In the mean time, while medical theories are coming in and going out,

there is a set of sensible men who are never run away with by them, but

practise their art sagaciously and faithfully in much the same way from

generation to generation. From the time of Hippocrates to that of our

own medical patriarch, there has been an apostolic succession of wise and

good practitioners. If you will look at the first aphorism of the

ancient Master you will see that before all remedies he places the proper

conduct of the patient and his attendants, and the fit ordering of all

the conditions surrounding him. The class of practitioners I have

referred to have always been the most faithful in attending to these

points. No doubt they have sometimes prescribed unwisely, in compliance

with the prejudices of their time, but they have grown wiser as they have

grown older, and learned to trust more in nature and less in their plans

of interference. I believe common opinion confirms Sir James Clark's

observation to this effect.

The experience of the profession must, I think, run parallel with that of

the wisest of its individual members. Each time a plan of treatment or a

particular remedy comes up for trial, it is submitted to a sharper

scrutiny. When Cullen wrote his Materia Medica, he had seriously to

assail the practice of giving burnt toad, which was still countenanced by

at least one medical authority of note. I have read recently in some

medical journal, that an American practitioner, whose name is known to

the country, is prescribing the hoof of a horse for epilepsy. It was

doubtless suggested by that old fancy of wearing a portion of elk's hoof

hung round the neck or in a ring, for this disease. But it is hard to

persuade reasonable people to swallow the abominations of a former

period. The evidence which satisfied Fernelius will not serve one of our

hospital physicians.

In this way those articles of the Materia Medica which had nothing but

loathsomeness to recommend them have been gradually dropped, and are not

like to obtain any general favor again with civilized communities. The

next culprits to be tried are the poisons. I have never been in the

least sceptical as to the utility of some of them, when properly

employed. Though I believe that at present, taking the world at large,

and leaving out a few powerful agents of such immense value that they

rank next to food in importance, the poisons prescribed for disease do

more hurt than good, I have no doubt, and never professed to have any,

that they do much good in prudent and instructed hands. But I am very

willing to confess a great jealousy of many agents, and I could almost

wish to see the Materia Medica so classed as to call suspicion upon

certain ones among them.

Thus the alien elements, those which do not properly enter into the

composition of any living tissue, are the most to be suspected,

--mercury, lead, antimony, silver, and the rest, for the reasons I have

before mentioned. Even iodine, which, as it is found in certain plants,

seems less remote from the animal tissues, gives unequivocal proofs from

time to time that it is hostile to some portions of the glandular system.

There is, of course, less prima facie objection to those agents which

consist of assimilable elements, such as are found making a part of

healthy tissues. These are divisible into three classes,--foods,

poisons, and inert, mostly because insoluble, substances. The food of

one animal or of one human being is sometimes poison to another, and vice

versa; inert substances may act mechanically, so as to produce the effect

of poisons; but this division holds exactly enough for our purpose.

Strictly speaking, every poison consisting of assimilable elements may be

considered as unwholesome food. It is rejected by the stomach, or it

produces diarrhoea, or it causes vertigo or disturbance of the heart's

action, or some other symptom for which the subject of it would consult

the physician, if it came on from any other cause than taking it under

the name of medicine. Yet portions of this unwholesome food which we

call medicine, we have reason to believe, are assimilated; thus,

castor-oil appears to be partially digested by infants, so that they

require large doses to affect them medicinally. Even that deadliest of

poisons, hydrocyanic acid, is probably assimilated, and helps to make

living tissue, if it do not kill the patient, for the assimilable

elements which it contains, given in the separate forms of amygdalin and

emulsin, produce no disturbance, unless, as in Bernard's experiments,

they are suffered to meet in the digestive organs. A medicine consisting

of assimilable substances being then simply unwholesome food, we

understand what is meant by those cumulative effects of such remedies

often observed, as in the case of digitalis and strychnia. They are

precisely similar to the cumulative effects of a salt diet in producing

scurvy, or of spurred rye in producing dry gangrene. As the effects of

such substances are a violence to the organs, we should exercise the same

caution with regard to their use that we would exercise about any other

kind of poisonous food,--partridges at certain seasons, for instance.

Even where these poisonous kinds of food seem to be useful, we should

still regard them with great jealousy. Digitalis lowers the pulse in

febrile conditions. Veratrum viride does the same thing. How do we know

that a rapid pulse is not a normal adjustment of nature to the condition

it accompanies? Digitalis has gone out of favor; how sure are we that

Veratrum viride will not be found to do more harm than good in a case of

internal inflammation, taking the whole course of the disease into

consideration? Think of the change of opinion with regard to the use of

opium in delirium tremens (which you remember is sometimes called

delirium vigilans), where it seemed so obviously indicated, since the

publication of Dr. Ware's admirable essay. I respect the evidence of my

contemporaries, but I cannot forget the sayings of the Father of

medicine,--Ars longa, judicium diffcile.

I am not presuming to express an opinion concerning Veratrum viride,

which was little heard of when I was still practising medicine. I am

only appealing to that higher court of experience which sits in judgment

on all decisions of the lower medical tribunals, and which requires more

than one generation for its final verdict.

Once change the habit of mind so long prevalent among practitioners of

medicine; once let it be everywhere understood that the presumption is in

favor of food, and not of alien substances, of innocuous, and not of

unwholesome food, for the sick; that this presumption requires very

strong evidence in each particular case to overcome it; but that, when

such evidence is afforded, the alien substance or the unwholesome food

should be given boldly, in sufficient quantities, in the same spirit as

that with which the surgeon lifts his knife against a patient,--that is,

with the same reluctance and the same determination,--and I think we

shall have and hear much less of charlatanism in and out of the

profession. The disgrace of medicine has been that colossal system of

self-deception, in obedience to which mines have been emptied of their

cankering minerals, the vegetable kingdom robbed of all its noxious

growths, the entrails of animals taxed for their impurities, the

poison-bags of reptiles drained of their venom, and all the inconceivable

abominations thus obtained thrust down the throats of human beings

suffering from some fault of organization, nourishment, or vital

stimulation.

Much as we have gained, we have not yet thoroughly shaken off the notion

that poison is the natural food of disease, as wholesome aliment is the

support of health. Cowper's lines, in "The Task," show the

matter-of-course practice of his time:

"He does not scorn it, who has long endured

A fever's agonies, and fed on drugs."

Dr. Kimball of Lowell, who has been in the habit of seeing a great deal

more of typhoid fever than most practitioners, and whose surgical

exploits show him not to be wanting in boldness or enterprise, can tell

you whether he finds it necessary to feed his patients on drugs or not.

His experience is, I believe, that of the most enlightened and advanced

portion of the profession; yet I think that even in typhoid fever, and

certainly in many other complaints, the effects of ancient habits and

prejudices may still be seen in the practice of some educated physicians.

To you, young men, it belongs to judge all that has gone before you. You

come nearer to the great fathers of modern medicine than some of you

imagine. Three of my own instructors attended Dr. Rush's Lectures. The

illustrious Haller mentions Rush's inaugural thesis in his "Bibliotheca

Anatomica;" and this same Haller, brought so close to us, tells us he

remembers Ruysch, then an old man, and used to carry letters between him

and Boerhaave. Look through the history of medicine from Boerhaave to

this present day. You will see at once that medical doctrine and

practice have undergone a long series of changes. You will see that the

doctrine and practice of our own time must probably change in their turn,

and that, if we can trust at all to the indications of their course, it

will be in the direction of an improved hygiene and a simplified

treatment. Especially will the old habit of violating the instincts of

the sick give place to a judicious study of these same instincts. It

will be found that bodily, like mental insanity, is best managed, for the

most part, by natural soothing agencies. Two centuries ago there was a

prescription for scurvy containing "stercoris taurini et anserini par,

quantitas trium magnarum nucum," of the hell-broth containing which

"guoties-cumque sitit oeger, large bibit." When I have recalled the

humane common-sense of Captain Cook in the matter of preventing this

disease; when I have heard my friend, Mr. Dana, describing the avidity

with which the scurvy-stricken sailors snuffed up the earthy fragrance of

fresh raw potatoes, the food which was to supply the elements wanting to

their spongy tissues, I have recognized that the perfection of art is

often a return to nature, and seen in this single instance the germ of

innumerable beneficent future medical reforms.

I cannot help believing that medical curative treatment will by and by

resolve itself in great measure into modifications of the food, swallowed

and breathed, and of the natural stimuli, and that less will be expected

from specifics and noxious disturbing agents, either alien or

assimilable. The noted mineral-waters containing iron, sulphur, carbonic

acid, supply nutritious or stimulating materials to the body as much as

phosphate of lime and ammoniacal compounds do to the cereal plants. The

effects of a milk and vegetable diet, of gluten bread in diabetes, of

cod-liver oil in phthisis, even of such audacious innovations as the

water-cure and the grape-cure, are only hints of what will be

accomplished when we have learned to discover what organic elements are

deficient or in excess in a case of chronic disease, and the best way of

correcting the abnormal condition, just as an agriculturist ascertains

the wants of his crops and modifies the composition of his soil. In

acute febrile diseases we have long ago discovered that far above all

drug-medication is the use of mild liquid diet in the period of

excitement, and of stimulant and nutritious food in that of exhaustion.

Hippocrates himself was as particular about his barley-ptisan as any

Florence Nightingale of our time could be.

The generation to which you, who are just entering the profession,

belong, will make a vast stride forward, as I believe, in the direction

of treatment by natural rather than violent agencies. What is it that

makes the reputation of Sydenham, as the chief of English physicians?

His prescriptions consisted principally of simples. An aperient or an

opiate, a "cardiac" or a tonic, may be commonly found in the midst of a

somewhat fantastic miscellany of garden herbs. It was not by his

pharmaceutic prescriptions that he gained his great name. It was by

daring to order fresh air for small-pox patients, and riding on horseback

for consumptives, in place of the smothering system, and the noxious and

often loathsome rubbish of the established schools. Of course Sydenham

was much abused by his contemporaries, as he frequently takes occasion to

remind his reader. "I must needs conclude," he says, "either that I am

void of merit, or that the candid and ingenuous part of mankind, who are

formed with so excellent a temper of mind as to be no strangers to

gratitude, make a very small part of the whole." If in the fearless

pursuit of truth you should find the world as ungracious in the

nineteenth century as he found it in the seventeenth, you may learn a

lesson of self-reliance from another utterance of the same illustrious

physician: "'T is none of my business to inquire what other persons

think, but to establish my own observations; in order to which, I ask no

favor of the reader but to peruse my writings with temper."

The physician has learned a great deal from the surgeon, who is naturally

in advance of him, because he has a better opportunity of seeing the

effects of his remedies. Let me shorten one of Ambroise Pare's stories

for you. There had been a great victory at the pass of Susa, and they

were riding into the city. The wounded cried out as the horses trampled

them under their hoofs, which caused good Ambroise great pity, and made

him wish himself back in Paris. Going into a stable he saw four dead

soldiers, and three desperately wounded, placed with their backs against

the wall. An old campaigner came up.--"Can these fellows get well?" he

said. "No!" answered the surgeon. Thereupon, the old soldier walked up

to them and cut all their throats, sweetly, and without wrath (doulcement

et sans cholere). Ambroise told him he was a bad man to do such a thing.

"I hope to God;" he said, "somebody will do as much for me if I ever get

into such a scrape" (accoustre de telle facon). "I was not much salted

in those days" (bien doux de sel), says Ambroise, "and little acquainted

with the treatment of wounds." However, as he tells us, he proceeded to

apply boiling oil of Sambuc (elder) after the approved fashion of the

time,--with what torture to the patient may be guessed. At last his

precious oil gave out, and he used instead an insignificant mixture of

his own contrivance. He could not sleep that night for fear his patients

who had not been scalded with the boiling oil would be poisoned by the

gunpowder conveyed into their wounds by the balls. To his surprise, he

found them much better than the others the next morning, and resolved

never again to burn his patients with hot oil for gun-shot wounds.

This was the beginning, as nearly as we can fix it, of that reform which

has introduced plain water-dressings in the place of the farrago of

external applications which had been a source of profit to apothecaries

and disgrace to art from, and before, the time when Pliny complained of

them. A young surgeon who was at Sudley Church, laboring among the

wounded of Bull Run, tells me they had nothing but water for dressing,

and he (being also doux de sel) was astonished to see how well the wounds

did under that simple treatment.

Let me here mention a fact or two which may be of use to some of you who

mean to enter the public service. You will, as it seems, have gun-shot

wounds almost exclusively to deal with. Three different surgeons, the

one just mentioned and two who saw the wounded of Big Bethel, assured me

that they found no sabre-cuts or bayonet wounds. It is the rifle-bullet

from a safe distance which pierces the breasts of our soldiers, and not

the gallant charge of broad platoons and sweeping squadrons, such as we

have been in the habit of considering the chosen mode of warfare of

ancient and modern chivalry. [Sir Charles James Napier had the same

experience in Virginia in 1813. "Potomac. We have nasty sort of fighting

here, amongst creeks and bushes, and lose men without show." "Yankee

never shows himself, he keeps in the thickest wood, fires and runs

off."--"These five thousand in the open field might be attacked, but

behind works it would be throwing away lives." He calls it "an

inglorious warfare,"--says one of the leaders is "a little deficient in

gumption,"--but--still my opinion is, that if we tuck up our sleeves and

lay our ears back we might thrash them; that is, if we caught them out of

their trees, so as to slap at them with the bayonet."--Life, etc. vol.

i. p. 218 et seq.]

Another fact parallels the story of the old campaigner, and may teach

some of you caution in selecting your assistants. A chaplain told it to

two of our officers personally known to myself. He overheard the

examination of a man who wished to drive one of the "avalanche" wagons,

as they call them. The man was asked if he knew how to deal with wounded

men. "Oh yes," he answered; "if they're hit here," pointing to the

abdomen, "knock 'em on the head,--they can't get well."

In art and outside of it you will meet the same barbarisms that Ambroise

Pare met with,--for men differ less from century to century than we are

apt to suppose; you will encounter the same opposition, if you attack any

prevailing opinion, that Sydenham complained of. So far as possible, let

not such experiences breed in you a contempt for those who are the

subjects of folly or prejudice, or foster any love of dispute for its own

sake. Should you become authors, express your opinions freely; defend

them rarely. It is not often that an opinion is worth expressing, which

cannot take care of itself. Opposition is the best mordant to fix the

color of your thought in the general belief.

It is time to bring these crowded remarks to a close. The day has been

when at the beginning of a course of Lectures I should have thought it

fitting to exhort you to diligence and entire devotion to your tasks as

students. It is not so now. The young man who has not heard the

clarion-voices of honor and of duty now sounding throughout the land,

will heed no word of mine. In the camp or the city, in the field or the

hospital, under sheltering roof, or half-protecting canvas, or open sky,

shedding our own blood or stanching that of our wounded defenders,

students or teachers, whatever our calling and our ability, we belong,

not to ourselves, but to our imperilled country, whose danger is our

calamity, whose ruin would be our enslavement, whose rescue shall be our

earthly salvation!

SCHOLASTIC AND BEDSIDE TEACHING.

An Introductory Lecture delivered before the Medical Class of Harvard

University, November 6, 1867.

The idea is entertained by some of our most sincere professional

brethren, that to lengthen and multiply our Winter Lectures will be of

necessity to advance the cause of medical education. It is a fair

subject for consideration whether they do not overrate the relative

importance of that particular mode of instruction which forms the larger

part of these courses.

As this School could only lengthen its lecture term at the expense of its

"Summer Session," in which more direct, personal, and familiar teaching

takes the place of our academic discourses, and in which more time can be

given to hospitals, infirmaries, and practical instruction in various

important specialties, whatever might be gained, a good deal would

certainly be lost in our case by the exchange.

The most essential part of a student's instruction is obtained, as I

believe, not in the lecture-room, but at the bedside. Nothing seen there

is lost; the rhythms of disease are learned by frequent repetition; its

unforeseen occurrences stamp themselves indelibly in the memory. Before

the student is aware of what he has acquired, he has learned the aspects

and course and probable issue of the diseases he has seen with his

teacher, and the proper mode of dealing with them, so far as his master

knows it. On the other hand, our ex cathedra prelections have a strong

tendency to run into details which, however interesting they may be to

ourselves and a few of our more curious listeners, have nothing in them

which will ever be of use to the student as a practitioner. It is a

perfectly fair question whether I and some other American Professors do

not teach quite enough that is useless already. Is it not well to remind

the student from time to time that a physician's business is to avert

disease, to heal the sick, to prolong life, and to diminish suffering?

Is it not true that the young man of average ability will find it as much

as he can do to fit himself for these simple duties? Is it not best to

begin, at any rate, by making sure of such knowledge as he will require

in his daily walk, by no means discouraging him from any study for which

his genius fits him when he once feels that he has become master of his

chosen art.

I know that many branches of science are of the greatest value as feeders

of our medical reservoirs. But the practising physician's office is to

draw the healing waters, and while he gives his time to this labor he can

hardly be expected to explore all the sources that spread themselves over

the wide domain of science. The traveller who would not drink of the

Nile until he had tracked it to its parent lakes, would be like to die of

thirst; and the medical practitioner who would not use the results of

many laborers in other departments without sharing their special toils,

would find life far too short and art immeasurably too long.

We owe much to Chemistry, one of the most captivating as well as

important of studies; but the medical man must as a general rule content

himself with a clear view of its principles and a limited acquaintance

with its facts; such especially as are pertinent to his pursuits. I am

in little danger of underrating Anatomy or Physiology; but as each of

these branches splits up into specialties, any one of which may take up a

scientific life-time, I would have them taught with a certain judgment

and reserve, so that they shall not crowd the more immediately practical

branches. So of all the other ancillary and auxiliary kinds of

knowledge, I would have them strictly subordinated to that particular

kind of knowledge for which the community looks to its medical advisers.

A medical school is not a scientific school, except just so far as

medicine itself is a science. On the natural history side, medicine is a

science; on the curative side, chiefly an art. This is implied in

Hufeland's aphorism: "The physician must generalize the disease and

individualize the patient."

The coordinated and classified results of empirical observation, in

distinction from scientific experiment, have furnished almost all we know

about food, the medicine of health, and medicine, the food of sickness.

We eat the root of the Solanum tuberosum and throw away its fruit; we eat

the fruit of the Solanum Lycopersicum and throw away its root. Nothing

but vulgar experience has taught us to reject the potato ball and cook

the tomato. So of most of our remedies. The subchloride of mercury,

calomel, is the great British specific; the protochloride of mercury,

corrosive sublimate, kills like arsenic, but no chemist could have told

us it would be so.

From observations like these we can obtain certain principles from which

we can argue deductively to facts of a like nature, but the process is

limited, and we are suspicious of all reasoning in that direction applied

to the processes of healthy and diseased life. We are continually

appealing to special facts. We are willing to give Liebig's artificial

milk when we cannot do better, but we watch the child anxiously whose

wet-nurse is a chemist's pipkin. A pair of substantial mammary glands

has the advantage over the two hemispheres of the most learned

Professor's brain, in the art of compounding a nutritious fluid for

infants.

The bedside is always the true centre of medical teaching. Certain

branches must be taught in the lecture-room, and will necessarily involve

a good deal that is not directly useful to the future practitioner. But

the over ambitious and active student must not be led away by the

seduction of knowledge for its own sake from his principal pursuit. The

humble beginner, who is alarmed at the vast fields of knowledge opened to

him, may be encouraged by the assurance that with a very slender

provision of science, in distinction from practical skill, he may be a

useful and acceptable member of the profession to which the health of the

community is intrusted.

To those who are not to engage in practice, the various pursuits of

science hardly require to be commended. Only they must not be

disappointed if they find many subjects treated in our courses as a

medical class requires, rather than as a scientific class would expect,

that is, with special limitations and constant reference to practical

ends. Fortunately they are within easy reach of the highest scientific

instruction. The business of a school like this is to make useful

working physicians, and to succeed in this it is almost as important not

to overcrowd the mind of the pupil with merely curious knowledge as it is

to store it with useful information.

In this direction I have written my lecture, not to undervalue any form

of scientific labor in its place, an unworthy thought from which I hope I

need not defend myself,--but to discourage any undue inflation of the

scholastic programme, which even now asks more of the student than the

teacher is able to obtain from the great majority of those who present

themselves for examination. I wish to take a hint in education from the

Secretary of the Massachusetts Board of Agriculture, who regards the

cultivation of too much land as a great defect in our New England

farming. I hope that our Medical Institutions may never lay themselves

open to the kind of accusation Mr. Lowe brings against the English

Universities, when he says that their education is made up "of words that

few understand and most will shortly forget; of arts that can never be

used, if indeed they can even be learnt; of histories inapplicable to our

times; of languages dead and even mouldy; of grammatical rules that never

had living use and are only post mortem examinations; and of statements

fagoted with utter disregard of their comparative value."

This general thought will be kept in view throughout my somewhat

discursive address, which will begin with an imaginary clinical lesson

from the lips of an historical personage, and close with the portrait

from real life of one who, both as teacher and practitioner, was long

loved and honored among us. If I somewhat overrun my hour, you must

pardon me, for I can say with Pascal that I have not had the time to make

my lecture shorter.

In the year 1647, that good man John Eliot, commonly called the Apostle

Eliot, writing to Mr. Thomas Shepherd, the pious minister of Cambridge,

referring to the great need of medical instruction for the Indians, used

these words:

"I have thought in my heart that it were a singular good work, if the

Lord would stirre up the hearts of some or other of his people in England

to give some maintenance toward some Schoole or Collegiate exercise this

way, wherein there should be Anatomies and other instructions that way,

and where there might be some recompence given to any that should bring

in any vegetable or other thing that is vertuous in the way of Physick.

"There is another reason which moves my thought and desires this way,

namely that our young students in Physick may be trained up better then

they yet bee, who have onely theoreticall knowledge, and are forced to

fall to practise before ever they saw an Anatomy made, or duely trained

up in making experiments, for we never had but one Anatomy in the

countrey, which Mr. Giles Firman [Firmin] now in England, did make and

read upon very well, but no more of that now."

Since the time of the Apostle Eliot the Lord has stirred up the hearts of

our people to the building of many Schools and Colleges where medicine is

taught in all its branches. Mr. Giles Firmin's "Anatomy" may be

considered the first ancestor of a long line of skeletons which have been

dangling and rattling in our lecture-rooms for more than a century.

Teaching in New England in 1647 was a grave but simple matter. A single

person, combining in many cases, as in that of Mr. Giles Firmin, the

offices of physician and preacher, taught what he knew to a few disciples

whom he gathered about him. Of the making of that "Anatomy" on which my

first predecessor in the branch I teach "did read very well" we can know

nothing. The body of some poor wretch who had swung upon the gallows,

was probably conveyed by night to some lonely dwelling at the outskirts

of the village, and there by the light of flaring torches hastily

dissected by hands that trembled over the unwonted task. And ever and

anon the master turned to his book, as he laid bare the mysteries of the

hidden organs; to his precious Vesalius, it might be, or his figures

repeated in the multifarious volume of Ambroise Pare; to the Aldine

octavo in which Fallopius recorded his fresh observations; or that giant

folio of Spigelius just issued from the press of Amsterdam, in which

lovely ladies display their viscera with a coquettish grace implying that

it is rather a pleasure than otherwise to show the lace-like omentum, and

hold up their appendices epiploicae as if they were saying "these are our

jewels."

His teaching of medicine was no doubt chiefly clinical, and received with

the same kind of faith as that which accepted his words from the pulpit.

His notions of disease were based on what he had observed, seen always in

the light of the traditional doctrines in which he was bred. His

discourse savored of the weighty doctrines of Hippocrates, diluted by the

subtle speculations of Galen, reinforced by the curious comments of the

Arabian schoolmen as they were conveyed in the mellifluous language of

Fernelius, blended, it may be, with something of the lofty mysticism of

Van Helmont, and perhaps stealing a flavor of that earlier form of

Homoeopathy which had lately come to light in Sir Kenelm Digby's

"Discourse concerning the Cure of Wounds by the Sympathetic Powder."

His Pathology was mythology. A malformed foetus, as the readers of

Winthrop's Journal may remember, was enough to scare the colonists from

their propriety, and suggest the gravest fears of portended disaster.

The student of the seventeenth century opened his Licetus and saw figures

of a lion with the head of a woman, and a man with the head of an

elephant. He had offered to his gaze, as born of a human mother, the

effigy of a winged cherub, a pterocephalous specimen, which our Professor

of Pathological Anatomy would hardly know whether to treat with the

reverence due to its celestial aspect, or to imprison in one of his

immortalizing jars of alcohol.

His pharmacopoeia consisted mainly of simples, such as the venerable

"Herball" of Gerard describes and figures in abounding affluence. St.

John's wort and Clown's All-heal, with Spurge and Fennel, Saffron and

Parsley, Elder and Snake-root, with opium in some form, and roasted

rhubarb and the Four Great Cold Seeds, and the two Resins, of which it

used to be said that whatever the Tacamahaca has not cured, the Caranna

will, with the more familiar Scammony and Jalap and Black Hellebore, made

up a good part of his probable list of remedies. He would have ordered

Iron now and then, and possibly an occasional dose of Antimony. He would

perhaps have had a rheumatic patient wrapped in the skin of a wolf or a

wild cat, and in case of a malignant fever with "purples" or petechiae,

or of an obstinate king's evil, he might have prescribed a certain black

powder, which had been made by calcining toads in an earthen pot; a

choice remedy, taken internally, or applied to any outward grief.

Except for the toad-powder and the peremptory drastics, one might have

borne up against this herb doctoring as well as against some more modern

styles of medication. Barbeyrac and his scholar Sydenham had not yet

cleansed the Pharmacopoeia of its perilous stuff, but there is no doubt

that the more sensible physicians of that day knew well enough that a

good honest herb-tea which amused the patient and his nurses was all that

was required to carry him through all common disorders.

The student soon learned the physiognomy of disease by going about with

his master; fevers, pleurisies, asthmas, dropsies, fluxes, small-pox,

sore-throats, measles, consumptions. He saw what was done for them. He

put up the medicines, gathered the herbs, and so learned something of

materia medico and botany. He learned these few things easily and well,

for he could give his whole attention to them. Chirurgery was a separate

specialty. Women in child-birth were cared for by midwives. There was

no chemistry deserving the name to require his study. He did not learn a

great deal, perhaps, but what he did learn was his business, namely, how

to take care of sick people.

Let me give you a picture of the old=fashioned way of instruction, by

carrying you with me in imagination in the company of worthy Master Giles

Firmin as he makes his round of visits among the good folk of Ipswich,

followed by his one student, who shall answer to the scriptural name of

Luke. It will not be for entertainment chiefly, but to illustrate the

one mode of teaching which can never be superseded, and which, I venture

to say, is more important than all the rest put together. The student is

a green hand, as you will perceive.

In the first dwelling they come to, a stout fellow is bellowing with

colic.

"He will die, Master, of a surety, methinks," says the timid youth in a

whisper.

"Nay, Luke," the Master answers, "'t is but a dry belly-ache. Didst thou

not mark that he stayed his roaring when I did press hard over the lesser

bowels? Note that he hath not the pulse of them with fevers, and by what

Dorcas telleth me there hath been no long shutting up of the vice

naturales. We will steep certain comforting herbs which I will shew

thee, and put them in a bag and lay them on his belly. Likewise he shall

have my cordial julep with a portion of this confection which we do call

Theriaca Andromachi, which hath juice of poppy in it, and is a great

stayer of anguish. This fellow is at his prayers to-day, but I warrant

thee he shall be swearing with the best of them to-morrow."

They jog along the bridle-path on their horses until they come to another

lowly dwelling. They sit a while with a delicate looking girl in whom

the ingenuous youth naturally takes a special interest. The good

physician talks cheerfully with her, asks her a few questions. Then to

her mother: "Good-wife, Margaret hath somewhat profited, as she telleth,

by the goat's milk she hath taken night and morning. Do thou pluck a

maniple--that is an handful--of the plant called Maidenhair, and make a

syrup therewith as I have shewed thee. Let her take a cup full of the

same, fasting, before she sleepeth, also before she riseth from her bed."

And so they leave the house.

"What thinkest thou, Luke, of the maid we have been visiting?" "She

seemeth not much ailing, Master, according to my poor judgment. For she

did say she was better. And she had a red cheek and a bright eye, and

she spake of being soon able to walk unto the meeting, and did seem

greatly hopeful, but spare of flesh, methought, and her voice something

hoarse, as of one that hath a defluxion, with some small coughing from a

cold, as she did say. Speak I not truly, Master, that she will be well

speedily?"

"Yea, Luke, I do think she shall be well, and mayhap speedily. But it is

not here with us she shall be well. For that redness of the cheek is but

the sign of the fever which, after the Grecians, we do call the hectical;

and that shining of the eyes is but a sickly glazing, and they which do

every day get better and likewise thinner and weaker shall find that way

leadeth to the church-yard gate. This is the malady which the ancients

did call tubes, or the wasting disease, and some do name the consumption.

A disease whereof most that fall ailing do perish. This Margaret is not

long for earth--but she knoweth it not, and still hopeth."

"Why, then, Master, didst thou give her of thy medicine, seeing that her

ail is unto death?"

"Thou shalt learn, boy, that they which are sick must have somewhat

wherewith to busy their thoughts. There be some who do give these tabid

or consumptives a certain posset made with lime-water and anise and

liquorice and raisins of the sun, and there be other some who do give the

juice of craw-fishes boiled in barley-water with chicken-broth, but these

be toys, as I do think, and ye shall find as good virtue, nay better, in

this syrup of the simple called Maidenhair."

Something after this manner might Master Giles Firmin have delivered his

clinical instructions. Somewhat in this way, a century and a half later,

another New England physician, Dr. Edward Augustus Holyoke, taught a

young man who came to study with him, a very diligent and intelligent

youth, James Jackson by name, the same whose portrait in his advanced

years hangs upon this wall, long the honored Professor of Theory and

Practice in this Institution, of whom I shall say something in this

Lecture. Our venerated Teacher studied assiduously afterwards in the

great London Hospitals, but I think he used to quote his "old Master" ten

times where he quoted Mr. Cline or Dr. Woodville once.

When I compare this direct transfer of the practical experience of a wise

man into the mind of a student,--every fact one that he can use in the

battle of life and death,--with the far off, unserviceable "scientific"

truths that I and some others are in the habit of teaching, I cannot help

asking myself whether, if we concede that our forefathers taught too

little, there is not--a possibility that we may sometimes attempt to

teach too much. I almost blush when I think of myself as describing the

eight several facets on two slender processes of the palate bone, or the

seven little twigs that branch off from the minute tympanic nerve, and I

wonder whether my excellent colleague feels in the same way when he

pictures himself as giving the constitution of neurin, which as he and I

know very well is that of the hydrate of trimethyle-oxethyle-ammonium, or

the formula for the production of alloxan, which, though none but the

Professors and older students can be expected to remember it, is C10 H4

N4 O6+ 2HO, NO5=C8 H4 N2 O10+2CO2+N2+NH4 O, NO5.

I can bear the voice of some rough iconoclast addressing the Anatomist

and the Chemist in tones of contemptuous indignation: "What is this stuff

with which you are cramming the brains of young men who are to hold the

lives of the community in their hands? Here is a man fallen in a fit;

you can tell me all about the eight surfaces of the two processes of the

palate bone, but you have not had the sense to loosen that man's

neck-cloth, and the old women are all calling you a fool? Here is a

fellow that has just swallowed poison. I want something to turn his

stomach inside out at the shortest notice. Oh, you have forgotten the

dose of the sulphate of zinc, but you remember the formula for the

production of alloxan!"

"Look you, Master Doctor,--if I go to a carpenter to come and stop a leak

in my roof that is flooding the house, do you suppose I care whether he

is a botanist or not? Cannot a man work in wood without knowing all

about endogens and exogens, or must he attend Professor Gray's Lectures

before he can be trusted to make a box-trap? If my horse casts a shoe,

do you think I will not trust a blacksmith to shoe him until I have made

sure that he is sound on the distinction between the sesquioxide and the

protosesquioxide of iron?"

--But my scientific labor is to lead to useful results by and by, in the

next generation, or in some possible remote future.--

"Diavolo!" as your Dr. Rabelais has it,--answers the iconoclast,--"what

is that to me and my colic, to me and my strangury? I pay the Captain of

the Cunard steamship to carry me quickly and safely to Liverpool, not to

make a chart of the Atlantic for after voyagers! If Professor Peirce

undertakes to pilot me into Boston Harbor and runs me on Cohasset rocks,

what answer is it to tell me that he is Superintendent of the Coast

Survey? No, Sir! I want a plain man in a pea-jacket and a sou'wester,

who knows the channel of Boston Harbor, and the rocks of Boston Harbor,

and the distinguished Professor is quite of my mind as to the matter, for

I took the pains to ask him before I ventured to use his name in the way

of illustration."

I do not know how the remarks of the image-breaker may strike others, but

I feel that they put me on my defence with regard to much of my teaching.

Some years ago I ventured to show in an introductory Lecture how very

small a proportion of the anatomical facts taught in a regular course, as

delivered by myself and others, had any practical bearing whatever on the

treatment of disease. How can I, how can any medical teacher justify

himself in teaching anything that is not like to be of practical use to a

class of young men who are to hold in their hands the balance in which

life and death, ease and anguish, happiness and wretchedness are to be

daily weighed?

I hope we are not all wrong. Oftentimes in finding how sadly ignorant of

really essential and vital facts and rules were some of those whom we had

been larding with the choicest scraps of science, I have doubted whether

the old one-man system of teaching, when the one man was of the right

sort, did not turn out better working physicians than our more elaborate

method. The best practitioner I ever knew was mainly shaped to

excellence in that way. I can understand perfectly the regrets of my

friend Dr. John Brown of Edinburgh, for the good that was lost with the

old apprenticeship system. I understand as well Dr. Latham's fear "that

many men of the best abilities and good education will be deterred from

prosecuting physic as a profession, in consequence of the necessity

indiscriminately laid upon all for impossible attainments."

I feel therefore impelled to say a very few words in defence of that

system of teaching adopted in our Colleges, by which we wish to

supplement and complete the instruction given by private individuals or

by what are often called Summer Schools.

The reason why we teach so much that is not practical and in itself

useful, is because we find that the easiest way of teaching what is

practical and useful. If we could in any way eliminate all that would

help a man to deal successfully with disease, and teach it by itself so

that it should be as tenaciously rooted in the memory, as easily summoned

when wanted, as fertile in suggestion of related facts, as satisfactory

to the peremptory demands of the intelligence as if taught in its

scientific connections, I think it would be our duty so to teach the

momentous truths of medicine, and to regard all useless additions as an

intrusion on the time which should be otherwise occupied.

But we cannot successfully eliminate and teach by itself that which is

purely practical. The easiest and surest why of acquiring facts is to

learn them in groups, in systems, and systematized knowledge is science.

You can very often carry two facts fastened together more easily than one

by itself, as a housemaid can carry two pails of water with a hoop more

easily than one without it. You can remember a man's face, made up of

many features, better than you can his nose or his mouth or his eye-brow.

Scores of proverbs show you that you can remember two lines that rhyme

better than one without the jingle. The ancients, who knew the laws of

memory, grouped the seven cities that contended for the honor of being

Homer's birthplace in a line thus given by Aulus Gellius:

Smurna, Rodos, Colophon, Salamin, Ios, Argos, Athenai.

I remember, in the earlier political days of Martin Van Buren, that

Colonel Stone, of the "New York Commercial," or one of his

correspondents, said that six towns of New York would claim in the same

way to have been the birth-place of the "Little Magician," as he was then

called; and thus he gave their names, any one of which I should long ago

have forgotten, but which as a group have stuck tight in my memory from

that day to this;

Catskill, Saugerties, Redhook, Kinderhook, Scaghticoke, Schodac.

If the memory gains so much by mere rhythmical association, how much more

will it gain when isolated facts are brought together under laws and

principles, when organs are examined in their natural connections, when

structure is coupled with function, and healthy and diseased action are

studied as they pass one into the other! Systematic, or scientific study

is invaluable as supplying a natural kind of mnemonics, if for nothing

else. You cannot properly learn the facts you want from Anatomy and

Chemistry in any way so easily as by taking them in their regular order,

with other allied facts, only there must be common sense exercised in

leaving out a great deal which belongs to each of the two branches as

pure science. The dullest of teachers is the one who does not know what

to omit.

The larger aim of scientific training is to furnish you with principles

to which you will be able to refer isolated facts, and so bring these

within the range of recorded experience. See what the "London Times"

said about the three Germans who cracked open John Bull Chatwood's

strong-box at the Fair the other day, while the three Englishmen hammered

away in vain at Brother Jonathan Herring's. The Englishmen represented

brute force. The Germans had been trained to appreciate principle. The

Englishman "knows his business by rote and rule of thumb"--science, which

would "teach him to do in an hour what has hitherto occupied him two

hours," "is in a manner forbidden to him." To this cause the "Times"

attributes the falling off of English workmen in comparison with those of

the Continent.

Granting all this, we must not expect too much from "science" as

distinguished from common experience. There are ten thousand

experimenters without special apparatus for every one in the laboratory.

Accident is the great chemist and toxicologist. Battle is the great

vivisector. Hunger has instituted researches on food such as no Liebig,

no Academic Commission has ever recorded.

Medicine, sometimes impertinently, often ignorantly, often carelessly

called "allopathy," appropriates everything from every source that can be

of the slightest use to anybody who is ailing in any way, or like to be

ailing from any cause. It learned from a monk how to use antimony, from

a Jesuit how to cure agues, from a friar how to cut for stone, from a

soldier how to treat gout, from a sailor how to keep off scurvy, from a

postmaster how to sound the Eustachian tube, from a dairy-maid how to

prevent small-pox, and from an old market-woman how to catch the

itch-insect. It borrowed acupuncture and the moxa from the Japanese

heathen, and was taught the use of lobelia by the American savage. It

stands ready to-day to accept anything from any theorist, from any

empiric who can make out a good case for his discovery or his remedy.

"Science" is one of its benefactors, but only one, out of many. Ask the

wisest practising physician you know, what branches of science help him

habitually, and what amount of knowledge relating to each branch he

requires for his professional duties. He will tell you that scientific

training has a value independent of all the special knowledge acquired.

He will tell you that many facts are explained by studying them in the

wider range of related facts to which they belong. He will gratefully

recognize that the anatomist has furnished him with indispensable data,

that the physiologist has sometimes put him on the track of new modes of

treatment, that the chemist has isolated the active principles of his

medicines, has taught him how to combine them, has from time to time

offered him new remedial agencies, and so of others of his allies. But he

will also tell you, if I am not mistaken, that his own branch of

knowledge is so extensive and so perplexing that he must accept most of

his facts ready made at their hands. He will own to you that in the

struggle for life which goes on day and night in our thoughts as in the

outside world of nature, much that he learned under the name of science

has died out, and that simple homely experience has largely taken the

place of that scholastic knowledge to which he and perhaps some of his

instructors once attached a paremount importance.

This, then, is my view of scientific training as conducted in courses

such as you are entering on. Up to a certain point I believe in set

Lectures as excellent adjuncts to what is far more important, practical

instruction at the bedside, in the operating room, and under the eye of

the Demonstrator. But I am so far from wishing these courses extended,

that I think some of them--suppose I say my own--would almost bear

curtailing. Do you want me to describe more branches of the sciatic and

crural nerves? I can take Fischer's plates, and lecturing on that scale

fill up my whole course and not finish the nerves alone. We must stop

somewhere, and for my own part I think the scholastic exercises of our

colleges have already claimed their full share of the student's time

without our seeking to extend them.

I trust I have vindicated the apparent inconsequence of teaching young

students a good deal that seems at first sight profitless, but which

helps them to learn and retain what is profitable. But this is an

inquisitive age, and if we insist on piling up beyond a certain height

knowledge which is in itself mere trash and lumber to a man whose life is

to be one long fight with death and disease, there will be some sharp

questions asked by and by, and our quick-witted people will perhaps find

they can get along as well without the professor's cap as without the

bishop's mitre and the monarch's crown.

I myself have nothing to do with clinical teaching. Yet I do not

hesitate to say it is more essential than all the rest put together, so

far as the ordinary practice of medicine is concerned; and this is by far

the most important thing to be learned, because it deals with so many

more lives than any other branch of the profession. So of personal

instruction, such as we give and others give in the interval of lectures,

much of it at the bedside, some of it in the laboratory, some in the

microscope-room, some in the recitation-room, I think it has many

advantages of its own over the winter course, and I do not wish to see it

shortened for the sake of prolonging what seems to me long enough

already.

If I am jealous of the tendency to expand the time given to the

acquisition of curious knowledge, at the expense of the plain

old-fashioned bedside teachings, I only share the feeling which Sydenham

expressed two hundred years ago, using an image I have already borrowed.

"He would be no honest and successful pilot who was to apply himself with

less industry to avoid rocks and sands and bring his vessel safely home,

than to search into the causes of the ebbing and flowing of the sea,

which, though very well for a philosopher, is foreign to him whose

business it is to secure the ship. So neither will a physician, whose

province it is to cure diseases, be able to do so, though he be a person

of great genius, who bestows less time on the hidden and intricate method

of nature, and adapting his means thereto, than on curious and subtle

speculation."

"Medicine is my wife and Science is my mistress," said Dr. Rush. I do

not think that the breach of the seventh commandment can be shown to have

been of advantage to the legitimate owner of his affections. Read what

Dr. Elisha Bartlett says of him as a practitioner, or ask one of our own

honored ex-professors, who studied under him, whether Dr. Rush had ever

learned the meaning of that saying of Lord Bacon, that man is the

minister and interpreter of Nature, or whether he did not speak

habitually of Nature as an intruder in the sick room, from which his art

was to expel her as an incompetent and a meddler.

All a man's powers are not too much for such a profession as Medicine.

"He is a learned man," said old Parson Emmons of Franklin, "who

understands one subject, and he is a very learned man who understands two

subjects." Schonbein says he has been studying oxygen for thirty years.

Mitscherlich said it took fourteen years to establish a new fact in

chemistry. Aubrey says of Harvey, the discoverer of the circulation,

that "though all his profession would allow him to be an excellent

anatomist, I have never heard of any who admired his therapeutic way."

My learned and excellent friend before referred to, Dr. Brown of

Edinburgh, from whose very lively and sensible Essay, "Locke and

Sydenham," I have borrowed several of my citations, contrasts Sir Charles

Bell, the discoverer, the man of science, with Dr. Abercrombie, the

master in the diagnosis and treatment of disease. It is through one of

the rarest of combinations that we have in our Faculty a teacher on whom

the scientific mantle of Bell has fallen, and who yet stands preeminent

in the practical treatment of the class of diseases which his inventive

and ardent experimental genius has illustrated. M. Brown-Sequard's

example is as, eloquent as his teaching in proof of the advantages of

well directed scientific investigation. But those who emulate his

success at once as a discoverer and a practitioner must be content like

him to limit their field of practice. The highest genius cannot afford

in our time to forget the ancient precept, Divide et impera.

"I suppose I must go and earn this guinea," said a medical man who was

sent for while he was dissecting an animal. I should not have cared to

be his patient. His dissection would do me no good, and his thoughts

would be too much upon it. I want a whole man for my doctor, not a half

one. I would have sent for a humbler practitioner, who would have given

himself entirely to me, and told the other--who was no less a man than

John Hunter--to go on and finish the dissection of his tiger.

Sydenham's "Read Don Quixote" should be addressed not to the student, but

to the Professor of today. Aimed at him it means, "Do not be too

learned."

Do not think you are going to lecture to picked young men who are

training themselves to be scientific discoverers. They are of fair

average capacity, and they are going to be working doctors.

These young men are to have some very serious vital facts to deal with.

I will mention a few of them.

Every other resident adult you meet in these streets is or will be more

or less tuberculous. This is not an extravagant estimate, as very nearly

one third of the deaths of adults in Boston last year were from phthisis.

If the relative number is less in our other northern cities, it is

probably in a great measure because they are more unhealthy; that is,

they have as much, or nearly as much, consumption, but they have more

fevers or other fatal diseases.

These heavy-eyed men with the alcoholized brains, these pallid youths

with the nicotized optic ganglia and thinking-marrows brown as their own

meerschaums, of whom you meet too many,--will ask all your wisdom to deal

with their poisoned nerves and their enfeebled wills.

Nearly seventeen hundred children under five years of age died last year

in this city. A poor human article, no doubt, in many cases, still,

worth an attempt to save them, especially when we remember the effect of

Dr. Clarke's suggestion at the Dublin Hospital, by which some twenty-five

or thirty thousand children's lives have probably been saved in a single

city.

Again, the complaint is often heard that the native population is not

increasing so rapidly as in former generations. The breeding and nursing

period of American women is one of peculiar delicacy and frequent

infirmity. Many of them must require a considerable interval between the

reproductive efforts, to repair damages and regain strength. This

matter is not to be decided by an appeal to unschooled nature. It is the

same question as that of the deformed pelvis,--one of degree. The facts

of mal-vitalization are as much to be attended to as those of

mal-formation. If the woman with a twisted pelvis is to be considered an

exempt, the woman with a defective organization should be recognized as

belonging to the invalid corps. We shudder to hear what is alleged as to

the prevalence of criminal practices; if back of these there can be shown

organic incapacity or overtaxing of too limited powers, the facts belong

to the province of the practical physician, as well as of the moralist

and the legislator, and require his gravest consideration.

Take the important question of bleeding. Is venesection done with

forever? Six years ago it was said here in an introductory Lecture that

it would doubtless come back again sooner or later. A fortnight ago I

found myself in the cars with one of the most sensible and esteemed

practitioners in New England. He took out his wallet and showed me two

lancets, which he carried with him; he had never given up their use.

This is a point you will have to consider.

Or, to mention one out of many questionable remedies, shall you give

Veratrum Viride in fevers and inflammations? It makes the pulse slower

in these affections. Then the presumption would naturally be that it

does harm. The caution with reference to it on this ground was long ago

recorded in the Lecture above referred to. See what Dr. John Hughes

Bennett says of it in the recent edition of his work on Medicine.

Nothing but the most careful clinical experience can settle this and such

points of treatment.

These are all practical questions--questions of life and death, and every

day will be full of just such questions. Take the problem of climate. A

patient comes to you with asthma and wants to know where he can breathe;

another comes to you with phthisis and wants to know where he can live.

What boy's play is nine tenths of all that is taught in many a

pretentious course of lectures, compared with what an accurate and

extensive knowledge of the advantages and disadvantages of different

residences in these and other complaints would be to a practising

physician.

I saw the other day a gentleman living in Canada, who had spent seven

successive winters in Egypt, with the entire relief of certain obscure

thoracic symptoms which troubled him while at home. I saw, two months

ago, another gentleman from Minnesota, an observer and a man of sense,

who considered that State as the great sanatorium for all pulmonary

complaints. If half our grown population are or will be more or less

tuberculous, the question of colonizing Florida assumes a new aspect.

Even within the borders of our own State, the very interesting researches

of Dr. Bowditch show that there is a great variation in the amount of

tuberculous disease in different towns, apparently connected with local

conditions. The hygienic map of a State is quite as valuable as its

geological map, and it is the business of every practising physician to

know it thoroughly. They understand this in England, and send a patient

with a dry irritating cough to Torquay or Penzance, while they send

another with relaxed bronchial membranes to Clifton or Brighton. Here is

another great field for practical study.

So as to the all-important question of diet. "Of all the means of cure

at our command," says Dr. Bennett, "a regulation of the quantity and

quality of the diet is by far the most powerful." Dr. MacCormac would

perhaps except the air we breathe, for he thinks that impure air,

especially in sleeping rooms, is the great cause of tubercle. It is

sufficiently proved that the American,--the New Englander,--the

Bostonian, can breed strong and sound children, generation after

generation,--nay, I have shown by the record of a particular family that

vital losses may be retrieved, and a feeble race grow to lusty vigor in

this very climate and locality. Is not the question why our young men

and women so often break down, and how they can be kept from breaking

down, far more important for physicians to settle than whether there is

one cranial vertebra, or whether there are four, or none?

--But I have a taste for the homologies, I want to go deeply into the

subject of embryology, I want to analyze the protonihilates precipitated

from pigeon's milk by the action of the lunar spectrum,--shall I not

follow my star,--shall I not obey my instinct,--shall I not give myself

to the lofty pursuits of science for its own sake?

Certainly you may, if you like. But take down your sign, or never put it

up. That is the way Dr. Owen and Dr. Huxley, Dr. Agassiz and Dr.

Jeffries Wyman, Dr. Gray and Dr. Charles T. Jackson settled the

difficulty. We all admire the achievements of this band of distinguished

doctors who do not practise. But we say of their work and of all pure

science, as the French officer said of the charge of the six hundred at

Balaclava, "C'est magnifique, mais ce n'est pas la guerre,"--it is very

splendid, but it is not a practising doctor's business. His patient has

a right to the cream of his life and not merely to the thin milk that is

left after "science" has skimmed it off. The best a physician can give

is never too good for the patient.

It is often a disadvantage to a young practitioner to be known for any

accomplishment outside of his profession. Haller lost his election as

Physician to the Hospital in his native city of Berne, principally on the

ground that he was a poet. In his later years the physician may venture

more boldly. Astruc was sixty-nine years old when he published his

"Conjectures," the first attempt, we are told, to decide the authorship

of the Pentateuch showing anything like a discerning criticism. Sir

Benjamin Brodie was seventy years old before he left his physiological

and surgical studies to indulge in psychological speculations. The

period of pupilage will be busy enough in acquiring the knowledge needed,

and the season of active practice will leave little leisure for any but

professional studies.

Dr. Graves of Dublin, one of the first clinical teachers of our time,

always insisted on his students' beginning at once to visit the hospital.

At the bedside the student must learn to treat disease, and just as

certainly as we spin out and multiply our academic prelections we shall

work in more and more stuffing, more and more rubbish, more and more

irrelevant, useless detail which the student will get rid of just as soon

as he leaves us. Then the next thing will be a new organization, with an

examining board of first-rate practical men, who will ask the candidate

questions that mean business,--who will make him operate if he is to be a

surgeon, and try him at the bedside if he is to be a physician,--and not

puzzle him with scientific conundrums which not more than one of the

questioners could answer himself or ever heard of since he graduated.

Or these women who are hammering at the gates on which is written "No

admittance for the mothers of mankind," will by and by organize an

institution, which starting from that skilful kind of nursing which

Florence Nightingale taught so well, will work backwards through

anodynes, palliatives, curatives, preventives, until with little show of

science it imparts most of what is most valuable in those branches of the

healing art it professes to teach. When that time comes, the fitness of

women for certain medical duties, which Hecquet advocated in 1708, which

Douglas maintained in 1736, which Dr. John Ware, long the honored

Professor of Theory and Practice in this Institution, upheld within our

own recollection in the face of his own recorded opinion to the contrary,

will very possibly be recognized.

My advice to every teacher less experienced than myself would be,

therefore: Do not fret over the details you have to omit; you probably

teach altogether too many as it is. Individuals may learn a thing with

once hearing it, but the only way of teaching a whole class is by

enormous repetition, representation, and illustration in all possible

forms. Now and then you will have a young man on your benches like the

late Waldo Burnett,--not very often, if you lecture half a century. You

cannot pretend to lecture chiefly for men like that,--a Mississippi raft

might as well take an ocean-steamer in tow. To meet his wants you would

have to leave the rest of your class behind and that you must not do.

President Allen of Jefferson College says that his instruction has been

successful in proportion as it has been elementary. It may be a

humiliating statement, but it is one which I have found true in my own

experience.

To the student I would say, that however plain and simple may be our

teaching, he must expect to forget much which he follows intelligently in

the lecture-room. But it is not the same as if he had never learned it.

A man must get a thing before he can forget it. There is a great world

of ideas we cannot voluntarily recall,--they are outside the limits of

the will. But they sway our conscious thought as the unseen planets

influence the movements of those within the sphere of vision. No man

knows how much he knows,--how many ideas he has,--any more than he knows

how many blood-globules roll in his veins. Sometimes accident brings

back here and there one, but the mind is full of irrevocable remembrances

and unthinkable thoughts, which take a part in all its judgments as

indestructible forces. Some of you must feel your scientific

deficiencies painfully after your best efforts. But every one can

acquire what is most essential. A man of very moderate ability may be a

good physician, if he devotes himself faithfully to the work. More than

this, a positively dull man, in the ordinary acceptation of the term,

sometimes makes a safer practitioner than one who has, we will say, five

per cent. more brains than his average neighbor, but who thinks it is

fifty per cent. more. Skulls belonging to this last variety of the human

race are more common, I may remark, than specimens like the Neanderthal

cranium, a cast of which you will find on the table in the Museum.

Whether the average talent be high or low, the Colleges of the land must

make the best commodity they can out of such material as the country and

the cities furnish them. The community must have Doctors as it must have

bread. It uses up its Doctors just as it wears out its shoes, and

requires new ones. All the bread need not be French rolls, all the shoes

need not be patent leather ones; but the bread must be something that can

be eaten, and the shoes must be something that can be worn. Life must

somehow find food for the two forces that rub everything to pieces, or

burn it to ashes,--friction and oxygen. Doctors are oxydable products,

and the schools must keep furnishing new ones as the old ones turn into

oxyds; some of first-rate quality that burn with a great light, some of a

lower grade of brilliancy, some honestly, unmistakably, by the grace of

God, of moderate gifts, or in simpler phrase, dull.

The public will give every honest and reasonably competent worker in the

healing art a hearty welcome. It is on the whole very loyal to the

Medical Profession. Three successive years have borne witness to the

feeling with which this Institution, representing it in its educational

aspect, is regarded by those who are themselves most honored and

esteemed. The great Master of Natural Science bade the last year's class

farewell in our behalf, in those accents which delight every audience.

The Head of our ancient University honored us in the same way in the

preceding season. And how can we forget that other occasion when the

Chief Magistrate of the Commonwealth, that noble citizen whom we have

just lost, large-souled, sweet-natured, always ready for every kind

office, came among us at our bidding, and talked to us of our duties in

words as full of wisdom as his heart was of goodness?

You have not much to fear, I think, from the fancy practitioners. The

vulgar quackeries drop off, atrophied, one after another. Homoeopathy has

long been encysted, and is carried on the body medical as quietly as an

old wen. Every year gives you a more reasoning and reasonable people to

deal with. See how it is in Literature. The dynasty of British

dogmatists, after lasting a hundred years and more, is on its last legs.

Thomas Carlyle, third in the line of descent, finds an audience very

different from those which listened to the silver speech of Samuel Taylor

Coleridge and the sonorous phrases of Samuel Johnson. We read him, we

smile at his clotted English, his "swarmery" and other picturesque

expressions, but we lay down his tirade as we do one of Dr. Cumming's

interpretations of prophecy, which tells us that the world is coming to

an end next week or next month, if the weather permits,--not

otherwise,--feeling very sure that the weather will be unfavorable.

It is the same common-sense public you will appeal to. The less

pretension you make, the better they will like you in the long run. I

hope we shall make everything as plain and as simple to you as we can. I

would never use a long word, even, where a short one would answer the

purpose. I know there are professors in this country who "ligate"

arteries. Other surgeons only tie them, and it stops the bleeding just

as well. It is the familiarity and simplicity of bedside instruction

which makes it so pleasant as well as so profitable. A good clinical

teacher is himself a Medical School. We need not wonder that our young

men are beginning to announce themselves not only as graduates of this or

that College, but also as pupils of some one distinguished master.

I wish to close this Lecture, if you will allow me a few moments longer,

with a brief sketch of an instructor and practitioner whose character was

as nearly a model one in both capacities as I can find anywhere recorded.

Dr. JAMES JACKSON, Professor of the Theory and Practice of Medicine in

this University from 1812 to 1846, and whose name has been since retained

on our rolls as Professor Emeritus, died on the 27th of August last, in

the ninetieth year of his age. He studied his profession, as I have

already mentioned, with Dr. Holyoke of Salem, one of the few physicians

who have borne witness to their knowledge of the laws of life by living

to complete their hundredth year. I think the student took his Old

Master, as he always loved to call him, as his model; each was worthy of

the other, and both were bright examples to all who come after them.

I remember that in the sermon preached by Dr. Grazer after Dr. Holyoke's

death, one of the points most insisted upon as characteristic of that

wise and good old man was the perfect balance of all his faculties. The

same harmonious adjustment of powers, the same symmetrical arrangement of

life, the same complete fulfilment of every day's duties, without haste

and without needless delay, which characterized the master, equally

distinguished the scholar. A glance at the life of our own Old Master,

if I can do any justice at all to his excellences, will give you

something to carry away from this hour's meeting not unworthy to be

remembered.

From December, 1797, to October, 1799, he remained with Dr. Holyoke as a

student, a period which he has spoken of as a most interesting and most

gratifying part of his life. After this he passed eight months in

London, and on his return, in October, 1800, he began business in Boston.

He had followed Mr. Cline, as I have mentioned, and was competent to

practise Surgery. But he found Dr. John Collins Warren had already

occupied the ground which at that day hardly called for more than one

leading practitioner, and wisely chose the Medical branch of the

profession. He had only himself to rely upon, but he had confidence in

his prospects, conscious, doubtless, of his own powers, knowing his own

industry and determination, and being of an eminently cheerful and

hopeful disposition. No better proof of his spirit can be given than

that, just a year from the time when he began to practise as a physician,

he took that eventful step which in such a man implies that he sees his

way clear to a position; he married a lady blessed with many gifts, but

not bringing him a fortune to paralyze his industry.

He had not miscalculated his chances in life. He very soon rose into a

good practice, and began the founding of that reputation which grew with

his years, until he stood by general consent at the head of his chosen

branch of the profession, to say the least, in this city and in all this

region of country. His skill and wisdom were the last tribunal to which

the sick and suffering could appeal. The community trusted and loved

him, the profession recognized him as the noblest type of the physician.

The young men whom he had taught wandered through foreign hospitals;

where they learned many things that were valuable, and many that were

curious; but as they grew older and began to think more of their ability

to help the sick than their power of talking about phenomena, they began

to look back to the teaching of Dr. Jackson, as he, after his London

experience, looked back to that of Dr. Holyoke. And so it came to be at

last that the bare mention of his name in any of our medical assemblies

would call forth such a tribute of affectionate regard as is only yielded

to age when it brings with it the record of a life spent in well doing.

No accident ever carries a man to eminence such as his in the medical

profession. He who looks for it must want it earnestly and work for it

vigorously; Nature must have qualified him in many ways, and education

must have equipped him with various knowledge, or his reputation will

evaporate before it reaches the noon-day blaze of fame. How did Dr.

Jackson gain the position which all conceded to him? In the answer to

this question some among you may find a key that shall unlock the gate

opening on that fair field of the future of which all dream but which not

all will ever reach.

First of all, he truly loved his profession. He had no intellectual

ambitions outside of it, literary, scientific or political. To him it

was occupation enough to apply at the bedside the best of all that he

knew for the good of his patient; to protect the community against the

inroads of pestilence; to teach the young all that he himself had been

taught, with all that his own experience had added; to leave on record

some of the most important results of his long observation.

With his patients he was so perfect at all points that it is hard to

overpraise him. I have seen many noted British and French and American

practitioners, but I never saw the man so altogether admirable at the

bedside of the sick as Dr. James Jackson. His smile was itself a remedy

better than the potable gold and the dissolved pearls that comforted the

praecordia of mediaeval monarchs. Did a patient, alarmed without cause,

need encouragement, it carried the sunshine of hope into his heart and

put all his whims to flight, as David's harp cleared the haunted chamber

of the sullen king. Had the hour come, not for encouragement, but for

sympathy, his face, his voice, his manner all showed it, because his

heart felt it. So gentle was he, so thoughtful, so calm, so absorbed in

the case before him, not to turn round and look for a tribute to his

sagacity, not to bolster himself in a favorite theory, but to find out

all he could, and to weigh gravely and cautiously all that he found, that

to follow him in his morning visit was not only to take a lesson in the

healing art, it was learning how to learn, how to move, how to look, how

to feel, if that can be learned. To visit with Dr. Jackson was a medical

education.

He was very firm, with all his kindness. He would have the truth about

his patients. The nurses found it out; and the shrewder ones never

ventured to tell him anything but a straight story. A clinical dialogue

between Dr. Jackson and Miss Rebecca Taylor, sometime nurse in the

Massachusetts General Hospital, a mistress in her calling, was as good

questioning and answering as one would be like to hear outside of the

court-room.

Of his practice you can form an opinion from his book called "Letters to

a Young Physician." Like all sensible men from the days of Hippocrates

to the present, he knew that diet and regimen were more important than

any drug or than all drugs put together. Witness his treatment of

phthisis and of epilepsy. He retained, however, more confidence in some

remedial agents than most of the younger generation would concede to

them. Yet his materia medica was a simple one.

"When I first went to live with Dr. Holyoke," he says, "in 1797, showing

me his shop, he said, 'There seems to you to be a great variety of

medicines here, and that it will take you long to get acquainted with

them, but most of them are unimportant. There are four which are equal

to all the rest, namely, Mercury, Antimony, Bark and Opium.'" And Dr.

Jackson adds, "I can only say of his practice, the longer I have lived, I

have thought better and better of it." When he thought it necessary to

give medicine, he gave it in earnest. He hated half-practice--giving a

little of this or that, so as to be able to say that one had done

something, in case a consultation was held, or a still more ominous event

occurred. He would give opium, for instance, as boldly as the late Dr.

Fisher of Beverly, but he followed the aphorism of the Father of

Medicine, and kept extreme remedies for extreme cases.

When it came to the "non-naturals," as he would sometimes call them,

after the old physicians,--namely, air, meat and drink, sleep and

watching, motion and rest, the retentions and excretions, and the

affections of the mind,--he was, as I have said, of the school of

sensible practitioners, in distinction from that vast community of

quacks, with or without the diploma, who think the chief end of man is to

support apothecaries, and are never easy until they can get every patient

upon a regular course of something nasty or noxious. Nobody was so

precise in his directions about diet, air, and exercise, as Dr. Jackson.

He had the same dislike to the a peu pres, the about so much, about so

often, about so long, which I afterwards found among the punctilious

adherents of the numerical system at La Pitie.

He used to insist on one small point with a certain philological

precision, namely, the true meaning of the word "cure." He would have it

that to cure a patient was simply to care for him. I refer to it as

showing what his idea was of the relation of the physician to the

patient. It was indeed to care for him, as if his life were bound up in

him, to watch his incomings and outgoings, to stand guard at every avenue

that disease might enter, to leave nothing to chance; not merely to throw

a few pills and powders into one pan of the scales of Fate, while Death

the skeleton was seated in the other, but to lean with his whole weight

on the side of life, and shift the balance in its favor if it lay in

human power to do it. Such devotion as this is only to be looked for in

the man who gives himself wholly up to the business of healing, who

considers Medicine itself a Science, or if not a science, is willing to

follow it as an art,--the noblest of arts, which the gods and demigods of

ancient religions did not disdain to practise and to teach.

The same zeal made him always ready to listen to any new suggestion which

promised to be useful, at a period of life when many men find it hard to

learn new methods and accept new doctrines. Few of his generation became

so accomplished as he in the arts of direct exploration; coming straight

from the Parisian experts, I have examined many patients with him, and

have had frequent opportunities of observing his skill in percussion and

auscultation.

One element in his success, a trivial one compared with others, but not

to be despised, was his punctuality. He always carried two watches,--I

doubt if he told why, any more than Dr. Johnson told what he did with the

orange-peel,--but probably with reference to this virtue. He was as much

to be depended upon at the appointed time as the solstice or the equinox.

There was another point I have heard him speak of as an important rule

with him; to come at the hour when he was expected; if he had made his

visit for several days successively at ten o'clock, for instance, not to

put it off, if he could possibly help it, until eleven, and so keep a

nervous patient and an anxious family waiting for him through a long,

weary hour.

If I should attempt to characterize his teaching, I should say that while

it conveyed the best results of his sagacious and extended observation,

it was singularly modest, cautious, simple, sincere. Nothing was for

show, for self-love; there was no rhetoric, no declamation, no triumphant

"I told you so," but the plain statement of a clear-headed honest man,

who knows that he is handling one of the gravest subjects that interest

humanity. His positive instructions were full of value, but the spirit

in which he taught inspired that loyal love of truth which lies at the

bottom of all real excellence.

I will not say that, during his long career, Dr. Jackson never made an

enemy. I have heard him tell how, in his very early days, old Dr.

Danforth got into a towering passion with him about some professional

consultation, and exploded a monosyllable or two of the more energetic

kind on the occasion. I remember that that somewhat peculiar personage,

Dr. Waterhouse, took it hardly when Dr. Jackson succeeded to his place as

Professor of Theory and Practice. A young man of Dr. Jackson's talent

and energy could hardly take the position that belonged to him without

crowding somebody in a profession where three in a bed is the common rule

of the household. But he was a peaceful man and a peace-maker all his

days. No man ever did more, if so much, to produce and maintain the

spirit of harmony for which we consider our medical community as somewhat

exceptionally distinguished.

If this harmony should ever be threatened, I could wish that every

impatient and irritable member of the profession would read that

beautiful, that noble Preface to the "Letters," addressed to John Collins

Warren. I know nothing finer in the medical literature of all time than

this Prefatory Introduction. It is a golden prelude, fit to go with the

three great Prefaces which challenge the admiration of scholars,

--Calvin's to his Institutes, De Thou's to his History, and

Casaubon's to his Polybius,--not because of any learning or rhetoric,

though it is charmingly written, but for a spirit flowing through it to

which learning and rhetoric are but as the breath that is wasted on the

air to the Mood that warms the heart.

Of a similar character is this short extract which I am permitted to make

from a private letter of his to a dear young friend. He was eighty-three

years old at the time of writing it.

"I have not loved everybody whom I have known, but I have striven to see

the good points in the characters of all men and women. At first I must

have done this from something in my own nature, for I was not aware of

it, and yet was doing it without any plan, when one day, sixty years ago,

a friend whom I loved and respected said this to me, 'Ah, James, I see

that you are destined to succeed in the world, and to make friends,

because you are so ready to see the good point in the characters of those

you meet.'"

I close this imperfect notice of some features in the character of this

most honored and beloved of physicians by applying to him the words which

were written of William Heberden, whose career was not unlike his own,

and who lived to the same patriarchal age.

"From his early youth he had always entertained a deep sense of religion,

a consummate love of virtue, an ardent thirst after knowledge, and an

earnest desire to promote the welfare and happiness of all mankind. By

these qualities, accompanied with great sweetness of manners, he acquired

the love and esteem of all good men, in a degree which perhaps very few

have experienced; and after passing an active life with the uniform

testimony of a good conscience, he became an eminent example of its

influence, in the cheerfulness and serenity of his latest age."

Such was the man whom I offer to you as a model, young gentlemen, at the

outset of your medical career. I hope that many of you will recognize

some traits of your own special teachers scattered through various parts

of the land in the picture I have drawn. Let me assure you that whatever

you may learn in this or any other course of public lectures,--and I

trust you will learn a great deal,--the daily guidance, counsel, example,

of your medical father, for such the Oath of Hippocrates tells you to

consider your preceptor, will, if he is in any degree like him of whom I

have spoken, be the foundation on which all that we teach is reared, and

perhaps outlive most of our teachings, as in Dr. Jackson's memory the

last lessons that remained with him were those of his Old Master.

THE MEDICAL PROFESSION IN MASSACHUSETTS.

A Lecture of a Course by members of the Massachusetts Historical Society,

delivered before the Lowell Institute, January 29, 1869.

The medical history of eight generations, told in an hour, must be in

many parts a mere outline. The details I shall give will relate chiefly

to the first century. I shall only indicate the leading occurrences,

with the more prominent names of the two centuries which follow, and add

some considerations suggested by the facts which have been passed in

review.

A geographer who was asked to describe the tides of Massachusetts Bay,

would have to recognize the circumstance that they are a limited

manifestation of a great oceanic movement. To consider them apart from

this, would be to localize a planetary phenomenon, and to provincialize a

law of the universe. The art of healing in Massachusetts has shared more

or less fully and readily the movement which, with its periods of ebb and

flow, has been raising its level from age to age throughout the better

part of Christendom. Its practitioners brought with them much of the

knowledge and many of the errors of the Old World; they have always been

in communication with its wisdom and its folly; it is not without

interest to see how far the new conditions in which they found themselves

have been favorable or unfavorable to the growth of sound medical

knowledge and practice.

The state of medicine is an index of the civilization of an age and

country,--one of the best, perhaps, by which it can be judged. Surgery

invokes the aid of all the mechanical arts. From the rude violences of

the age of stone,--a relic of which we may find in the practice of

Zipporah, the wife of Moses,--to the delicate operations of to-day upon

patients lulled into temporary insensibility, is a progress which

presupposes a skill in metallurgy and in the labors of the workshop and

the laboratory it has taken uncounted generations to accumulate. Before

the morphia which deadens the pain of neuralgia, or the quinine which

arrests the fit of an ague, can find their place in our pharmacies,

commerce must have perfected its machinery, and science must have refined

its processes, through periods only to be counted by the life of nations.

Before the means which nature and art have put in the hands of the

medical practitioner can be fairly brought into use, the prejudices of

the vulgar must be overcome, the intrusions of false philosophy must be

fenced out, and the partnership with the priesthood dissolved. All this

implies that freedom and activity of thought which belong only to the

most advanced conditions of society; and the progress towards this is by

gradations as significant of wide-spread changes, as are the varying

states of the barometer of far-extended conditions of the atmosphere.

Apart, then, from its special and technical interest, my subject has a

meaning which gives a certain importance, and even dignity, to details in

themselves trivial and almost unworthy of record. A medical entry in

Governor Winthrop's journal may seem at first sight a mere curiosity;

but, rightly interpreted, it is a key to his whole system of belief as to

the order of the universe and the relations between man and his Maker.

Nothing sheds such light on the superstitions of an age as the prevailing

interpretation and treatment of disease. When the touch of a profligate

monarch was a cure for one of the most inveterate of maladies, when the

common symptoms of hysteria were prayed over as marks of demoniacal

possession, we might well expect the spiritual realms of thought to be

peopled with still stranger delusions.

Let us go before the Pilgrims of the Mayflower, and look at the shores on

which they were soon to land. A wasting pestilence had so thinned the

savage tribes that it was sometimes piously interpreted as having

providentially prepared the way for the feeble band of exiles. Cotton

Mather, who, next to the witches, hated the "tawnies," "wild beasts,"

"blood-hounds," "rattlesnakes," "infidels," as in different places he

calls the unhappy Aborigines, describes the condition of things in his

lively way, thus: "The Indians in these Parts had newly, even about a

Year or Two before, been visited with such a prodigious Pestilence; as

carried away not a Tenth, but Nine Parts of Ten (yea't is said Nineteen

of Twenty) among them so that the Woods were almost cleared of those

pernicious Creatures to make Room for a better Growth."

What this pestilence was has been much discussed. It is variously

mentioned by different early writers as "the plague," "a great and

grievous plague," "a sore consumption," as attended with spots which left

unhealed places on those who recovered, as making the "whole surface

yellow as with a garment." Perhaps no disease answers all these

conditions so well as smallpox. We know from different sources what

frightful havoc it made among the Indians in after years,--in 1631, for

instance, when it swept away the aboriginal inhabitants of "whole towns,"

and in 1633. We have seen a whole tribe, the Mandans, extirpated by it

in our own day. The word "plague" was used very vaguely, as in the

description of the "great sickness" found among the Indians by the

expedition of 1622. This same great sickness could hardly have been

yellow fever, as it occurred in the month of November. I cannot think,

therefore, that either the scourge of the East or our Southern malarial

pestilence was the disease that wasted the Indians. As for the

yellowness like a garment, that is too familiar to the eyes of all who

have ever looked on the hideous mask of confluent variola.

Without the presence or the fear of these exotic maladies, the forlorn

voyagers of the Mayflower had sickness enough to contend with. At their

first landing at Cape Cod, gaunt and hungry and longing for fresh food,

they found upon the sandy shore "great mussel's, and very fat and full of

sea-pearl." Sailors and passengers indulged in the treacherous delicacy;

which seems to have been the sea-clam; and found that these mollusks,

like the shell the poet tells of, remembered their august abode, and

treated the way-worn adventurers to a gastric reminiscence of the heaving

billows. In the mean time it blew and snowed and froze. The water turned

to ice on their clothes, and made them many times like coats of iron.

Edward Tilley had like to have "sounded" with cold. The gunner, too, was

sick unto death, but "hope of trucking" kept him on his feet,--a Yankee,

it should seem, when he first touched the shore of New England. Most, if

not all, got colds and coughs, which afterwards turned to scurvy, whereof

many died.

How can we wonder that the crowded and tempest-tossed voyagers, many of

them already suffering, should have fallen before the trials of the first

winter in Plymouth? Their imperfect shelter, their insufficient supply

of bread, their salted food, now in unwholesome condition, account too

well for the diseases and the mortality that marked this first dreadful

season; weakness, swelling of the limbs, and other signs of scurvy,

betrayed the want of proper nourishment and protection from the elements.

In December six of their number died, in January eight, in February,

seventeen, in March thirteen. With the advance of spring the mortality

diminished, the sick and lame began to recover, and the colonists,

saddened but not disheartened, applied themselves to the labors of the

opening year.

One of the most pressing needs of the early colonists must have been that

of physicians and surgeons. In Mr. Savage's remarkable Genealogical

Dictionary of the first settlers who came over before 1692 and their

descendants to the third generation, I find scattered through the four

crowded volumes the names of one hundred and thirty-four medical

practitioners. Of these, twelve, and probably many more, practised

surgery; three were barber-surgeons. A little incident throws a glimmer

from the dark lantern of memory upon William Direly, one of these

practitioners with the razor and the lancet. He was lost between Boston

and Roxbury in a violent tempest of wind and snow; ten days afterwards a

son was born to his widow, and with a touch of homely sentiment, I had

almost said poetry, they called the little creature "Fathergone" Direly.

Six or seven, probably a larger number, were ministers as well as

physicians, one of whom, I am sorry to say, took to drink and tumbled

into the Connecticut River, and so ended. One was not only doctor, but

also schoolmaster and poet. One practised medicine and kept a tavern.

One was a butcher, but calls himself a surgeon in his will, a union of

callings which suggests an obvious pleasantry. One female practitioner,

employed by her own sex,--Ann Moore,--was the precursor of that intrepid

sisterhood whose cause it has long been my pleasure and privilege to

advocate on all fitting occasions.

Outside of this list I must place the name of Thomas Wilkinson, who was

complained of, is 1676, for practising contrary to law.

Many names in the catalogue of these early physicians have been

associated, in later periods, with the practice of the profession,

--among them, Boylston, Clark, Danforth, Homan, Jeffrey, Kittredge,

Oliver, Peaslee, Randall, Shattuck, Thacher, Wellington, Williams,

Woodward. Touton was a Huguenot, Burchsted a German from Silesia,

Lunerus a German or a Pole; "Pighogg Churrergeon," I hope, for the honor

of the profession, was only Peacock disguised under this alias, which

would not, I fear, prove very attractive to patients.

What doctrines and practice were these colonists likely to bring, with

them?

Two principal schools of medical practice prevailed in the Old World

during the greater part of the seventeenth century. The first held to

the old methods of Galen: its theory was that the body, the microcosm,

like the macrocosm, was made up of the four elements--fire, air, water,

earth; having respectively the qualities hot, dry, moist, cold. The body

was to be preserved in health by keeping each of these qualities in its

natural proportion; heat, by the proper temperature; moisture, by the due

amount of fluid; and so as to the rest. Diseases which arose from excess

of heat were to be attacked by cooling remedies; those from excess of

cold, by heating ones; and so of the other derangements of balance. This

was truly the principle of contraries contrariis, which ill-informed

persons have attempted to make out to be the general doctrine of

medicine, whereas there is no general dogma other than this: disease is

to be treated by anything that is proved to cure it. The means the

Galenist employed were chiefly diet and vegetable remedies, with the use

of the lancet and other depleting agents. He attributed the four

fundamental qualities to different vegetables, in four different degrees;

thus chicory was cold in the fourth degree, pepper was hot in the fourth,

endive was cold and dry in the second, and bitter almonds were hot in the

first and dry in the second degree. When we say "cool as a cucumber," we

are talking Galenism. The seeds of that vegetable ranked as one of "the

four greater cold seeds" of this system.

Galenism prevailed mostly in the south of Europe and France. The readers

of Moliere will have no difficulty in recalling some of its favorite

modes of treatment, and the abundant mirth he extracted from them.

These Galenists were what we should call "herb-doctors" to-day. Their

insignificant infusions lost credit after a time; their absurdly

complicated mixtures excited contempt, and their nauseous prescriptions

provoked loathing and disgust. A simpler and bolder practice found

welcome in Germany, depending chiefly on mineral remedies, mercury,

antimony, sulphur, arsenic, and the use, sometimes the secret use, of

opium. Whatever we think of Paracelsus, the chief agent in the

introduction of these remedies, and whatever limits we may assign to the

use of these long-trusted mineral drugs, there can be no doubt that the

chemical school, as it was called, did a great deal towards the

expurgation of the old, overloaded, and repulsive pharmacopoeia. We

shall find evidence in the practice of our New-England physicians of the

first century, that they often employed chemical remedies, and that, by

the early part of the following century, their chief trust was in the few

simple, potent drugs of Paracelsus.

We have seen that many of the practitioners of medicine, during the first

century of New England, were clergymen. This relation between medicine

and theology has existed from a very early period; from the Egyptian

priest to the Indian medicine-man, the alliance has been maintained in

one form or another. The partnership was very common among our British

ancestors. Mr. Ward, the Vicar of Stratford-on-Avon, himself a notable

example of the union of the two characters, writing about 1660, says,

"The Saxons had their blood-letters, but under the Normans physicke,

begunne in England; 300 years agoe itt was not a distinct profession by

itself, but practised by men in orders, witness Nicholas de Ternham, the

chief English physician and Bishop of Durham; Hugh of Evesham, a

physician and cardinal; Grysant, physician and pope; John Chambers, Dr.

of Physick, was the first Bishop of Peterborough; Paul Bush, a bachelor

of divinitie in Oxford, was a man well read in physick as well as

divinitie, he was the first bishop of Bristol."

"Again in King Richard the Second's time physicians and divines were not

distinct professions; for one Tydeman, Bishop of Landaph and Worcester,

was physician to King Richard the Second."

This alliance may have had its share in creating and keeping up the many

superstitions which have figured so largely in the history of medicine.

It is curious to see that a medical work left in manuscript by the Rev.

Cotton Mather and hereafter to be referred to, is running over with

follies and superstitious fancies; while his contemporary and

fellow-townsman, William Douglass, relied on the same few simple remedies

which, through Dr. Edward Holyoke and Dr. James Jackson, have come down

to our own time, as the most important articles of the materia medica.

Let us now take a general glance at some of the conditions of the early

settlers; and first, as to the healthfulness of the climate. The

mortality of the season that followed the landing of the Pilgrims at

Plymouth has been sufficiently accounted for. After this, the colonists

seem to have found the new country agreeing very well with their English

constitutions. Its clear air is the subject of eulogy. Its dainty

springs of sweet water are praised not only by Higginson and Wood, but

even the mischievous Morton says, that for its delicate waters "Canaan

came not near this country." There is a tendency to dilate on these

simple blessings, which reminds one a little of the Marchioness in

Dickens's story, with her orange-peel-and-water beverage. Still more

does one feel the warmth of coloring,--such as we expect from converts to

a new faith, and settlers who want to entice others over to their

clearings, when Winslow speaks, in 1621, of "abundance of roses, white,

red, and damask; single, but very sweet indeed;" a most of all, however,

when, in the same connection, he says, "Here are grapes white and red,

and very sweet and strong also." This of our wild grape, a little

vegetable Indian, which scalps a civilized man's mouth, as his animal

representative scalps his cranium. But there is something quite charming

in Winslow's picture of the luxury in which they are living. Lobsters,

oysters, eels, mussels, fish and fowl, delicious fruit, including the

grapes aforesaid,--if they only had "kine, horses, and sheep," he makes

no question but men would live as contented here as in any part of the

world. We cannot help admiring the way in which they took their trials,

and made the most of their blessings.

"And how Content they were," says Cotton Mather, "when an Honest Man, as

I have heard, inviting his Friends to a Dish of Clams, at the Table gave

Thanks to Heaven, who had given them to suck the abundance of the Seas,

and of the Treasures Aid in the Sands!"

Strangely enough, as it would seem, except for this buoyant determination

to make the best of everything, they hardly appear to recognize the

difference of the climate from that which they had left. After almost

three years' experience, Winslow says, he can scarce distinguish New

England from Old England, in respect of heat and cold, frost, snow, rain,

winds, etc. The winter, he thinks (if there is a difference), is sharper

and longer; but yet he may be deceived by the want of the comforts he

enjoyed at home. He cannot conceive any climate to agree better with the

constitution of the English, not being oppressed with extremity of heats,

nor nipped by biting cold:

"By which means, blessed be God, we enjoy our health, notwithstanding

those difficulties we have undergone, in such a measure as would have

been admired, if we had lived in England with the like means."

Edward Johnson, after mentioning the shifts to which they were put for

food, says,--

"And yet, methinks, our children are as cheerful, fat, and lusty, with

feeding upon those mussels, clams, and other fish, as they were in

England with their fill of bread."

Higginson, himself a dyspeptic, "continually in physic," as he says, and

accustomed to dress in thick clothing, and to comfort his stomach with

drink that was "both strong and stale,"--the "jolly good ale and old," I

suppose, of free and easy Bishop Still's song,--found that he both could

and did oftentimes drink New England water very well,--which he seems to

look upon as a remarkable feat. He could go as lightclad as any, too,

with only a light stuff cassock upon his shirt, and stuff breeches

without linings. Two of his children were sickly: one,--little misshapen

Mary,--died on the passage, and, in her father's words, "was the first in

our ship that was buried in the bowels of the great Atlantic sea;" the

other, who had been "most lamentably handled" by disease, recovered

almost entirely "by the very wholesomeness of the air, altering,

digesting, and drying up the cold and crude humors of the body."

Wherefore, he thinks it a wise course for all cold complexions to come to

take physic in New England, and ends with those often quoted words, that

"a sup of New England's air is better than a whole draught of Old

England's ale." Mr. Higginson died, however, "of a hectic fever," a

little more than a year after his arrival.

The medical records which I shall cite show that the colonists were not

exempt from the complaints of the Old World. Besides the common diseases

to which their descendants are subject, there were two others, to say

nothing of the dreaded small-pox, which later medical science has

disarmed,--little known among us at the present day, but frequent among

the first settlers. The first of these was the scurvy, already

mentioned, of which Winthrop speaks in 1630, saying, that it proved fatal

to those who fell into discontent, and lingered after their former

conditions in England; the poor homesick creatures in fact, whom we so

forget in our florid pictures of the early times of the little band in

the wilderness. Many who were suffering from scurvy got well when the

Lyon arrived from England, bringing store of juice of lemons. The

Governor speaks of another case in 1644; and it seems probable that the

disease was not of rare occurrence.

The other complaint from which they suffered, but which has nearly

disappeared from among us, was intermittent fever, or fever and ague. I

investigated the question as to the prevalence of this disease in New

England, in a dissertation, which was published in a volume with other

papers, in the year 1838. I can add little to the facts there recorded.

One which escaped me was, that Joshua Scottow, in "Old Men's Tears,"

dated 1691, speaks of "shaking agues," as among the trials to which they

had been subjected. The outline map of New England, accompanying the

dissertation above referred to, indicates all the places where I had

evidence that the disease had originated. It was plain enough that it

used to be known in many localities where it has long ceased to be

feared. Still it was and is remarkable to see what a clean bill of

health in this particular respect our barren soil inherited with its

sterility. There are some malarious spots on the edge of Lake Champlain,

and there have been some temporary centres of malaria, within the memory

of man, on one or more of our Massachusetts rivers, but these are

harmless enough, for the most part, unless the millers dam them, when

they are apt to retaliate with a whiff from their meadows, that sets the

whole neighborhood shaking with fever and ague.

The Pilgrims of the Mayflower had with them a good physician, a man of

standing, a deacon of their church, one whom they loved and trusted, Dr.

Samuel Fuller. But no medical skill could keep cold and hunger and bad

food, and, probably enough, desperate homesickness in some of the feebler

sort, from doing their work. No detailed record remains of what they

suffered or what was attempted for their relief during the first sad

winter. The graves of those who died were levelled and sowed with grain

that the losses of the little band might not be suspected by the savage

tenants of the wilderness, and their story remains untold.

Of Dr. Fuller's practice, at a later period, we have an account in a

letter of his to Governor Bradford, dated June, 1630. "I have been to

Matapan" (now Dorchester), he says, "and let some twenty of those people

blood." Such wholesale depletion as this, except with avowed homicidal

intent, is quite unknown in these days; though I once saw the noted

French surgeon, Lisfranc, in a fine phlebotomizing frenzy, order some ten

or fifteen patients, taken almost indiscriminately, to be bled in a

single morning.

Dr. Fuller's two visits to Salem, at the request of Governor Endicott,

seem to have been very satisfactory to that gentleman. Morton, the wild

fellow of Merry Mount, gives a rather questionable reason for the

Governor's being so well pleased with the physician's doings. The names

under which he mentions the two personages, it will be seen, are not

intended to be complimentary. "Dr. Noddy did a great cure for Captain

Littleworth. He cured him of a disease called a wife." William Gager,

who came out with Winthrop, is spoken of as "a right godly man and

skilful chyrurgeon, but died of a malignant fever not very long after his

arrival."

Two practitioners of the ancient town of Newbury are entitled to special

notice, for different reasons. The first is Dr. John Clark, who is said

by tradition to have been the first regularly educated physician who

resided in New England. His portrait, in close-fitting skull-cap, with

long locks and venerable flowing beard, is familiar to our eyes on the

wall of our Society's antechamber. His left hand rests upon a skull, his

right hand holds an instrument which deserves a passing comment. It is a

trephine, a surgical implement for cutting round pieces out of broken

skulls, so as to get at the fragments which have been driven in, and lift

them up. It has a handle like that of a gimlet, with a claw like a

hammer, to lift with, I suppose, which last contrivance I do not see

figured in my books. But the point I refer to is this: the old

instrument, the trepan, had a handle like a wimble, what we call a brace

or bit-stock. The trephine is not mentioned at all in Peter Lowe's book,

London, 1634; nor in Wiseman's great work on Surgery, London, 1676; nor

in the translation of Dionis, published by Jacob Tonson, in 1710. In fact

it was only brought into more general use by Cheselden and Sharpe so late

as the beginning of the last century. As John Clark died in 1661, it is

remarkable to see the last fashion in the way of skull-sawing

contrivances in his hands,--to say nothing of the claw on the handle, and

a Hey's saw, so called in England, lying on the table by him, and painted

there more than a hundred years before Hey was born. This saw is an old

invention, perhaps as old as Hippocrates, and may be seen figured in the

"Armamentarium Chirurgicum" of Scultetus, or in the Works of Ambroise

Pare.

Dr. Clark is said to have received a diploma before he came, for skill in

lithotomy. He loved horses, as a good many doctors do, and left a good

property, as they all ought to do. His grave and noble presence, with

the few facts concerning him, told with more or less traditional

authority, give us the feeling that the people of Newbury, and afterwards

of Boston, had a wise and skilful medical adviser and surgeon in Dr. John

Clark.

The venerable town of Newbury had another physician who was less

fortunate. The following is a court record of 1652:

"This is to certify whom it may concern, that we the subscribers, being

called upon to testify against doctor William Snelling for words by him

uttered, affirm that being in way of merry discourse, a health being

drank to all friends, he answered,

"I'll pledge my friends,

And for my foes

A plague for their heels

And,'----

[a similar malediction on the other extremity of their feet.]

"Since when he hath affirmed that he only intended the proverb used in

the west country, nor do we believe he intended otherwise.

"[Signed] "WILLIAM THOMAS. "THOMAS MILWARD.

"March 12th 1651, All which I acknowledge, and am sorry I did not

expresse my intent, or that I was so weak as to use so foolish a proverb.

"[Signed] "GULIELMUS SNELLING."

Notwithstanding this confession and apology, the record tells us that

"William Snelling in his presentment for cursing is fined ten shillings

and the fees of court."

I will mention one other name among those of the Fathers of the medical

profession in New England. The "apostle" Eliot says, writing in 1647,

"We never had but one anatomy in the country, which Mr. Giles Firman, now

in England, did make and read upon very well."

Giles Firmin, as the name is commonly spelled, practised physic in this

country for a time. He seems to have found it a poor business; for, in a

letter to Governor Winthrop, he says, "I am strongly sett upon to studye

divinitie: my studyes else must be lost, for physick is but a meene

helpe."

Giles Firmin's Lectures on Anatomy were the first scientific teachings of

the New World. While the Fathers were enlightened enough to permit such

instructions, they were severe in dealing with quackery; for, in 1631,

our court records show that one Nicholas Knopp, or Knapp, was sentenced

to be fined or whipped "for taking upon him to cure the scurvey by a

water of noe worth nor value, which he solde att a very deare rate."

Empty purses or sore backs would be common with us to-day if such a rule

were enforced.

Besides the few worthies spoken of, and others whose names I have not

space to record, we must remember that there were many clergymen who took

charge of the bodies as well as the souls of their patients, among them

two Presidents of Harvard College, Charles Chauncy and Leonard Hoar,--and

Thomas Thacher, first minister of the "Old South," author of the earliest

medical treatises printed in the country,[A Brief Rule to Guide the

Common People in Small pox and Measles. 1674.] whose epitaph in Latin

and Greek, said to have been written by Eleazer, an "Indian Youth" and a

member of the Senior Class of Harvard College, may be found in the

"Magnalia." I miss this noble savage's name in our triennial catalogue;

and as there is many a slip between the cup and lip, one is tempted to

guess that he may have lost his degree by some display of his native

instinct,--possibly a flourish of the tomahawk or scalping-knife.

However this may have been, the good man he celebrated was a notable

instance of the Angelical Conjunction, as the author of the "Magnalia"

calls it, of the offices of clergyman and medical practitioner.

Michael Wigglesworth, author of the "Day of Doom," attended the sick,

"not only as a Pastor, but as a Physician too, and this, not only in his

own town, but also in all those of the vicinity." Mather says of the

sons of Charles Chauncy, "All of these did, while they had Opportunity,

Preach the Gospel; and most, if not all of them, like their excellent

Father before them, had an eminent skill in physick added unto their

other accomplishments," etc. Roger Williams is said to have saved many

in a kind of pestilence which swept away many Indians.

To these names must be added, as sustaining a certain relation to the

healing art, that of the first Governor Winthrop, who is said by John

Cotton to have been "Help for our Bodies by Physick [and] for our Estates

by Law," and that of his son, the Governor of Connecticut, who, as we

shall see, was as much physician as magistrate.

I had submitted to me for examination, in 1862, a manuscript found among

the Winthrop Papers, marked with the superscription, "For my worthy

friend Mr. Wintrop," dated in 1643, London, signed Edward Stafford, and

containing medical directions and prescriptions. It may be remembered by

some present that I wrote a report on this paper, which was published in

the "Proceedings" of this Society. Whether the paper was written for

Governor John Winthrop of Massachusetts, or for his son, Governor John of

Connecticut, there is no positive evidence that I have been able to

obtain. It is very interesting, however, as giving short and simple

practical directions, such as would be most like to be wanted and most

useful, in the opinion of a physician in repute of that day.

The diseases prescribed for are plague, small-pox, fevers, king's evil,

insanity, falling-sickness, and the like; with such injuries as broken

bones, dislocations, and burning with gunpowder. The remedies are of

three kinds: simples, such as St. John's wort, Clown's all-heal, elder,

parsley, maidenhair, mineral drugs, such as lime, saltpetre, Armenian

bole, crocus metallorum, or sulphuret of antimony; and thaumaturgic or

mystical, of which the chief is, "My black powder against the plague,

small-pox; purples, all sorts of feavers; Poyson; either, by Way of

Prevention or after Infection." This marvellous remedy was made by

putting live toads into an earthen pot so as to half fill it, and baking

and burning them "in the open ayre, not in an house,"--concerning which

latter possibility I suspect Madam Winthrop would have had something to

say,--until they could be reduced by pounding, first into a brown, and

then into a black, powder. Blood-letting in some inflammations, fasting

in the early stage of fevers, and some of those peremptory drugs with

which most of us have been well acquainted in our time, the infragrant

memories of which I will not pursue beyond this slight allusion, are

among his remedies.

The Winthrops, to one of whom Dr. Stafford's directions were addressed,

were the medical as well as the political advisers of their

fellow-citizens for three or four successive generations. One of them,

Governor John of Connecticut, practised so extensively, that, but for his

more distinguished title in the State, he would have been remembered as

the Doctor. The fact that he practised in another colony, for the most

part, makes little difference in the value of the records we have of his

medical experience, which have fortunately been preserved, and give a

very fair idea, in all probability, of the way in which patients were

treated in Massachusetts, when they fell into intelligent and somewhat

educated hands, a little after the middle of the seventeenth century:

I have before me, while writing, a manuscript collection of the medical

cases treated by him, and recorded at the time in his own hand, which has

been intrusted to me by our President, his descendant.

They are generally marked Hartford, and extend from the year 1657 to

1669. From these, manuscripts, and from the letters printed in the

Winthrop Papers published by our Society, I have endeavored to obtain

some idea of the practice of Governor John Winthrop, Junior. The learned

eye of Mr. Pulsifer would have helped me, no doubt, as it has done in

other cases; but I have ventured this time to attempt finding my own way

among the hieroglyphics of these old pages. By careful comparison of

many prescriptions, and by the aid of Schroder, Salmon, Culpeper, and

other old compilers, I have deciphered many of his difficult paragraphs

with their mysterious recipes.

The Governor employed a number of the simples dear to ancient women,

--elecampane and elder and wormwood and anise and the rest; but he also

employed certain mineral remedies, which he almost always indicates by

their ancient symbols, or by a name which should leave them a mystery to

the vulgar. I am now prepared to reveal the mystic secrets of the

Governor's beneficent art, which rendered so many good and great as well

as so many poor and dependent people his debtors,--at least, in their

simple belief,--for their health and their lives.

His great remedy, which he gave oftener than any other, was nitre; which

he ordered in doses of twenty or thirty grains to adults, and of three

grains to infants. Measles, colics, sciatica, headache, giddiness, and

many other ailments, all found themselves treated, and I trust bettered,

by nitre; a pretty safe medicine in moderate doses, and one not likely to

keep the good Governor awake at night, thinking whether it might not

kill, if it did not cure. We may say as much for spermaceti, which he

seems to have considered "the sovereign'st thing on earth" for inward

bruises, and often prescribes after falls and similar injuries.

One of the next remedies, in point of frequency, which he was in the

habit of giving, was (probably diaphoretic) antimony; a mild form of that

very active metal, and which, mild as it was, left his patients very

commonly with a pretty strong conviction that they had been taking

something that did not exactly agree with them. Now and then he gave a

little iron or sulphur or calomel, but very rarely; occasionally, a good,

honest dose of rhubarb or jalap; a taste of stinging horseradish, oftener

of warming guiacum; sometimes an anodyne, in the shape of

mithridate,--the famous old farrago, which owed its virtue to poppy

juice; [This is the remedy which a Boston divine tried to simplify. See

Electuarium Novum Alexipharmacum, by Rev. Thomas Harward, lecturer at

the Royal Chappell. Boston, 1732. This tract is in our Society's

library.] very often, a harmless powder of coral; less frequently, an

inert prescription of pleasing amber; and (let me say it softly within

possible hearing of his honored descendant), twice or oftener,--let us

hope as a last resort,--an electuary of millipedes,--sowbugs, if we must

give them their homely English name. One or two other prescriptions, of

the many unmentionable ones which disgraced the pharmacopoeia of the

seventeenth century, are to be found, but only in very rare instances, in

the faded characters of the manuscript.

The excellent Governor's accounts of diseases are so brief, that we get

only a very general notion of the complaints for which he prescribed.

Measles and their consequences are at first more prominent than any other

one affection, but the common infirmities of both sexes and of all ages

seem to have come under his healing hand. Fever and ague appears to have

been of frequent occurrence.

His published correspondence shows that many noted people were in

communication with him as his patients. Roger Williams wants a little of

his medicine for Mrs. Weekes's daughter; worshipful John Haynes is in

receipt of his powders; troublesome Captain Underhill wants "a little

white vitterall" for his wife, and something to cure his wife's friend's

neuralgia, (I think his wife's friend's husband had a little rather have

had it sent by the hands of Mrs. Underhill, than by those of the gallant

and discursive captain); and pious John Davenport says, his wife "tooke

but one halfe of one of the papers" (which probably contained the

medicine he called rubila), "but could not beare the taste of it, and is

discouraged from taking any more;" and honored William Leete asks for

more powders for his "poore little daughter Graciana," though he found it

"hard to make her take it," delicate, and of course sensitive, child as

she was, languishing and dying before her time, in spite of all the

bitter things she swallowed,--God help all little children in the hands

of dosing doctors and howling dervishes! Restless Samuel Gorton, now

tamed by the burden of fourscore and two years, writes so touching an

account of his infirmities, and expresses such overflowing gratitude for

the relief he has obtained from the Governor's prescriptions, wondering

how "a thing so little in quantity, so little in sent, so little in

taste, and so little to sence in operation, should beget and bring forth

such efects," that we repent our hasty exclamation, and bless the memory

of the good Governor, who gave relief to the worn-out frame of our

long-departed brother, the sturdy old heretic of Rhode Island.

What was that medicine which so frequently occurs in the printed letters

under the name of "rubila"? It is evidently a secret remedy, and, so far

as I know, has not yet been made out. I had almost given it up in

despair, when I found what appears to be a key to the mystery. In the

vast multitude of prescriptions contained in the manuscripts, most of

them written in symbols, I find one which I thus interpret:

"Four grains of (diaphoretic) antimony, with twenty grains of nitre, with

a little salt of tin, making rubila." Perhaps something was added to

redden the powder, as he constantly speaks of "rubifying" or "viridating"

his prescriptions; a very common practice of prescribers, when their

powders look a little too much like plain salt or sugar.

Waitstill Winthrop, the Governor's son, "was a skilful physician," says

Mr. Sewall, in his funeral sermon; "and generously gave, not only his

advice, but also his Medicines, for the healing of the Sick, which, by

the Blessing of God, were made successful for the recovery of many."

"His son John, a member of the Royal Society, speaks of himself as 'Dr.

Winthrop,' and mentions one of his own prescriptions in a letter to

Cotton Mather." Our President tells me that there was an heirloom of the

ancient skill in his family, within his own remembrance, in the form of a

certain precious eye-water, to which the late President John Quincy Adams

ascribed rare virtue, and which he used to obtain from the possessor of

the ancient recipe.

These inherited prescriptions are often treasured in families, I do not

doubt, for many generations. When I was yet of trivial age, and

suffering occasionally, as many children do, from what one of my

Cambridgeport schoolmates used to call the "ager,"--meaning thereby

toothache or face-ache,--I used to get relief from a certain plaster

which never went by any other name in the family than "Dr. Oliver."

Dr. James Oliver was my great-great-grandfather, graduated in 1680, and

died in 1703. This was, no doubt, one of his nostrums; for nostrum, as

is well known, means nothing more than our own or my own particular

medicine, or other possession or secret, and physicians in old times used

to keep their choice recipes to themselves a good deal, as we have had

occasion to see.

Some years ago I found among my old books a small manuscript marked

"James Oliver. This Book Begun Aug. 12, 1685." It is a rough sort of

account-book, containing among other things prescriptions for patients,

and charges for the same, with counter-charges for the purchase of

medicines and other matters. Dr. Oliver practised in Cambridge, where

may be seen his tomb with inscriptions, and with sculptured figures that

look more like Diana of the Ephesians, as given in Calmet's Dictionary,

than like any angels admitted into good society here or elsewhere.

I do not find any particular record of what his patients suffered from,

but I have carefully copied out the remedies he mentions, and find that

they form a very respectable catalogue. Besides the usual simples,

elder, parsley, fennel, saffron, snake-root, wormwood, I find the Elixir

Proprietatis, with other elixire and cordials, as if he rather fancied

warming medicines; but he called in the aid of some of the more energetic

remedies, including iron, and probably mercury, as he bought two pounds

of it at one time.

The most interesting item is his bill against the estate of Samuel Pason

of Roxbury, for services during his last illness. He attended this

gentleman,--for such he must have been, by the amount of physic which he

took, and which his heirs paid for,--from June 4th, 1696, to September 3d

of the same year, three months. I observe he charges for visits as well

as for medicines, which is not the case in most of his bills. He opens

the attack with a carminative appeal to the visceral conscience, and

follows it up with good hard-hitting remedies for dropsy,--as I suppose

the disease would have been called,--and finishes off with a rallying

dose of hartshorn and iron.

It is a source of honest pride to his descendant that his bill, which was

honestly paid, as it seems to have been honorably earned, amounted to the

handsome total of seven pounds and two shillings. Let me add that he

repeatedly prescribes plaster, one of which was very probably the "Dr.

Oliver" that soothed my infant griefs, and for which I blush to say that

my venerated ancestor received from Goodman Hancock the painfully

exiguous sum of no pounds, no shillings, and sixpence.

I have illustrated the practice of the first century, from the two

manuscripts I have examined, as giving an impartial idea of its every-day

methods. The Governor, Johannes Secundus, it is fair to remember, was an

amateur practitioner, while my ancestor was a professed physician.

Comparing their modes of treatment with the many scientific follies still

prevailing in the Old World, and still more with the extraordinary

theological superstitions of the community in which they lived, we shall

find reason, I think, to consider the art of healing as in a

comparatively creditable state during the first century of New England.

In addition to the evidence as to methods of treatment furnished by the

manuscripts I have cited, I subjoin the following document, to which my

attention was called by Dr. Shurtleff, our present Mayor. This is a

letter of which the original is to be found in vol. lxix. page 10 of the

"Archives" preserved at the State House in Boston. It will be seen that

what the surgeon wanted consisted chiefly of opiates, stimulants,

cathartics, plasters, and materials for bandages. The complex and varied

formulae have given place to simpler and often more effective forms of

the same remedies; but the list and the manner in which it is made out

are proofs of the good sense and schooling of the surgeon, who, it may be

noted, was in such haste that he neglected all his stops. He might well

be in a hurry, as on the very day upon which he wrote, a great body of

Indians--supposed to be six or seven hundred--appeared before Hatfield;

and twenty-five resolute young men of Hadley, from which town he wrote,

crossed the river and drove them away.

HADLY May 30: 76

Mr RAWSON Sr

What we have recd by Tho: Houey the past month is not the cheifest of our

wants as you have love for poor wounded I pray let us not want for these

following medicines if you have not a speedy conveyance of them I pray

send on purpose they are those things mentioned in my former letter but

to prevent future mistakes I have wrote them att large wee have great

want with the greatest halt and speed let us be supplyed. Sr Yr Sert WILL

LOCHS

(Endorsed)

Mr. Lockes Letter Recd from the Governor 13 Jane & acquainted ye Council

with it but could not obtaine any thing to be sent in answer thereto.

13 June 1676

I have given some idea of the chief remedies used by our earlier

physicians, which were both Galenic and chemical; that is, vegetable and

mineral. They, of course, employed the usual perturbing medicines which

Montaigne says are the chief reliance of their craft. There were,

doubtless, individual practitioners who employed special remedies with

exceptional boldness and perhaps success. Mr. Eliot is spoken of, in a

letter of William Leete to Winthrop, Junior, as being under Mr.

Greenland's mercurial administrations. The latter was probably enough

one of these specialists.