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Toua lea autres axemplairee originaux sont filmte en commen^ant par la premiere page qui comporte une empreinte d'impression ou d'illustration -vt an terminant par la darniire page qui comporte une telle empreinte. Un dee symboles suivanta apparaftra sur la darnlAre image de cheque microfiche, selon le caa: la symbols — «» signifie "A SUIVRE", le symbols y signifie "FIN". Les cartas, pia'ncheec tableaux, etc., peuvent Atre fllmte A dee taux de reduction diff«rents. Lorsque le document est trop grand pour Atre reproduit en un seul clich*. ii est film« A partir de I'angle supArieur gauche, de gaucho A droita, et de haut en bas. an prenant le nombre d'imagea nAcassaira. Les diagrammes suivanta illuatrant la m^thode. 1 2 3 4 5 6 V. ^^ /- ■ INTEODUCTORY LEOTUHE, Delivered at the opening of the Faculty of Medicine, University of MoGUl College, November 5, 1860, by D. C. MaoCallum, M. D., Professor of Clinical Medicine and Medical Junsprudenoe. Gentlemen, — Our first duty in meeting together for the first time in thie new and beautiful lecture room, is to pay a tribute of respect to the memory of one who during his life time held the most prominent position amongst the Me- dical Faculty, who waa one of the original founders of the medicd school of McGill College, who was always the conscientious and indefatigable supporfpx of its best interests, and the warm and faithful friend of its alumni. I refer to Dr. Andrew F. Holmes, late Dean and Professor in this University. To the majority of those I address, he was personally known, and I am certain that the hearts of many of you, even as I speak, will bear silent witness to the truth of what I now say, that loved and respected as he waa by all, he was most loved and respected by those who knew him best. His was one of those quiet and un- demonstrative natures that attract not the giddy and thoughtless many, but that are appreciated thorougnly by the discriminating few. Around men such as he was, cluster home affections, the loves of kindred and the truest friendships. The deep warm current of feeling underlying the cool and placid surface of mere manner, is only known to those who have taken the trouble to sound carefully the depths of such hearts. Dr. Holmes, as you well know, was universally and deservedly esteemed in this city, for that high sense of duty towards his God and towards his fellowmen, the possession of which invariaUy characterizes the true Christian. No person, I firmly believe, ever felt more sincere anxiety to know what were his duties in all the relations of life, or performed these duties with more unswerving conscien- tiousness, when he once fully understood in what they consisted. During his connection with this medical school, from the time he associated himself, about the year 1824, with the late Drs. Bobertson, Stephenson, and Caldwell, in its 31 \ 9 establishment, down to the period of his sudden demise, he laboured unceasingly for its advancement. Many able men have, at various times, been connected with it as lecturers or professors ; but not one ever had its welfare more at heart or strove more earnestly and assiduously for its success. To Dr. Holmes, then, the last of the founders of this school, to his talented co-founders and their able successors, now no more, and to the older members of the present faculty, belongs the honour of placing McGill College in the proud position she now oc- cupies in the estimation of the public, both at home and abroad, as a flourishing and successful school of medicine. In the practice of his profession he was everything that a true physician ought to be :— courteous, kind, attentive, considerate, cautious. His sympathies were ever with suffering humanity. The querulous complainings of the sick, the stories of their manifold trials and sorrows, fell not upon an impatient or inat- tentive ear. The sympathizing countenance, the word of comfort, and the en- couraging tone of voice were ever ready with him t'- soothe the pain-racked victims of disease, to cheer the mourning and desolate ones, and to raise the fearful and downcast. In the life of Dr. Holmes, moral, social and professional, you and I, gentle- men, have an example which we would do well to closely follow. Strive, then, to live as he lived, and whether or not the summons to quit this weary worid comes to you in as sudden and unexpected a manner as it came to him, happy and peaceful will be your end ; for what saith the inspired Psalmist—" Mark the perfect man, and behold the upright, for the end of that man is peace." " Knowledge," says Addison, " is that which, next to virtue, truly and essen- tially raises one man above another. It finishes one-half of the human soul." Would you test the truth of this assertion, gentlemen ? Then, look abroad into the world and single out from the community of nations those that occupy the most commanding positions — whose might is feared — whose friendship is courted, and whose counsels are respected : examine into the causes of their superiority to other nations, and you will find the most prominent one to be — that they excel in knowledge. Look around you — and, whether you reside in a city — a town, cr a village hamlet, what do you observe? Who are the men most honored and respected in the community, who av the men of power and influence, who fill the places of trust and use- fulness ? Are they not emphatically, as compared with their neighbours, the men of knowledge ? Knowledge, then, must be desirable. " A certain degree of ease and independence," says Dugald Stewart, " is essentially requisite to inspire men with the desire of knowledge." I must confess to differ with this astute philosopher, as I believe that all men are actuated, to a greater or less degree, by a desire to acquire knowledge. Various existing circumstances, such aa mental capacity of race, state of civilization, &c., insomuch as they increase or diminish the motives which originate the desire, undoubtedly determine, not only what shall be the extent of the desire but also what shall be the kind of knowledge desirable. If, however, we except Cretins of the first degree, in whom every ray of intelligence ia absorbed by the 8 gloom of absolute fatuity, and who are capable of experiencing merely sen- sorial ploiiaurc, it is questionable if there exist a class of human beings, who do not evince by their actions, a strong desire to become acquainted with many things external to themselves. In a barbarous state, the desire is most limited, and the determining motives in its production are of the lowest order. 3Ian, in this condition, prompted by sensations of hunger, and his experience of the ncces- Bity of providing suitable covering to defend his body from vicissitudes of tem- perature, seeks to know what of vegetable, and what of animal life are best adapted to supply his wants. To learn the haunts and habits of the various animals that roam through the forest wilds — to become accjuainted with the more palatable and healthful edible fish that frequent the lakes and rivers — and to ascertain which are the esculent among the fruits of the earth, appear to consti- tute almost the whole of his desire. In a state of semi-barbarism, advance in civilization brings with it added wants — increased motives, and, as a consequence, a more extended desire. He would now know by what processes the varied products of nature may be so altered from their original conditions, as to afford increased gratification to his senses and additional pleasure to his mind. Impressed with a sense of the magnitude and importance of nature's operations, he would know somewhat of the how and the vihereforc of her mysterious workings. Limited in his powers, and unenlightened by a revelation of truth, he deifies much that inspires him with awe or terror. He peoples the air, the earth and the water with innumerable gods, and renders grovelling homage to the most disgusting objects of creation. Some idea may be formed of the might of this desire, and of the all-powerful grasp with which it seizes while it directs the minds of men in a state of com- plete civilization by reflecting on the untiring energy, displayed by the great intellects of the civilized countries of Europe and America in their pnrsuit of knowledge ; and the marked avidity with which the masses endeavour to acquaint themselves with all the discoveries of the master minds. Thus it is, that one man passes night after night contemplating the movements of the heavenly bodies, or gazing, by means of the telescope, into the far-away regions of space, if haply he may be able to add something to his own knowlcdfe and that of his fellows ; whilst another, actuated by the same desire, wanders through different climes, observing, arranging and naming the various natural productions of and animals peculiar to each ; or accumulating information re- garding the characteristics of the inhabitants, the climate, the qualities of soil the mineral wealth and the general aspect of each. Thus it is, that one man will make the trackless ocean the field of his wanderings, and, leaving all the sweet allurements and endearing associations of home, take himself away to where the cold seems intense enough to paralyse anything but the indomitable bravery and perseverance of the Arctic voyager, in the hope of discovering a passage through the glacial barrier of the Polar Seas ; whilst another will court retirement and spend days and nights in the study of the properties and probable nature of that part of himself which he can more particularly call I. Thus it is, that earnest enquirers have been found willing, in all ages, to forego every pleasure, to labour under the obloquy poured upon them by an unthink- ing and superstitious world, so that they might attain the great object of their desire — to know the conBtniction of the beautiful, intricate and truly wonderftil machinery of the human body ; whilst others, again, with a courage and self- devotion that cannot bo too highly lauded, have quietly faced the grim king of terrors in his most favorite haunts, for the sole purpose of becoming acquainted with those dread diseases, which, in their visitations, so scourge vex and decimate the human race. In the confined and filthy chamber, where a few straggling rays of heaven's sun may occasionally penetrate, the abode and hiding-place of want and wretchedness: in the densely crowded boarding-house of the homeless and poverty stricken wanderer, the Ishmaelite of modern and civilized times : in the dank and noisome alley or court, full of garbage and excrement, the receptacle of the accumulated filth of years : in the Lazar house or hospital ward, with their atmosphere laden with the emanations arising from the prostrate victims of disease, and charged with a miasm of the most suotle and deadly nature : in such places, have these heroic souls, worked a short but glorious space of time, in singleness of heart and nobleness of purpose, for the benefit of humanity, and then died martyrs in the purest sense of the term, leaving behind them a bright example to their followers in their deeds of love and mercy, and a valuable legacy to all genera- tions in the knowledge patiently accumulated by them at every moment, even while the shadow of death with gradually deeprjning gloom stole o'er their senses, obscuring and rendering more and more indistinct the subjects of their observation and study. What for, gentlemen, are you in this lecture room ? Why have you left your homes for a period of six months, and congregated in the halls of this college? When you left those homes how full of soul yearnings and aspirations were you I Yearnings incomprehensible mayhap to many of yon, but which are innate to us all ; which constitute a feature of the mind of man, stamped indelibly there, and to be transmitted to his offspring through all time, at the period when thoughts less mother Eve turned a too willing ear to the voice of the tempter and, at his suggestion, put forth her hand, plucked and ate of that forbidden fruit, which, in its ingestion, was to make her like unto the Gods and give her a knowledge of good and evil. It is not beoiuse your parents or friends have selected medi- cine as a profession for you, nor, I firmly believe, from any purely sordid or interested motives that you have experienced those stirrings within you. Were you to remain without any well defined course of life open before you, still would you feel a gnawing unsatisfied desire to know the other, and still the other. The mind is active and will not rest. It will seek knowledge, although perdi- tion be the result. Well has it been observed by Montesquieu in his " Essai tur la gout," " Notre Sme est faite pour penser, c'est-^dire pour apercevoir : or un tel etre doit avoir de la curiosity ; car, comme toutes les choses sont dans une chaine oil chaque idde en pr6c6de une et en suit une autre, on ne pent aimer b. voir une chose sans d^sirer d'en voir une autre, C'est done le plaisir que nous donne un objet qui nous porte vers un autre ; c'est pour cola que I'Sme chorche toujours les choses nouvelles, et ne se repose jamais." Oh ! this insat- iable thkst, these measureless longings for what to us are the regions of the nnknown. How they whip and goad and spur the panting soul from childhood to youth, from youth to manhood, from manhood to old age ; and yet, after the 'i \ «> 1 1 ■J moat Huper-humnn efforts have been made, and the mnu stands at the brink of the grave, how exceedingly paltry and small does his stock of knowledge appear. He feels as if ho had gathered a few of the pebbles only from the shores of the knowable, while the vast ocean itself stretches out before him unexplored. " I live joyless in my eighty-ninth year," writes the great Humboldt to his friend Varnhagen, " because of the much for which I have striven from my youth, so little has been accomplished." So it is, and so it always will be! Despite his loftiest attainments, man always feels an intellectual want that must be satisfied, an intellectual void that must bo filled. And, what is most singular, the more varied and profound his knowledge, the deeper ho may have penetrated the arcana of nature, tho richer and more glorious the truths he may have brought from thence, the more weak and ignorant does he appear to his own scrutinizing introspection. What distinguished talent 1 What indefatigable perseverance I What rare industry ! What accumulated stores of learning him such a one, exclaim a wondering public, who are conscious that an incalculable distance intervenes between their own acciuirements and his. Whilst he, the scholar and wise man, according to the testimony of all, in view of the higher and still higher heights of truths remaining to be scaled, and whose outlines are appre- ciable to i)is exalted sense alone, in view of the ever-widening and ever-lengthen- ing vist^ that opens up before him as he pursues his travels into regions of thought and territories of investigation which were never before penetrated, bewails his own littleness, his want of energy and mental vigour, for knowledge OS a rule, certainly has the cScct of making its most favoured votaries, the humblest and least self-conceited of men. lie regards the three score years and ten allotted to man in this state of existence, a mere fleeting point of time, all too short a period in which to grasp even a tithe of what presents itself for in- vestigation, and he, therefore, looks hopefully forward to an infinite future, where his soul may bathe without check or limit in the pure, unchangeable waters of truth. The desire for knowledge, then, has doubtless brought you here. And the knowledge you seek is of that special kind included in what is termed a medical education. It is not necessary for me to enter upon a particular description of the different branches into which medicine is divided, as you will soon become practically acquainted with them. Suffice it that I make a few very general remarks on the causes that have originated and perpetuated medical knowledge, and on several of the obstructions that encumber its path. Man must die ! Such is the fiat that has gone forth from the counsels of the Almighty. He comes into the world, he is here, and he is not. From the moment he emerges from the womb, and even before, he is exposed to influences which liave a tendency to bring his existence to a termination. There is, I believe, in all the human race, an instinctive dread of death, of that dissolution of man's component parts which all know they must submit to, of that resolu- tion of the mere material portion into its original chemical constituents ; the extinction of vitality, and the unknown flight of the psyche or soul to enter on an untried state of existence in " that undiscovered country from whose bourne no traveller returns." A brave and courageous soul a man may have, but still bp shrinks from laying himself down to sleep that sleep from which there is in ,j ^^m this world no awakening. Thoro is, however, a slavish foar of death, which renders those who arc its eubjcota, the most miacruble and unliappy of beings. It is not confined solely to persons who are living in habitual violation oi" moral law but is found as well to embitter the existence of upright and God-fearing men. " Men," says Lord Bacon, " fear death as children fear to go into the dark ; and as that natural fear in children is 'ncreased with talcs, so is the other." Were men educated to look upon their dissolution, not only as an event certain to take place, but as one which as " a tribute due to nature " ought to bo met calmly and manfully ; were they to make it more frequently the subject of their oonversiitions and private contemplutions, it would be greatly shorn of its terrors and divested of much of that rcpulsiveness which now render its approach so terrifying to the majority of munkiiid. " It is worthy the observing," says tho greater thinker I have already quoted from, " that there is no passion in the mind of man so weak but it mates and masters the fear of death ; and, there- fore, death is no such terrible an enemy when a man hath so many attendants about him that can win the combat of him. llevenge triumphs over death ; love slights it; honour aspireth lo it; grief flocth to it; fear anticipateth it ; nay, we read, after Otho the emperor had slain himself, pity (which is the tendercst of affections) provoked many to die out of mere compassion to their sovereign, and as the truest sort of followers. Nay, Seneca adds, nicencss and satiety" '' a man would die," sjvys he, " though he were neither valiant nor mi- serable, only upon a weariness to do the same thing so oft over and over." What Lord Bacon says is doubtless true, as numerous instances attest, but the rule certainly is, that men dread to die, and hence arises tliat sense of insecurity and desire for self preser\-ation which have given origin to medicine. In the early periods of the world's history, diseases and bodily injuries must have carried consternation to the minds of men, for observation and experience would tell them that these conditions placed life in jeopardy, as they were exceedingly apt to prove fatal. What more natural, then, than that they should apply themselves to the discovery of means whereby they might ward off the threatened danger. Of necessity the knowledge accumulated, must for centuries, have been limited. We may form an approximative idea of the condition of medicine in these early times by observing the amount of knowledge on this subject possessed by savage communities. An approximative idea, I say, as these communities have gradually added, through a long series of years, to their stores of such informa- tion. If we take the aborigines of this continent, we find that they are acquainted with the medicinal properties of a number of the more common indigenous plants of the country, which they administer with benefit in certain simple diseased states of the body ; but it is true, nevertheless, that their " medicine men " whenever they have difficult cases to deal with, trust more to incanta- tions and diablerie than in herbs and nature. Diseases and bodily injuries, however, being common to all times and to all conditions of society we find the same dread of death to prevail now as at all former ages. And, as human life is held in higher estimation among civilized communities, a more thorough cultivation of medical science, in these latter days D i 4- l ^^m t i 4 2 has been tho result. The different kingdoms of nature have been rnnsnckod for remedies to alleviate suffering and euro the manifold ills that flcf h is heir to. And not satisfied with merely rescuing the victim of disease, great and success- ful efforts arc being made to discover those hygienic conditions favorable to itB development and multiplication, as well as those which most conduce to prolong life Indeed, tho problem which has occupied tho minds of men at every period of the world's history, having for its subject " man sick" has never be- fore had so much talent and energy expended on it. In connection with tho subject of tho mortality of mankind and in conscquenco of tho bearing it has on the question of the necessity for the existence of medi- cal science and medical practitioners, I should not omit to notice a species of fatalism which is quite prevalent. You will not be long in practice before meet- ing with persons who are more or less tinctured with it, and their boldly ex- pressed views may cause you to experience a certain degree of mental uneasiness, and even lead you to doubt whether you have really acquired a profession as honourable and as useful as it is usually represented. The four or more years which you have spent in acquiring medical knowledge may seem to you, viewed throu-h the distorting medium of this pernicious fatalism, as so much time wasted in the pursuit of information, which, when acquired, is absolutely worth- less to the possessor. Every man, say these worthies, has a time appointed to him when he must resign his life and be gathered to his fathers. This period is fixed in the unalterable decrees of Heaven. It will occur at the proper moment in spite of all the unwearied care and anxious solicitude of friends, or tho best applied skill of the most talented and learned physicians. And, further, no man can or lolll die before his time. Now, if these bold assertions, and to say the least, rashly expressed views were correct, or if they were extensively credited, do you not see the consequence that would naturally flow therefrom ? What need, forsooth, would there be for physicians? Why should you or / spend valuable time in prosecuting studies that must prove so utterly worthless? If a man must die at a certain hour on a certain day, and there is not the re- motest possibility of his dying at any other time, why trouble him when disease invades his body with prescriptions and useless attentions ? If he is to recover he will get well without them. But, is this fatalism true? We trow not. Omniscience is one of the attributes of the Deity, whom we all reverence as the Creator and Preserver of all things, whether it be in the heavens above, on the earth beneath, or in the waters under the earth. His knowledge includes infi- nity and extends to eternity. The future of every living being is open before him, if he desires to scan it, from the moment they enter on their mysterious existence. But I cannot believe that he maintains a constant and direct inter- ference in the affairs of each individual. Men come into the world and find themselves surrounded by and in intimate relation with phenomena that are the results of immutable laws. In the air they breathe, in the food they eat, and in the water they drink, lurk many a hidden foe to thoir vitality. Deep in the interior of the world upon whose superstratum they fearlessly walk, in that strar turn itself with its endless diversity and beauty of surface, and in the life sus- taining atmosphere by which it is enveloped, forces mighty beyond their wildest conceptions, remain chained and passive workers of the Almighty's will. Man ia surrounded ou »11 sides by raalip;n influoncos, which, by the induction of diffe- rent disonses, tend to brinf? about hia dissolution, Indcod, Bichat defines lifo itflolf to bo " an assemblage of the funotioim which resist death." The Creator of man, however, has not exposed him helplessly to tiio operation of these influ- ences and their effects. By the gift of reason and the capacity for prosecuting and acquiring knowledge, ho is fully furnished with the power »iccu*tury to guide him unscathed through this world, until ho arrives at tho period, appointed from the beginning, when a " sickness unto death," removes him from his pro- bationary state. For that there is a period fixed for the death of every mortal, WO freely admit; but while doing so, wo would strenuously a.s8ert that it is (juito possible for a man to dio before his time. That is, ho may ho violate the laws of his nature by a reckless course of conduct, or carelessly expose his body to the influence of well known deleterious influences, that a mortal disease may strike him down ore half his days are numbered. It being, then, uncertain, whenever a person is indisposed, whether that indisposition will or will not terminate in death, tho result in many instances depending materially on the careful and correct appli- cation of the means whereby a bountiful nature has provided for tho restoration of the aberrant functions to their natural and hculthful action, how important that there sliould bo a class of men to dovoto their time and talents to tuo eluci- dation of disease and tho proper methods of obviating its effects on tho body. In truth there is an absolute necessity for medical knowledge and medical practi- tioners. Society cannot and will not do without them. This want of faith in tho efficacy of mediciio is not, I am sorry to say, en- tirely confined to the unprofessional. Wo find a class of physicians who profesa to despise therapeutics and trust entirely to tho " vi» medicatrix naturcn." On the continent of Europe they are known as those who practice according to what is termed " tho expectant treatment." Doubtless this scepticism on tho part of numerous talented and celebrated men in the ranks of the profession, has done much to extend among the people that kind of fatalism of which I have just Bpokon. The greatest scepticism is exhibited by the Vienna School. The fol- lowing interesting pen and ink portrait by Dr. Gallavardin, of the celebrated Skoda, the very typo of the spirit and tendencies of that school, will serve to show the extent to which disbelief in practical medicine exists in high quarters : " That which constitutes the originality of Skoda among all the teachers of Ger- many, and which has made for him so universal a reputation, is his scepticism. In medicine there has been rarely seen, if ever, a c?o«6