ADDRESSES THE GRADUATING CLASS Cooper Medical College November 12, 1889. Professor S. 0. L. POTTER, A.M., M.D. Rev. JACOB VOORSANGER, D.D. SAN FRANCISCO: WooduiardA Co., Pacifie Medical Journal Print, 522 California Street, 1889 k^ ^^ PROFESSIONAL SUCCESS. A VALEDICTORY ADDRESS Delivered to the Graduating Class at Cooper Medical College, San Francisco, November 12th, 1889. By sam'l o. l. potter, a. M., M. D. Professor of Theoiyand Practice of Medicine. Ladies and Gentlemen, Members of the Graduating Glass of 1889: — It has fallen to my lot to take leave of you as students and to dismiss you from the halls of this College, with the vale, the farewell of its Faculty, upon this momentous occasion in your lives, when you enter upon the duties and privileges of our profession. I feel, however, in thus addressing you, that there is hardly the ordinary appropriateness in my being selected for this privilege, inasmuch as I may be said to be graduating myself to-night, having just completed my first course of three years as a teacher beneath this roof. When you entered these halls, three years ago, as students, I entered them with you, as your teacher. Together we have worked hard since then, in pursuing the course of your professional educa- tion — you in acquiring what I have been striving to impart, in conjunction with my more experienced and learned brethren of the Faculty. And now, at the end of our mutual study, I am impressed with the sense of my own graduation at this com- mencement, and with the hope that I may be found to be as worthy of my professorial chair, as you have been pronounced to be of your diplomas. Happy, smiling faces, reflecting the warm hearts and kind wishes of your friends, greet you to-night on every side. All the members of this assembly' seem to be overflowing with the most genuine good feeling for you, and to join with your indi- vidual near ones in making this an occasion of delightful re- membrance. No cloud should dim your sky to-night, no shadow should fall upon your thoughts, to mar the pleasure you feel in entering upon what you are now resolving shall be successful and honorable careers. How shall I, as the representative of the Faculty for this hour, most fitly close this happy evening. 45ri3t> 2 Address. and yet leave upon your ears some words which may burn them- selves into your memories, and help to raise your aspirations to the front rank, among the members of the noble profession to which you are wedded to-night ? What shall be the most in- spiring theme, on which to address you in this hour of your first victory, a theme which shall nerve you to the struggle for greater conquests in your future prof est- ional careers? When the military student goes forth from the halls of his alma mater, to enter upon a life which is consecrated to the defense of his country; when the newly-ordained minister turns his back upon the theological seminary, to engage in the never- ending warfare with sin, and to hold up the banner of the cross before a sin-loving world; when the student of the law receives the certificate which authorizes him to plead the cause of a suitor before the tribunals of the State; and when the medical student is graduated, and endowed with all the rights, privileges and duties of one whose life is devoted to the relief of suffering humanity — what subject above all others can charm his ear, or entrance his mind, or rivet his attention, as will that of his probable personal share in what is called " success? ' ' Success is the loadstone which now attracts your purposes, enchains your thoughts, your dreams; success is the ultimate center of your aims, the nucleolus of your aspirations, the goal of all your hopes; success in life, in love, in war with disease and death. Surely, no theme could be more appropriate for consideration at this "commencement" of your professional lives, than the measure of success which you may attain to, and the kind of success for which you should strive. Success is a quantity of unknown limits, a conception of a condition which cannot be clearly defined. Every one has his own ideal of it, and this is so varying in quality and degree, that what would be success to one might be miserable failure to another, even in the same career. The poet writes : " It is success that colors all in life, Makes villains honest, and the rogue admired ; Yea, even virtue, if opposed by strife, Yields to success, no matter how acquired. " But this conception of success, while unfortunately too com- mon, is yet a low, a false one, referring only to the realization of the material things of life — place, power and riches. It does not embrace the spiritual part of existence, nor find place for Address. 3 happiness, for that "peace which passeth understanding," the only true crown of a successful life. It is, however, too often the highest ideal of professional men, too many of whom believe that success means the possession of these things which all the world seems aiming for. With such a conception the success of the quack would be the highest in our professional view, for most of this class acquire wealth, many obtain political place, and nearly all are possessed of such power that they stand above the law, no jury being found to convict them, even when guilty of the highest crime known to the law, murder most foul, the murder of the helpless innocent. While it is beyond belief that the aspirations of any before me to-night tend in the direction of the charlatan's success, it is by no means improbable that some of you may be tempted to win by essaying a compromise course of conduct, and thus may eventually find yourselves upon the list, already a very large one, of apparently reputable physicians, who are afflicted with a species of mental strabismus, keeping one eye upon the code of ethics, and the other directed crosswise at every known means of violating its spirit, while carefully keeping within the letter of its law. Guided by such an obliquity of moral vision, the course of these men is always inclined towards the open sea of quackery, rather than for the straight though nar- row channel of ethical professional conduct. How to be adver- tised without open advertising is the sole guiding-star of life's voyage for them; and the only harbor they seek to anchor in is one the sands of which consist of dollars, forming silver shores washed up by the hoarse waves of notoriety. For them the medical profession is only a trade, — and trade-signs surround their every movement. Each one of you will eventually find yourself in line with this class of physicians, or with that which tries to live up to the highest ethics of your profession; and much will depend on the first steps you take in shaping your path, in deciding the rank you will finally fall in with. If you would be mustered with the Jenners, the Brights, the Virchows, the Pagets, the Grosses, the Da Costas, with all the princes of medicine and surgery, you must enrol yourselves with them in ethical conduct from this very night, — for even occasional wandering from the rules by which their lives were guided will gradually but surely draw you down to the level of, and associate your names with, the 4 Address. Cagliostros, the HoUoways, the Hahnemaniacs of Medicine, the peddlers of puerile pellets, the vendors of elixirs of life, safe- cures, and microbe-killers. There is a wide gulf of separation between a profession and a trade. The one opens its doors widely to all competent comers, and places no restriction on its membership save those of a proper education and a proper course of conduct: — the other ties itself up in trades-unions, fixing one wage for all, lowering the most skilled to the level of the poorest workman, and prevents even the children of its members from learning their father's trade, by restricting the number of apprentices in a shop. A profes- sion works, as a rule, without fixed compensation for each min- ute of time or act of skill, does fully one-half of its work for charity, and varies its fees in accordance with the ability of its clients; — the trade does nothing for sweet charity, but demands from rich and poor alike a fixed price for every minute its journeyman spends in loafing along the streets, and keeps a lien upon the work until its demands are fully complied with. The profession gives more than it agrees to for all it gets — the trade puts forth its best efforts in striving to realize the largest possible profits from its contracts. The profession, of its own accord, furnishes the best material attainable for its work — the trade puts in the worst material it can get accepted, and strives to cover its defective material and poor work with some varnish which will hide its faults. The profession publishes its discoveries, tries to educate the people in its methods, to make them familiar with its tools, and to inculcate a mode of living which will lessen the demand for its services — the trade hides all its secrets, or protects them by patents, and not infrequently does direct injury to property for the purpose of making future work for itself. The profes- sion exhibits but a modest sign, to show its abiding-place, and avoids every appearance of show or display — the trade covers walls, windows and fences, even the rocks, with glaring and often vulgar devices, proclaiming itself to the ignorant, and ex- alting itself above its neighbors, by claims which are frequently as false as they are impudent. In all professions you will find tradesmen, individuals who have only the trade idea, and who consequently debase their profession by lowering it to the trade level, and working for money alone. In none is this prostitution more frequently Address. 5 seen, than in the one upon which you are entering. As you will find lawyers who foment quarrels, sell out their clients, and make laws so loosely as to increase litigation; as there are clergy- men who cry hell-fire from their pulpits, and trade upon the fear of everlasting punishment in a future life ; as you will find dentists who will drill holes in sound teeth, in order to fill them at another time, and who hang monster molars in gilded wood before their offices, — so you will find p%sicians in every commu- nity who prey on the ignorance and confidence of mankind, frightening their clients into long periods of treatment by ex- aggerating their ills; pretending to make operations or making useless ones, on parts of the body which the patient cannot see; falsely announcing the existence of specific diseases to which the patient's folly may have exposed him; and advertising themselves and their cures by every method which ingenuity can suggest. Whatever the particular methods employed, the trail of the ser- pent is over them all; they have one object alone, the advertising of their owner to the world. Morally viewed, all advertising is wrong, because it tells only one side of the story, and keeps the other side studiously con- cealed. There is, however, less wrong about it in the trades, because every buyer is supposed to know something about the quality of the goods and their prices; and can, at any rate, go around from shop to shop, examine and compare, before pur- chasing. But in a profession there is no such opportunity, no such safe-guard, for the client. The public cannot weigh a lawyer's judgment, or feel of a physician's skill, it only knows what rumor says as to the successful results of either man's prac- tice; and this rumor emanating from himself and his friends, it deals only with his cures, his successes, — never with his failures to cure, unless in cases where such failure will redown to his benefit by letting it be known that he is engaged in a criminal practice. The legal profession is pretty free from the most obnoxious sorts of advertining, and the reason is found in the complete control which that profession exercises over its membership — a privilege which it has never given to our profession. Suppose that a lawyer came here from an eastern city, and commenced his professional career by advertising in the daily papers that he had never lost a case intrusted to him, that he had more 1 egal learning and a better legal education than any other law- 6 Address. yer in the community, that his control over judges was para- mount, and his influence with juries unassailable, that in short he had a corner on all legal machinery, and could guarantee a successful issue to every case he accepted, that consultations with him were free, and that " no judgment, no pay," was his rule of practice, — how long would such a man retain the privilege of practising before the courts of this State ? Not one legal day after his advertisement was presented to a court; and his dis- barment would operate, not only here, but in every part of the country, so that he could not emigrate from one State to do the same in another. Yet lawyers deny us the right to expel simi- lar advertisers from the medical profession, and even State Su- preme Courts reverse convictions on the most flimsy pretexts, gravely stating that a physician has a right to inform the public of his self-asserted skill, and thus casting the mantle of legal protection around the most glaring violators of our time-honored ethics. Though these instances of professional wrong-doing are by far too common, they are not so flagrant as they were in former years, in the body of the regular profession. The open adver- tisers are relegated to the quack-list, debarred from any profes- sional association or help in time of trouble . Hence they must always be on the wing, ready to flee if serious prosecution arises, or else be prepared to purchase a successful result, by sur- rendering a large portion of their gains. Between satisfying the black-mailing portion of their clientele, the regular charges for medical advertisements, and the fees to lawyers and juries, the financial lot of the quack is not always an enviable one. His half-brother, the would-be advertiser, is not, on the whole, much better off. Generally shunned by his brethren, and cor- dially despised by the best elements in his profession, his peculiar practices bring him into a constant warfare, as he struggles to rise on the ruin of others. No matter how many of the laity are sounding his praises, no physician ever commends him. Too often has he ruthlessly trampled on their feelings in consultations, ingratiated himself into their families by un- worthy means, and slaughtered their reputations before their patients — so that, poor human nature not being yet angelic in its forgiveness, they pay him back when they get the chance, and the chance is sure to come. The change in professional feeling about such matters is well Address. 7 exhibited by contrasting the elevated tone of our code of ethics with the advice given one hundred and fifty years ago to a young graduate, by the celebrated Dr. Mead, one of the most highly distinguished and honored physicians of London. Among many other things he said — " The first thing I advise you to do is to make all the noise and bustle you can, to make the whole town ring of you if pos- sible, so that every one may know that there is such a being, and here in town, too, such a physician." '• If your wife mind business in her way, it will certainly in- crease yours." '• Should you have an itching to write a book on physic, I would advise you to choose a subject by which you think you will get most money, as fevers, smallpox, etc. For in these dis- eases some must always live, some die; it is a hard matter to tell when right or when wrong." " And next then I would advise you, whatever the subject you write upon, rather to write so as neither to make downright sense or nonsense thereof, than otherwise; because thus none of the profession can well lay hold of you for any particular part; or, if they should, there is room for you to defend it, being as easily understood one way as the other." The author of this advice was a member of the Boyal Society, physician to St. Thomas' Hospital, lecturer at the Surgeon's Hall, regular physician to Queen Anne and King George the 2nd, the recognized head of his profession in England in his day, and the author of several important medical works. Fancy a Paget, a Quain, or a Gross, giving such advice to a young grad- uate at the present time ! It is, however, a fact, highly complimentary to the American medical profession, that the great majority of physicians given to these trade methods in this country are men of foreign birth and education. Excluding the openly-acknowledged quacks, and looking at the regular ranks alone, you will find these ob- jectionable practices chiefly indulged in by medical immigrants, not by graduates of our own schools. Received by us with open arms, admitted to practice on diplomas, which in many cases do not confer the right to practice in the countries where they were issued, a very large proportion of these men utterly ignore our ethics, treat our graduates with half-disguised scorn, and habit- ually employ methods of professional practice which they would not dare to use in their own countries. As one young man said to me, when I remonstrated with him for some unethical con- duct, " Well, you know, I thought one could do almost anything 8 Address. in America." It is high time we abandoned free trade in foreign diplomas and compelled the respect of medical immigrants by enforcing on them the same requirements that their countries demand of our graduates, before permitting them to practice here. When we do this, our first-class diplomas will obtain full recognition abroad, in every civilized country, a recognition which will never be accorded to them until we so honor them ourselves. One unpleasant feature of professional success is that eveiy step in its course entails a certain amount of professional failure to some other one, pehaps equally, perhaps more deserving. Every case the lawyer wins, some other lawyer must lose; and almost every patient you get, in your first years of practice, will leave some other physician. As a man rises in any profession, he is obliged to tread upon the position of some one of his brethren. This, of course, entails a certain amount of jealousy, the outcome of our human nature, and which cannot be entirely prevented; though by his own conduct, it is in the power of the rising man to abate much of it, and even to make firm friends of those who are injured by his success. If no harsh words are uttered, if no mean implications are thrown out, but if, on the contrary, the interests of the displaced physician are carefully guarded by the successor, there may be some feeling at first, but in the end a friend will be gained, for his friendship has been deserved. One of the best rules to follow, when succeed- ing another physician in a case from which he has been dismissed, is to say that you are greatly indebted to your predecessor for having so thoroughly exhausted a certain line of treatment and thereby prevented your having to go over the same ground. This you can truthfully say, for it will be true in almost every such case. It will exalt you, as well as the other man, in the eyes of the family, for in honoring the work of his brethren, a physician always honors himself. Professor Gross laid down a noble example in this respect, for all of us to profit by. In his autobiography he says: " I never spoke ill of a professional brother, or did anything directly or indirectly to undermine his standing with his patients, the profession or the public. On the contrary, I have often gone out of my own way to sustain and defend him; sometimes, I fear, when silence might have been the correct course." And well was he rewarded for his magnanimity! No American surgeon was ever so beloved by Address. 9 his brethren, or so highly honored by them at home and abroad, as he; and when, a few years since, he passed away, crowned with the glory of years and fame, no surgeon was ever so re- gretted throughout the length and breadth of the land. One of my greatest treasures is a letter from his hand, written a short time only before his death, in reply to one of mine submitting the details of a case to him, and asking for his advice thereon. Though full of years and infirmities, and in the sickness which soon after ended his life, the dear old man wrote to me at length with his own hand, paying as much attention to the request of an obscure physician in the far West, as he would to one of eminent position in an Eastern metropolis. The professional jealousy of physicians is a never-failing theme of amusement and vilification, on the part of nonprofessional people, and even on that of other professional men towards ours. It is claimed that we are absurdly jealous of each other, that our requirements as to professional courtesy are too strict tO be observed, and that no man can possibly live up to the full de- mands of our code of ethics. But when a little thought is given to this subject, the charge will be seen to be unfounded. We do hold each other to very strict ethical lines, and it is necessary that we should, for there is no other profession in which profes- sional propriety is so easily transgressed. The lawyer deals with courts and juries; by argumentative appeals to reason, precedent and statute law he influences the former; by oratorical power and, sometimes, by cunning re- presentation, he gains the latter; but all his utterances are said in open court, and in the hearing of the accused and his counsel. Then, too, if he fails, he has the court and the jury, as well as the law, to share with him the blame, and he must be a poor lawyer, if he cannot show that the case was not lost through any fault of his. Even the clergyman, in his professional work, deals chiefly with the members of some one organization, bound by many obligations to sustain him, and has no rival to contend with in his immediate sphere. His hearers are sane, are healthy, and are never permitted to reply to his arguments. He is su- preme over all he surveys, as long as he does not offend the prejudices of the influential members of his flock. But the doc- tor deals with the sick, with those whose minds are warped by anxiety or by disease, and with those, perhaps, whose judgments are clouded by insanity. He has no judge to lay the blame upon, 10 Address. no jury to stand between himself and abuse; he must take all the fault of the failure on his own shoulders, and, reversing the clergyman's position, he can never reply in his own defence, though open to assault from every direction. Homceopathic friends, who have known of such wonderful cures, urge the family to send for their pet physicians; others, no less generous, have some miraculous oil, or wonder working salve, which, if only tried, will be sure to do her good. Or, perhaps, some one cured by Christian science of a disease which never existed, prayerfully pleads with the sick one to dismiss you and send for the holy healer, who will show her the way to recovery by faith and prayer. Even the nurse, trained as she may be, may bring advertisements of patent medicines into the sick room ; or, perhaps, beguile the lonely hours by telling your patient of the wonderful success of some other physician, who has never shown a disposition to resent her various little schemes for pleasure, profit and self-glorification. Is it any wonder, then, that with all these influences to contend against, the physician should hold his own brethren to a strict line of conduct, when by merely lifting an eyebrow, or shrugging a shoulder, they can express a doubt as to his ability to those who are eagerly watching for any straw on which to cling their hope for resto- ration to health? And yet all that he demands in this regard is compliance with the golden rule of doing unto others as we our- selves would have them do unto us. You are going out into a hard world, and entering upon a hard profession, — one that has few material rewards to bestow, and reserves her favors for those who devote theaaselves most strictly to her requirements. She brooks no half allegiance, — permits no other pursuit to engross the time of her successful aspirants — no other aim to divide the energies of those who would be crowned by her. But in all ages she has stood among the first of the callings of men; from the very dawn of story, when the Supreme Being himself performed a surgical opera- tion upon the first man's rib, from which to manufacture the master-piece of creation, — down to the heroic era, when the first and grandest of poets pronounced a skilful physician to be worth an army, — and to the present day, when a sovereign's son is a practising surgeon. Next after warriors, the ancients exalted physicians among the gods. Back in the myths of my- thology, before history had a beginning, we find the king-phy- Address. 11 sician, .^sculapius, who had divine honors paid to him, was ranked among the gods, and gave his name to the profession of which he was the earliest representative. Even in the days of Rome's imperial sway, and during her most brilliant intellectual epoch, her foremost orator and author, the great Cicero, de- clared that " men in no way approach nearer to the gods, than in giving health to their fellow-men." This was uttered 2,000 years ago; but nearly 4,000 years before then, Tosorthros, the King of Egypt, who gave three hundred and sixty-five days to the year, was a devoted student of medicine, and recorded on the monumental rocks of that primal store-house of art and science, his veneration for the physician's calling. Those of you who for some years will look from the sidewalk upon your more pros- perous brethren in their carriages, may divest yourselves of envy if you can believe that the most successful physician this world ever saw, he whose name is now daily repeated by mill- ions of those who worship him as the Son of God, — who had power over all disease, and even over death and the grave, — that he walked about the streets on his missions of mercy; had no home, not even a place to lay his head; and in his most tri- umphal hour had only an ass, and a colt, the foal of an ass, upon which to ride through the crowds of his worshippers. In your early years of struggle, you will need more solid comfort than legend can give you, to encourage your hopes; and the^history of medicine gives you this encouragement, in showing you that the princes of our profession were those who struggled against adversity in the first (and often many) years of their practice. Cheyne, when thirty-four years old, and in his second year's practice, only received three guineas during the last half of that year, — but nine years afterwards he was making £5,000 per annum. Chambers, of London, when thirty- four years old, and in practice five years, only took in £211 in a year, but seventeen years after his annual professional income reached £9,000. Baillie, who, before Chambers, had the best London practice, receiving £11,000 a year when that amount represented five times as much as it does now, had a slow and tedious march upwards, having been for twelve years a physi- cian to St. George's Hospital, and for nearly twenty years a lec- turer in the schools, before even moderate success began to come to him. Hunter, who spent a large fortune on the splen- did museum which now graces the University of Glasgow, was 12 Address. so " hard ap " one year in London, that he had to postpone for two weeks the opening of his third lecture season, not hav- ing money enough to pay for the usual class advertisements. Sir Astley Cooper only received five guineas during his first year's London practice, though he was already a lecturer on anatomy and surgery. In after life, his professional income in one year reached £23,000. Sir Benj. Brodie did not get into full prac- tice until he had been for twenty years lecturing, practicing and publishing. These are some of the instances which medical annals afford, of men successful above all others of their com- peers in material results as well as in fame, who came up through trials and tribulations of every kind, the overcoming of which gave them new strength to bear them onward in their course. It is a beautiful idea, that of the ancient hero, who, when pressed by his adversary to the earth, received new vigor from his contact with the mother of all, and arose with greater strength for the eucounter. In your future years of success, in full tide flowing fast and strong, your greatest pleasure will be derived from the remembrance of your early struggles; and you will then see that you too arose stroager every time that you seemed to have been beaten to the earth. These remem- brances will be all the more delightful if you know that your strength was always put forth worthily, and that your art was always revered as someting never to be defiled; — that, like the Mohammedan, who never holds his koran below the girdle, nor touches it with unwashen hands, because of bis belief in its di- vine origin, you have ever held your profession above the baser things of life, have ministered in it from pure motives, and never practiced it with unclean hands. Those of you who are young have the greatest element of success at your command, namely — youth — your most valuable qualification. Only in youth can the ground- work of a really good education be laid, and it is in your youth that you must consti-uct the substructure which shall be broad enough and deep enough to support the superstructure of success, and make it enduring. But even iu your youth you can do much toward actual success. The greatest work done in this world has been done by young men, Jesus and Alexander lived each only thirty-three years, but one had conquered the world by his arms, and the other was to conquer it by his love and self-sac- rifice. jSapoleon commanded the army of Italy at twenty-seven. Address. 18 was First-Consul at thirty, Emperor at thirty-five and King of Kings at thirty-eight. Vesalius was only twenty-four when he wrote his great work on anatomy; Newton was but twenty- three when his observation of the falling apple gave to the world the knowledge of the greatest of its physical laws. Even in our profession, where a certain age has ever been considered a nec- essary qualification, the younger men are daily coming into greater prominence. So do not feel badly when you hear that some older physician has said of you, " Oh! yes, Dr. Jones is a very nice young man, a graduate of Cooper, too, a most excel- lent college, stands at the head ! He will, no doubt, make a very excellent physician, when he has had some few years ex- perience." This kind of remark does not impress people as it formerly did. In order to attain professional success there are three very necessary requirements, without each of which its accomplish- ment would be miraculous. The first is that you must deserve it. ** Tis not in mortals to command success, but we'll do more, Sempronius, we'll deserve it." And in order that you may de- serve it you must work for it. " Seest thou a man diligent in his business; he shall stand before Kings, he shall not stand before mean men." So wrote the wisest of Kings, and human experience in every walk of life verifies his words, and teaches the inexorable lesson, that it is labor and only labor, that con- quers. One of our most successful surgeons, the elder Gross, who was honored both in his own country and abroad as few American physicians were ever honored before, has left behind the following testimony to the same effect. He says: " To accomplish great ends demands patience, perseverance, un- swerving application, order and system, and a definite aim, — in a word, talent rather than genius. The only genius I possess is the genius of industry; if I have any other I have not been able to discover it. The position which I have attained in my profession has been achieved by hard labor, by no special intel- lectual endowment, by no special gifts from God, by no special favor from man, but by my own unaided efforts, continued steadily and perseveringly through a long series of years." And lastly you must have aspiration, you must aspire to suc- cess, not now, not for a year, but for life; and as one difficulty is overcome and others open up before you, as Alp on Alps arise on your horizon, your look must be ever upward if you would 14 Address. reach the summit of the range. All higher life is constant as- piration, — in morals for the good and true; in art, for the beauti- ful; in science, for the unknown. In this pursuit there is nothing too small to be neglected. The most insignificant fact, if unobserved before, may be the means of giving a new truth to the world, and securing for its observer immortal fame. A chance word uttered by an English dairy- maid in the presence of a young physician, led him into an investigation. which resulted in the conquering of one fell dis- ease, and gave Jenner a crown of glory which time can never remove from his brow. Who could have thought that when the physician Galvani observed the twitching of the frog's legs as they hung on copper hooks from an iron rail, his observation would in a little more than fifty years develop into the telegraph, and soon afterwards into the telephone; or that the dark lines seen by Frauenhofer in the spectrum would become the means of determining the physical constitution of the sun, and give to chemists the most delicate method of analysis ever discovered ! The kind of success to which you should aspire is that of the eminent medical man in all ages and in every community — one who is thought well of and looked up to by his brethren, and trusted implicitly by his patients. To be honored by your own profession, as a man of learning, skill and judgment, — to be beloved by your families, and to be the chosen counselor of their young men and maidens, — to be the one above all others to whom your clients turn for advice in time of sickness and trouble, — to be eagerly sought in the hour of danger and an- guish with full confidence in your power of relieving, — to have the family altar laid bare before you, and its secrets intrusted to your keeping, with the fullest faith in their being safely guarded, — to be the hope of many, the friend of all around you, — to be in a position enabling you to be benevolent and charitable beyond any other vocation, imbued with the feeling that to refuse your professional aid in the relief of suffering, even to a personal enemy, is a disgrace, — to be taught by the daily exercise of your calling those virtues which make men great and good, — to succeed in these aims is true success, be- yond the measure of any professional income. After every such act of your professional ministration, you will find a glow in your heart, which no amount of money gained by fraud and deception could ever bring there. Having these results of success, you will not want for the pe- Address. 15 cuniary part of it. " Seek ye first the kingdom of God and his righteousness, and all these things shall be added unto you," was said of old from the Mount of Olives, and is as true in pro- fessional as in spiritual life. If you seek first the standing and reputation of the true physician, the material rewards will come in due time; and standing at last before the Osiris of the public and professional judgment, you will be able to defend your career in the ancient formula, — "I have not been idle; I have not been intoxicated; 1 have not told secrets; I have not defrauded; I have not caused tears. I have given food to the hungry, drink to the thirsty, and clothes to the naked. " And as the Osiris of the ancient belief received the justified soul unto himself, and ab- sorbed in into his own person — so may the purity of your pro- fessional lives perhaps justify your exaltation to the throne of ^sculapius, and the incorporation of your soul into the divine essence, from which may emanate the souls of other physicians in some future age. Much more of counsel might be said to you who go forth from these halls to-night to enter upon the commencement of your professional lives; and if I were sure that you would profit thereby I would gladly continue, in the hope of sparing you the consequences of some future stumble. But it is a recognized law that ' ' neither nations nor individuals profit much by the experience of others," — and so it is with physicians, each one must go through his experience for himself, " learning through suffering, succeeding through blundering," and attaining to the calmness of wisdom through the pains of folly. Hence I will now take leave of you, and in bidding you farewell, I must give voice to the hope that though we separate here as students and teachers, there are cords now extending from this room into your hearts, which in your after lives shall bind your teachers to you and you to them. May you fare well indeed in all you under- take, every one of you; and may your lives be as serviceable to humanity and as honorable to yourselves as your most elevated impulses can desire. This must be, if in the darker hours, of your early struggles you will keep before you the noble words so often quoted, but never quoted too often, in which the first of American poets has said that " Lives of great men all remind us We can make our lives sublime; And departing, leave behind us, Footprints on the sands of time. 16 Address. Footprints that perhaps another Sailing o'er life's solemn main, A forlorn and ship-wrecked brother, Seeing, shall take heart again. Let us, then, be up and doing. With a heart for any fate; Still achieving, still pursuing. Learn to labor and to wait." And, if laboring and waiting in this spirit, you will not wait in vain, for all other things being equal, success will surely come to each one of you. But, when success does come, forget not those by whom it came, and with grateful hearts to all the friends of your struggling years, continue in the paths which I have tried to point out, letting your " light so shine before men, that they, seeing your good works, may glorify" the noble pro- fession of which you are a member, and honor the college whose diploma you bear. ADDRESS By rev. JACOB VOORSANGER, D.D. Ladies and Gentlemen or the Gkaduating Class : — It is claimed that a Jew becomes a Gentile in bat one spot on earth, the Mormon-ridden Territory of Utah. It may likewise be said that a school devoted to the study of medicine is the only one where a clergyman becomes a layman. As a layman, therefore, I esteem it an honor and a great privilege to address you upon this, the most important evening of your lives. Important to such an extent, that I fancy you must be profoundly impressed with the solemnity of the moment. The school is about to close its doors upon you. Tour trial is about to commence. For no man is truly tried until he has been weighed in the balance of public opinion, and has not been found wanting. The opened door must reveal to you the seething mass of human beings, all impelled by the laws of force and motion, some beginning the tramp through life, some hurrying to that eternal bourne, whose veil cannot be pierced even by the physician's experi- enced eye. Tour place in this world of human beings, what is it ? Tour station amongst the children of this generation, must needs be one of eminence, because it will bring you peril and labor, and very little enjoyment. The priests of humanity do not distinguish themselves in the banqueting hall. The most eminent servants of suffering men are those whose lives are devoted to the greatest toil. Tour place, therefore, being one that will bring you in contact with human weakness, rather than with human strength, it may not be amiss, gentlemen, to supplement your knowledge of medicine with a few considera- tions, which may induce you to believe that others, beside your- selves, have a high and exalted opinion of the profession you have adopted as your life's work. There is no profession on earth, that requires so much actual knowledge joined to strength of will and character as the pro- fession of the physician. Notice, that I do not use the usual term profession of medicine. Time and circumstances, the eter- nal progress of things and the increased refinement of humani- 18 Address. ty's perceptions have made you something higher, greater and holier thau mere doctors of medicine, that is to say disciples of a certain branch of mental experience. In the application of that mental experience to the needs and sufferings of men lies the greater mission, the more useful profession. You graduate as doctors of medicine, you will be judged by your ability as physicians. To-day it is your knowledge theoretical that ena- bles you to pass out from here provided with a sheepskin; to- morrow it will not be so much your knowledge as your skill to apply it, not so much your diploma as your character, not so much your fine minds as your sympathetic hearts that will win you the plaudits of humanity. To-day the question is whether you have satisfied the programmes and schedules provided by the Faculty for your instruction. To-morrow you enter the greater school of the two, the school bounded by no walls, limited by no horizon. Its amphitheater is the bedside of every patient, and you, the professors, will have as audience the entire host of sufferers who shall be confided to your care. To-day ends the preliminary investigation, to-morrow begins your trial. The judge sits everywhere; his name is public opinion. As you have merited the approbation of your teachers, may you like- wise exhibit those traits of character which we would fain be- lieve have impelled you to enter the classic precincts of your profession. Then you will be adjudged veritable priests of humanity, your place will be in the high places, and your re- ward will be sure to come. You may congratulate yourselves, gentlemen, that the world to-day has an adequate appreciation of the importance of your profession. It has not ever been thus. As a mental experience, the science of medicine has been compelled to fight its way to the front. The world is slow to recognize the eternal principles of truth. That which has been appeals stronger to the conser- vatism of man than the mere indication of what will be. The animalism in man impels him, alligator-like, to sleep away half of his life and with it half of his advantages. The growth of sci- ence is a record of the pertinacity of man's conservatism. New ideas are always suspected, because they indicate changes in the polity and economy of human action; and man has rarely been fond of new ideas. Applying this fact to that branch of sci- ence you are to demonstrate with your skill before the world, it will surely be to your advantage to turn now and then from Address. 19 your busy toil and institute a comparative study of medicine to- day, and medicine in former times. You will learn, then, that the world itself has to some extent changed its attitude toward science. Formerly the herald of a new era was hooted by his contemporaries; his reward came after his death. To-day the world treats new ideas as a child his toys; one after the other are cast away to make room for something new, something more glittering. There is perhaps nothing extraordinary in this. It means that we multiply experiences faster, much faster than our fathers have done. Kepler and Galileo are types of their day. as Edison is of ours. Medicine has not escaped this evolution- ary tendency. Forty years ago an anaesthetic was laughed at. They used to heal wounds by pouring boiling oil on them or cauterizing them. They healed fever by bleeding, and a large category of ills was generalized under the name of distemper. The physician of old had an easy time of it. What he princi- pally needed was some knowledge of herbs, to wear a black gown and to look wise. To be sure, it would be the very height of ingratitude to use this pleasantry in any other but a compara- tive way. For after all, the degree of scientific progress and improvement depends mainly upon the number of experiences that have contributed to make progress possible. And these experiences are not born with us. They are the legacy of anter- ior times. The incantation of every ancient priest, the formula of every ancient herbalist contributed to the materia medica of Hippocratic times. Human judgment has never failed to ex- pend its keenest perceptions upon the sick and the suffering. Medicine is older than Hippocrates, surgery is rather a science of necessity than an art. The great imperative of all applied knowledge, necessity, has brought forth the great healers of the human race. Nature which gives birth to the infinite variety of living things creates likewise the ills to which flesh is heir, but like abeneficient mother she creates the remedy as well as the evil, and places in the human mind the perception to remove the evil, the power to restore physical and mental harmony as well as the faculty to suffer. The degree of knowledge of these ills is on a par with the relative power to remove them. It may, therefore, be set down as fact that in no branch of human ex- perience the relative development thereof is so much governed by necessity as in that branch denominated as medicine. It is, therefore, the oldest and most useful of all sciences. We 20 Address. can dispense with much that applied science has called into existence. We could illuminate the darkness of our nights with an oil lamp and be as complacent as ever; we could travel across the continent in the old, slow way and be happy still; we could afford to dispense with telephonic communications and yet suc- cessfully discharge our social and professional duties, but in view of that great and dread necessity of hearkening to the voice of mother nature in her dispensations of the destiny of humanity, the least retrogression or reaction in the applied sci- ence of medicine would be a crime for which there can be neither pardon nor atonement. In view thereof how marvelous it is that humanity has been as conservative toward that providential science as toward every other experience calculated to widen the horizon of human knowledge. There seems to be a chasm between the golden age of Hippocrates and the era when mod- ern medicine emanated from the scholasticism of mediaeval times. The Greek physician was a courted philosopher, the favored of the gods, the inspired dreamer, to whom in visions of night, remedies were revealed that were more readily adopted by his patients than the advice the priesthood bestowed by direction of their oracles. The Jewish priest, who was likewise the healer of his constituents, was, I fancy, more courted for his power to heal leprosy, than for his knowledge of the mysteries he thought to behold in the curling smoke as it ascended from the sacrificial altar. There may be a psychological or perhaps a social reason for this chasm. The G-reeks and Romans, the Egyptians and the Jews, were the exponents of an almost per- fect social organization. In a nearly permanent state of peace, attended by the comforts that make life pleasant, humanity more readily detects its ailments and turns with more confidence to anyone who has the power of healing them. These are the times when the school is asked to respond to the voice of the world, and science is commanded to shield humanity with its protecting raiment. But in mediaeval times humanity stood on a volcano. No one could tell when the crater would begin to emit its destructive substance. No voice had come to it from antiquity; it was as if the spirit of God had never breathed on the face of the deep. In Byzantium that voice had been sup- pressed, and when it spoke again it spoke as from a grave. Con- stantine and the princes who came after him, dominated by ecclesiastical influence, killed the aspirations of the wise men of Address. 21 their generation, and directly caused the lamentable ignorance of the middle ages. Listen a moment to Draper: " The Ascle- pions were closed, the schools of philosophy prohibited, the libraries dispersed or destroyed, learning branded as magic or punished as treason, philosophers driven into exile and as a class exterminated, when it became apparent that a void had been created which it was incumbent on the victors — priests — to fill. Among the great prelates, who was there to stand in the place of those men whose achievements had glorified the human race ? Who was to succeed to Archimedes, Hipparchus, Euclid, Herophilus, Erastosthenes ? Who to Plato and Aristotle ? The quackeries of miracle cure, shrine cure, relic cure, were des- tined to eclipse the genius of Hippocrates and nearly two thou- sand years to intervene between Archimedes and Newton, nearly 1,700 between Hipparchus and Kepler." It is a true picture. Our medisBval ancestors had no knowledge of antiquity and its blessings, for all the experiences of that age were bottled up in the cloisters and the churches. When they turned their faces to the East again, the clouds receded from their vision. The germs of social and scientific life that the crusaders brought with them were planted in European soil, where slowly, very slowly, they took root. And still there are four centuries be- tween them and Paracelsus, and two centuries more between Paracelsus and Harvey, since whose time, I presume, the prog- ress of the science has been uninterrupted. We find then, truly, that for almosb two thousand years the glorious science you follow as your mistress has been permitted to remain at a stand- still. Is it not a sad testimony of the enslavement of the human mind for all these years ? For all these reasons I emphasize once more that you may congratulate yourselves of becoming the servants of humanity in the 19th century. To-day science stands revealed in all her beauty, and she fears neither the domination of priest-craft nor the blasting touch of ignorance. To-day, in her triumphant march through the towns and villages where men do congregate, the soft melody of her strains is no longer confounded with the tinkling of a fool's bells, of that very fool who followed in her wake, and whose occupation is gone forever. To-day her votaries are called blessed; the prison no longer stores them, the pyre no longer claims them. To-day wisdom sits in the high places of the earth, and those who pursue her ways are the real agents of a benign divinity. And you, gentle- 22 Address. men, you, who are to-night called to sacred service on behalf of humanity and in the service of science, be sure that you hearken to the voice of your mother. You have learned much; she tells you that her knowledge is inexhaustible. Your actual experi- ence is about to begin. If you now confess yourself content with the moiety of information you have gathered, ifc would have been better had you never commenced. For there is a greater curse in our modern world, to my mind, than a narrow-minded priest, and that is a narrow-minded, unfinished, uninformed physician who has not kept abreast of the times. Your profes- sion and your duty both demand that all the days of your lives you shall remain delvers in the gold mines of science, for knowl- edge is power, and since power is given you, you must have knowledge. Then, from this place shall go forth to-night apos- tles of humanity, whose names shall shine lustrously with the merit that crowns their careers, and on the entablatures of future renown their names shall be registered as worthy scions of a noble race of benefactors to humanity. And then, as I have had the honor of observing already, your duty lies not exclusively in the gathering of experience, in the acquisition of skill, or in the opening of new avenues of truth; it lies, perhaps, in a greater degree in the acquisition of those personal qualities that stamp the physician as a great man. Your mission is to remove the sting of suffering. You will come in con- tact with humanity divested of all the attributes of strength. You will meet men, the strongest of whom will ask to lean upon you as upon a staff of support, women who will look upon you as their deliverers, fathers and mothers who next to their God will call you the Savior of their children. You will enter homesteads dis- turbed by the presence of the dread angel of death; your eye alone will see the glitter of that ominous sword that cuts the thread of life; your power alone, under the dispensation of that omniscient spirit that moves you, may suspend the fatal descent of that sword. You will meet humanity in tears and in pain, you will enter hospitals where side by side suffering men give witness of the large catalogue of human ills; you may be called upon to stand, like Aaron the High Priest of Israel, between the living and the dead, and stay the plague that may be wafted on pestilential wings from distant climes. You may, God give that you may not, stand between lines mowed down by the scythe of death, men shot on the field, their life arrested by shot and Address. 28 . bomb and cannon ball, and you standing to protest against the destructive power of man himself. When these tests come to yoU; what will you do ? Gentlemen, ask your Maker on bended knees to give you the greatest strength, the greatest endurance that can come to you. If you have it not, stand back ! Hu- manity will not be served by weaklings. And then, look to the reward that will come to you. You are bread-winners, it is true, but so are we all. But God help us, if our life were but a strug- gle for bread. Think of the greater reward that will come to you, the strengthening pressure of hands, whose owners you have snatched from death, the grateful look of sufferers whose wounds you have healed, the benisons of loving mothers whose babes you have saved, the approbation of your own conscience that the task was well done ! And then again, you are expected to set an example in still another direction. To inspire confidence you must be better than your neighbor. You must at least try to be. Your truest claim on the confidence of your patients will be established by the loftiness of your own character. The world is not very eager to confide its most sacred interests to men whose character is not above reproach. Therefore, whilst you will be the exponents of science, you must be at the same time the exponents of the highest conception of morality, the demonstrators not alone of the ailments of men, but of the high- est duties of citizenship, the cultivators of all that is truly noble in our time and generation. Thus equipped, your strength will be great, your light will shine as the noon-day sun, and your mother will bless you, for that her sons have proved worthy of the trust she reposed in them. And now, gentlemen, permit me, as an humble layman, to con- gratulate you upon the distinction that has come to you, and to wish you a full measure of success in your undertakings. An ancient maxim sayth the day is short, and the work is much. 'Tis so indeed. What a short span of life is ours — how immense the measure of our work ! And it is sometimes discouraging to think that all human effort, be it ever so great, ends in the grave. We leave nothing but our experiences behind us, to bless those who will come after us. Be it so, gentlemen. Go forth to your duties, to battle with the arch-enemy of man — death — armed with the consciousness, that the greatest glory of a well-spent life is the immortality that has its seat in the grateful memories of man- 24 Address. kind,— that the greatest punishment to idle, unaspiring men is not death, but oblivion, dismissal from the attention and memory of a generation eager to distinguish the brave, the true and the good. But can the wiles of art, the grasp of power, Snatch the rich relics of a well spent hour ? These, when the trembling spirit wings her flight. Pour round her path a stream of living light. And gild those pure and perfect realms of rest. Where virtue triumphs, and her sons are blest ! ^^5^ «OKRO>5^BO 14 D^ ^HlCtt BO u;!^kls due on^lS^^^^Sat^ This book IS ^^^ ^^, ^X(it Tu iw""^j^ ot ,ed books. G-^S^-^ l3oi''"'^rWeV (jtoisio) Gaylord Bros. Makers Syracuse, N. Y, PAT. JAN. 21, 1908 ^514aG UNIVERSITY OF CALIFORNIA LIBRARY ■•'i:???'!^