\/v 1121 . A = Al M = 1— — ^^ — ' = _^_ -L ^■^K m =^= 3D = = 33 2 = 2 = *■ 1 = ^= CD —^ JD n = u — 1 -^ -n U = =^^ 1 — — ( ^^2 -< 2 MEDICAL EDUCATION IN EARLY NEW YORK SAMUEL BARD i>RARy UNlVERSiTY OF CALIFORNIA SAN OJEeo rBMT BIOMEDICAL LIBRARY UNIVERSITY OF CALIFORNIA, SAN llEGQ DATE DUE ■ AUG 3 REq-Q CAYLCRD PRINTED IN U.S. A Medical Education in Early New York SAMUEL BARD, M.D., LL.D. From "A Domestic Narrative of the Life of Samuel Bard, M.D., LL.D., late President of the College of Physicians and Surgeons of the University of the State of New York, &c." By Rev. John M'Vickar, A.M., Professor of Moral Philosophy and Rhetoric, Columbia College, New York. New York: Published at the Lite- rary Rooms, corner of Broadway and Pine-Street. A Paul, Printer. 1822. King's College in the background. Two Discourses Dealing with Medical Education in Early New York By Samuel Bard, M.D. Professor of the Practice of Medicine in King's College Later President of the College of Physicians and Surgeons COLUMBIA UNIVERSITY PRESS 1921 » INTRODUCTION At a time when Columbia University is undertaking a long step forward in the better organization of medical education and research, and when the Society of the New York Hospital is celebrating the one hundred and fiftieth anniversary of its organization, it is appropriate that there should be reprinted for the information of this generation the prophetic "Discourse upon the Duties of a Physician; with some Sentiments upon the Usefulness and the Necessity of a Public Hospital," delivered before the President and Governors of King's College at the commencement held on May i6, 1769, by Dr. Samuel Bard, Professor of the Practice of Medicine in King's College, and also the discourse on medical education delivered at the medical commencement of the College of Physicians and Surgeons on April 6, 18 19 when Dr. Bard was President of that College. The story of Dr. Samuel Bard's life is told in an address by Dr. Henry William Ducachet delivered before the New York Historical Society, August 14, 1821, and reprinted at Philadelphia in October, 1821 from the fourth volume of the American Medical Recorder. Of Huguenot descent. Dr. Bard was born in Philadel- phia on April i, 1742 and in due time became the chief practitioner of medicine in the City and Province of New York. The first of the two discourses now reprinted, was delivered in 1769 "as advice to those gentlemen who then received the first medical degrees" conferred by what is now Columbia University. These two addresses, and particularly the first address, speak for themselves. They establish Dr. Bard's leadership in medical education in America and justify his reputation as prophet and seer. Dr. Bard lived to be seventy-nine years of age and died on May 25, 182 1. Of the early years of King's College and Columbia College Dr. Bard was a chief ornament. He served not only as Professor of the Theory and Practice of Medicine, but later as Professor of Chemistry as well as of Natural Philosophy and Astronomy. From 1787 to 1804 he was a Trustee of the College. Nicholas Murray Butler March i, 1921 I A DISCOURSE UPON THE DUTIES OF A PHYSICIAN Delivered before the President and Gover- nors of King's College at the Commence- ment held on the i6th day of May, 1769. II A DISCOURSE ON MEDICAL EDUCATION Delivered at the Medical Commencement of the College of Physicians and Surgeons on the 6th of April, 1819. A DISCOURSE UPON THE DUTIES OF A PHYSICIAN, With sq m e Sentiments, O N T H E USEFULNESS and NECESSITV O F A PUBLIC HOSPITAL: DELIVERED BEFORE IHE PRESIDENT AMD GOVERNORS F K I N G's C O L L E G £, AT THE COMMEP^CEMENT, Held on the i6th of M a y, i 769. As Advice to thofe Gentlemen who then received the Flrft Medical Decrees conferred by that U N 1 V E R S I T Y. By S A M U E L B A R D, M. D. I'rofcffjr of ihs Pradice of Mediiiine in K 1 n o's C o l l e c e, N E W-r O R K: Pi-ljuetl by A. &; J. R O B E R T S O N, at the Comer &f B K A V E K - S T R F E t, M,DCC,LXIX. To IBs ExCEtlEMCT Sir H E N R Y MOORE, Bart Captain General, and GoveiTior in Chief, in and over the Province of N E w-Y o r K, and the Territories de- pending thereon, in A M E R IC Ay Chancellor, and Vice-i^dmiral of the fiune. Si^, TH E favourable Sentiments you were pleafcd toexprcfs of the fol- lowing Difcourfe, when it was de- livered, and the very generous Warmth with which your Excellency entered into the Propofal it contains, of fcmnd- ing a Public Infirmary in this City, have emboldened th^ Author to fubmit; it to the Cdnfideration of the Public ; and to infurc it a favourable Recep- tion, he h^s ventured to prefix to it your Excellency's f^ame ; not doubt* ing but that the fame Benevolence which prompted you fo generoufly to undertake the Caufe of the Poor and^ Un- it P E D I C A T I O N. Unhappy, will now plead his Exetife, for the Liberty he has taken of pro- pofing your Excellency's humane and benevolent Example, to the Imitation of his Fellow Citizens and Country Men, May your Excellency, and every generous Contributor to this Tnftitu- tion, enjoy the Happinefs of feeing the good Effex^s of your charitable Endeavours j and as the juft Reward of your Humanity, may " th& Blejftng of him that is ready to ferijh come up-^ myouT \^ which Hope, I have the Honor to be. With the greatcfl Refpcd. Your Excellency's Moft obedient Hunable Servant, SAMUEL BARD. THE PREFACE. TH E Scheme of a Public Hofpltal for the Reception of the poor Sick of this Goyernment and City, is a Subjed^, which for a long Time paft, ha« employed the Attention of many charitable and benevolent Inhabitants ; particularly of thofc Gentlemcti engaged in tlie pradlce of Phyfic, and Offices of Religion, whofe Profeffions afford them the njoft frequent Opportuniues of knowing tho great NeceiTity there is fojr fu^Ji m JnAitution, In particular, a Plan has often been propofed, and the moft proper Method for putting it ill Execution coniid^red, tiy a Set of Medical Gentlemen, who have formed them fclvcs into a Society for promoting the Knowledge, and extending the Ufcfulnefs of their ProfcHion : and it has been a Refolutioa entered upon the Minutes of that Society, from its firft laditny lion, that, they (ho aid Addfeii the Lcgiflaturc upon that Subjed, on the firft favourable Op* ttortunity. It it PREFACE, It likcwifc has i^ieatcdly been mentioned hj the different Profcflbrs of Medicine, (particu- larly Do<5tor$ Middlctort, and Jones,) in their public Le<5lures, and earneftly recommended to the Confidcration of the Inhabitanis ; the unhappy Difputes however, in which we have lately been engaged with our Mother Coun- try, liave hitherto rendered their Endeavours fruitleis; but, they neverthclefs (convinced of the great Neceffity there was for fuch an In- ftitution, and the very greatAdvantages which all Orders of People muft derive from it) re-i {blved to perfift in their Endeavours, until fome happy Occafion fhould offer of pushing it with fome Probability of Succefs. Such an Occa* fion now prefcnts itfelf, and the Warmth and Zeal, which his Excellency th« Governor, and moft of his honorable Council, have exprcfied for it, and the Liberality, with which they have fubicribcd towards it, induce them to think the prefent, the fitted Time, for recom- mending it, to the ferious Confideration of the Public. /\nd PREFACE. iii And as an Inftitution of this Nature, muft tiectffarily be calculated for the Benefit of the diftrcffcd of all Se(fts and Perfuafions whatlb- ;ver, it is hoped, that the generous and pub- lic fpirited of every Denomination, will entef warmly into the Dclign, and promote it with that Zeal, which fhould adtuate the Breaft of every Man, who thinks it his Duty to relieve the Neceflities of his Fellow Creatures, or pro- mote the Happinefs of Society A DIS- DISCOURSE U P O N T H E DUTIES OF A PHYSICIAN Homines ad Deos^ nulla re proprtus accedunt^ qtlam Saiutem Hoiihiibus dand'o, C i c s r o. Thert is noth'mg ij >which a Men approaches ntarer to the Pir* ftdions of the Deifjr, that: Iry rejitrifig the SUkj to tie Etf jiytnen* of the Bleffiiigs of Health. THAT this Country Iias, evdr iincc its Difcovery and Settlement, laboured unaer the greatcft Difadvantagci, from the impeffcdt Manner, in which Students have been inftrudted in the Principles of Meditinci nod from the Confequcnt prevailing Ignorance of but too many of its ProfciTors; is a Truth which cannot be cuntcftedj and of which many unh^appy Families have levciely felt the fata! B Th« (^ ) The prelent Occafion therefore mud give the moft real Pleafurc to every confiderate Man, or Lover of his Country ; and furely there is no Friend of Learning, but muft rejoice to fee thefe Gentlemen, who have given the mofl puhlic and ampid TeRimony of their Abilities, now fbliciting the Honors of this Univcrfity, in a Pi-ofcflion hitherto (at leafl in a regular Man* ner) uncultivated amongfl us. lam therefore particularly happy in having this Opportunity of congratulating every public Spirited Friend and Patron of this College, and efpecially thbfe of the medical Inftitution, up- on the prcfent Inftance of its Succefs, which affords fo pleafing a Profpedl of its rifing -Re- putation and future Utility. But it is to you. Gentlemen, who are Can- didates for medical Degrees, that 1 mean in a more particular Manner to addrefs my pre- fcnt Difcourfe j receive then my Thanks for the Honors you have already rcfle<5ted upon us, and as both for your Sakes and our own, I cannot but be anxious for your future Repu- tation > ( 3 ) tfttion ; let me once more, before we part, rcr queil your Attentiop for a few Moments, YfhM I endeavour to explain to you the weighty duties of your Profeffion A Pro- feffion, in the Praai<:e of which, Integrity and Abilities, will place you among the moft ufc- ful ; and Ignorance and Diflionefty, among the moff pernicious Members of Society. And be not alarmed, if I fet out with tell- ing you, that your Labours mufl have no End. No lefs than Life, and its greateft Blefling Health, are to be the Objedj of your At- tention ; and would you acquit yourfelvcs to your. !©wn Conftiences, you muft fpend yoitr Days in ^4iiou8 Enquiries, after the Means of rendering ihofe of others long and happy. Do not therefore imagine, that from thi« Time your Studies are to ceafe ; To far from it» you are to be confidered as but juft entering upon them ; and unlefs your whole Lives, arc one continued Series of Application and Im- provement, you will fall fhort of your Duty. For, if in the Eye of the Law, the Man who docs not afford, to all immediately under his Care Care and Pr >tection, as far as In him lies, the nrcefiHiry Means of preferving Life, is corifi- d;r:;d as acceffary to Murder, hovr will that Phyiician excuf<; himfelf to his own Confci- ence, or what Palliation of his Guilt, will ho plead at the awful Btr of eternal Jufllcc, wh0 inftcad of embracing and induilrioufly culliya- ting every OpportuTiity of Improvement, ihall (confcioas of his own Inability) raflily tamper with the Lives of hi^ Fellow Creatures; and, at the rifk of their Safety, defraud them of their Property? Would not any one confider the Lawyer an Impofter, not to ufe a haifhcr Phrafe, who, confcious of his own Ignorance, ihould give Advice, which might endanger the Eftatc of another? And is noi the Phyficiari whp impafes Ignorance upon cie for Know- ledge, and puts my Life to the hazard of an uncertain die; fo much the greater I rrjpoflor, in as much as my Life, is of greater Eftirlia- tlon than my Eftate. In a ProfefTion thcrt, like that you have embraced, where the Ob* jed is of fo great Importance as the Life of t Man ; you are accountalTe even for the Eriiors of Ignorance, unlefs you have embraced every Opportuuiry of obtaining Knowledge. And (5) ^nd to a Man, who ha« ahy ConCJcntc at .«11» it will be but a flight Alleviation of his Remorff, to fay, after fomc fatal Bi under, / knfw no better\ Unlels he can likewifc add, *Hat it is to be attributed to thfc Frailty of hit Mature, and not to the Negligence of his Difr pofition, that he was not better informed. Nor will a weeping Parent receive much Confola- tion from this Refledion, th^i by the fatal Ig- ijorance of his Phyfician, and not by the rAa- lignancy of the Difeafe, he has been robbed of the Staff and Support of his Life, the Joy and Comfort of his declining Age. PidI know a Wretch among the Praditi- oners of Medicine, whofe infcnfible Soul nei- ther feels for the Didrefl'es he may Occairon, cor partakes in tlie Joys he may give rife to; J fay, did I know a Man f ) void of every Sfen*- f iment of Tepdernefs, and Humanity ; I would advifc him, from Moiives of Intereft and Gain, to endeavour at the Attainment of Skill m his Profeliion. But to you, Gex^lemen, I will point out the Gratificatiun infeparable from the Acquifition of Knowledge, that ever to b« wiihcd (6) wiAed for Prjtife, which falls froqi the Lipp of the Wife and the Virtuous, the Applaufe df an jtpproviAg Confcience» and the uofpeakabb ^mCan of doing good» a& the Reward of 41 your Toil, and a» the (Irongeft Spur to yoijir ibcurc Indudry* As to thofe who have neither Emulation nor Honefty, who iKither have Abilities, nor will give themfelvcs the Trouble of acquiring them ; I would recommend it to fuch, feriouily to. confidcr the Sixth Commandment, *Thou Shalt do no Murder/ In the Profecution of your Studies, let fuch Authors as have tranfmitted to us Obfervations fijundcd upooNature, cjaim your particular At- tention. Ofthefe, Hippocrates fhines the locemofli his unwearied Diligence in qbferviqg And collec^ng the Symptoms of Difeaies, his Fidelity and Accuracy in relating them, his happy FaciHty in difcovering their Caufes, his almofl: prophetic Knowledge of their Events, and his fuccefsful Treatment of them, can ne- Fcr be fufficiently admired, and will hand down hk Name, with Honor and Applaofe to the Utca Poilcrity. A few (7) A few others among the Ancicfiti^ who have followed the Steps of Hippocrates^ aro well worth your Pcrufal; but whilft you •€«• knowledge their Merit, do not affeft the Pc* dantry of defpifing the Moderns^ and carefully avoid that Rock, upon which moft of the fond Admired of Antiquity have fplit, a blind and ila\rifh Attachment to its Opinions; the Bar where Truth has been fo often Shipwrecked* and which more than the want of Ingenuity or Capacity,- flopped the Progrefs of Learning for above twelve hundred Years. Why ihould We give more to thofe TimeSj than they attributed to themfelves ? Read the Writings of the wifeft among the Ancients» «nd they are filled with Modcfty and Dil&- dence, vvhy then (hould we afcribe to «"hcmt Infallibility and Omnifcience ? They doubted the Aflertions, and controverted the Opinions of the Times which preceded them; why (hould not we doubt and controvert theirs ; and leave to Pofterity the Liberty of controverting ours ? Let us then examine their Writings witli Candour, but with Freedom, and embrace or rejed^ (8) ftie<£l tfieir Opinions ; as they (hall be fbond conliftcnt, car inconfiftcnt with later Expc* fiencc* Without tb(:a-efbrc depreciating the Merit of the Ancierit$> let us do Juftipe to thdf Pof- tcfity, and do not from an Over IZeal fpr Anti- quity, facfificc Sydenham and Bocrhaave, to tHe Manes of Hippocrates and Galen. — I fee no Reafoa why Tim« only (hould Ic0en our Abilities, and furely Experience muft increafe ©ur Knowledge : and although I think hmc of the Ancients may be read with great Ad- vantage; yet it is the moft celebrated Moderns |who with equal Abilities enjoy the additional Advantage of near 2000 Years of Experience) whom I would recommend to your moft at- tentive* Pcrufal ; particularly thole great Orna- ments of their ProfefTjop, Sydenham, Eoer- HAAVE, HUXHAM, PRINGLE, and WhYTTj and fotne others of our latcft Englifh and Scotch Phyficians, " Horum Scrtpta no^urnM verfaie manuy verjdie dturna,** In your Intcrcourfc with your Fellow Prac* titioners, let Intw-grity, Candour-, w^d Delicacy be (9 ) be youf Guides. There is a particular Senfi-?. bility of Difpofition, which feems cffential to delicate Honof, and which I bejieve is the ,beil Counterpoife to Sdf-Intereft. This I would by all Means advife you to cultivate, as you will meet with many Occafioiis where it only can difedl your Conduct. Never afFcd: to defpife a Man for the want of a regular Education, and treat even harm- lefs Ignorance, with Delicacy and Compafllon, but when you meet with it joined with fool- hardinefs and Prefumption, you muft give it no quarter. On no Pretence whatever, pradice thoft little Arts of Gunning and Diflimulation, which to the Scandal of the Profeffion, have been but too frequent amongft us. Nor ever attempt to raife your Fame on the Ruins of another's Reputation ; and remember that you ought not only to be cautious of your Words^ a Shrug or a Whifpcr, the ftare of Surprife, or a piteous Exclamation of Sorrow, more effec- tually wound another's Reputation, and more clearly betray the Bafenefs of a Man'« own Heart, than the loudeft Exprelllons. C D(? ( 1° ) Do not pretend to Secrets, Panacea's, and Noftrums, they are illiberal, diflioneft, and in- confiflent with your Chara(fler?, as Gentkmen and Phyiicians, and with your Duty a« Men — For if you are polfeffed of any valuable Re- medy, it is undoubtedly your Duty to divulge it, that as maay as poffible may reap the Be- nefit of iti and if not, (which is generally the Cafe) you are propagating a Falfchood, and jmpofing upon Mankind. In your Behaviour to the Sick, remember always that your Patient is the Obje7 ) be learned only in public HofpitaU, whet-e ha- ving si nuniber of Sick at one Titne^ not only aflx3rds an Opportuhity of the better compaTing: and remarking their Symptoms, but they be* ing under a certain Difciplirte and Rcgulatiorti the Faces of their difeafeS arc not changed, cither by the inditlgence of friends or the offi- cioufndS of Nurfes; which is too often tlae cafe in private praidlice. Another Argument, (and that by no means the leaft,) for an Ihfti>» tution of this Nature, is, that tt affords the beft and only means of properly intruding Pupils in the Practice of Medicine; as far therefore, as the breeding good and able Phylicians, which in all Countries and at all Times had been thought an obje(5t of the higheft Impor- ^cc; deferves the Confideration of the Pub* lie, this inftitution muft likcwifc claim its Pro- tcdtion and Encouragement. Nor is the Scheme of i Public HofJ>ital 1 be- lieve fo impradticablci nor the Execution of it, I hope at fo great adiftanec,a8 at firft fight it may tppearto be. There are Numbcrt in this Place I am furc (vya« a Subfcription once kt on foot^ upon ,( in upon an exMnfive and generous Plan) whcfe Fortunes enable them, and whofe Benevolence would prompt them, liberally to contribute to fb ofeful an Inftitution ; it wants but a Prime Mover, whole Authority would give Weight to the Undertaking, and whole Zeal and In- duftcy, would promote it. Such a one I hope efcrilong Jo fee rife up amongft us, and may the Blefiing df ^c Poor, and the Applaufe of the Gbod and Humane, be the Rev/ard of his Affidtiity and Labour. FINIS. DISCOURSE nftrvxtlXD AT THI li£0I€Al4 COBflfElfCEifEKT tjm €tmaLa&: or physicians anx> sgsgeon^ or THX 0!WTER»»v ov THE STATE OF trfiW-VeaX, eirTBB UXTB OF APSIL, 1M». BT SAMUEL BARD, M.D. LL.D. Prestdsat of «b« CeUeg*, NEW'TOBK t Yriated bf C S. T« Wisld*, ^riolcr to tb« OahFenily, JVk. iOl CtrHomntk iStrttt. 1S19. DISCOURSE ON GsiNTLEMEN, A sound mind, in a sound body, consti* tutes the principal happiness and perfection of man ; the means, therefore, by which such great and essential benefits are to be secured, have ever been the object of his solicitude, and most anx- ious inquiry. Bountiful nature has placed both, to a certain degree, within our reach ; but she has not offered them gratuitously to our accept- wice ; and if we would enjoy, we must consent to purchase them, at the price which she has in- variably set upon these, and all other blessings, she pours 30 profusely around us. That price, (young gentlemen, 1 address myself particularly to you,) that -price is persevering industry ^ and 4 well-directed labour ; without which, ncFthin^ great or excellent was ever attained ; but when properly aided by these, it is not easy to set limits to the powers of man, or to say, what he may not atchieve. Nor is this universal law of our nature more applicable tc the health of the body than it is to the improvement of the mind ; every exer- cise of which " upon the theorems of science, (says the admirable author of Hermes,) tends to call forth and strengthen our native and original vigour. Be the subject immediately productive or not, the nerves of reason are braced by mere employ, and we become better actore in the drama of life, whether our parts be of the sedate oi the active kind." Man, in every state of society^ is obliged to ac- knowledp-e this truth. It is only in the ends he has in view, in the variety of things wirich he deems good and useful, that the untutored savage differs from the civilized man — that the ignorant and the vicious differ from the wise and the good. The means by which the objects of their pmrsuit are acquired, are the same in both. " It is as easy to oecome a scholar, as it is to become a gamester, or any other character equally I w and illiberal : the same application, the same quantity of habits will fit us for the one, as completely as for thf other."* Indeed, we are, in a peculiar de* gree, the creatures of habi*., and it is as easy to es- tablish ^ood and useful, as it is to establish evil and pernicious, habits. Hence the great value and im- portance of education ; that such talents and facul- ties as God and nature have given us, may not only be called forth, but restricted within proper limits, and directed to their proper objects: to private happiness, and to the public good. Otherwise, like seed committed to a fertile soil, but not enli- vened b} a genial sun, they may lie buried and inactive forever ; or if not restrained by due cul- ture, they will shoot out into wild and luxuriant branches, which will never produce good and wholesome truit. For man is an active and a restless being ; nothing becomes so insupportable to him as continued inaction ; if he is not doing good, he wiU probably be engaged in evil ; he will "Harris. do mischief rather than do nothing. Even the savage, to whom rest is the most dignified, as well as the most grateful, enjoyment, continually has recourse to the laborious toils of the chase, or to the fatiguing dangers of war, to relieve him- self from the irksome feelings of protracted quiet ; thus, too, in civilized life, all the envied qualities of great genius and brilliant talents are ever at work on good or evil. When unimproved by stu- dy, and unrestrained by discipline, they too fre^ quently, like a wandering and a blazing meteor, burn and destroy every thing they approach ; but when restricted in their course by proper princi- ples, and directed by wisdom and virtue, they warm, and cherish, and illuminate, like the bless- ed sun. It is, therefore, in the constitution of our frame, and in the nature and structure of our minds, that we discover the reason and truth of the maxim, that the happiness of private life, the peace of society, and the stability of government, especially of all free governments, depends upon the instruction, information, and correct habits, of the people. To give these their proper direction. and to establish them firmly, we must begin with early youth ; we must lay the foundation of all professional excellence, correct morals, and pure religion, as well as of good government, in our common schools. From whence, otherwise, shall offices be fiJled with ability ; where shall we find just magistrates, and able teachers of religion and virtue ; where the protectors of our rights and our property ; where the preservers of our health and our lives ; where, in short, good citizens, if we neglect to instruct our youth, and leave them to grope their devious way without a guide trough the labyrinth of this mazy world ? But general observations on the necessity and advantage of education, cannot be very necessary before this audience ; let us, therefore, turn our at- tention to that branch of learning, to which this College is particularly devoted, and after consider- ing the necessary preparation, endeavour to ex- plain the nature of such institutions and discipline as experience has proved to be useful and requi- site in the education of an accomplished physician and surgeon. 8 It has of late been made a question, sanctioned by some great names, particularly in this country, how far the study of the Greek and Latin languages is necessary, or even useful, in either ot the learn- ed professions, excepting , that of Divinity. But yielding, for the present, the argument for their ab- solute necessity, I believe it may be said with great truth, that there is no study or discipline, in which a boy, who is intended for any liberal profession, not excepting merchandise, which is the most ge- neral — or who may take a part in the government of his country, to which, with us, all may aspire — can, from the age of eight years to that of sixteen or eighteen, be employed, so generally and truly useful, as classical learning. The study of gram- mar, and the application of its rules, as practised in a good school, form, perhaps, the very best ex- ercise that can be invented, to rouse the ambition, to quicken the apprehension, to ripen the judg- ment, and to establish a habit of close and dili- gent application, the first and the greatest lesson of life. And the youth who can read Homer and Virgil, Plato and Cicero, without imbibing some 9 of their noble and generous sentiments, without having his judgment strengthened, his taste refi- ned, and his heart mended, must be strangely defi- cient in all good feeling, or in any improvable faculty of mind. The elements, therefore, of classical learning may justly be considered, and have been proved by lon^ experience, to be the best preparation for any employment above those of the mechanic arts ; and before it is time to be- gin the study of either of the learned professions, or to pntPF a counting house, a young man may easily acquire these, together with a correct knowledge of his own language, and so much mathematical learning as is necessary and useful in the ordinary business of life. As to the modern languages, their great utility in the commerce of the world cannot be denied : but in forming the character, an object of far greater consequence, they certiiinly fall very far below the ancient lan- guages ; nor can any person, who will considei how much the knowledge of one language facili- tates the acquisition of another, and how much more the knowledge of two facilitates that «1 2 10 a third, think, even in this respect, the time lost, which is spent in acquiring the Latin, the root and origin of the Italian, Spanish, and French, languages. But farther ; languages are the repositories of science ; losing a language, therefore, is like the destruction of an immense library, which cannot be replaced If the originals are neglected pur- posely, the copies may be accidentally lost, by the ravages of a barbarous foe, or the lapse of time, and thus by neglecting a language, one means of perpetuating knowledge, so far as that language is concerned, is certainly lost. Besides, though science may be translated, taste and talent cannot. The spirit of original composition is too volatile to be transfused ; to catch it, we must as- cend to the fountain head. Although, therefore, we acknowledge that every- thing really necessary in the theory and practice of medicine, may be learned from the excellent authors who have written originally in English ; and that all the best works of other languages are to be had correctly translated into our own, still, 11 as it is not very becoming for a professional man to be totally ignorant of those languages in which all the ancient records of his art are preserved, and from which all the technical terms of which he is in the daily use are derived ; it is hoped that classical learning will again assume its place, if not as absolutely necessary, at least as very use- ful, and highly ornameptal, in the character of a physician. The great error in our system of education is, that we are too much in a hurry, and that our young men are ushered into the world, and com- mence the practice of their professions, at a period so early, and after a preparation so slight, that very few have acquired the prudence or the know- ledge requisite to govern their conduct in either ; and hence arise the errors and failure of too many, and our general, and I am afraid I may say, too just, reputation for superficial attainments. Could we keep our youth at school until sixteen, at college untiitwenty, and in a counting house, or at the study of the professions, until twenty-four or twenty-five years of age, they would be more 12 generally successful in life ; we should have fewer failures in trade, and more respectability and emi- nence in our professional men. Am I asked how it happens that in our own profession the general practice is so widely different ? I can only answer, it is a state which we rather submit to than ap- prove ; that for the present we must palliate a dis- ease we cannot immediately cure ; that such is the condition of medicine throughout this widely extended, and thinly inhabited country, that very few of its practitioners can be compensated for an expensive education ; and that the interest of the people, as well as the utility of the profession, are better promoted by sending abroad a considerable number of young men, decently, but competently initiated in the principles of their art, than only a few of higher qualifications. But this state of things is rapidly changing — perhaps has hitherto been unavoidable ; and a just apology for it may be found in the infancy of our country, and its re- cent emancipation from a state of thraldom and dependence. I rejoice, therefore, to see, and congratulate my 13 fellow-citizens on, the change. Many able advo- cates for the good, old discipline have lately risen up among us, aad a great and manifest improve- ment, in this respect, has already been made, and is rapidly progressing, in our schools and colleges. A classical education is a fine preparation for acting in society with complacence, propriety, and dignity ; for sound learning, and correct taste, are nearly connected with pure morals : independent of all principle, they undoubtedly give a delicacy and sensibility to the mind, very favourable to virtue ; and whilst they are, in themselves, a pro- minent source of happiness to the individual, and place him above the necessity of seeking it from sources less pure, they, at the same time, become the means of diffusing happiness around him. " A wise and able magistrate, a learned professor of the law, a humane and benevolent physician, no less than an enlightened teacher of religion, contri- bute to the happiness of posterity, as well as that of the age in which they live : by their know- ledge, they mitigate the evils of their cotempora- ries ; by their example, they mend the characters 14 of those with whom they associate ; and, by their precepts, they sow the seeds of excellence which may bless and exa^t their country to future gene- rations." Medicine is a comprehensive and an intri- cate science, founded on numberless facts which have been discovered through the successive pe- riods of distant ages, and which have been col- lected and preserved in the writings of almost innumerable authors, of different nations and tongues. It has necessarily been coloured and disfigured by the credulity of some ; rejected, lost, and again revived, by the cautious discrimination of others; elucidated by new discoveries, and confirmed by later experience. Among ignorant and barbarous nations, this science has ever been connected with religion, involved in mystefy, and disfigured by superstition. As men advanced from barbarism, it assumed a more rational form, and, resting on the solid basis of experience, under the polished Greeks, directed by the genius of Hippo- crates, acquired beauty, symmetry, and strength : until, as the refinements of a speculative philoso- 15 phy began to prevail, theoretic opinions were sub- stituted for fact and experiment ; the subtlety of the schools, and the wanderings of the imagina- tion, for sound reasoning and chaste deduction. By these errors, the progress of medical science, though not absolutely arrested, was greatly check- ed ; until, through the important discovery of the circulation of the blood, by Harvey, and the in- troduction of a strict philosophy, by Bacon, in which opinion was made to give place to obser- vation, and a patient investigation of facts was substituted for the quibbles of sophistry, the science pf medicine became again placed on its proper basis— nature, observation, and experience. From this moment, anatomy, chemistry, natural history, and natural philosophy, which, although they had long been in the train of medicine, had rather followed, than directed her researrhes, were impressed into her service, and made to take the lead in a medical education ; nor until he has made considerable progress in these, can the student of medicine be properly qualified even to begin what is the great object of his pursuit, the study of diseases, and their cure. 16 In a profession so various, so intricate, and so expensive, it is easy to see that the scholar can make but little progress by private study. Lost and bewildered in the multiplicity of objects, and in the contrariety of conflicting opinions, he abso- lutely requires the hand -of a master to lead him into the plainest and most direct path ; to remove^ as he goes along, the obstacles which may obstruct his progress; and to point out such as are most worthy his observation. Nor are there many in- dividuals who are qualified to teach all the preli- minary branches; each of them is sufficiently ex- tensive to empjoy the time, and occupy the atten- tion, of a man ot no common attainments. Besides, chemistry requires a laboratory ; bo- tany a garden ; and anatomy a theatre and sub- jects ; and, above all, the nature of diseases, and the practice of medicine, cannot be taught bqt in a public hospital. Much, therefore, as oral in- struction, and tne voice of a professor, are to be preferred to the silent investigations of the closet, still more is required : the co-operation of several teachers, and the facilities of a public institution 17 and thus-, too, in a large city, where only, in this country at least, anatomy and the practice of medicine can be properly taught. In both these branches, the student must not only receive the instructions of his teacher — he must not only reflect on and digest what he hears and reads, but he must see, and handle, and examine, for himself. In auciiomy, the subject, properly prepared, must be placed before him; without this, the most accurate description, even when aided by the finest plates and drawings, will be found wholly inadequate to convey correct ideas, or to make durable impressions on his mind. The parts must be unfolded by the knife ; they must be distended by injections; and whatever is uninteresting, and obscures their intimate structure, must be remo- ved ; or the student will look with a vacant eye, upon what, to him at least, will appear an un- formed mass : and if possible, after having been taught what he is to look for, and what is most worthy his observation, he should handle the knife and the syringe for himself — he should learn 3 how to prepare the subject for the instruction of others. In chemistry, the science of nature^ hy which we are admitted into her confidence, are taught her secrets, and learn her processes, but slow pro- gress can be made without a teacher, aided^ too, by a large and expensive apparatus ; for although by the introduction of a more correct language, and a more liberal philosophy, all the jargon and mystery in which the old chemists clothed their communications, and concealed their art, have been done away ; still, the multiplicity of facts, the delicacy of processes, and the variety of ap- paratus, are such, that practice only can give that dexterity which is necessary to ensure success; and to acquire this dexterity unassisted, would require more time, and be accompanied by greater expense, than most students of medicme could well afford. In botany and natural histor}^, the number oi objects to be exammed, and with which it is ne- cessary to become acquainted, is so great, that without a garden and a museum, without ar- 19 rangement and system, no correct or valuable knowledge can be acquired. And, laatly, in the study of diseases, and in the practice of medicine, no histories, however accu- rat** — no reasoning, however just — can convey the knowledge necessary for their treatment and cure. The student must see, and hear, and feel for him- self. The hue of the complexion the feel of the skin, the lustre or languor of the eye, the throODinff ot the pulse and the palpitations of the heart, the quickness and ease of '•esniration, and the tone ana tremor of the voice, the confi- dence of hope, and the despondence of fear, as they are expressed in the countenance, baffle all description : and yet all and each of these con- vey important and necessary information. Where can these be learned but at the bedsides if the sick? and where shall a young man, who cannot be admitted into the privacies of families, or the chambers of women, acquire this necessarv in- formation, but in a public hospital, which is not only intended as an asylum to relieve the compli cated misery of poverty and sickness, but as a 20 school of medicine, to contribute to the public welfare ; and, as such, deserves and receives the patronage of government, even more than as a mere charitable institution. But beside these considerations, and the im- possibility of teaching medicine in private, there are many advantages which attend public institu- tions in this, as well as most other sciences : one is, that from the division of the subject, a more enlarged, comprehensive, and systematic view of the whole will be taken ; its connection with, and dependence on, other branches of learning, will be more clearly pointed out; and general laws and fundamental principles will be better taught. The student learns what are the proper ob- jects of his inquiry at eat.h stage, and, as he goes along, is taught how to make a proper use of his previous acquirements and experience. Besides, young men engaged in the same studies, mutually assist each other; emulation, which warms and engages the passions on the side of whatever is excellent, cannot be excited without rivals ; without emulation in the scholar, 21 irtstrtiction will proceed bui with a languid pace, and excellence is never attained. Nor is emu- lation confined to the scholar. The emoluments of the teacher depend on his fame, and both on feis talents and industry. Stimulated, therefore, by his inter-est, and spurred on by his ambition, he will make every exertion to recommend his lectures which he knows are to be brought to the ordeal of a nice and critical examination. Among his hearers, there will always be a num- ber of the elder students, very able to judge of his merits, and very wilhng to discover his errors. Such a system of education cannot long be con- ducted in a slovenly or incompetent manner ; neg- ligence will sit very uneasily m=ki and incompe- tence cannot long keep her seat in a professor's chair. Nor is it by exciting their emulation only, that young men, assembled in a public school, are of use to each other; they mutuallv instruct one another, by their daily conversation, and in so- cieftes formed for the purpose of discussing pro- fessional opinions, on which they often exercise a 22 degree of attention and acuteness which serves as no inadequate test of their truth and useful- ness ; and this farther serves to explain them to their understandings, and fix them in their me- mories, with more clearness and precision than hearing them many times repeated from their professors. Indolence is the greatest enemy to learning; but indolence is a vice bred and nourished in so- litude, and can hardly exist at a public school, but in minds of so heavy a mould as to be inca- palle of culture. But dissipation is the error into which a young man of lively disposition and quick parts, especially on first coming from the retirement of the country into a large and luxu- riant city, is most apt to fall ; and unless he pos- sess some strength of mind, the variety of new scenes, the novelty of surrounding objects, and the allurements of pleasure, too frequently seize upon his imagination, occupy his thoughts, waste his time and his resources, blast his own prospects, and disappoint the hopes and expecta- tions of his friends. Against this I have nothing 23 to urge but the coinihon, though strong and ir- tesistible, argument of duty and necessity; nor any remedy to propose, but liiat of wholesome employment It is at the conimencement of you? career that you will be in tbe greatest danger ; if you postpone your indulgence for a short titne, even for a few weeks, until you are fairly enga- ged in your studies, full occupation will at least lessen the temptation; and when onee you see how absolutely incompatible dissipation and plea- sure are with duty and improvement, you will pobably find yourselves able to resist their attrac- tions, or, I should rather hope, they will have no attractions for you. On the other hand, to ocmtinue in retirement, and there to labour without plan or design, may isdeed accumulate a confused mass of materials ; but beauty, order, ano proportion, are the result of skill: he that would build a palace, must employ an architect. So the student of medicine, who trusts to his own unassisted researches, or who is directed by an inadequate guide, may load hij) memory and conioujid his judgment, by a 24 great number of facts, and a medley of opinions, which will only lead him into error, and end at last in darkness and confusion. But he who is properly initiated into the rudiments of his art, pursues his improvement in the light of day; every step he takes, brings him nearer to his purposed end ; every fact and opinion he learns, takes its proper place; and knowledge-— clear, precise, and accurate knowledge, is the happy result. In no profession are sound learning, clear and definite opinions, and correct conduct, of more consequence, than in that of medicine; in the exercise of which, our dearest interests, our health and lives, and the health and lives of our parents, wives, children, and friends, are deeply and essentially concerned. For let it be remembered, that there is no middle course in medicine : it is a mistake, to suppose me con- duct of a physician is ever of that neutral and inconsequential nature, that although it do no good, it will do but little harm. If, through ig- norance, a physician does not do good, he will probably do much inj^vy ; for our opportunities of acting are so fleeting, that they must be seized at the moment ; and to lose time is, ^equeutly, to do all we can to render the case under our care desperate or fatal. Nor, on the contrary, is there any profession, in which that cautious diffidence, which is the result of deep know- ledge, is of greater consequence, than in that of the physician. In our profession, to |Lnow when to act with vigour, when to palliate symptoms, or to look oa with patience, and froni what cir- cumstances to draw our indications, is the result onlv of a thorough knowledge of our subject ; nor in anv nrofftssion is that meddling presump- tion, which is ever the companion, and most fre- quently the veil, of ignorance, more dangerous. Nor ^re the happy consequences of a good education, in medicine, confined to the chambers of the sick ; a physician must always, in some measure, become the companion, and frequently the intimate friend, of his patient ; he must often share Ms confidence, and, on some occasions, become the depositary of his secrets. His prin- f6 ciples, therefottf his knowledge, and bis exam- ple, bfecome extensively useful or prejuclicisA. Is he learned, and wise, and gpod ? — his learning will ittstnict, his skill and his humanit]^ wBl bless, and his advice and example may amend many among those with whom he daily con- verses. Is he ignorant, and loose, and debauched ? —what mischief may he not do to the younger members of those families who place their con- fidence in him^ and who generdly look up to him as a character of superior talent, learning, and worth. Again ; the medical character ib not only very influential— it is also the most nume^ rous, among the learned professions : the exam- ple, therefore, of a physician's knowledge and virtues, or the contstminatton of his ignorance 8i»d his vicee, will assume a wider and mote ex- tended range. Is it pe«sible^, then, thac greafCer ioducements can b« <»^rtd to a young mati, tid {Simulate Jiis most strenuous exertions, and A) call forth all the force of his understandia'g, atld every genewms feeling of his heart, than are to be fauild in the S7 namret the extent* and the influence of oui pro- £Bssi«H3. Occupied on the most important sub- jects, Ae ease, the comfort, the happiness, and the lives, of our fellow creatures, it imperiously calls for knowledge and abil*tP>'. Extensive, be- yond the liulits of any other science, io the va- riety of its objects, the coatinually changing nature of its subjects, aod the endtesa pregre^ve march of its i0ipFOf)eQiems» it is itoposaible either to acquire what if now kiiAwo, or to keep pa<;» with its daily acoessioas of knowJNge, but by a aeal and iadustcy as stwdy and per/Severiug as time itself! Extended onre* the face of the whole earth, and at thci same tim