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Les diagrammes suivants illustrent la m6thode. 1 2 3 4 5 6 ^\ Os\tr , ^vv Ui\lU6l^« //, ^fJ AN ALABAMA STUDENT BY WILLIAM OSLER J ^ BALTIMOHE THE FRIEDENWALD COMPANY 1896 V^^ i"^] I'i THE OSLER LIBRARY McGILL UNIVERSITY MONTREAL Ace. Johns Hopkins^ flotpital flintorical Club, January, 1895. I VN ALABAMA STUDENT BY WILLIAM OSLER BALTIMORE THK FRIEDENWALD COMTANY 1896 [From The Johm ffopkins JTonpitiil Uulletin, Xo. 58. January, ISIHJ.J AN ALABAMA STUDENT. Chief among the hard sayings of the Gospels is the declara- tion, He that loveth father or mother or son or daughter more than me is not worthy of me. Yet the spirit that made possible its acceptance, and which is responsible for Christianity as it is— or rather, perhaps, as it was — is the same which in all ages has compelled men to follow ideals, even at the sacrifice of the near and the dear ones at home. In varied tones, to all, at one time or another, the call comes : to one, to forsake all and follow Him; to another, to scorn delights and live the laborious days of a student ; to the third, to renounce all in the life of a Sunnyasi. Many are the wand-bearers, few are the mystics, as the old Greek has it, or, in the words which we know better. Many are called, but few are chosen. The gifts were diversi- fied, but the same spirit animated the " llamiug heart of St. Theresa," the patient soul of Palissy the potter, and the mighty intellect of John Hunter. We honor those who respond to the call ; we love to tell the story of their lives ; and while feeling, perhaps, that Ave could not have been, with them, faithful unto death, yet we recognize in the power of their example the leaven which leavens the mass of seltishness about us. These "mystics" and "chosen" are often not happy men, often not the successful men. They see of the travail of their souls and are not satis- fied, and, in the bitterness of the thought that they are not better than their fathers, are ready, with Elijah, to lie down and die. To-niglit I wish to tell you the story of a man of -whom you have never heard, whose name is not written on the scroll of fame, but of one who heard the call and forsook all and fol- lowed his ideal. When looking over the literature of malarial fevers in the South, chance threw in my way Fenner's Sou /hern Medical Reports, \'ols. T and II, which were issued in IS-tD-no and 1850-51. Among many articles of interest I Avas particularly impressed with two by Dr. eTohn Y. Bassett, of Iluntsville, Ala., in whom I seemed to recognize a "likeness to the wise below," a "kindred with the great of old." I wrote to Huntsville to ascertain what had become of Dr. Bassett, and my correspondent referred me to his daughter, from Avhom I received a packet of letters written from Paris in 1830. I have her permission to make the extracts which are here given. By temperament or conviction there are a few men in every community who cannot bow to the Baals of the society about them, and who stand aloof, in thought at least, from the com- mon herd. Such men in small circles tread a steep and thorny road, and of such in all ages has the race delighted to make its martyrs. The letters indicate in Dr. Bassett a restless, non- conforming spirit, which turned aside from the hollowness and deceit of much of the life about him. As a student he had doubtless felt a glow of enthusiasm at the rapid development of the science of medicine, and amid the worries and vexations of a country practice his heart burned with the hope of some time visiting the great centres of learning. As the years passed, the impulse grew more and more urgent to go forth and see the great minds which had controlled his hours of study. All students ilocked to Paris in the fourth decade. Nowhere else was the pool so deeply stirred, and Laennec, Broussais, Louis, Andral, V^elpeau, and others dominated the thoughts of the profession. One can imagine how carefully the plan was laid, and how for years the little surplus earnings were hoarded for the purpose. But the trial Avhich demanded the greatest K^ i< courage was the leaving of wife and children, and there are passages in the letters which indicate that the struggle was hard, not indeed without bitterness. He apologizes frefjuently for an apparent cruelty in leaving them for the sake of his profession ; and the neighbors did not make it easier for the poor wife, whose desertion they could not understand. Jn one of the letters he says, 'SSo people say 1 have left you ? Well, so I have, and you ought always to put tlie most charitable construction on such renuirks ; the same i)eople when I come back will possibly say I have returned. Sometimes remarks of this sort are made carelessly, as men tramp upon Avornis ; sometimes from wantonness, as boys pull off the wings of Hies anil j)ierce them with pins ; sometimes for sport, as hunters shoot inoffensive creatures that are of no service ; sometimes for spite, as we kill lleas; sometimes for experiment, as i)hi- losophers torture dogs ; but seldom from wickedness, as i)agans skin saints, and as Christians skin one another." And in another he says, "My expressions put me in mind of a sick man's repentance. I know, Isaphaena, you have borne much for and from me, and you will have to do so again, and I ho])e you may do it pleasantly; and if it is any gratification to you to know, you have a husband who appreciates your conduct." The letters begin from Baltimore in the last week of December, 1835. He had lost his diploma, for he applied to Ur. James H. Miller, the President and Professor of Anatomy of the Washington Medical College, for a certificate, which is found among the papers, stating that he is a regular graduate of tluit institution, but not mentioning the year. He took passage by the Roscoe, Capt. Delano in command, bound for Liverpool. He sailed on Jan. 6th, and in an inter- esting letter an account is given of the voyage. They reached the English Channel on the 2Gth. A glowing description is given of the fine way in which the passengers lived on these packet-ships. He entreats his wife to feel sure that all would go well, though she might not hear from him very regularly, and he begs her in all matters to remember his motto, " Peace 6 on earth and good will towards men." He expresses great anxiety about the training of his two chiUlren, and bids her not to spare the rod if necessary, saying, «' as tlie twig is bent the tree inclines." The first long letter, descriptive of Manchester, York, and Edinburgh, is illustrated l)y very neat little sketches. He Avas very much impressed with York, and says that " if ever 1 was to be born again I wouUl like it to be ut York." In Edinburgh he visited everything, from the fifteen-story hovels to the one-story palaces. He gives u description of some graves at Leith covered with iron grates and locked to keep the surgeons out, and over which a watch was kept the entire night. He was enchanted with Edinburgh in all matters except one. He says, "0 Scotland! thou land o' cakes! Edinburgh! thou city of learning, thou cluster of palaces, thou city with suburbs in the centre and precincts fit for the residences of princes, thou modern Athens! whose candles seem to emulate the stars in height, if not in lustre ! ! ! Could you not invent any other method of getting your coal out of the mine save on the backs of females ! ! I ! It is a fact that there are women Avhom they call bearers, whose business it is to carry coal out of the pit." Pie was very enthusiastic about the museum of the College of Surgeons, and the Infirmary, where he witnessed in the presence of Mr. Syme, an operation by '' Mr. Ferguson, a young surgeon From Edinburgh he proceeded to Glasgow, then to Belfast and Dublin, and then on to London, where he spent two Aveeks, apparently of great misery, as the Aveather Avas atrocious. He shook the mud of England from his feet at Dover, and departed, hoping never to be soiled Avith it again. He took a through passage from London to Paris for £1 18s., and he gives an amusing description of the additional payments. He asked the master of the hotel to give him some information regarding French traveling, and got, he says, a regular English account, Johnsonian Avithout his Avit. " They will cheat you at every step; they will rob you; they will poison you with dirt; everything is filthy; you will get no mutton or beef, and nothing but sour wine." Then he says, "Though T paid everything in London, I will give you u list of the little extra charges on the road, and in eight out of ten cases paid." He gives an itemized ])ill of twenty-eight extra charges in the two days and one night which he spent in the diligence. One of his items was for walking down a ladder, one shilling, lie told this fellow to go to h and jumped over his ladder. "To the commissioner of one of the hotels, for seeing that nobody cheated you but himself, six shillings." "The commissioner of the diligence, the most useless of all damned rascals, for pestering you aiul telling lies, 1 shilling and sixpence." He reached Paris and took lodgings in the Place Pantlieon. He writes, " I am now in the very region of Voltaire and i{ous- seau ; and the Pantheon, in which one set of bigots deposited their bodies, from whence another set tore their bones, raises its classic front before my Avindow. I look on it and feel I am not so much of an inlidel as Avhen surrounded by (Christians." He attached himself at once to the clinic of Velpeau at La Charite. On his first day he says he did not understand more than half he said, but he understood his operations. He says there was a gentleman from ^Mobile, Mr. Jewett, who had been there for three years. Amfricans were not scarce ; there Avere four or live from New York, tv^o from Baltimore, and several from Boston and Philadelphia. He does not mention their names, but it is pleasant to tlii: k he may have attended classes at La Pitie Avith BoAvditch, Holmes, Shattuck, Gerhard and Stille. He began dissections at once ; subjects Avere cheap — six francs apiece— and he secured a child on the first day for forty sous. Some of the lectures Avere in the evening, at scA'en o'clock, and he Avent to hear M. Helmagrande on midwifery. He says, "The hospitals here are conducted on the most liberal terms ; there is nothing to pay but for the private courses, and the fee 8 is small for them. The facilities for the study of midwifery are astonishing ; there are plenty of cases always on hand, and this I determined to profit by." In a letter of March i6th he mentions his daily routine: "I get up in the morning at six o'clock and am at La Oharite by seven, follow Velpeau until eight, see him operate and lecture until half after nine, break- fast at ten at a cafe. At eleven I am at a school of practical anatomy, where I dissect until two. Then I attend a class of practical surgery until three ; then hear Broussais and Andral until five; then dine. At seven I attend Helmagrande's class of midwifery, Avhich lasis until nine ; then I come to my room and read or write until eleven, when I retire." He waf= much impressed by the opportunities for dissection, lu his letter of the third of July he says: "There is a dis- secting school at Clamart for the summer on a most extensive scale. There is room and material for 200 or upwards, though there is but few there at present; this place was provided for the inscribed students of the school, and they get their sub- ject'! for a mere trifle. There is not the least prejudice exist- ing here against dissections ; even the subjects do not seem to mind it, though they are aware of their fate, for more than two-thirds of the dead are carried to the I'Ecole Pratique or Clamart. I have private instruction in the use of the stetho- scope for heart complaints in La Pi tie. The other day an old A> Oman bade me adieu as we passed her bed without calling, and I stopped to ask if she was going out. Then she said she was going to Clamart, and that we might meet again." He had evidently occupied his time to good advantage, as early in July he received from Velpeau the appointment of externe at La Charite. He says in his letter of the 10th of July " I h^ve a piece of news to communicate that I know will gratify yen ; at least I feel very much gratified myself. This morning I received the appointment of externe in La Charite under Velpeau. The duties of an externe require him to be at the hospital at six o'clock, answer to his name, follow the surgeon round a certain number of beds, attend to 9 his prescriptions, and to dress the patients. For this service we receive nothing, and for this privilege we pay nothing; you ought to be gratified at this, because it will convince you I have not been wasting my time. I was on the eve of starting for Switzerland, and was only waiting to witness the celebrations on the 27th, 28th and 29th; but when this offer was made me I did what I have been doing all my life — made another sacrifice for my profession, and determined to remain and take the service. I have not been more gratified since I have been in Europe ; it is a real benefit and came unsolicited." He was very much impressed by the incessant industry of the French physicians. He says: "When I look at some of the medical men by whom I am surrounded, it makes me blush for shame ; old men daily may be seen mixing their white locks with boys, aad pursuing their profession with the ardor of youth. There is not a solitary great man in France that is idle, for if he was, that moment he would be out- stripped ; it is a race, and there are none so far ahead that they are not pressed by others ; many are distanced, it is true, but there are none allowed to walk over the course. Wicness Broussais, lecturing and laboring daily to sustain himself, after having elevated himself to the pinnacle; Lisfranc, an old bachelor with thousands, who after making his daily visit and lei;on for ten months for duty, during- the vacation of two months he from choice gives a course of operations; and old Eollier may be seen daily supporting himself from bed-post to bed-post as jolly as if he were not far over sixty. Veipeau, from a poor boy without money, time, education or friends, has by industry made himself one of the first surgeons in Europe." In : e of his last letters there is this interesting note about Broussais, who had just finished his course on phrenology: " The pupils of '3G have struck off his head. It is in bronze, a little less than our old Washington and Franklin in wax. Broussais is a genius, and when he entered life he saw that something was to be done, or rather that he must do some- 10 good old r • thing, and he seized the science of medicine as a doctor would a bottle of lotion, and shook it manfully Prance, Germany, all Europe, parts of Asia, and America have felt the agitation. But younger men also feel the neces- sity of doing something, and they are now endeavoring to quiet the commotion he has raised, and in France they have measurably succeeded. AVhen the giant dies I doubt if he will find a successor — his conquests, like Alexander's, will be divided and then fall into insignificance. He fights well while in the ring against awful odds, for the truth is against him, but some of her brightest geniuses he has put to rout or silence. Time is now about to enter the field, and I have no doubt will place a splendid monument over him, to — prevent him from being forgotten." " I am glad I know what great men are. I am glad T know of what they are made, and how they made themselves great, though this knowledge has broken the last of my house- hold gods ; yet it has taken away the flaming swords that stood before the gates of this Paradise, where may still be seen the track of the serpent and of the devil himself, so I will keep out of bad company." Scattered through his long, often closely-crossed letters, there are here and there some choice bits which indicate the character of the man. For months he did not hear a word from home; then letters came at long intervals. He appar- ently had been re-reading some of his wife's letters, in one of which she had been reproaching him for using strong language. He says : " Isaphaena, you tell me to break myself of swearing, and not to spend my time about different profes- sions of religion ; that it will make eneinies, etc. Xow listen to me while I speak +he truth, for on this subject you know that I always do speak what I think is true. I never did swear much, and I have quit it almost entirely, for nobody Avould understand me, and it would be useless to waste breath when I know I can put it to a better use. As to religion, there is not much here of any kind, and I assure you I have not said •ir \ 11 -& \ ten words on the subject since I left, nor do I expect to ; and here, where Voltaire, Kousseau, and the whole constellation of mighty-minded men lived and wrote and died, I feel — Isaphaena — not so much an infidel as when at home surrounded by church-going people. Why is this ? I have never for a moment doubted the sincerity of my immediate friends, but at home I looked into the evil more closely than the good eifects — there I saw ignorance, bigotry and deceit ever foremost; they were the most prominent, therefore the most likely to be seen. Here I still look on the evil side and find it terrible. God save me from a country loithout religion, and from a government with it — I know you will say Amen also to the next sentence — and return me safe to a country with religion and a govern- ment without it. I am convinced that the evils of infidelity are worse —ay, much worse — than any religion whatever." "Had I the talents of the above-mentioned men I would not spend it as they did, nor would they, could they see the effect produced. Their object was good — to correct the evils of a corrupt priesthood — but their works were like edged tools given to children. Human nature is not perfect, and their refined and perfected systems of morals will not apply, and if we were perfect we would not need them. I speak the words of truth and soberness." He evidently was of St. Paul's opinion with reference to the subjection of the wife. He says in one place : " What if I have spoken cross to you, scolded at you; if it was not my duty it was at least my privilege, and T expect to have the pleasure of doing it again. Are we not told, if our right hand offends to cut it off, etc.; then surely if our better-half offends we ought to have the liberty of swearing a little." His last letter is from Paris, dated October 16th, and he speaks in it of his approaching departure. I have no information as to the date of his return, but his intention was, he states frequently in his letters, to be back by the first of the year, so that after this date he probably resumed practice at Huntsville. 12 The two papers in Fanner's Southern Medical Reports are the only ones I see credited to him. They are charmingly written and display in every page the wise physician; wise not only with the wisdom of the schools, but with that deeper knowledge of the even-balanced soul " who saw life steadily and saw it whole." The Eeport in Vol. I deals with the topography, climate, and diseases of Madison County. Dr. Fenner states that it was accompanied by a beautiful map drawn by the author, and a large number of valuable statistics. In an historical sketch of the settlement he thus depicts the early border life: "The most of those who did not pro- cure homes at that time, belonged to a class who, from taste or compulsion, had separated themselves from the whites, to live on the trail of the Indians; and who, like tigers, and Judases, were not without their use in the mysterious economy of nature. They surpassed the natives in physical force and in genius, and equalled them in ferocity. They had the piratical appetite for gain natural to the English race, which they had cultivated among the whites, and they readily acquired the Indian taste for blood." " Thus, without anv particular standard of morals of then- own, and having fallen out with that which restrained their Christian brethren, they found their interest in adopting the ancient one of Moses and of the savages among whom they resided— 'An eye for an eye,' and 'blood for blood '." " These men, like the fabulous Behemoth that lay m the reedy fens of the early world, drinking up the abundant waters and eating down the luxuriant forests, to make way for civilization, have left little more than a vague tradition of their existence and exploits, the latter of which has been so embellished that the former already begins to be doubted.' "Such a race leave but short records of their diseases. Where bloodshed is always epidemic and every man his own suro-eon, the few that recover feel grateful to none, and hang no ^^otive tablets 'on the natural columns of their forests ; 13 and when a missionary or a novc4ist is the only historian, it would puzzle Hippocrates himself to collate the cases ; but, as most things, as well as lions, track the earth in some manner as they pass over it, these early squatters have also made their mark." The good example of Dr. Thomas Fearn, who in the early days of the regular settlement was the leader of the profes- sion, is well drawn. "The influence of this gentleman's reputation upon the profession was favorable to the residence of thoroughbred physicians in the neighborhood, many of whom he had been directly instrumental in educating; another consequence followed: quackery and empiricism abated. Although quackery is indigenous in the human heart, like thieving and lying, and always will exist, yet it flourishes in the indirect ratio of the science and general qualifications of the regular part of the profession. When regular, and extensively patronized physicians, armed with all requisite diplomas and the experience of years, suffer themselves to grow so dull in diagnosis as to bleed a typhoid patient half an hour before death in the evening, that they had been stimulating through the day ; or so far forget, or compromise the dignity of their high calling, as to practice ' Mesmerism,' or prescribe ' Mother's Relief ' to a parturient woman, men of smaller pretensions, and more professional pride, or better information, should not, and do not wonder at quackery springing up around such like mushrooms in a spring morn- ing, where a fat cow has lain over night and warmed the soil for their reception." Dr. Fearn is credited with the practice of giving enormous doses of quinine in the malarial fevers. Dr. Bassett mentions five or six cases of night blindness caused by these large doses. Very full accounts are given of eindemics of scarlet fever and of smallpox, and a discussion on the cold water treatment of the former disease. Dr. Bassett must have had a well- equipi)ed library, and his references to authors both old and new are not only ' t full, but most appropriate. "In the 14 spring of 1833 we were visited by the scarlet fever in its most malignant form ; during the prevalence of this epidemic more than fifty infants perished in liuntsville, at the only age they are not an annoyance here. I treated nine bad cases, and four terminated fatally ; I lost nearly half in almost every instance. An older practitioner was called in, but I am not certain that in their own proper practice they were more fortunate. In more than one instance there lay more than one dead child in the same house at the same time. I feel certain that tliis was a most malignant disease; but I do not feel certain that in every case our best physicians remembered the united counsel of Hippocrates and Ovid, that 'nothmg does good but what may also hurt,' and which should never be lost sight of by the man of medicine." The following is an extract from the account of the small- pox epidemic of 1835 : " ^My treatment Avas pretty much that laid down by Dr. Meade : bleeding, gentle aperients, cool air, sub-acid drinks, mild anodvnes and vitriolic infusion of barks. Although the purgative part of this treatment embroiled the faculty of the early part of the 18th century to such a degree that the like has not been heard since the days of Guy Patin and Antimony — shaking the authority even of the celebrated triumvirate. Mead, Friend and Kadcliffe, and who, on their part, embalmed one Dr. Woodward in their gall and handed him down to posterity, like a ' dried preparation,' as a speci- men of the folly of small men who attempt to run against ' the throned opinions of the world '—and a proof that 'polite literature does not always polish its possessors ' — yet we of liuntsville were too willing that our brethren should have our cases, to question each other's practice." Dr. Bassett states that among the 30,000 inhabitants of the county, thirty physicians practiced who were paid about $30,000 a year, "which," he says, "is but hread, and scarce at that "; and when we contemplate the 50 lbs. calomel and 1000 ozs. quinine which they swallow, it reminds one of Falstaff's bill of fare: "But one half-penny worth of bread to this intolerable deal of sack." 15 There is a very clever discussion on tlie, at that time, much debated question of the use of anaesthetics in labor. The following is a good extract: "It is truly humiliating to science to have to stop and rest upon her course until the dullness of the clergy can frame an excuse for an obvious truth— to see such a man as Dr. Simpson, of Edinburgh, stopping in the midst of his labor, to chop logic by the way- side, like a monk of the fifteenth century, to endeavor to prove a truth at midday, by argument, which he had proven by practice in the morning, and thereby running at least a risk of losing by night what he had earned tlirough the day. Let us examine in plain English his new translation of the Hebrew authority for the use of chloroform and see if in getting one dent out of his turtle's egg, he does not put another in." At the head of the article by Dr. Bassett in the second volume of Fenner's Eeports stands the quotation, "Celsus thought it better, in doubtful cases, to try a doubtful remedy, than none at all "; which he quotes only to condemn in the following vigorous style: "In giving my individual experi- ence and opinions, I desire to censure none. In such cases the best informed fear the most, and experience but renders us charitable. T will therefore only say that I have been fortunate, in my own practice, in reversing the aphorism at the head of this article. That rule of practice has found favor in the eyes of every generation of both doctors and patients, and it is not wonderful that the few able men of every age that have opposed it have warred in vain,— that the science of French expectancy, and the quackery of German homceopathy, have alike failed ; dying men will have pills and parsons." "When physicians were required, by public opinion, to follow the dictates of Hippocrates, and his immediate succes- sors, as closely as Christians now profess to follow the com- mandments of Moses and the prophets, they claimed a right to act boldly their faith in these authorities, and public opinion sustained them ; and however difficult the task, they 16 found it miicli easier to understand the written language of ni]ipocrates than the yet more obscure teachings of Nature, between which and his followers he stood an infallible inter- preter, making her mysteries so plain that wayfaring men, though fools, could not err therein. Hippocrates was but our fellow-servant, and we are but ministers of Nature ; our Avholo art consists in understanding her language and laws ; our whole practice, in obeying her mandates : if we do not under- stand them, it is either our fault or misfortune; to act as though we did is quackery. Celsus says, this bold practice of old, fere quos ratio non restituit ieniirifas adjumtj but shrewdly remarks, that ' Physicians of this sort diet other men's patients more happily than their own.' I doubt, how- ever, if, in the present state of medicine, a thorough physician is ever, in any stage of any disease, so completely without rational education as to be thus nonplussed, and driven to the necessity of dealing a blow in the dark ; where there are no intelligible indications, it is clear there should be no action." " Then, if I have not followed the advice of this master, it has not been lightly laid aside ; nor, as I have stated, without precedent ; and if I have, in a measure, adopted another of his rules, to make food physic (optimum vero medicamentum est, cibus datus), it has not been upon his mere authority. I revere authority, believing with the royal preacher, that 'whoso breaketh a hedge, a serpent shall bite'; yet I rejoice that its fetters are broken in medicine — that we no longer are hedged with the eternal cry of ' Hippocrates and reason.' But if, in getting rid of the authority of the Ancients, we have discarded the example of their labor and learning, and turned a deaf ear to their opinions, it is easier to be lamented than corrected. If the unthinking part of the profession of old, that followed authority, and ' on the first day of a fever loosened the belly, on the next opened a vein, on the third gave a bolus,' etc., are now represented by those who follow fashion, and give calomel, quinine and cod-liver oil every day, we have but changed authority for fashion, and are yet in 1 bondage; hut fashion, thongli indoniitahle, changes with the wind, and if for a time it carries the small craft, the weak or designing in its current, it soon leaves them stranded, as land- marks, at which we can at least laugh, without fear of pro- fessional martyrdom." Rarely has the credo of a zealous physician been more beau- tifully expressed than in the following words : " I do not say that the study of nature, human and comparative, as far as it relates to medicine, is an easy task ; let any one undertake a foreign language, and when he thinks he has mastered it, let him go into its native country and attempt to use it among the polite and well-informed ; if he succeed, let him go among the illiterate and rude, where slang is current; into the lunatic asylum, where the vernacular is babbled in broken sentences through the mouth of an idiot, and attempt to understand this ; should he again succeed he may safely say that he knows that language. Let him then set down and calculate the cost, in labor, time and talent; then square this amount and go boldly into the study of physiology; and when he has exhausted his programme, he will find himself humbly knocking at the door of the temple, and it will be opened ; for diligence, like the vinegar of Hannibal, will make a way through frozen Alps; it is the ^open sesame' of our profession. AVhen he is satisfied with the beautiful pro- portions of the interior, its vast and varied dimensions, the intricate and astounding action of its machinery, obeying laws of a singular stability, whose very conflict produces haxinony under the government of secondary laws — if there be anything secondary in nature ! — when he is satisfied (and such are not satisfied until informed), he will be led to his ultimate object, to take his last lessons from the poor and suffering, the fevered and phrenzied, from the Jobs and Lazaruses, — into the pest-houses and prisons, and here, in these magazines of misery and contagion, these Babels of disease and sin, he must not only take up his abode, but fol- lowing the example of his Divine Master, he must love to dwell there ; — this is Pathology." 18 '' When such an one reenters the world, he is a physician ; his vast hihors have not only taught him how little he knows, but that he knows this little well. Conscious of this virtue, he feels no necessity of trumpeting his professional acquire- ments abroad, but with becoming modesty and true dignity, Avhich constitute gennine professional pride, he leaves this to the good sense of his fellow-citizens to discover." Dr. Bassett developed tuberculosis, and the last letter in the budget sent to me was dated April IGth, 1851, from Florida, whither he had gone in search of health. He died November :^d of the same year, aged 46. To a friend he writes on the date of April 5th : " This world has never occupied a very large share of my attention or love. I have asked but little of it, and got but little of what I asked. It has for many years been growing less and less in my view, like a receding object in space ; but no better land has appeared to my longing vision ; what lies behind me has become insig- nificant, before me is a vast interminable void, but not a cheerless one, as it is full of pleasant dreams and visions and glorious hopes. I have covered it Avith the landscapes of Claude, and peopled it with the martyrs of science, the pioneers of truth, the hound-hunted and crucified of this world, that have earned and then asked for bread and received a serpent — all who have suffered for the truth. How glorious it is to contemplate in the future these time-buffeted at rest, Avith their lacerated feelings soothed as mine have been this day by the tender regard your wife has manifested for my future Avell-being." The saddest lament in Oliver Wendell Holmes' poems is for the voiceless, " for those who never sing, But die with all their music in them." The extracts Avhich I have read shoAv Dr. Bassett to have ])een a man of more than ordinary gifts, but he was among the voiceless of the profession. Nowadays environment, the 19 opportunity for work, the skirts of happy chance carry men to the summit. To those restless spirits who have had ambition without opportunities, and ideals not realizable in the world in which they move, the story of his life may be a solace. I began by saying that I would tell you of a man of whom you had never heard, of a humble student from a little town in Alabama. What of the men whom he revered, and for whom in 1H3() he left wife and children ? Are they better known to us? To-day scarcely one of those whom he mentions touches us with any firmness from the past. Of a majority of them it may be said, they are as though they had not been. Vclpeau, Andral, Broussais, the great teachers Avhom Bassett followed, are shadowy forms (almost as indistinct as the l)U})il), dragged out to the daylight by some laudator tcmporis acti, who would learn philosophy in history. To have striven, to have nuide an effort, to have been true to certain ideals — these alone are worth the struggle. Now and again in a generation, one or two snatch something from dull oblivion; but for the rest of us, sixty years — we, too, are with Bassett and his teachers — and " no one asks Who or what we have been, More than he asks what waves, In the moonlit solitudes mild Of tlie midmost ocean, have swelled, Foam'd for a moment, and gone."