the first discerning criticism on the authorship of the
Pentateuch. Our John Locke enlightened them with his letters
concerning toleration; and their Cotton Mather obscured our twilight
with his "Nishmath Chajim."

Yet we must remember that the name of Basil Valentine, the monk, is
associated with whatever good and harm we can ascribe to antimony;
and that the most remarkable of our specifics long bore the name of
"Jesuit's Bark," from an old legend connected with its introduction.
"Frere Jacques," who taught the lithotomists of Paris, owes his
ecclesiastical title to courtesy, as he did not belong to a religious

Medical science, and especially the study of mental disease, is
destined, I believe, to react to much greater advantage on the
theology of the future than theology has acted on medicine in the
past. The liberal spirit very generally prevailing in both
professions, and the good understanding between their most
enlightened members, promise well for the future of both in a
community which holds every point of human belief, every institution
in human hands, and every word written in a human dialect, open to
free discussion today, to-morrow, and to the end of time. Whether
the world at large will ever be cured of trusting to specifics as a
substitute for observing the laws of health, and to mechanical or
intellectual formula as a substitute for character, may admit of
question. Quackery and idolatry are all but immortal.

We can find most of the old beliefs alive amongst us to-day, only
having changed their dresses and the social spheres in which they
thrive. We think the quarrels of Galenists and chemists belong to
the past, forgetting that Thomsonism has its numerous apostles in our
community; that it is common to see remedies vaunted as purely
vegetable, and that the prejudice against "mineral poisons,"
especially mercury, is as strong in many quarters now as it was at
the beginning of the seventeenth century. Names are only air, and
blow away with a change of wind; but beliefs are rooted in human
wants and weakness, and die hard. The oaks of Dodona are prostrate,
and the shrine of Delphi is desolate; but the Pythoness and the Sibyl
may be consulted in Lowell Street for a very moderate compensation.
Nostradamus and Lilly seem impossible in our time; but we have seen
the advertisements of an astrologer in our Boston papers year after
year, which seems to imply that he found believers and patrons. You
smiled when I related Sir Kenelm Digby's prescription with the live
eel in it; but if each of you were to empty his or her pockets, would
there not roll out, from more than one of them, a horse-chestnut,
carried about as a cure for rheumatism? The brazen head of Roger
Bacon is mute; but is not "Planchette" uttering her responses in a
hundred houses of this city? We think of palmistry or chiromancy as
belonging to the days of Albertus Magnus, or, if existing in our
time, as given over to the gypsies; but a very distinguished person
has recently shown me the line of life, and the line of fortune, on
the palm of his hand, with a seeming confidence in the sanguine
predictions of his career which had been drawn from them. What shall
we say of the plausible and well-dressed charlatans of our own time,
who trade in false pretences, like Nicholas Knapp of old, but without
any fear of being fined or whipped; or of the many follies and
inanities, imposing on the credulous part of the community, each of
them gaping with eager, open mouth for a gratuitous advertisement by
the mention of its foolish name in any respectable connection?

I turn from this less pleasing aspect of the common intelligence
which renders such follies possible, to close the honorable record of
the medical profession in this, our ancient Commonwealth.

We have seen it in the first century divided among clergymen,
magistrates, and regular practitioners; yet, on the whole, for the
time, and under the circumstances, respectable, except where it
invoked supernatural agencies to account for natural phenomena.

In the second century it simplified its practice, educated many
intelligent practitioners, and began the work of organizing for
concerted action, and for medical teaching.

In this, our own century, it has built hospitals, perfected and
multiplied its associations and educational institutions, enlarged
and created museums, and challenged a place in the world of science
by its literature.

In reviewing the whole course of its history we read a long list of
honored names, and a precious record written in private memories, in
public charities, in permanent contributions to medical science, in
generous sacrifices for the country. We can point to our capital as
the port of entry for the New World of the great medical discoveries
of two successive centuries, and we can claim for it the triumph over
the most dreaded foe that assails the human body,--a triumph which
the annals of the race can hardly match in three thousand years of
medical history.


[A Valedictory Address delivered to the Graduating Class of the
Bellevue Hospital College, March 2, 1871.]

The occasion which calls us together reminds us not a little of that
other ceremony which unites a man and woman for life. The banns have
already been pronounced which have wedded our young friends to the
profession of their choice. It remains only to address to them some
friendly words of cheering counsel, and to bestow upon them the
parting benediction.

This is not the time for rhetorical display or ambitious eloquence.
We must forget ourselves, and think only of them. To us it is an
occasion; to them it is an epoch. The spectators at the wedding look
curiously at the bride and bridegroom; at the bridal veil, the
orange-flower garland, the giving and receiving of the ring; they
listen for the tremulous "I will," and wonder what are the mysterious
syllables the clergyman whispers in the ear of the married maiden.
But to the newly-wedded pair what meaning in those words, "for
better, for worse," "in sickness and in health," "till death us do
part!" To the father, to the mother, who know too well how often the
deadly nightshade is interwoven with the wreath of orange-blossoms,
how empty the pageant, how momentous the reality!

You will not wonder that I address myself chiefly to those who are
just leaving academic life for the sterner struggle and the larger
tasks of matured and instructed manhood. The hour belongs to them;
if others find patience to listen, they will kindly remember that,
after all, they are but as the spectators at the wedding, and that
the priest is thinking less of them than of their friends who are
kneeling at the altar.

I speak more directly to you, then, gentlemen of the graduating
class. The days of your education, as pupils of trained instructors,
are over. Your first harvest is all garnered. Henceforth you are to
be sowers as well as reapers, and your field is the world. How does
your knowledge stand to-day? What have you gained as a permanent
possession? What must you expect to forget? What remains for you
yet to learn? These are questions which it may interest you to

There is another question which must force itself on the thoughts of
many among you: "How am I to obtain patients and to keep their
confidence? "You have chosen a laborious calling, and made many
sacrifices to fit yourselves for its successful pursuit. You wish to
be employed that you may be useful, and that you may receive the
reward of your industry. I would take advantage of these most
receptive moments to give you some hints which may help you to
realize your hopes and expectations. Such is the outline of the
familiar talk I shall offer you.

Your acquaintance with some of the accessory branches is probably
greater now than it will be in a year from now,--much greater than it
will by ten years from now. The progress of knowledge, it may be
feared, or hoped, will have outrun the text-books in which you
studied these branches. Chemistry, for instance, is very apt to
spoil on one's hands. "Nous avons change tout cela" might serve as
the standing motto of many of our manuals. Science is a great
traveller, and wears her shoes out pretty fast, as might be expected.

You are now fresh from the lecture-room and the laboratory. You can
pass an examination in anatomy, physiology, chemistry, materia
medica, which the men in large practice all around you would find a
more potent sudorific than any in the Pharmacopceia. These masters
of the art of healing were once as ready with their answers as you
are now, but they have got rid of a great deal of the less
immediately practical part of their acquisitions, and you must
undergo the same depleting process. Hard work will train it off, as
sharp exercise trains off the fat of a prize-fighter.

Yet, pause a moment before you infer that your teachers must have
been in fault when they furnished you with mental stores not directly
convertible to practical purposes, and likely in a few years to lose
their place in your memory. All systematic knowledge involves much
that is not practical, yet it is the only kind of knowledge which
satisfies the mind, and systematic study proves, in the long-run, the
easiest way of acquiring and retaining facts which are practical.
There are many things which we can afford to forget, which yet it was
well to learn. Your mental condition is not the same as if you had
never known what you now try in vain to recall. There is a perpetual
metempsychosis of thought, and the knowledge of to-day finds a soil
in the forgotten facts of yesterday. You cannot see anything in the
new season of the guano you placed last year about the roots of your
climbing plants, but it is blushing and breathing fragrance in your
trellised roses; it has scaled your porch in the bee-haunted honey-
suckle; it has found its way where the ivy is green; it is gone where
the woodbine expands its luxuriant foliage.

Your diploma seems very broad to-day with your list of
accomplishments, but it begins to shrink from this hour like the Peau
de Chagrin of Balzac's story. Do not worry about it, for all the
while there will be making out for you an ampler and fairer
parchment, signed by old Father Time himself as President of that
great University in which experience is the one perpetual and all-
sufficient professor.

Your present plethora of acquirements will soon cure itself.
Knowledge that is not wanted dies out like the eyes of the fishes of
the Mammoth Cave. When you come to handle life and death as your
daily business, your memory will of itself bid good-by to such
inmates as the well-known foramina of the sphenoid bone and the
familiar oxides of methyl-ethylamyl-phenyl-ammonium. Be thankful
that you have once known them, and remember that even the learned
ignorance of a nomenclature is something to have mastered, and may
furnish pegs to hang facts upon which would otherwise have strewed
the floor of memory in loose disorder.

But your education has, after all, been very largely practical. You
have studied medicine and surgery, not chiefly in books, but at the
bedside and in the operating amphitheatre. It is the special
advantage of large cities that they afford the opportunity of seeing
a great deal of disease in a short space of time, and of seeing many
cases of the same kind of disease brought together. Let us not be
unjust to the claims of the schools remote from the larger centres of
population. Who among us has taught better than Nathan Smith, better
than Elisha Bartlett? who teaches better than some of our living
contemporaries who divide their time between city and country
schools? I am afraid we do not always do justice to our country
brethren, whose merits are less conspicuously exhibited than those of
the great city physicians and surgeons, such especially as have
charge of large hospitals. There are modest practitioners living in
remote rural districts who are gifted by nature with such sagacity
and wisdom, trained so well in what is most essential to the practice
of their art, taught so thoroughly by varied experience, forced to
such manly self-reliance by their comparative isolation, that, from
converse with them alone, from riding with them on their long rounds
as they pass from village to village, from talking over cases with
them, putting up their prescriptions, watching their expedients,
listening to their cautions, marking the event of their predictions,
hearing them tell of their mistakes, and now and then glory a little
in the detection of another's blunder, a young man would find himself
better fitted for his real work than many who have followed long
courses of lectures and passed a showy examination. But the young
man is exceptionally fortunate who enjoys the intimacy of such a
teacher. And it must be confessed that the great hospitals,
infirmaries, and dispensaries of large cities, where men of well-
sifted reputations are in constant attendance, are the true centres
of medical education. No students, I believe, are more thoroughly
aware of this than those who have graduated at this institution.
Here, as in all our larger city schools, the greatest pains are taken
to teach things as well as names. You have entered into the
inheritance of a vast amount of transmitted skill and wisdom, which
you have taken, warm, as it were, with the life of your well-schooled
instructors. You have not learned all that art has to teach you, but
you are safer practitioners to-day than were many of those whose
names we hardly mention without a genuflection. I had rather be
cared for in a fever by the best-taught among you than by the
renowned Fernelius or the illustrious Boerhaave, could they come back
to us from that better world where there are no physicians needed,
and, if the old adage can be trusted, not many within call. I had
rather have one of you exercise his surgical skill upon me than find
myself in the hands of a resuscitated Fabricius Hildanus, or even of
a wise Ambroise Pare, revisiting earth in the light of the nineteenth

You will not accuse me of underrating your accomplishments. You know
what to do for a child in a fit, for an alderman in an apoplexy, for
a girl that has fainted, for a woman in hysterics, for a leg that is
broken, for an arm that is out of joint, for fevers of every color,
for the sailor's rheumatism, and the tailor's cachexy. In fact you
do really know so much at this very hour, that nothing but the
searching test of time can fully teach you the limitations of your

Of some of these you will permit me to remind you. You will never
have outgrown the possibility of new acquisitions, for Nature is
endless in her variety. But even the knowledge which you may be said
to possess will be a different thing after long habit has made it a
part of your existence. The tactus eruditus extends to the mind as
well as to the finger-ends. Experience means the knowledge gained by
habitual trial, and an expert is one who has been in the habit of
trying. This is the kind of knowledge that made Ulysses wise in the
ways of men. Many cities had he seen, and known the minds of those
who dwelt in them. This knowledge it was that Chaucer's Shipman
brought home with him from the sea a

"In many a tempest had his berd be shake."

This is the knowledge we place most confidence in, in the practical
affairs of life.

Our training has two stages. The first stage deals with our
intelligence, which takes the idea of what is to be done with the
most charming ease and readiness. Let it be a game of billiards, for
instance, which the marker is going to teach us. We have nothing to
do but to make this ball glance from that ball and hit that other
ball, and to knock that ball with this ball into a certain caecal
sacculus or diverticulum which our professional friend calls a
pocket. Nothing can be clearer; it is as easy as "playing upon this
pipe," for which Hamlet gives Guildenstern such lucid directions.
But this intelligent Me, who steps forward as the senior partner in
our dual personality, turns out to be a terrible bungler. He misses
those glancing hits which the hard-featured young professional person
calls "carroms," and insists on pocketing his own ball instead of the
other one.

It is the unintelligent Me, stupid as an idiot, that has to try a
thing a thousand times before he can do it, and then never knows how
he does it, that at last does it well. We have to educate ourselves
through the pretentious claims of intellect, into the humble accuracy
of instinct, and we end at last by acquiring the dexterity, the
perfection, the certainty, which those masters of arts, the bee and
the spider, inherit from Nature.

Book-knowledge, lecture-knowledge, examination-knowledge, are all in
the brain. But work-knowledge is not only in the brain, it is in the
senses, in the muscles, in the ganglia of the sympathetic nerves,--
all over the man, as one may say, as instinct seems diffused through
every part of those lower animals that have no such distinct organ as
a brain. See a skilful surgeon handle a broken limb; see a wise old
physician smile away a case that looks to a novice as if the sexton
would soon be sent for; mark what a large experience has done for
those who were fitted to profit by it, and you will feel convinced
that, much as you know, something is still left for you to learn.

May I venture to contrast youth and experience in medical practice,
something in the way the man painted the lion, that is, the lion

The young man knows the rules, but the old man knows-the exceptions.
The young man knows his patient, but the old man knows also his
patient's family, dead and alive, up and down for generations. He
can tell beforehand what diseases their unborn children will be
subject to, what they will die of if they live long enough, and
whether they had better live at all, or remain unrealized
possibilities, as belonging to a stock not worth being perpetuated.
The young man feels uneasy if he is not continually doing something
to stir up his patient's internal arrangements. The old man takes
things more quietly, and is much more willing to let well enough
alone: All these superiorities, if such they are,'you must wait for
time to bring you. In the meanwhile (if we will let the lion be
uppermost for a moment), the young man's senses are quicker than
those of his older rival. His education in all the accessory
branches is more recent, and therefore nearer the existing condition
of knowledge. He finds it easier than his seniors to accept the
improvements which every year is bringing forward. New ideas build
their nests in young men's brains. "Revolutions are not made by men
in spectacles," as I once heard it remarked, and the first whispers
of a new truth are not caught by those who begin to feel the need of
an ear-trumpet. Granting all these advantages to the young man, he
ought, nevertheless, to go on improving, on the whole, as a medical
practitioner, with every year, until he has ripened into a well-
mellowed maturity. But, to improve, he must be good for something at
the start. If you ship a poor cask of wine to India and back, if you
keep it a half a century, it only grows thinner and sharper.

You are soon to enter into relations with the public, to expend your
skill and knowledge for its benefit, and find your support in the
rewards of your labor. What kind of a constituency is this which is
to look to you as its authorized champions in the struggle of life
against its numerous enemies?

In the first place, the persons who seek the aid of the physician are
very honest and sincere in their wish to get rid of their complaints,
and, generally speaking, to live as long as they can. However
attractively the future is painted to them, they are attached to the
planet with which they are already acquainted. They are addicted to
the daily use of this empirical and unchemical mixture which we call
air; and would hold on to it as a tippler does to his alcoholic
drinks. There is nothing men will not do, there is nothing they have
not done, to recover their health and save their lives. They have
submitted to be half-drowned in water, and half-choked with gases, to
be buried up to their chins in earth, to be seared with hot irons
like galley-slaves, to be crimped with knives, like cod-fish, to have
needles thrust into their flesh, and bonfires kindled on their skin,
to swallow all sorts of abominations, and to pay for all this, as if
to be singed and scalded were a costly privilege, as if blisters were
a blessing, and leeches were a luxury. What more can be asked to
prove their honesty and sincerity?

This same community is very intelligent with respect to a great many
subjects-commerce, mechanics, manufactures, politics. But with
regard to medicine it is hopelessly ignorant and never finds it out.
I do not know that it is any worse in this country than in Great
Britain, where Mr. Huxley speaks very freely of "the utter ignorance
of the simplest laws of their own animal life, which prevails among
even the most highly educated persons." And Cullen said before him
"Neither the acutest genius nor the soundest judgment will avail in
judging of a particular science, in regard to which they have not
been exercised. I have been obliged to please my patients sometimes
with reasons, and I have found that any will pass, even with able
divines and acute lawyers; the same will pass with the husbands as
with the wives." If the community could only be made aware of its
own utter ignorance, and incompetence to form opinions on medical
subjects, difficult enough to those who give their lives to the study
of them, the practitioner would have an easier task. But it will
form opinions of its own, it cannot help it, and we cannot blame it,
even though we know how slight and deceptive are their foundations.

This is the way it happens: Every grown-up person has either been ill
himself or had a friend suffer from illness, from which he has
recovered. Every sick person has done something or other by
somebody's advice, or of his own accord, a little before getting
better. There is an irresistible tendency to associate the thing
done, and the improvement which followed it, as cause and effect.
This is the great source of fallacy in medical practice. But the
physician has some chance of correcting his hasty inference. He
thinks his prescription cured a single case of a particular
complaint; he tries it in twenty similar cases without effect, and
sets down the first as probably nothing more than a coincidence. The
unprofessional experimenter or observer has no large experience to
correct his hasty generalization. He wants to believe that the means
he employed effected his cure. He feels grateful to the person who
advised it, he loves to praise the pill or potion which helped him,
and he has a kind of monumental pride in himself as a living
testimony to its efficacy. So it is that you will find the community
in which you live, be it in town or country, full of brands plucked
from the burning, as they believe, by some agency which, with your
better training, you feel reasonably confident had nothing to do with
it. Their disease went out of itself, and the stream from the
medical fire-annihilator had never even touched it.

You cannot and need not expect to disturb the public in the
possession of its medical superstitions. A man's ignorance is as
much his private property, and as precious in his own eyes, as his
family Bible. You have only to open your own Bible at the ninth
chapter of St. John's Gospel, and you will find that the logic of a
restored patient was very simple then, as it is now, and very hard to
deal with. My clerical friends will forgive me for poaching on their
sacred territory, in return for an occasional raid upon the medical
domain of which they have now and then been accused.

A blind man was said to have been restored to sight by a young person
whom the learned doctors of the Jewish law considered a sinner, and,
as such, very unlikely to have been endowed with a divine gift of
healing. They visited the patient repeatedly, and evidently teased
him with their questions about the treatment, and their insinuations
about the young man, until he lost his temper. At last he turned
sharply upon them: "Whether he be a sinner or no, I know not: one
thing I know, that, whereas I was blind, now I see."

This is the answer that always has been and always will be given by
most persons when they find themselves getting well after doing
anything, no matter what,--recommended by anybody, no matter whom.
Lord Bacon, Robert Boyle, Bishop Berkeley, all put their faith in
panaceas which we should laugh to scorn. They had seen people get
well after using them. Are we any wiser than those great men? Two
years ago, in a lecture before the Massachusetts Historical Society,
I mentioned this recipe of Sir Kenelm Digby for fever and ague: Pare
the patient's nails; put the parings in a little bag, and hang the
bag round the neck of a live eel, and place him in a tub of water.
The eel will die, and the patient will recover.

Referring to this prescription in the course of the same lecture, I
said: "You smiled when I related Sir Kenehn Digby's prescription,
with the live eel in it; but if each of you were to empty his or her
pockets, would there not roll out, from more than one of them, a
horse-chestnut, carried about as a cure for rheumatism?" Nobody saw
fit to empty his or her pockets, and my question brought no response.
But two months ago I was in a company of educated persons, college
graduates every one of them, when a gentleman, well known in our
community, a man of superior ability and strong common-sense, on the
occasion of some talk arising about rheumatism, took a couple of very
shiny horse-chestnuts from his breeches-pocket, and laid them on the
table, telling us how, having suffered from the complaint in
question, he had, by the advice of a friend, procured these two
horse-chestnuts on a certain time a year or more ago, and carried
them about him ever since; from which very day he had been entirely
free from rheumatism.

This argument, from what looks like cause and effect, whether it be
so or not, is what you will have to meet wherever you go, and you
need not think you can answer it. In the natural course of things
some thousands of persons must be getting well or better of slight
attacks of colds, of rheumatic pains, every week, in this city alone.
Hundreds of them do something or other in the way of remedy, by
medical or other advice, or of their own motion, and the last thing
they do gets the credit of the recovery. Think what a crop of
remedies this must furnish, if it were all harvested!

Experience has taught, or will teach you, that most of the wonderful
stories patients and others tell of sudden and signal cures are like
Owen Glendower's story of the portents that announced his birth. The
earth shook at your nativity, did it? Very likely, and

"So it would have done,
At the same season, if your mother's cat
Had kittened, though yourself had ne'er been born."

You must listen more meekly than Hotspur did to the babbling
Welshman, for ignorance is a solemn and sacred fact, and, like
infancy, which it resembles, should be respected. Once in a while
you will have a patient of sense, born with the gift of observation,
from whom you may learn something. When you find yourself in the
presence of one who is fertile of medical opinions, and affluent in
stories of marvellous cures,--of a member of Congress whose name
figures in certificates to the value of patent medicines, of a
voluble dame who discourses on the miracles she has wrought or seen
wrought with the little jokers of the sugar-of-milk globule-box, take
out your watch and count the pulse; also note the time of day, and
charge the price of a visit for every extra fifteen, or, if you are
not very busy, every twenty minutes. In this way you will turn what
seems a serious dispensation into a double blessing, for this class
of patients loves dearly to talk, and it does them a deal of good,
and you feel as if you had earned your money by the dose you have
taken, quite as honestly as by any dose you may have ordered.

You must take the community just as it is, and make the best of it.
You wish to obtain its confidence; there is a short rule for doing
this which you will find useful,--deserve it. But, to deserve it in
full measure, you must unite many excellences, natural and acquired.

As the basis of all the rest, you must have all those traits of
character which fit you to enter into the most intimate and
confidential relations with the families of which you are the
privileged friend and counsellor. Medical Christianity, if I may use
such a term, is of very early date. By the oath of Hippocrates, the
practitioner of ancient times bound himself to enter his patient's
house with the sole purpose of doing him good, and so to conduct
himself as to avoid the very appearance of evil. Let the physician
of to-day begin by coming up to this standard, and add to it all the
more recently discovered virtues and graces.

A certain amount of natural ability is requisite to make you a good
physician, but by no means that disproportionate development of some
special faculty which goes by the name of genius. A just balance of
the mental powers is a great deal more likely to be useful than any
single talent, even were it the power of observation; in excess. For
a mere observer is liable to be too fond of facts for their own sake,
so that, if he told the real truth, he would confess that he takes
more pleasure in a post-mortem examination which shows him what was
the matter with a patient, than in a case which insists on getting
well and leaving him in the dark as to its nature. Far more likely
to interfere with the sound practical balance of the mind is that
speculative, theoretical tendency which has made so many men noted in
their day, whose fame has passed away with their dissolving theories.
Read Dr. Bartlett's comparison of the famous Benjamin Rush with his
modest fellow-townsman Dr. William Currie, and see the dangers into
which a passion for grandiose generalizations betrayed a man of many
admirable qualities.

I warn you against all ambitious aspirations outside of your
profession. Medicine is the most difficult of sciences and the most
laborious of arts. It will task all your powers of body and mind if
you are faithful to it. Do not dabble in the muddy sewer of
politics, nor linger by the enchanted streams of literature, nor dig
in far-off fields for the hidden waters of alien sciences. The great
practitioners are generally those who concentrate all their powers on
their business. If there are here and there brilliant exceptions, it
is only in virtue of extraordinary gifts, and industry to which very
few are equal.

To get business a man mast really want it; and do you suppose that
when you are in the middle of a heated caucus, or half-way through a
delicate analysis, or in the spasm of an unfinished ode, your eyes
rolling in the fine frenzy of poetical composition, you want to be
called to a teething infant, or an ancient person groaning under the
griefs of a lumbago? I think I have known more than one young man
whose doctor's sign proclaimed his readiness to serve mankind in that
capacity, but who hated the sound of a patient's knock, and as he sat
with his book or his microscope, felt exactly as the old party
expressed himself in my friend Mr. Brownell's poem

"All I axes is, let me alone."

The community soon finds out whether you are in earnest, and really
mean business, or whether you are one of those diplomaed dilettanti
who like the amusement of quasi medical studies, but have no idea of
wasting their precious time in putting their knowledge in practice
for the benefit of their suffering fellow-creatures.

The public is a very incompetent judge of your skill and knowledge,
but it gives its confidence most readily to those who stand well with
their professional brethren, whom they call upon when they themselves
or their families are sick, whom they choose to honorable offices,
whose writings and teachings they hold in esteem. A man may be much
valued by the profession and yet have defects which prevent his
becoming a favorite practitioner, but no popularity can be depended
upon as permanent which is not sanctioned by the judgment of
professional experts, and with these you will always stand on your
substantial merits.

What shall I say of the personal habits you must form if you wish for
success? Temperance is first upon the list. Intemperance in a
physician partakes of the guilt of homicide, for the muddled brain
may easily make a fatal blunder in a prescription and the unsteady
hand transfix an artery in an operation. Tippling doctors have been
too common in the history of medicine. Paracelsus was a sot,
Radcliffe was much too fond of his glass, and Dr. James Hurlbut of
Wethersfield, Connecticut, a famous man in his time, used to drink a
square bottle of rum a day, with a corresponding allowance of opium
to help steady his nerves. We commonly speak of a man as being the
worse for liquor, but I was asking an Irish laborer one day about his
doctor, who, as he said, was somewhat given to drink. "I like him
best when he's a little that way," he said; "then I can spake to
him." I pitied the poor patient who could not venture to allude to
his colic or his pleurisy until his physician was tipsy.

There are personal habits of less gravity than the one I have
mentioned which it is well to guard against, or, if they are formed,
to relinquish. A man who may be called at a moment's warning into
the fragrant boudoir of suffering loveliness should not unsweeten its
atmosphere with reminiscences of extinguished meerschaums. He should
remember that the sick are sensitive and fastidious, that they love
the sweet odors and the pure tints of flowers, and if his presence is
not like the breath of the rose, if his hands are not like the leaf
of the lily, his visit may be unwelcome, and if he looks behind him
he may see a window thrown open after he has left the sick-chamber.
I remember too well the old doctor who sometimes came to help me
through those inward griefs to which childhood is liable. "Far off
his coming "--shall I say "shone," and finish the Miltonic phrase, or
leave the verb to the happy conjectures of my audience? Before him
came a soul-subduing whiff of ipecacuanha, and after him lingered a
shuddering consciousness of rhubarb. He had lived so much among his
medicaments that he had at last become himself a drug, and to have
him pass through a sick-chamber was a stronger dose than a
conscientious disciple of Hahnemann would think it safe to

Need I remind yon of the importance of punctuality in your
engagements, and of the worry and distress to patients and their
friends which the want of it occasions? One of my old teachers
always carried two watches, to make quite sure of being exact, and
not only kept his appointments with the regularity of a chronometer,
but took great pains to be at his patient's house at the time when he
had reason to believe he was expected, even if no express appointment
was made. It is a good rule; if you call too early, my lady's hair
may not be so smooth as could be wished, and, if you keep her waiting
too long, her hair may be smooth, but her temper otherwise.

You will remember, of course, always to get the weather-gage of your
patient. I mean, to place him so that the light falls on his face
and not on yours. It is a kind of, ocular duel that is about to take
place between you; you are going to look through his features into
his pulmonary and hepatic and other internal machinery, and he is
going to look into yours quite as sharply to see what you think about
his probabilities for time or eternity.

No matter how hard he stares at your countenance, he should never be
able to read his fate in it. It should be cheerful as long as there
is hope, and serene in its gravity when nothing is left but
resignation. The face of a physician, like that of a diplomatist,
should be impenetrable. Nature is a benevolent old hypocrite; she
cheats the sick and the dying with illusions better than any
anodynes. If there are cogent reasons why a patient should be
undeceived, do it deliberately and advisedly, but do not betray your
apprehensions through your tell-tale features.

We had a physician in our city whose smile was commonly reckoned as
being worth five thousand dollars a year to him, in the days, too, of
moderate incomes. You cannot put on such a smile as that any more
than you can get sunshine without sun; there was a tranquil and
kindly nature under it that irradiated the pleasant face it made one
happier to meet on his daily rounds. But you can cultivate the
disposition, and it will work its way through to the surface, nay,
more,--you can try to wear a quiet and encouraging look, and it will
react on your disposition and make you like what you seem to be, or
at least bring you nearer to its own likeness.

Your patient has no more right to all the truth you know than he has
to all the medicine in your saddlebags, if you carry that kind of
cartridge-box for the ammunition that slays disease. He should get
only just so much as is good for him. I have seen a physician
examining a patient's chest stop all at once, as he brought out a
particular sound with a tap on the collarbone, in the attitude of a
pointer who has just come on the scent or sight of a woodcock. You
remember the Spartan boy, who, with unmoved countenance, hid the fox
that was tearing his vitals beneath his mantle. What he could do in
his own suffering you must learn to do for others on whose vital
organs disease has fastened its devouring teeth. It is a terrible
thing to take away hope, even earthly hope, from a fellow-creature.
Be very careful what names you let fall before your patient. He
knows what it means when you tell him he has tubercles or Bright's
disease, and, if he hears the word carcinoma, he will certainly look
it out in a medical dictionary, if he does not interpret its dread
significance on the instant. Tell him he has asthmatic symptoms, or
a tendency to the gouty diathesis, and he will at once think of all
the asthmatic and gouty old patriarchs he has ever heard of, and be
comforted. You need not be so cautious in speaking of the health of
rich and remote relatives, if he is in the line of succession.

Some shrewd old doctors have a few phrases always on hand for
patients that will insist on knowing the pathology of their
complaints without the slightest capacity of understanding the
scientific explanation. I have known the term "spinal irritation"
serve well on such occasions, but I think nothing on the whole has
covered so much ground, and meant so little, and given such profound
satisfaction to all parties, as the magnificent phrase "congestion of
the portal system."

Once more, let me recommend you, as far as possible, to keep your
doubts to yourself, and give the patient the benefit of your
decision. Firmness, gentle firmness, is absolutely necessary in this
and certain other relations. Mr. Rarey with Cruiser, Richard with
Lady Ann, Pinel with his crazy people, show what steady nerves can do
with the most intractable of animals, the most irresistible of
despots, and the most unmanageable of invalids.

If you cannot acquire and keep the confidence of your patient, it is
time for you to give place to some other practitioner who can. If
you are wise and diligent, you can establish relations with the best
of them which they will find it very hard to break. But, if they
wish to employ another person, who, as they think, knows more than
you do, do not take it as a personal wrong. A patient believes
another man can save his life, can restore him to health, which, as
he thinks, you have not the skill to do. No matter whether the
patient is right or wrong, it is a great impertinence to think you
have any property in him. Your estimate of your own ability is not
the question, it is what the patient thinks of it. All your wisdom
is to him like the lady's virtue in Raleigh's song:

"If she seem not chaste to me,
What care I how chaste she be?"

What I call a good patient is one who, having found a good physician,
sticks to him till he dies. But there are many very good people who
are not what I call good patients. I was once requested to call on a
lady suffering from nervous and other symptoms. It came out in the
preliminary conversational skirmish, half medical, half social, that
I was the twenty-sixth member of the faculty into whose arms,
professionally speaking, she had successively thrown herself. Not
being a believer in such a rapid rotation of scientific crops, I
gently deposited the burden, commending it to the care of number
twenty-seven, and, him, whoever he might be, to the care of Heaven.

If there happened to be among my audience any person who wished to
know on what principles the patient should choose his physician, I
should give him these few precepts to think over:

Choose a man who is personally agreeable, for a daily visit from an
intelligent, amiable, pleasant, sympathetic person will cost you no
more than one from a sloven or a boor, and his presence will do more
for you than any prescription the other will order.

Let him be a man of recognized good sense in other matters, and the
chance is that he will be sensible as a practitioner.

Let him be a man who stands well with his professional brethren, whom
they approve as honest, able, courteous.

Let him be one whose patients are willing to die in his hands, not
one whom they go to for trifles, and leave as soon as they are in
danger, and who can say, therefore, that he never loses a patient.

Do not leave the ranks of what is called the regular profession,
unless you wish to go farther and fare worse, for you may be assured
that its members recognize no principle which hinders their accepting
any remedial agent proved to be useful, no matter from what quarter
it comes. The difficulty is that the stragglers, organized under
fantastic names in pretentious associations, or lurking in solitary
dens behind doors left ajar, make no real contributions to the art of
healing. When they bring forward a remedial agent like chloral, like
the bromide of potassium, like ether, used as an anesthetic, they
will find no difficulty in procuring its recognition.

Some of you will probably be more or less troubled by the pretensions
of that parody of mediaeval theology which finds its dogma of
hereditary depravity in the doctrine of psora, its miracle of
transubstantiation in the mystery of its triturations and dilutions,
its church in the people who have mistaken their century, and its
priests in those who have mistaken their calling. You can do little
with persons who are disposed to accept these curious medical
superstitions. The saturation-point of individual minds with
reference to evidence, and especially medical evidence, differs, and
must always continue to differ, very widely. There are those whose
minds are satisfied with the decillionth dilution of a scientific
proof. No wonder they believe in the efficacy of a similar
attenuation of bryony or pulsatilla. You have no fulcrum you can
rest upon to lift an error out of such minds as these, often highly
endowed with knowledge and talent, sometimes with genius, but
commonly richer in the imaginative than the observing and reasoning

Let me return once more to the young graduate. Your relations to
your professional brethren may be a source of lifelong happiness and
growth in knowledge and character, or they may make you wretched and
end by leaving you isolated from those who should be your friends and
counsellors. The life of a physician becomes ignoble when he suffers
himself to feed on petty jealousies and sours his temper in perpetual
quarrels. You will be liable to meet an uncomfortable man here and
there in the profession,--one who is so fond of being in hot water
that it is a wonder all the albumen in his body is not coagulated.
There are common barrators among doctors as there are among lawyers,
--stirrers up of strife under one pretext and another, but in reality
because they like it. They are their own worst enemies, and do
themselves a mischief each time they assail their neighbors. In my
student days I remember a good deal of this Donnybrook-Fair style of
quarrelling, more especially in Paris, where some of the noted
surgeons were always at loggerheads, and in one of our lively Western
cities. Soon after I had set up an office, I had a trifling
experience which may serve to point a moral in this direction. I had
placed a lamp behind the glass in the entry to indicate to the
passer-by where relief from all curable infirmities was to be sought
and found. Its brilliancy attracted the attention of a devious
youth, who dashed his fist through the glass and upset my modest
luminary. All he got by his vivacious assault was that he left
portions of integument from his knuckles upon the glass, had a lame
hand, was very easily identified, and had to pay the glazier's bill.
The moral is that, if the brilliancy of another's reputation excites
your belligerent instincts, it is not worth your while to strike at
it, without calculating which of you is likely to suffer most, if you

You may be assured that when an ill-conditioned neighbor is always
complaining of a bad taste in his mouth and an evil atmosphere about
him, there is something wrong about his own secretions. In such
cases there is an alterative regimen of remarkable efficacy: it is a
starvation-diet of letting alone. The great majority of the
profession are peacefully inclined. Their pursuits are eminently
humanizing, and they look with disgust on the personalities which
intrude themselves into the placid domain of an art whose province it
is to heal and not to wound.

The intercourse of teacher and student in a large school is
necessarily limited, but it should be, and, so far as my experience
goes, it is, eminently cordial and kindly. You will leave with
regret, and hold in tender remembrance, those who have taken you by
the hand at your entrance on your chosen path, and led you patiently
and faithfully, until the great gates at its end have swung upon
their hinges, and the world lies open before you. That venerable
oath to which I have before referred bound the student to regard his
instructor in the light of a parent, to treat his children like
brothers, to succor him in his day of need. I trust the spirit of
the oath of Hippocrates is not dead in the hearts of the students of
to-day. They will remember with gratitude every earnest effort,
every encouraging word, which has helped them in their difficult and
laborious career of study. The names they read on their diplomas
will recall faces that are like family-portraits in their memory, and
the echo of voices they have listened to so long will linger in their
memories far into the still evening of their lives.

One voice will be heard no more which has been familiar to many among
you. It is not for me, a stranger to these scenes, to speak his
eulogy. I have no right to sadden this hour by dwelling on the deep
regrets of friendship, or to bid the bitter tears of sorrow flow
afresh. Yet I cannot help remembering what a void the death of such
a practitioner as your late instructor must leave in the wide circle
of those who leaned upon his counsel and assistance in their hour of
need, in a community where he was so widely known and esteemed, in a
school where he bore so important a part. There is no exemption from
the common doom for him who holds the shield to protect others. The
student is called from his bench, the professor from his chair, the
practitioner in his busiest period hears a knock more peremptory than
any patient's midnight summons, and goes on that unreturning visit
which admits of no excuse, and suffers no delay. The call of such a
man away from us is the bereavement of a great family. Nor can we
help regretting the loss for him of a bright and cheerful earthly
future; for the old age of a physician is one of the happiest periods
of his life. He is loved and cherished for what he has been, and
even in the decline of his faculties there are occasions when his
experience is still appealed to, and his trembling hands are looked
to with renewing hope and trust, as being yet able to stay the arm of
the destroyer.

But if there is so much left for age, how beautiful, how inspiring is
the hope of youth! I see among those whom I count as listeners one
by whose side I have sat as a fellow-teacher, and by whose
instructions I have felt myself not too old to profit. As we
borrowed him from your city, I must take this opportunity of telling
you that his zeal, intelligence, and admirable faculty as an
instructor were heartily and universally recognized among us. We
return him, as we trust, uninjured, to the fellow-citizens who have
the privilege of claiming him as their own.

And now, gentlemen of the graduating class, nothing remains but for
me to bid you, in the name of those for whom I am commissioned and
privileged to speak, farewell as students, and welcome as
practitioners. I pronounce the two benedictions in the same breath,
as the late king's demise and the new king's accession are proclaimed
by the same voice at the same moment. You would hardly excuse me if
I stooped to any meaner dialect than the classical and familiar
language of your prescriptions, the same in which your title to the
name of physician is, if, like our own institution, you follow the
ancient usage, engraved upon your diplomas.

Valete, JUVENES, artis medicae studiosi; valete, discipuli, valete,

Salvete, VIRI, artis medicae magister; Salvete amici; salvete


[Dedicatory Address at the opening of the Medical Library in Boston,
December 3, 1878.]

It is my appointed task, my honorable privilege, this evening, to
speak of what has been done by others. No one can bring his tribute
of words into the presence of great deeds, or try with them to
embellish the memory of any inspiring achievement, without feeling
and leaving with others a sense of their insufficiency. So felt
Alexander when he compared even his adored Homer with the hero the
poet had sung. So felt Webster when he contrasted the phrases of
rhetoric with the eloquence of patriotism and of self-devotion. So
felt Lincoln when on the field of Gettysburg he spoke those immortal
words which Pericles could not nave bettered, which Aristotle could
not have criticised. So felt he who wrote the epitaph of the builder
of the dome which looks down on the crosses and weathercocks that
glitter over London.

We are not met upon a battle-field, except so far as every laborious
achievement means a victory over opposition, indifference,
selfishness, faintheartedness, and that great property of mind as
well as matter,--inertia. We are not met in a cathedral, except so
far as every building whose walls are lined with the products of
useful and ennobling thought is a temple of the Almighty, whose
inspiration has given us understanding. But we have gathered within
walls which bear testimony to the self-sacrificing, persevering
efforts of a few young men, to whom we owe the origin and development
of all that excites our admiration in this completed enterprise; and
I might consider my task as finished if I contented myself with
borrowing the last word of the architect's epitaph and only saying,
Look around you!

The reports of the librarian have told or will tell you, in some
detail, what has been accomplished since the 21st of December, 1874,
when six gentlemen met at the house of Dr. Henry Ingersoll Bowditch
to discuss different projects for a medical library. In less than
four years from that time, by the liberality of associations and of
individuals, this collection of nearly ten thousand volumes, of five
thousand pamphlets, and of one hundred and twenty-five journals,
regularly received,--all worthily sheltered beneath this lofty roof,
--has come into being under our eyes. It has sprung up, as it were;
in the night like a mushroom; it stands before us in full daylight as
lusty as an oak, and promising to grow and flourish in the perennial
freshness of an evergreen.

To whom does our profession owe this already large collection of
books, exceeded in numbers only by four or five of the most extensive
medical libraries in the country, and lodged in a building so well
adapted to its present needs? We will not point out individually all
those younger members of the profession who have accomplished what
their fathers and elder brethren had attempted and partially
achieved. We need not write their names on these walls, after the
fashion of those civic dignitaries who immortalize themselves on
tablets of marble and gates of iron. But their contemporaries know
them well, and their descendants will not forget them,--the men who
first met together, the men who have given their time and their
money, the faithful workers, worthy associates of the strenuous
agitator who gave no sleep to his eyes, no slumber to his eyelids,
until he had gained his ends; the untiring, imperturbable, tenacious,
irrepressible, all-subduing agitator who neither rested nor let
others rest until the success of the project was assured. If,
against his injunctions, I name Dr. James Read Chadwick, it is only
my revenge for his having kept me awake so often and so long while he
was urging on the undertaking in which he has been preeminently
active and triumphantly successful.

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