THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 
 MRS. PRUDENCE W. KOFOID 
 
MEMOIR 
 
 OF 
 
 J AME S JAC KS ON, Jr 
 
MEMOIR 
 
 OP 
 
 JAMES JACKSON, Jr. M. D. 
 
 WRITTEN BY HIS FATHER, 
 
 WITH 
 
 EXTRACTS FROM HIS LETTERS, 
 
 AND 
 
 REMINISCENCES OF HIM, 
 
 BY A FELLOW STUDENT. 
 
 FOR THE WARREN STREET CHAPEL. 
 
 The Cross and the Press are the two great instruments for the ciril- 
 izatioa of the human race. — Lamartine. 
 
 BOSTON: 
 HILLIARD, GRAY & CO 
 1836. 
 
Entered according to Act of Congress, in the year 1836, 
 
 Bt John L. Emmons, 
 
 In the Clerk's Office of the District Court of Massachusetts. 
 
 TuLtUe, Weeks & Dennett Power Press 17, School StreeC. 
 

 \<^ i^y^-'xj 
 
 i-ib-^ 
 
 cKvU 
 
 CONTENTS. 
 
 Page. 
 
 Memoir, by his Father, - - - " 
 
 Early life and studies - - - - 3 
 Letter from his Father to him while in New York 
 
 on the eve of his departure for Europe - 13 
 
 Extract from his answer - - - 16 
 
 Arrival in Paris - - - " ^^ 
 
 Connexion with M. M. Louis and Andral - 25 
 
 Letter from M. Louis to his Father - - 27 
 
 Asiatic Cholera . - - - - 34 
 
 His feelings and labors upon this occasion - 35 
 
 Visit to Great Britain - - - - 40 
 
 Return to Paris - - - " ** 
 
 His labors at the hospital la Pitie - - 47 
 
 Society for Medical Observation . - 49 
 
 Departure from Paris - - - " ?^ 
 
 Note from M. Louis on that occasion - ib. 
 
 Letter to his Father - - - - 58 
 
 Arrival at New York - - - - 59 
 
 Death - - ... 60 
 
 Some features of his character . - 62 
 
 Notes to the Memoih. 
 
 A, some reasons why a medical man should not in 
 
 n ■ 3^ it. 
 
CONTENTS. 
 
 Page, 
 this country devote himself entirely to the merely 
 scientific pursuit of his profession - - - 79 
 
 B, Ram Mohun Roy - - - 83 
 
 C, Louis and his labors - - - - 84 
 E, Notice of Jackson, published in Daily Advertiser 99 
 
 Extracts from Letters 
 
 Oct. 28, 1831. The difficulties of auscultation 
 Hotel Dieu and La Pitie 
 
 Nov. 28, " 
 Dec. 1, " 
 
 Feb. 16, 1831. 
 " 27, " 
 
 Diseases of the Brain 
 Emphysema of the lungs ; case 
 Louis ; his method ; Society 
 
 107 
 109 
 114 
 115 
 116 
 119 
 125 
 
 March 1, 1832. Louis's clinique and Andral's elo- 
 quence _ . - - - 
 March 20, 1832. 
 April 1; " 
 
 " 8, 
 
 " 25, " 
 June 30, " 
 
 123 
 129 
 132 
 136 
 139 
 
 July 10, 
 
 August 19, 
 Sept. 14, 
 " 22, 
 
 " 28, 
 Oct. 1, 
 Nov. 1, 
 " 13^ 
 " 24, 
 
 Society for Medical Observation 
 Cholera in Paris 
 
 do. shall he quit Paris ? 
 
 Havre, on way to London 
 
 Liverpool. Treatment of cholera 141 
 
 Journey through England - 143 
 
 Edi nburgh. Treatment of cholera 149 
 
 Suggestions for Boston - 151 
 
 Dublin. Museum. Ireland 152 
 
 London. Guy's Hospital Museum 156 
 
 " Hunterian Museum 157 
 
 Mr Owen - - - 158 
 
 Bartholcmew's Museum - 159 
 
 Hunterian Museum - - 160 
 
 Circulation in the web of a frog 161 
 
 Paris. Andral's Eloquent Lecture 163 
 
 " Louis's laws - - 164 
 
 " Morbid Anatomy,Chemistry 165 
 
 Knowledge of disease, &c. 166 
 
 Doubts - - 167 
 
 Observation - - 169 
 
CONTENTS. XI 
 
 Page 
 Dec. 27, " " Inflammation - - 174 
 
 Jan. 16, 1833. " Study of Medicine - ib- 
 
 •* 25, " " Auscultation. Observation 179 
 
 Feb. 6, " " Practice of Medicine - 183 
 
 April 5, " " Louis's accuracy - - ib. 
 
 June 6, " " " Superb" case - - 186 
 
 " 27 " " Feelings in regard to obser- 
 
 vation ------ 189 
 
 Dec. 9, 1832. " Letter to a friend - 191 
 
 June 18, 1833. » « . . 198 
 
 Reminiscences, by a fellow student - - 205 
 
 Letter from Jackson - - - - 219 
 
 Notes. 
 
 1, Letter from C. C. Emerson - - -226 
 
 2, Jouffroy 228 
 
PREFACE. 
 
 The Teachers of the Warren Street Chapel, 
 have determined to publish from time to time 
 works which will lead to a more elevated stand- 
 ard of merit, more liberal views of moral and 
 religious truth, and at the same time procure for 
 themselves funds by w^hich they may be able to 
 extend still farther the usefulness of their institu- 
 tion. With these views they present this volume 
 to the public, in the full conviction that the Memoir 
 and the Letters of such an individual as he was 
 whose life is portrayed in them, will be perused 
 with interest and that they will do good. - 
 
 Should our means be sufficient we shall issue 
 as soon as possible another volume, 
 
 Boston, Nov. 10, 1836. 
 
TO 
 
 P. CH. A. LOUIS, M. D., 
 
 OF PARIS , 
 
 Who was regarded by the subject of this Memoir as a 
 second father, not with more admiration than filial respect 
 and affection ; — and 
 
 TO 
 
 FRANCIS BOOTT, M. D., 
 
 OF LONDON, 
 
 Whose brio^ht mind and pure and elevated virtues inspired 
 the most ardent and sincere love in his young friend ; — 
 
 The two men, to whom, among many, he felt most indebted 
 whilst in Europe ; — 
 
 With the respect and gratitude, which under such circum_ 
 stances, a father must feel, this Memoir is respectfully and 
 afiectionately dedicated by 
 
 JAMES JACKSON. 
 
 Boston, April 15, 1835. 
 
JAMES JACKSON, JR. 
 
 '/^^H^^^c^X/ 
 
 MEMOIR. 
 
 /s^6 
 
 The following pages contain a memoir of the 
 life of my late son, James Jackson, Jr. M. D., 
 with extracts from his letters and a selection 
 from the medical cases collected by him, princi- 
 pally in Paris. I have been induced to print 
 these cases by the solicitation of those, who 
 knew how he had collected them. I have been 
 induced to write the memoir in consequence of 
 the sug-Dfestion of those who knew something; of 
 him, and whose opinions I respect. In some 
 points the task has been grateful to me ; sad, 
 though it may seem, for a father. I thank God 
 that I have been aMe to maintain my cheerful- 
 ness and to attend to the common occupations of 
 life since the deplorable loss, which I suffered in 
 his departure from this world. But every hour 
 has he been in my mind. In every occupation 
 in almost every conversation, however little oth- 
 1 
 
^ ^^T>' could see the connexjon, ni^ .& Deen 
 
 A tjcfore me. ^It has beerivji beautiful uniag-e and 
 
 has not checked any pleasure, nor even any 
 
 *^v g^i^^V' ^^ which I thought that he could have 
 
 J ''•:Fnder a^y circumstances I might seem an 
 _^ improper .person to give his history, and my 
 «st§Ltemsnts may be deemed scarcely worthy of 
 credit. "Who will believe that I shall be impar- 
 tial ? I can say however that I would not wil- 
 lingly be guilty of exaggeration, if it were only 
 from a respect to the love of truth, which formed 
 the most distinguishing trait in his character. 
 He loved me as few sons love their fathers. Of 
 this I have had ample and constant proofs. But 
 he loved truth better, and would not subscribe to 
 any opinion because it was mine, though he was 
 quite willing, in his conduct, to submit to my 
 direction and control. 
 
 But, if I draw a fancy picture, while I design 
 to paint the character of my son, if that presents 
 a young man who devoted his time most assidu- 
 ously to the acquisition of useful knowledge, 
 who cultivated at the same time his best moral 
 affections and acted from the highest love of vir- 
 tue, and who thereby secured the friendship of 
 the wise and good, the fiction at least may have 
 
JAMES JACKSON, JR. 3 
 
 some good influence on the young and inexpe- 
 rienced. At least it may lead them to reflect 
 on the immutable connexion between virtue and 
 happiness. 
 
 The subject of this story was not indeed re- 
 warded by long life. But in this age will it be 
 maintained that long life is the greatest of bles- 
 sings ? This is a topic, on which I shall not 
 enlarge ; but I will only say for myself, which I 
 do most sincerely, that I would not have added 
 a year to my son's life by an habitual and allowed 
 indulgence in a single vice. 
 
 The history of my son's life is very simple 
 and it may be told very briefly. He was born 
 on the 15th January, 1810, w^as graduated at the 
 University in Cambridge in 1828, and then en- 
 gaged in the study of medicine. This he did 
 under my direction and as my pupil. He con- 
 tinued as such till the April of 1831, and during 
 this time he attended the medical lectures of our 
 University and saw the practice of the Massa- 
 chusetts General Hospital. In the spring, 1831, 
 he went to Paris, wdiere he arrived in May, and 
 remained till July, 1833, except during a visit of 
 six months to Great Britain and Ireland in the 
 spring and summer of 1832. He reached home 
 
4 MEMOIR OF 
 
 at the end of the summer, 1833, and was grad- 
 uated as Doctor of Medicine in our University 
 in February, 1834. He was now prepared to 
 engage in practice, and took rooms for himself 
 in Franklin Place. He was thus brought to the 
 starting place of active life, and under circum- 
 stances the most flattering and the most grateful, 
 when he was arrested in his course. Exactly 
 at this point he was arrested. His arrangements 
 being made, he sent an advertisement to the 
 public papers, which appeared on the 5th of 
 March, and on that day he was taken sick so 
 as to lodge at my house instead of occupying the 
 rooms, which he had just announced as his res- 
 idence. This sickness was his last, and he died 
 on the 27th of the same month, being in his 25th 
 year. 
 
 Thus cut off before he had yet been tried in 
 the serious business of life, and having passed 
 his brief course without encountering any of the 
 trials to which many men are subjected, it would 
 seem that his story could hardly afford any details 
 of interest except to his own family. And yet 
 he did excite an interest during his life in very 
 many friends, abroad as well as at home, and 
 that of the warmest kind ; and his loss has been 
 deeply mourned by those, whom I never saw, 
 
JAMES JACKSON, JR. O 
 
 and to whom he was recommended only by his 
 own conduct. There must then have been some- 
 thing in him to have excited this interest, which 
 I shall call deep and ardent, disregarding the 
 imputation to which I subject myself of a blind 
 partiality. This'something was in his character. 
 If he is to be commemorated it should be by 
 delineating that character ; and while doing this 
 I shall be led to detail, though it may not be in 
 exact order, the events of his life as illustrating 
 it. Any friend in pursuing this course would 
 be thought liable to run into eulogy instead of 
 giving a true description of the subject of his 
 discourse ; a fond father must certainly be sub- 
 ject to this suspicion. Those who know the 
 truth in this case must decide whether this sus- 
 picion is justified by what follows. I may how- 
 ever premise that I shall not attempt to write 
 coldly, while I shall endeavor to keep in mind 
 that my business is not to display my own feel- 
 ings toward the beloved subject of my discourse, 
 but to draw a picture of one whose features are 
 more perfectly engraved on my mind than on 
 that of any one else. 
 
 From his earliest age my son always mani- 
 fested great cheerfulness of temper and gaiety of 
 heart, so that he was never long depressed by 
 
6 MEMOIR OF 
 
 trouble of any kind. He was always ready to 
 sympathize with those about him, and he loved 
 to engage their sympathy in return. He was 
 not contented without constant action, except 
 when engaged in study or other occupation. 
 These characteristics are common enough in 
 boyhood, and did not distinguish him among his 
 fellows at that stage of life. It was by myself 
 only perhaps that his indomitable gaiety of heart 
 was then noticed ; though I also remarked, very 
 early, that his mind was capable of being engaged 
 in the most solemn subjects. From these char- 
 acteristics he was often boisterous and annoying 
 to those about him, but he was so good-humored 
 they could not long be angry with him. He 
 had very little ambition to gain distinction, or to 
 be a leader among his comrades, but delighted 
 to join in their sports on terms of equality, as 
 anxious that they should be pleased as to have 
 his share of the sport. He was agreeable to his 
 young friends without being distinguished among 
 them. His schoolmaster loved hitn ; but had to 
 punish him continually for the sin of laughing, 
 of which he could not break him however. He 
 would strive at times to get a high rank in his 
 class to please me, for he always loved me most 
 ardently ; but he seemed not otherwise to value 
 
JAMES JACKSON, JR. 7 
 
 the distinction. Once, when a little boy, he had 
 kept at the head of his class for two or three 
 days, and then a younger boy got above him. I 
 reproached him for permitting this. But he 
 said, with great naivete, that the other boy 
 " ought to be at the head sometimes." I hardly 
 gave him credit at the moment for this generous 
 wish for the gratification of his rival, but his 
 companions in later life will agree with me in 
 believing that it was the result of that interest 
 in the happiness of others, which he manifested 
 more and more strongly as long as he lived. 
 
 In college his ready sympathy led him at first 
 into the company of those, who were most gay, 
 and for a few months he joined in their pleasures. 
 At the end of six months the excellent president 
 gave me warning that my son had become in- 
 timate with those, whose company was the most 
 dangerous. This would have caused me great 
 distress but that, happily, my son had recently 
 given me the same information and had told me 
 that he had discovered his danger ; in fact, as 
 soon as he perceived the vices of his associates, 
 he no longer sympathized with them ; he had 
 broken with them. . It was so ; and his connex- 
 ion was never afterwards renewed with them, 
 nor with those who were like them. He now 
 
8 MEMOIR OF 
 
 happily formed an intimacy with one who en- 
 couraged all his virtuous aspirations, and he 
 began to cultivate, upon principle, a purity of 
 heart, of which the fruits were forming in all his 
 subsequent life. He was not led into habits, nor 
 into any feelings of austerity. Gaiety he could 
 not dismiss ; it was ever springing up in him. 
 He was guilty of imprudences like others. But 
 he constantly studied his duty, he cultivated 
 more and more the best principles of action, and 
 from year to year his standard of excellence was 
 placed higher and higher. He never attained a 
 distinguished rank in his class by an exact atten- 
 tion to his collegiate duties, a circumstance which 
 I do not mention in commendation. Yet with- 
 out my knowledge, until long afterwards, he 
 established for himself certain rules of action 
 and habits of industrious study, from which he 
 seldom deviated subsequently, and was really 
 storing his mind with valuable knowledge. I 
 was not aware of his industry, though I thought 
 that I watched him closely, till he had left the 
 college. He did not tell me of it, though he was 
 very open and ingenuous in telling me his feel- 
 ings and his errors. When he began the study 
 of medicine under my eye, he gave himself to it 
 with an energy and industry that surprised me. 
 
JAMES JACKSON, JR. ^ 
 
 I thought at the moment that he Avas resolved to 
 make up for past negligences, but that his zeal 
 would probably soon abate. I did not yet under- 
 stand him. Subsequently my only apprehension 
 was from his too great devotion to his studies, 
 which constantly went on increasing. I pre- 
 sumed that the temptations to pleasure in Europe 
 would draw him off from laborious study quite 
 enough ; but not so ; there, even more than here, 
 he spent his strength, without reserve, in his 
 professional pursuits ; though he meant to keep 
 himself within the limits of safety. The only 
 temptation, which he could not at all resist, was 
 that furnished by the invaluable opportunities, 
 there offered to him, for the increase of useful 
 knowledge. 
 
 When he went abroad his reading on profes- 
 sional subjects had been so extensive and his 
 habits of observation so well formed, that I 
 thought him fully prepared to avail himself of 
 the advantages he might derive from the excellent 
 schools of Paris, London, and Edinburgh. I 
 dared not then say so even in my own family, 
 for I feared the evil consequences of too much 
 praise ; but I regarded his acquisitions as very 
 extraordinary for a student of his standing, and 
 therefore let him go at an earlier period than 
 
10 MEMOIR OF 
 
 tliat at which I commonly advise young men to 
 take the same step. Those who are acquainted 
 with medical literature will believe that I did not 
 overrate his diligence after considering the fol- 
 lowing statement. Before the termination of 
 the second year of his pupilage he went through 
 the Epistles of Morgagni on the seats and causes 
 of diseases, as translated by Alexander, in three 
 thick quarto volumes. He took notes of what 
 he read, and as he went on compared with it the 
 invaluable work of Baillie on morbid anatomy, 
 another quarto, with the plates accompanying it. 
 This he did indeed in the quiet of the country, 
 but he took proper time for exercise, and did not 
 seem to me more industrious than at other peri- 
 ods. He however completed the whole in seven 
 weeks. Nor did he read this work, as a task, 
 without possessing himself of its contents. He 
 read it with great interest ; and he fixed in his 
 mind so many of its details, that by the aid of 
 his short notes he was able to refer to it after- 
 wards. Thus I find in his early autopsies in 
 Paris, which he entered in his common-place 
 book, many references in the margin to cases in 
 this great storehouse of post-mortem researches. 
 Indeed I have not been acquainted with any one, 
 who was so intimate with the details of this 
 
JAI^IES JACKSON, JR. 11 
 
 work, as he was. Immediately after this, and 
 before his second year of medical studies was 
 tenninated, he v^TOte a long dissertation on pneu- 
 monia, in doing which he consulted all the wri- 
 tings on the subject which he could get at, both 
 those expressly on it and those which embraced 
 it with other subjects in systematic works. This 
 dissertation gained him the Boylston medical 
 prize from a committee, among the members of 
 which was Dr AVare. Dr Ware spoke to me of 
 this work at the time in terms of great commen- 
 dation, and I confess that, when I read it, I was 
 fearful that it would be supposed I had rendered 
 assistance in the preparation of it, which in such 
 a case would have been improper. But in fact 
 I had only pointed out the sources of information 
 and had made some general remarks on the 
 subject, as I should in conversation with any 
 pupil. I was aware that he was writing on the 
 subject, but thought at the time it was only an 
 exercise as a member of the Boylston medical 
 society, not a dissertation for a prize. 
 
 I have stated these things as examples of his 
 industry. I may add, that in the period of his 
 medical studies, before he went to Europe, scarce- 
 ly two years and a half, if I deduct the time 
 employed on journeys, he had read a very large 
 
12 MEMOIR OF 
 
 proportion of all the valuable English standard 
 works on medicine, and very many of the 
 French, frequently and carefully consulting older 
 works in other languages when referred to, espe- 
 cially when facts were concerned. At the same 
 time he had engaged as fully as most others in 
 dissection in its proper season ; he had attended 
 the hospital most punctually except in the sum- 
 mer season ; he had seen much of disease else- 
 where, particularly at the House of Industry, 
 where Dr Fisher was then physician, and fre- 
 quently invited him when there was anything 
 particularly interesting ; and he took notes of 
 lectures and of everything which came under 
 his observation, especially of the autopsies which 
 he attended, so that he had covered twelve hun- 
 dred folio pages of his common-place books, 
 when he left home. 
 
 It was thus prepared he went to Paris, there 
 to take care of himself when just past twentyone 
 years of age. Thus far, except two or three 
 journeys, he had lived in a limited circle under 
 the eyes and care of his friends. At college, 
 even, he resided principally in a private family 
 of the first respectability, and of the greatest 
 moral worth, where he had been treated as a 
 child and a friend, and had been allured by kind- 
 
JAMES JACKSON, JR. 13 
 
 ness to submit to wholesome restraints and to 
 Me friendly warnings of wisdom and experience. 
 I could not dismiss one so inexpressibly dear to 
 me without anxiety, though satisfied that it was 
 wise that he should go. The following extracts 
 will show something of the state of his mind, 
 and of my own. They will bring before the 
 reader the true feelings and principles which 
 then reigned in his heart, and if I may write 
 about him at all, I see not why I may not pro- 
 duce them. 
 
 EXTRACT FROM BIY LETTER TO HIM, APRIL 9, 1831. 
 
 " I look forward with sanguine hopes of ben- 
 efit from the opportunities you will have. I feel 
 satisfied that you will not omit to avail yourself 
 of them. It is this hope of benefit to you which 
 reconciles me to your absence, for I have already 
 begun to look to you as my most interesting 
 companion for the remainder of my daj'^s. As 
 to the hazards to which you are exposed, I cer- 
 tainly do not disregard them; yet I shall not 
 allow a regard to them to make me unhappy. 
 At least, I think so now. There is a risk of life, 
 — and it would indeed alter the aspect of my 
 
 N 
 
14 
 
 MEMOIR OF 
 
 future days, if I did not hope to have you by my 
 side and to leave you behind me in this world^ 
 But this is the smallest risk by far. Whether 
 we pass a few short years together in this world 
 is comparatively of little consequence. Whether 
 we meet in a better world is of immeasurable 
 importance. This depends on ourselves; — on 
 the strict regard to morality which we both 
 maintain; — a morality in Dr Holyoke's sense, 
 which includes piety, — a regard to our Maker, 
 as well as to ourselves and fellow-men. Now I 
 am not insensible to the temptations, to which 
 young and old are exposed in Paris and London. 
 I can think of them till I tremble. But my, 
 trembling is stilled by the confidence I place in 
 you. This confidence is sincere and strong. It 
 is not unlimited, but it is as great as it can be in 
 any young man. I know that your fondness for 
 society, arising from the best feelings, is very 
 strong ; but I feel assured that you know how to 
 control it, — and that your principles are strong 
 and of the best kind. I shall not therefore allow 
 myself to be anxious ; and it is more to tell you 
 this than to insinuate any cautions, that I have 
 been led into this long statement of my views 
 and feelings. In temptation, I think you will 
 first think of home, — and then cast your eyes 
 
JAMES JACKSON, JR. 15 
 
 higher, — to the home we all ultimately hope 
 for, and to the Father who is better than any 
 earthly parent. I referred to the dangers of 
 society ; — I wish to add that among men of the 
 world, and I may say such gentlemen as a trav- 
 eller meets, there is a sort of presumption con- 
 veyed in conversation, that no one feels bound 
 very strictly by the rules of morality. Now one 
 need not turn knight-errant, nor missionary, to 
 beat down the obnoxious principles thus indirectly 
 maintained. But, on the other hand, I have 
 never found any society, in which I needed to 
 remain, in which a gentleman was bound to 
 a^ent to such principles, — or in which he 
 might not declare his dissent from them, when 
 he was compelled to speak of them directly. In 
 short, a man never loses, but almost always gains 
 with the worst men, by pursuing an honorable 
 and virtuous course. The share of reputation, 
 which you have yourself gained, while leading 
 a quiet and you may almost say, a secluded life, 
 shows you that a man gains reputation fully in 
 proportion to his merits. Some persons must 
 see your course, — and by them, even while 
 they do not think of doing so, it is published and 
 fixes your character. Not that a regard to char- 
 acter is the highest motive to action, but I was 
 
16 MEMOIR OF 
 
 led to speak of it in another view, viz. : that a 
 regard to it in the eyes of those about you, need 
 not lead you to make sacrifices to their vices and 
 follies." 
 
 The letter from which the foregoing extract is 
 made, reached my son in New York, on his 
 arrival there, after sailing upon the Hudson, and 
 visiting the Trenton Falls. In his reply, of 
 which the greater part follows, he refers to the 
 scenes, in which his mind had been delightfully 
 engaged. 
 
 "New York, April 15, 1831. 
 '" MY DEAR FATHER, 
 
 " My heart beats, and my eyes fill, and my 
 hopes are brightened, and my resolutions are 
 strengthened, as I advance in reading your kind 
 letter of aflfection and advice. Be assured I will 
 not neglect the opportunities which I am about 
 to enjoy. My constant prayer is to God, that 
 he will give me strength, moral and mental, to 
 improve them to the utmost. I have already, 
 some time since, said to you that, were it not 
 that I may with every reason expect to be in 
 
JAMES JACKSON, JR. 17 
 
 your society and under your guidance again on 
 my return, I would on no account visit Europe. 
 I feel and know that my opportunities for improve- 
 ment during any two years, which I shall be 
 absent, would be much greater at home than any 
 I can obtain abroad; — but both have their pecu- 
 liar advantages, and trusting in the mercy and 
 providence of God, who has already poured upon 
 me so many blessings, I feel a confident hope 
 that I may enjoy both without foregoing either. 
 
 " You next speak, my dear father, of the temp- 
 tations abroad to young men. I, too, can and 
 do think, and have oftentimes thought of them, 
 ^till I tremble. I feel myself to be weak, weaker 
 than I should be. I am not phlegmatic; — I 
 have not yet learned to be master of myself ; — 
 I am yet, too often, much too often, the slave of 
 circumstances. I feel that this is to be the toil 
 and study of my life, to become master of myself. 
 I am learning each day, more and more, that it 
 is the education of the immortal part, which 
 should and must demand man's most serious and 
 untiring attention. I begin to feel too that it is 
 his highest happiness to cultivate it. I see the 
 difficulties with which I must contend, and I feel 
 deeply conscious of my moral weakness; — but 
 again I feel a sort of confidence in remembering 
 2 
 
18 MEMOIR OF 
 
 that the Creator has given to man strength to 
 resist all moral evil, and in hoping and praying 
 that he will enable me to exert it. The future, 
 Avith all, especially with a young man, is uncer- 
 tain ; — but for all that is important it is in our 
 hands ; — an awful responsibility, indeed, but 
 yet ennobling and encouraging. One thought is 
 most cheering, — we may depend upon it with 
 security, — in the right conduct of the future, 
 we have the certain aid and assistance of our all- 
 powerful and benevolent Father, who will point 
 us to the right path and safely conduct us over 
 it, however rugged, if we will but open our eyes 
 to see, and our hearts to accept, instead of blindly , 
 refusing his kind offers. My dear father, this 
 is no affectation ; — it is no unmeaning rhap- 
 sody ; — my mind for some time has been be- 
 coming more and more convinced of the essential 
 importance of these subjects, and I promise you 
 the last week has not been spent in vain ; — not 
 only has my mind been improving ; — my heart, 
 too, is better for what I have seen ; — it is good 
 for me to have been the spectator of these ma- 
 jestic works of the Deity in the natural world 
 around us. My heart has been warmed with a 
 sense of his benevolence, and my mind opened 
 anew and more strongly, to a conviction of his 
 power and greatness. 
 
JAMES JACKSON, JR. 19 
 
 " In anticipating my future career in life, my 
 mind is filled with what ? I can tell you, for I 
 have spent much time during the last three 
 months, in a serious consideration of the subject^ 
 and feel that I have arrived at somewhat more 
 definite views than I had previously entertained. 
 I would divide all the objects of my aim and 
 ejTorts into two classes, — the essentials and the 
 desirables ; — and in a few w^ords they are these. 
 Among the first, are a moral character, in the 
 fullest acceptation of the term ; or in other 
 words a life of virtue, so spent as shall be accep- 
 table to God, and render me fit to enjoy the 
 blessings of the virtuous ; an honorable and 
 useful exercise of my profession; — these two 
 will perhaps include the only remaining essential, 
 viz. such a situation in society, as to property, 
 respectability, and so forth, as every young man 
 brought up, as I have been, feels it his duty to 
 except and provide for. 
 
 " Among the second, I would reckon the plea- 
 sures of social life, a handsome and independent 
 property, and a high professional reputation. 
 The time has been, and that not very long since, 
 when I looked upon this last as the most impor- 
 tant of all. But I am now wiser. I have not 
 ceased to value this abstractedly as much as 
 
20 MEMOIR OF 
 
 before ; but its relative place among the objects 
 of my desire is cliang-ed, — I trust irrevocably 
 changed. 
 
 " One word more on this subject, and I have 
 done. You say it is rather to express your 
 confidence in my principles, than to insinuate 
 any cautions, that you have written me so fully 
 on this subject. Trust not too much in my 
 principles. At this moment they are as firm 
 and as virtuous as I could wish; but I have told 
 you that I am weak, and have yet to learn the 
 severe lesson of self-denial. For your own 
 comfort and happiness believe me strong if you 
 will; but for my good, believe me weak. It is 
 my sincere wish and desire, I may almost say 
 command, (for in such matters the child may 
 command the parent,) that you will often remind 
 nae in your letters of the temptations to which I 
 am exposed, and the incentives to avoid them. 
 Do not think that I am writing words which 
 mean nothing. It had been my intention for 
 some weeks past to write you, before I left the 
 country, on this very subject ; to request your 
 direct and constant aid in the preservation and 
 improvement of my moral character. I hope 
 that you will read and understand this request 
 literally ; as much so as any I ever made for a 
 
JAMES JACKSON, JR. 21 
 
 book to improve my mind, or a dollar to clothe 
 my body. One duty yet remains, — a cheerful 
 and a pleasant one, and yet one which I can 
 perform but too inadequately ; — it is to express 
 my gratitude to you ; to express to you all that 
 I feel would be impossible ; — perhaps also it 
 would be unnecessary, as you must know it 
 already. It might have been expressed more 
 fully, and most becomingly in the actions of my 
 past life ; but it has not been. No mode is now 
 left me, but by words and my future conduct. 
 No words that I can use, can ever exhibit to you 
 my real feelings ; and for my future conduct I 
 fear, yet hope. The duties of a parent to his 
 child, which your approving conscience must 
 tell you in more audible tones than I can utter, 
 have been by you most strictly exercised, call 
 for a correspondent gratitude from the child, 
 none the less because they are the duties of his 
 parent. But in my case, there is something 
 more than this. Though I love to dwell upon 
 the relation, which exists between us, and the 
 circumstances and scenes and events, which have 
 arisen from that relation ; yet I have sometimes 
 taken another view of the subject. I have con- 
 sidered the relation of parent and child as adven- 
 titious or accidental ; — I have looked upon you 
 
22 MEMOIR OF 
 
 and myself as two beings whom God had placed 
 upon this earth, and whom accident had brought 
 together ; I have then thought of how much I 
 was indebted to you for all the principles and 
 knowledge and powers that I possess ; — but, 
 my dear father, I will stop. You see what is in 
 my mind, — I have been writing you, till I am 
 getting too much excited; — but it is a holy 
 excitement, and will do me good. My prayer is 
 to God, that we may meet again in this world, — 
 but I know it is uncertain, — my prayer and 
 efforts too are and shall be, that my life may be 
 so spent as to meet you in another world, if not 
 in this, which may God in his infinite mercy 
 grant." 
 
 It is easy for a young man to make promises 
 in any situation. We all know how uncertain 
 must be the strength of his resolution when 
 brought to trial. I certainly should not have 
 given these extracts, if I did not believe that my 
 son's conduct abroad was in full accordance with 
 the promises implied in them. That he was 
 always wise and discreet is not to be presumed. 
 But, if all who knew him did not combine to 
 
JAMES JACKSON, JR. 23 
 
 deceive me, and if, also, evidences of everj^ kind, 
 which I could examine, were not fallacious, his 
 life was such, when out of my sight, as it had 
 been at home ; — marked by moral purity, as 
 well as by incessant industry. The abundant 
 testimonials of his industry which I now possess, 
 specimens of which are in the following pages, 
 show that he had not time to engage in those 
 pernicious indulgences which too often engross 
 young men in the cities of Europe. Indeed, I 
 would not intimate that he was singular in this 
 respect. I gladly avail myself of the occasion 
 to state that the medical students from this 
 country, with very rare exceptions, are too much 
 occupied with their professional studies, when 
 in Paris or London, to allow much time to the 
 ruinous pleasures of those great cities. This 
 may perhaps be fairly attributed to the very in- 
 teresting character of those studies. 
 
 In Paris my son attended principally in three 
 hospitals, viz. ; La Pitie, St Louis, and that for 
 sick children, (Hopital des Enfans Malades.) 
 In the first of these he saw the practice of M. 
 Louis and M. Andral, and heard their clinical 
 lectures. It was here he spent most of his time. 
 In the second, (St Louis,) he attended to diseases 
 of the skin and to the lectures of M. Biett. It 
 
24 MEMOIR OF 
 
 was not possible for him to give time for a fre- 
 quent attendance at the Hopital des Enfans 
 Malades, at the regular hours, without omitting 
 his visits at La Pitie. He was, however, so 
 fortunate as to obtain permission to go with the 
 interne, or house-pupil of that hospital in his 
 evening visit. He was thus able, no other pupil 
 being present, to examine more minutely the 
 numerous cases there collected, than he could 
 have done in any other way. 
 
 The liberality of the French government, for 
 it is by the national government that the hospi- 
 tals are maintained, permits foreigners to join 
 their own pupils in attendance on their hospitals 
 without any fee. The liberal feelings of the 
 physicians and surgeons of those hospitals lead 
 them in like manner to give instruction to all, 
 who will attend to it, without any pecuniary 
 reward. Of the privileges thus granted, my son 
 partook with others. He had not any special 
 introduction to the medical gentlemen on whom 
 he attended. But he received from them not 
 merely favors, but such substantial services, that 
 I am bound to acknowledge them in giving this 
 account of his life. I mean, however, also to 
 adduce the services thus rendered him, as the 
 evidence of impartial witnesses in proof of his 
 
JAMES JACKSON, JR. 25 
 
 merit as their pupil. I refer particularly to 
 M. Louis and M. Andral. By the latter he was 
 treated not only with civilities, to which a com- 
 mon stranofer could have no claim, but he was 
 indulged in the favor of free intercourse at once 
 most flattering and most useful from such a 
 source. I can scarcely describe with how much 
 reverence for the genius of this eloquent profes- 
 sor, and with how much gratitude these favors 
 were received. By the former, M. Louis, he 
 was distinguished so peculiarly, that I shall take 
 the liberty to print two of M. Louis's letters to 
 me, lest I be suspected of exaggeration. There 
 grew up between them a friendship of no com- 
 mon kind. M. Louis treated him with as much 
 kindness and confidence as he could have shown 
 to a son ; and James felt toward him an affection 
 second only to that which he experienced toward 
 myself. 
 
 The acquaintance commenced by very flatter- 
 ing attentions from M. Louis, to his young pupil, 
 at a period, when even his name was probably 
 unknown to his master. This gave my son 
 confidence in addressing him. Subsequently 
 with two excellent friends from Philadelphia, he 
 requested from M. Louis, private instructions on 
 auscultation and percussion. They offered com- 
 
26 MEMOIR OF 
 
 pensation for the time and trouble, which he 
 would bestow on them. The compensation was 
 not such as could have been an inducement to 
 M. Louis, yet he complied instantly with their 
 request. They had not dared to promise them- 
 selves this success, and had almost feared that 
 he would regard them as too presumptuous. 
 They were transported with the prospect before 
 them, and still more with the excellent instruc- 
 tion which they obtained in consequence of it. 
 Soon after this, the epidemic cholera appeared 
 in Paris. The part which my son took at this 
 time, I shall state more distinctly by itself; but 
 at present I refer to this period as the time, in 
 which the acquaintance of my son wdth both his 
 great masters, became more intimate. When 
 he left Paris, after having studied this disease, 
 at the end of April, 1832, M. Louis manifested 
 a regard for him in terms the most grateful and 
 most flattering. Venerating him, as my son 
 now did, his affectionate heart knew not how to 
 respond to so much kindness. On his return to 
 Paris, in the following autumn, he at once was 
 admitted to the full friendship of his master, 
 and, while he remained with him, their inter- 
 course was of the most confidential character ; 
 and to the pupil was most instructive. 
 
JAJIES JACKSON, JR. 27 
 
 I must now be permitted to give the letters 
 before mentioned, to show that I have not exag- 
 gerated the favorable opinion of M. Louis toward 
 my son. 
 
 TRANSLATION OF LETTERS FROM BI. 
 LOUISTO DR JACKSON. 
 
 SIR, MY RESPECTED BROTHER, 
 
 I have received with gratitude the letter you 
 did me the honor to write me in regard to your 
 son and his memoir upon cholera. I give you 
 special and hearty thanks for having afforded 
 me so good an occasion to speak of one, toward 
 whom I entertain sentiments of real friendship 
 as well as of esteem. 
 
 It did not require much time for me to appre- 
 ciate fully the sagacity and talent, which your 
 son possesses, in the observation of nature. I 
 had remarked these characteristics in him, before 
 I knew who he was. Soon afterwards, learning 
 that he would ere long return to Boston, I 
 pointed out to him the advantage it would be for 
 science and for himself, if he would devote sev- 
 eral years exclusively to the observation of dis- 
 
28 
 
 MEMOIR OF 
 
 eases. I now retain the same opinion and am 
 strengthened in it ; for the more I become 
 acquainted with, and the more I notice him 
 applying- himself to observation, the more am I 
 persuaded that he is fitted to render real service 
 to science, — to promote its progress. I find 
 that he would be well pleased to follow for a 
 certain period the vocation, for which nature has 
 fitted him ; but he has stated to me that there 
 are many difficulties, which would prevent his 
 devoting himself exclusively to observation for 
 several j^ears. But can these difficulties be 
 insurmountable ? Must we compel ourselves to 
 believe that a man, w^hom nature has peculiarly 
 qualified for observation, cannot be permitted to 
 exercise the peculiar talents bestowed on him. 
 For my own part I cannot admit the belief; I 
 hope and trust that the difficulties, of which he 
 has spoken, will disappear. 
 
 Let us suppose that he should pass four more 
 years without engaging in the practice of medi- 
 cine, what a mass of positive knowledge will he 
 have acquired ! How many important results 
 will he have been able to publish to the world 
 during that period ! After that he must neces- 
 sarily become one of the bright lights of his 
 country ; others will resort to him for instruction, 
 
JAMES JACKSON, JR. 29 
 
 and he will be able to impart it with distin- 
 guished -honor to himself. If all these things be 
 duly weighed, it will appear that he will soon 
 redeem the four years, which men of superficial 
 views will believe him to have lost. 
 
 It is with the utmost seriousness, sir, that I 
 write to you thus. It would not be without the 
 deepest conviction of the advantages of the plan 
 I propose, that I should offer my advice on a 
 subject, on which I have not been consulted. It 
 is not for the sake of making to a parent some 
 grateful remarks about his son, that I have 
 pointed out to you how much may, in my opin- 
 ion, be hoped from the talents for observation, 
 which belong to Mr Jackson; but simply to 
 render homage to truth. Excuse me then for 
 the step I have ventured to take, and believe 
 that, if I had not felt that I had in this case a 
 duty to fulfil, I should not have offered to you 
 my advice, nor addressed to you my petition ; 
 for it is rather a petition I have addressed to you, 
 than advice that I have given you. How could 
 I venture to do the latter? 
 
 Nevertheless in reading over my letter, it 
 seems to me to betray the tone of an advocate 
 who is pleading a cause ; and I would willingly 
 begin it anew, were I not afraid that from my 
 
30 MEMOIR OF 
 
 deep conviction of the truth of what I have 
 stated, I should relapse into the same fault. 
 Accept it then, sir, such as it is, with indulgence, 
 and believe that no one here is more sincerely 
 attached to your son, or entertains for him a 
 higher esteem than myself. Above^ all, listen to 
 the suggestions, which I have ventured to make ; 
 and may my wishes that your son may devote 
 himself exclusively to observation be ultimately 
 realized ; for it is to that point I constantly 
 return. 
 
 I conclude by renewing to you my thanks, 
 and beg you to be assured of the sentiments, &c. 
 
 (Signed,) Louis, 
 
 Parts, October 28, 1832. 
 
 SIR, MY RESPECTED BROTHER, 
 
 I thank you most sincerely for your last 
 letter and particularly for the details into which 
 you were kind enough to enter with regard to 
 your son. Nothing certainly could be more 
 grateful to my feelings ; for it is almost a mark 
 of affection for myself, and I feel almost worthy 
 of it from the strength of that, which I bear to 
 your excellent son. He will soon leave us ; but 
 his name will long be mentioned among us, and 
 
JAMES JACKSON, JR. 31 
 
 I hope that the ocean, which is to separate us, 
 will not be a complete barrier to our intercourse. 
 
 I feel more than any one else how much you 
 must long to see as soon as possible a son, whose 
 profession is the same as your own, and with 
 whom it will be so delightful to you to converse 
 respecting it. Indeed, I never thought of induc- 
 ing you to leave him Avith us in Europe for four 
 or five years. I love in Mr Jackson the man 
 and the physician ; but he is a son, and you are 
 a father ; and though I have never known the 
 delights of paternal affection, I should not have 
 regarded as possible the sacrifice which you 
 understood me to propose to you. My only wish 
 was that you should allow your son to devote 
 himself exclusively to observation, for several 
 years in Boston. I recommended this to you, 
 because no one is more capable than he is of 
 cultivating science and consequently of promoting 
 the progress of practice. For what is practice 
 but science brought into daily use ? 
 
 Think for a moment, sir, of the situation in 
 which we physicians are placed. We have no 
 legislative chambers to enact laws for us. We 
 are our own lawgivers ; or rather we must dis- 
 cover the laws, on which our profession rests. 
 We must discover them and not invent them ; 
 
32 MEMOIR OF 
 
 for the laws of nature are not to be invented. 
 And who is to discover these laws ? Who 
 should be a diligent observer of nature for this 
 purpose, if not the son of a physician, who has 
 himself experienced the difficulties of the obser- 
 vation of disease, who knows how few minds 
 are fitted for it, and how few have at once the 
 talents and inclination requisite for the task? 
 The inclination especially ; for this requires that 
 the observer should possess a thorough regard 
 for truth, and a certain elevation of mind, or 
 rather of character, which we rarely meet with. 
 All this is united in your son. You ought, for 
 in my opinion it is a duty, you ought to conse- 
 crate him for a few years to science. This, sir, 
 is my conviction, and I hope it will be yours 
 also. I know very well that every one will not 
 be of the same opinion ; but what matters it, if 
 it be yours ; if you look upon a physician, as I 
 do, as holding a sacred office, which demands 
 greater sacrifices than are to be made in any 
 other profession. 
 
 Believe me that I do not forget in all this the 
 force of established usages. I think of all this ; 
 but I am none the less convinced that Mr Jack- 
 son, entering into practice after three or four 
 years, with the esteem of all his professional 
 
JAMES JACKSON, JR. 33 
 
 brethren, and surrounded as it were with their 
 respect, will very rapidly regain all which he 
 may have sacrificed and much more.^ At all 
 events my best v/ishes and those of all his 
 friends here, will follow him, whatever may be 
 his course ; and I shall always esteem myself 
 happy in having knowni him. Permit me, sir, 
 to assure you of this, and of the sentiments of 
 respect and affection, with which I am, &c. 
 
 (Signed,) Louis. 
 
 Paris, March 22, 1833. 
 
 To the foregoing letters, I might add others, 
 not only from M. Louis, but from other gentle- 
 men in Europe, addressed to me after my son's 
 death. But, while I am extremely grateful for 
 the kind sjnupathy they manifest toward me, 
 and have felt assured by them, that my partiality 
 has not led me to a very extravagant estimate of 
 the loss I have suffered, I cannot think it neces- 
 sary to add any further testimony to that which 
 I have given above. 
 
 The period of the epidemic cholera in Paris 
 
 * See note A. 
 
34 ME3I0IR OF 
 
 was one of the greatest interest and of the 
 greatest anxiety to the subject of this memoir. 
 Until the end of the winter 1831-2, the accounts 
 which we had received in this country of the 
 cholera in Europe, were of the most alarming 
 character. We knew that, arising many years 
 previously in tlie hot climates of Asia, this deadly 
 malady had passed in a northwest direction into 
 the coldest regions of Europe, and was thence 
 extending itself over that quarter of the globe. 
 Why it thus spread, and whether it was propa- 
 gated by contagion, many persons were ready to 
 decide upon general principles ; but precise facts, 
 on which to form a decision, were not yet fur- 
 nished. One thing was certain, that it affected 
 great numbers, wherever it went, and proved 
 fatal to a large proportion of those affected. Re- 
 garding my son as comparatively without friends 
 in a foreign country, not then knowing the kind 
 feelings already entertained for him by those 
 most capable of taking care of him, I wrote to 
 him urgently to fly before this plague, and even 
 to leave Europe, should the disease invade at 
 once France and Great Britain. Such letters, 
 and such only had he received on this subject, 
 when the disease appeared in Paris, on the last 
 days of March. It had already been introduced 
 
JAJIES JACKSON, JR. 35 
 
 into England, but had there been comparatively 
 limited in its extension. In Paris, it extended 
 at once to very large numbers, and assumed 
 within one week the most terrific aspect ; such 
 as to excite within that short period the most 
 outrageous mobs, under a belief that the poorer 
 classes had been designedly poisoned. On the 
 sudden outbreak of this most alarming disease, 
 my son's mind was exercised in a distressing 
 manner. The following extract from his letter 
 of April 8th, which will be given in full among 
 his letters, will describe his feelings, and give 
 the result to which he was brought in this 
 dilemma. 
 
 " I almost weep to UTite you again from Paris. 
 It is now the first moment of my life, that I have 
 been placed between two duties, each strong, 
 each binding, and where my difficulty is to 
 decide which is the most so. But I have de- 
 cided, — as I know, against your wishes. God 
 grant that circumstances may be such that you 
 shall soon accord with me, when the time is 
 passed. A medical man has his duties ; — I am 
 a boy in medicine ; — granted. But I am like 
 the other Americans here about me. An oppor- 
 tunity is offered us of studying a disease, which 
 will probably visit our hitherto untouched coun- 
 
36 
 
 MEMOIR OF 
 
 try. Were the disease about you, would you 
 fly ? You could not, for the public would look 
 to you. You would not, for your sense of duty 
 would prevent you. I am, in a measure, in the 
 same condition." 
 
 The moment was a fearful one, most assuredly. 
 The mortality in Paris rose to eight hundred a 
 day within three weeks from the first appearance 
 of the disease. It was in the Hotel Dieu my 
 son first saw the victims of it in any number, 
 and the emphatic w^ords in which he described 
 it were nearly the same, as were often used by 
 others. " The disease is death," he said; " truly, 
 at Hotel Dieu, where I have seen fifty and more 
 in a ward, it is almost like walking through an 
 autopsy room ; in many, nothing but the act of 
 respiration shows that life still exists. It is 
 truly awful." 
 
 At a meeting of the Academy of Medicine, 
 on the evening of 3d of April, cholera was the 
 subject of discussion, and various suggestions 
 and opinions were offered by men of sanguine 
 characters. My son followed M. Andral on his 
 leaving this meeting, and asked permission to 
 visit the hospital (la Pitie,) at that hour, with 
 the view of seeing any new cases which might 
 have been admitted. M. Andral kindly took 
 
JAMES JACKSON, JR. 37 
 
 him into his cabriolet and gave him every facility. 
 " Our conversation," says my son, " turned natu- 
 rally upon the cholera, and turning to me with 
 a certain nod of his head, which is peculiar to 
 him, and to me very significant, for I know that 
 it is a thinking head which nods, — ' I am deeply 
 interested,' said he, ' my mind is totally occupied 
 by this subject ; but as yet I see nothing which 
 is not vague ; — but I shall go to work upon it, 
 and I indulge the hope of arriving at some val- 
 uable results.' This is not his exact language, 
 but it is the idea ; — and that idea inspired me ; 
 it seemed as if he had imparted to me a new 
 feeling ; I may call it a new besoin, so essential 
 have I since found and still find it to satisfy and 
 to yield to it." 
 
 James's resolution was fixed, and he felt only 
 an ardor to study this plague under his excellent 
 masters at la Pitie, hoping he might make his 
 knowledge useful in his own country, if that 
 also should be invaded by the universal epidemic. 
 Accordingly he devoted his whole heart and 
 mind to this study during the month of April, 
 only taking the precaution to lodge in a healthy 
 part of the city, to be cautious in his diet, and 
 to take regular exercise in the open air. He 
 pursued the plan of his master Louis in taking 
 
38 MEMOIR OF 
 
 down with minuteness and fidelity the cases, 
 which came under his observation, and the 
 resuhs ascertained by dissection in the fatal 
 cases. This labor occupied his whole time ; he 
 almost lived in the hospital. At the end of a 
 month he took his papers to London and there 
 arranged them. He made a copy of sixty of 
 the most perfect of them, of which thirty were 
 favorable and thirty fatal in their termination. 
 From these he made the deductions which they 
 afforded ; and this required an exact analysis of 
 each case. To this analysis he added the few 
 reflections, which he thought to be fully author- 
 ized by the facts, but restrained himself from 
 engaging in any speculations on the subject. 
 This was a restraint, to which at his age he 
 would not have submitted, had he not been fully 
 imbued with the rigid, philosophical principles 
 of his master Louis. At the end of May and 
 first of June he sent to me the papers thus pre- 
 pared, in two parcels. Coming by prii^ate hands 
 I did not get them all till the first of August. 
 After obtaining the advice of a judicious friend 
 I determined to publish them, for my son had 
 left it to me to do so or not. I am willing now 
 to refer to them in support of the praise, which 
 I have ventured to give to my own son. The 
 
JAMES JACKSON, JR. 39 
 
 only object of the bock was to throw light on 
 the pathology, or strictly to give the natural his- 
 tory of the disease and to draw such inferences 
 as the facts afforded. On the treatment he 
 would not venture to offer anything, except in- 
 deed that the disease had not thus far been 
 influenced by remedies. The book w^as pub- 
 lished here, when the public had begun to be 
 tired of reading the numerous pamphlets upon it, 
 with which the press teemed for three months. 
 On this account it did not attract so much atten- 
 tion as it v/ould have done otherwise. Besides, 
 it promised no aid as to the treatment, in which 
 the public were naturally and properly most 
 interested. But, for its purpose, I might beg 
 that it should now be compared with any other 
 work on the same subject, which has been pub- 
 lished anywhere. This is strong language and 
 I should not be thus bold perhaps, if I claimed 
 for my son all the merit of the work. I did and 
 do give to him great credit, but the materials 
 were gathered under the guidance of, and in 
 part directly from his masters at la Pitie, to 
 whom I have so often referred. 
 
 While he was engaged on this work in Lon- 
 don he made some acquaintances there, and 
 acquaintances of the most valuable character. 
 
40 MEMOIR OF 
 
 Though he went from this country without 
 letters to medical men in Paris, the friendship of 
 distinguished physicians there had furnished him 
 with a flattering introduction to medical men in 
 London and Edinburgh. In London also he 
 was received, almost at once, by my friend Dr 
 Boott, on whose character, and kindness to my 
 son I shall refrain from making the remarks, 
 which my heart dictates. Thus was my son 
 enabled to gain access to whatever was valuable 
 in that city both then and in his subsequent visit 
 in the autumn. 
 
 But it was not only by an intercourse with 
 professional men that he was benefited. Far 
 greater was the advantage, which was afforded 
 to his mind and his heart, from an introduction 
 to a select circle by the gentleman whom I have 
 just named. In France he had studied the 
 external world only, under the best of masters 
 indeed, and men whose whole conduct evinced 
 the excellence of their hearts as well as the 
 depth of their science, and their holy devotion to 
 truth. But in London he was refreshed by 
 being brought into domestic society and among 
 people of the greatest refinement, whose minds 
 were engaged in the study and the elevation of 
 the human character ; — persons who were filled 
 
JAMES JACKSON, JR. 41 
 
 with philanthropy, and who took delight in fos- 
 tering all the best propensities of his heart. "^ 
 The hospitality of England delighted him ; and 
 for a tune he became elevated almost beyond 
 himself in the little paradise, in which he was 
 placed. All his good and holy resolutions were 
 strengthened, and he learned to view his profes- 
 sion only as the means of being useful to his 
 fellow men. 
 
 The plan how^ever, which he had laid out for 
 himself, was to spend a few weeks during the 
 summer in Edinburgh, to make a brief ^dsit to 
 Ireland, and to get back to London early in the 
 autumn. Accordingly he tore himself from the 
 dehghtful circle, in w^hich it had been his priv- 
 ilege to be admitted as a friend, and made a 
 circuitous journey to Edinburgh, visiting many 
 interesting places on his way. I am tempted to 
 give here some extracts from his letters at this 
 period, to show, not only his readiness to avail 
 himself of opportunities for information, but also 
 the excellent spirit of those whom it was his 
 happiness to meet. But enough will be found 
 on this score in the letters which follow, under 
 dates of June, July and August, 1832. The 
 letter of June 30th especially, contains evidence 
 
 * See Note B. 
 
42 MEMOIR OF 
 
 of the substantial hospitality, not that of the 
 table merely, which is shown by men of science 
 in Great Britain. 
 
 In Edinburgh, as elsewhere, he was admitted 
 to free intercourse by the most distinguished 
 men, and had opened to him every source of 
 information, of which he could avail himself in 
 so short a visit. At Glasgow he stopped only 
 to examine the famous museum of Dr William 
 Hunter. He walked over the highlands with a 
 friend and fellow-student from our own. city; 
 and read, with vastly increased delight, the Lady 
 of the Lake on the borders of the lake itself. 
 
 The cholera was in Edinburgh while he was 
 there, and the treatment by saline injections was 
 at that moment under trial. He had spent half 
 a day at London in conversation with Dr Stevens 
 on his peculiar opinions, physiological and patho- 
 logical, those especially which had a bearing on 
 the saline remedies ; and he was much indebted 
 to that gentleman for his polite attentions. On 
 his journey through England he had an oppor- 
 tunity of learning something of the trial of these 
 remedies. Although not sanguine in his expec- 
 tations, he attended to the effects of the saline 
 injections in Edinburgh with the most ardent 
 desire that they might be found useful. But 
 
JAMES JACKSON, JR. 43 
 
 the result in his mind was the same, as I believe 
 it has been in the minds of most of those, who 
 made trial of this treatment of cholera in Europe 
 and America. His letter of August 10th goes 
 into some details on this subject, and in that and 
 others there were many statements very inter- 
 esting at the moment, but which I do not think 
 worthy of publication at this time. 
 
 In his visit to Dublin he was confirmed in the 
 high opinion which he had formed of the excel- 
 lent spirit and high scientific attainments of its 
 physicians. There has arisen in that city within 
 the present century a number of talented and 
 learned men, who have labored much to advance 
 the science of medicine. Their labors have not 
 been in vain, and their merit is acknowledged 
 in all parts of the world ; at least in all where 
 the English language is spoken. My son de- 
 rived great advantage from the museum of the 
 College of Surgeons at Dublin, the value of 
 which he thought greatly increased by a proper 
 catalogue. He also praised very highly the 
 excellent lying-in hospital of that city. 
 
 Returning to London at the end of August, 
 he first indulged in the luxury of visiting the 
 friends, from whose society he had already de- 
 rived so much pleasure and so much benefit; in 
 
44 MEMOIR OF 
 
 which he found his feelings and affections con- 
 stantly purified and elevated. He then looked 
 around for the means of pursuing his professional 
 studies. He was in truth too far advanced to 
 find any adequate advantage in devoting his 
 hours to regular courses of elementary lectures, 
 even though from most distinguished men. Sur- 
 gery he did not meddle with ; and the mode of 
 pursuing pathological researches in the London 
 hospitals did not seem to him at all equal to 
 those, which he had witnessed at la Pitie. It 
 happened that the arrangements for the Avinter 
 would not permit him to hear the clinical lectures 
 of those physicians, whom he would have been 
 most pleased to attend. He found then those 
 monuments of industry and science, the anatom- 
 ical museums of London, to be the only objects, 
 which in the actual state of his mind and at his 
 stage of study, could repay him for delaying his 
 return to Paris. He had before desisrned to 
 
 o 
 
 revisit this city in the spring for a few weeks, 
 after passing the winter in London. But he 
 now decided that his winter could be spent most 
 profitably in Paris. At once then he engaged 
 in the study of the excellent museum of morbid 
 anatomy at Guy's hospital, which owes its ex- 
 istence to Dr Hodgkin. This most pure and 
 
JAMES JACKSON, JK. 45 
 
 philanthropic physician afforded him every pos- 
 sible assistance. My son examined each pre- 
 paration carefully, inquiring minutely into the 
 history of the subject from whom it was derived, 
 and taking notes as he proceeded, especially in 
 cases where the whole history could be obtained. 
 This study occupied him a fortnight. 
 
 He next visited the museum of John Hunter, 
 now belonging to the Royal College of Surgeons 
 of London. Having learned in the first year of 
 his medical studies to venerate the name of the 
 great author of this stupendous work, he went 
 to it with the highest anticipations. His delight 
 in seeing it was even greater than he had 
 expected, and he thought that he derived great 
 advantage as well as pleasure from his visits to 
 it. But he saw that the advantage might have 
 been much greater under more favorable circum- 
 stances. His remarks on this subject, or some 
 of them, are given in his letters of September, 
 1832. The want of a catalogue, a want which 
 is about to be supplied, made it impossible for 
 him to study the preparations in a useful manner, 
 notwithstanding the excellence of their scientific 
 arrangement. 
 
 I ought not perhaps to omit an acknowledg- 
 ment of, what he felt very strongly, the pleasure 
 
46 MEMOIR OF 
 
 and profit he derived from an intercourse, in 
 which he was indulged, with some eminent 
 medical men in London ; and I cannot omit to 
 say that Sir Astley Cooper, one of the teachers 
 on whom I myself attended more than thirty 
 years before, was among them. But my son 
 was so short a time in London that he could not 
 acquire a very accurate knowledge of individuals 
 there ; and I do not deem it proper to quote his 
 transient remarks on them, although these re- 
 marks were, for the most part, both respectful 
 and accompanied by strong expressions of grati- 
 tude. 
 
 On his return to Paris, about the 20th of 
 October, my son engaged at once under the 
 greatest advantages in his attendance at the 
 Hospital la Pitie. He was now well prepared 
 for observation of the phenomena of disease in 
 the living and the dead. In addition to what 
 he had previously gained, he now had the ad- 
 vantage of having learned many of the views 
 and opinions of the greatest living masters on 
 the leading questions in pathology. He knew 
 that his whole life, of such a length as he then 
 had reason to anticipate, would be too short for 
 the full solution of these questions, even to his 
 own satisfaction. He knew also the inestimable 
 
JAMES JACKSON, JR. 47 
 
 value of the opportunities aftbrded him in Paris 
 for this purpose, such as he could not look for 
 again ; a value increased tenfold by the aid and 
 guidance of his beloved and revered master. It 
 was at this time that M. Louis almost adopted 
 him as a son, admitting him to the most unre- 
 served intercourse, and affording him every pos- 
 sible facility in the wards under his care. There 
 James devoted himself entirely to careful obser- 
 vation and the collection of facts. Not to a 
 selection of the facts, which favored particular 
 doctrines ; but really and truly to an exact 
 inquisition into all the facts appertaining to the 
 cases before him. These, as far as time would 
 permit, were all carefully noted on the spot in 
 his daily visits ; and these visits were not limited 
 to the regular hours of the physician. By the 
 orders of M. Louis he was admitted at all hours, 
 and permitted to pass most of his day in the 
 collection of his cases. Fully aware how much 
 is lost to us in hospitals, in comparison with 
 private practice, from not being acquainted -w^th 
 the families and with the personal constitutions 
 and morbid dispositions of the patients, he en- 
 deavored to get a compensation by the most 
 exact inquiries on these points. From the pa- 
 tient, or his friends who visited him, he constantly 
 
48 MEMOIR OF 
 
 sought an answer to the following and similar 
 questions, viz. Where was the patient born 
 and Avhen ? Was he nursed at the breast of his 
 mother, or of a stranger ? What have been his 
 occupation and his habits of life ? What have 
 been his previous diseases ? Do his parents 
 live ; if not, at what age did they die ; to what 
 diseases were they and their relatives subject ; 
 and of what diseases did they die ? Were they 
 affected by palsy, asthma, or any disease of the 
 thorax? If so, w^hat particular symptoms did 
 they manifest ? Has the patient any children ? 
 If so, do they live and with what diseases have 
 they been affected ? 
 
 The observations thus collected were all of 
 them such as he could himself have employed 
 usefully, in connexion with others of a similar 
 kind, in seeking answers to many general ques- 
 tions. For instance, he noticed, and, so far as I 
 know, he first noticed the frequency with which 
 asthma and either apoplexy, or palsy occur in 
 the same family. To ascertain the accuracy of 
 this observation, he inquired of all those he* 
 examined, whether asthmatic or not, if these 
 diseases of the nervous system had occurred in 
 their families. But, valuable as the cases he 
 collected would have been to himself, the larger 
 
JAMES JACKSON, JR. 49 
 
 part of them were not such as could repay a 
 perusal by others. Those, in which the event 
 was fatal, and where the details were full and 
 precise, are the most instructive to others. It is 
 from among those principally that the cases in 
 this hook have been selected. These are not 
 sufficiently numerous to furnish positive answers 
 to many interesting questions. They are to be 
 regarded as contributions to medical science ; 
 and, when they shall be taken in connexion with 
 many similar observations, the whole being care- 
 fully analysed, they will give results of perma- 
 nent value. They are printed with this view ; 
 and a peculiar encouragement to expect benefit , 
 from them is derived from circumstances, which 
 I shall proceed to mention. 
 
 In the year 1832 there was formed in Paris a 
 Society entitled " The Society of Medical Obser- 
 vation." It had for its first President M. Louis, 
 and for its Vice Presidents MM. Chomel and 
 Andral. Its active members were young men. 
 who were proud to call M. Louis their master. 
 Their object was to accumulate observations, 
 made with the accuracy which their President 
 had inculcated both by precept and example,^ 
 and to draw from them the inferences, which a 
 
 * See note C. 
 4 
 
50 MEMOIR OF 
 
 careful comparison of them should permit. Of 
 
 • 
 
 this society, ori^nally very small, its members 
 being from different countries, my son was a 
 member at its formation. It was one of his first 
 desires to contribute his proportion of materials 
 to its stores ; stores which must become ample 
 if its plan is not abandoned, and which will be 
 opened freely to all the world. 
 
 During his residence in Europe my son had 
 a strong desire to visit Germany, fully aware of 
 the means there to be found for increasing med- 
 ical knowledge, as well as of the benefit of per- 
 sonal communication with those, whose lives 
 have been devoted to science and whose minds 
 are stored with it. Each has his own mode of 
 viewing objects and of presenting them to the 
 minds of others. From every one something is 
 to be gained. But, on the other hand, if one is 
 limited by time, his mind may suffer from the 
 kind of dissipation which arises from visiting 
 even rich mines of learning, into which he does 
 not enter as a laborer. From considerations of 
 this kind, very judiciously urged by M. Louis, 
 my son resisted the temptation and gave himself 
 up to observation of disease at la Pitie, as has 
 been stated. He had fixed on the end of June, 
 1833, as the period when he should relinquish 
 
JAMES JACKSON, JR. 51 
 
 this employment, which grew more interesting 
 every day. When July arrived he scarcely 
 knew how to tear himself away, though he felt 
 at the same time an eager desire to revisit his 
 own family. Especially the idea of leaving 
 M. Louis forever was afflicting to him in the 
 highest degree. Never was attachment more 
 just on the part of a pupil to a master, and never 
 could it have been warmer, or more sincere. 
 M. Louis gave him some beautiful articles as 
 testimonials of his affection, and the delight, 
 with which he subsequently regarded them, fre- 
 quently made his eyes swim with tears. I can- 
 not resist the gratification of inserting the note 
 by which these articles were accompanied, as 
 also my son's last letter to me from Paris. 
 
 Translation of a note from M. Louis to J. Jackson, Jr. on 
 his leaving Paris, accompanied with a bronzed inkstand 
 and two pieces of marble, of which one was surmounted 
 by the famous dog of St Bernard, bearing a child on its 
 back ; to which reference is made in the note. 
 
 There is a satisfaction, though I confess it is 
 accompanied by feelings which render it a very 
 slight one, in leaving some token of remem- 
 
52 MEMOIR OF 
 
 brance with friends from whom we are about to 
 part; yet a satisfaction it certainly is, and for 
 that reason, my dear friend, I beg you to permit 
 me to enjoy it. Your thoughts would very nat- 
 urally dwell at times upon your good friends in 
 Paris ; but, for my part, I choose you should 
 have something to recall them more particularly 
 to your recollection. I must therefore beg you 
 to accept this inkstand, which I hope you will 
 keep upon your study table, and these two little 
 pieces of marble, which will serve to keep in 
 their places the leaves upon which you will be 
 writing the results of your researches. From 
 these researches let nothing divert you ; be con- 
 stant in your pursuit three or four years and do 
 not let the poor child whom the faithful dog is 
 bearing to his home, speak too feelingly to your 
 heart. Do not forget that you are to be one of 
 the lawgivers in our art ; and that, if it is our 
 duty upon earth to use our faculties in the best 
 possible manner and for the advantage of the 
 greatest number, you owe yourself to observation. 
 Your future fortune will be none the less, and 
 the satisfaction you will derive from four years' 
 labor will be incomparably greater. Be assured 
 that my best wishes follow you wherever you 
 go, that no one can more sincerely desire your 
 
JAMES JACKSON, JR. 53 
 
 happiness, that I fully appreciate the value of 
 your friendship and of your esteem, and that I 
 should be most happy to be able to give you 
 proofs of it. Farewell, my dear friend. 
 
 (Signed,) Louis. 
 
 July 10, 1833. 
 
 Parts, July 13, 1833. 
 MY DEAR FATHER, 
 
 In two hours I am out of Paris. I will not 
 attempt to describe to you the agony it gives me 
 to quit Louis. He is my second father, and 
 God knows that is a name I of all men cannot 
 use lightly. I may not persuade you to look 
 upon him with my eyes exactly as a scientific 
 man ; but in your heart he must have the share 
 of a brother ; for he almost shares my affection 
 with you. From one, upon whom I had no 
 claims, but those which my life and mind and 
 habits gave me, I have experienced a care, an 
 affection which I never could dare expect from 
 any but my dear father, and which I shall ever 
 feel to be the most honorable and truly worthy 
 prize of my life. To meet with satisfaction in 
 the eyes of such a man, and to hold a place in 
 his heart as I do, I allow I am proud of. But, 
 
64 MEMOIR OF 
 
 my dear father, I cannot write ; I am sittmg 
 here, expecting to see Louis for the last time in 
 my life, and it is only upon the occasion of quit- 
 ting yourself, whom I have ever felt to be a part 
 of me, that I have suffered as I do at present. 
 The ties of relationship are strong, the strongest 
 when that relationship is close and dependent ; 
 especially if it be mingled with the strongest and 
 warmest sympathies. But one's mind's friends, 
 the hearts that not nature, but our oa\ti characters 
 have given us, the friend, who not father to our 
 bodies, has yet been and is ever to be the 
 source, fountain and direction of the dearest 
 thoughts of our minds, that friend and that rela- 
 tionship is also dear. It is that friendship I must 
 now quit, probably forever ; it is that relationship 
 that in the person I must now break, though 
 in the mind and in the heart it can never be bro- 
 ken. Till now, I knew not how I loved my 
 French master. I know well I shall rarely be 
 called to such trials ; they can occur but few 
 times in life. Thank God, that with me, grief 
 is as short, as it is poignant, and that in a few 
 days nought will occupy my mind, but the anti- 
 cipations of the joys of home. Once more in 
 the arms of my beloved family, and under the 
 wings of my dear father, and I can imagine no 
 higher joy. 
 
JAMES JACKSON, JE. 55 
 
 In addition to the testimonials of M. Louis's 
 affection above referred to, my son obtained 
 shortly before he left Paris another memorial of 
 him, which he valued as above all price. This 
 was a picture, and an excellent likeness of his 
 master, executed by Champmartin, which M. 
 Louis very kindly consented to sit for. The 
 emotions which my son experienced on the arri- 
 ' val of this picture, which was during his conva- 
 lescence from his fever in December, 1833, were 
 too strong and too deep to admit of description. 
 From his younger friends also, James could not 
 part without the greatest sensibility ; from those 
 especially whose home was in Europe. To one 
 of these, M. Maunoir, of Geneva, he felt the 
 attachment of a brother. Some, or all of these 
 friends, perhaps, were surprised not to hear more 
 from him after his return to this country. I 
 therefore avail myself of this opportunity to say 
 to them that he survived his return to us scarcely 
 seven months ; that half of that time was passed 
 in the chamber of sickness ; that, in the residue, 
 he could not find time to respond fully to the kind 
 expressions of affection and most friendly atten- 
 tions on his return and during his first sickness, 
 which were abundantly poured out upon him ; 
 while he had also professional objects constantly 
 
56 MEMOIR OF 
 
 calling for his observation. The friends, to 
 whom I allude, will well understand how much 
 interested he was in the inquiry as to certain 
 points in typhus fever in this country, in regard 
 to tuberculous cases and many similar subjects, 
 which had interested him and them in Paris. 
 
 Under any circumstances my son's gloomy 
 feelings on leaving Paris would soon have sub- 
 sided, although without any forgetfulness of what 
 he had left behind. His natural cheerfulness 
 was sufficient. But he had also the pleasures 
 of home in view, and he had more immediately 
 the joy of seeing his friends in London, and the 
 prospect of crossing the Atlantic with a rare 
 company of friends, as fellow-passengers. It 
 may seem like romance to speak thus of his 
 happiness in finding rare and excellent friends 
 at every turn. Yet, if it were well to bring out 
 the evidence, many who will read this would 
 know that this language is quite as cool as the 
 subject will permit. 
 
 I shall not however dwell on the high gratifi- 
 cation he received during a few days passed in 
 London and Liverpool, nor that which attended 
 his voyage to this country. The ship which 
 brought him arrived at New York on the 23d of 
 August, 1833, with a precious freight, which 
 
JAMES JACKSON, JR. 57 
 
 rejoiced many hearts besides those of my family. 
 For my household how little then seemed there 
 occasion to apprehend the sad sufferings, to which 
 they were soon to be called. The dangers of 
 the sea and the risks of a long absence were 
 over, the fearful cholera had left my son untouch- 
 ed, and now we embraced him as if we had a 
 security of the happiness he was so capable and 
 so anxious to afford us. He could indulge his 
 heart at this moment in expressing his love for 
 his friends with an ardor, which the cold manners 
 of our country scarcely permit on ordinary occa- 
 sions, and he was almost in a delirium of joy. 
 But after an indulgence of this kind for two or 
 three weeks, he felt that the serious business of 
 life called him, and sought to renew his obser- 
 vations on disease. 
 
 The opportunities offered him for this purpose 
 were ample, though not so great as- those he had 
 left in Paris. My connexion with the Massa- 
 chusetts General Hospital afforded him every 
 facility at that institution. Besides, here as eve- 
 rywhere, he met the kindest attentions, and he 
 soon found that the most busy among the medical 
 men of our city were ready to show him their 
 important cases and to invite him to their post- 
 mortem examinations. In this way his time 
 
58 MEMOIR OF 
 
 was abundantly occupied ; and in accepting the 
 kind hospitalities of numerous friends it was 
 more than occupied. He was constantly under 
 too great a pressure and I was seeking how to 
 prevent it. The temptations came day by day, 
 and in so many instances were the results of 
 the most friendly kindness, that to resist at once 
 was impossible. Our autumnal fever was prev- 
 alent much more than usual, and with some 
 uncommon severity. The opportunity to study 
 this and to compare it with the fever of Paris, 
 on which Louis had written so admirably, was 
 one which he could not forego. And when he 
 found that this disease exhibited in the livino: 
 and in the dead the same characters, which his 
 master had so accurately delineated, his ardor 
 was increased more and more, and he put all his 
 powers to their greatest trial. It is not surpris- 
 ing, in the retrospect, that he became affected 
 with the prevailing disease. He was attacked 
 just two months after his arrival in New York, 
 and underwent this fever in a very severe form. 
 Some of my sanguine brethren will ask why we 
 did not crush the disease at once ? It is in 
 accordance with my experience certainly, that, in 
 most instances, the early use of active remedies, 
 of which antimonials are the most important, 
 
JAMES JACKSON, JR. 59 
 
 will diminish the violence of this fever, and in 
 many cases will arrest it. But in some instances 
 a peculiarly irritable state of the alimentary 
 canal will not permit the use of these remedies ; 
 or, evil only will follow their use. Such was 
 my son's case ; owing in part to a stomach natu- 
 rally irritable, but in part also to an intestinal 
 disease which he had suffered abroad. Notwith- 
 standing some active treatment at the beginning 
 the fever took its course, and during the second 
 and third week its result was very uncertain. 
 It then became more mild, yet for six weeks he 
 was unable to assume the erect position. His 
 convalescence was not rapid, but in three months 
 from its commencement he seemed to be in per- 
 fect health, having then been three weeks riding 
 and walking abroad. His convalescence was 
 not destitute of pleasure to him ; on the contrary 
 he spoke of it as a happy period ; he thought it 
 good for him to have been sick, that he should 
 better know how to minister to others, and that 
 his own heart would be the better. His sensi- 
 bility to the kindness of his friends and the 
 pleasure he derived from them were also increas- 
 ed ; and we all meanwhile promised ourselves 
 that his health would become more firm. 
 
 The time now arrived when he should apply 
 
60 MEMOIR OF 
 
 for admission as a Doctor of Medicine in our 
 University. If he had been at home he might 
 have taken this step in August, 1S31. He had 
 now been five years and a half engaged in the 
 study of medicine. It could not be a question 
 whether he could pass the requisite examination. 
 Yet he felt some anxiety, because he thought it 
 would be shameful for him to be found deficient 
 in any point. This examination was about the 
 middle of February. He had seemed quite well 
 at the end of January and beginning of Febru- 
 ary. But he now appeared less firm, and had 
 some recurrence of a diarrhoea, which had 
 afflicted him in France. I attributed this to the 
 momentary anxiety he felt as to the examination, 
 and to the deeper anxiety as to the more weighty 
 duties which were before him ; as he was soon 
 to enter on the reponsible duties of his profession. 
 The examination being passed, and the degree 
 conferred, I felt desirous that he should make his 
 arrangements at once to engage in business, 
 hoping that he would feel a tranquillity when 
 this was done. But I was in an error as to 
 the cause of his difficulty. It was a physical 
 and not a moral one. He thought his diarrhoea 
 was no more than he had often had before. But 
 suddenly the disease grew worse, it assumed the 
 
JAMES JACKSON, JR. 61 
 
 character of severe dysentery and he was entirely 
 prostrated at once. Under this disease he suf- 
 fered much and struggled hard, retaining his 
 firmness of mind and fully aware of the uncer- 
 tainty of its issue. He was severely sick about 
 three weeks, but after the first fortnight, I re- 
 garded him as safe. The dysenteric affection 
 was clearly subsiding, and he recovered some 
 appetite, though still very weak. Suddenly a 
 change occurred, of which the cause was latent ; 
 the prostration was extreme ; his mind gave 
 way, and in less than two da^^s and a half he 
 ceased to breathe.^ In his last hours, his mind, 
 amidst many wandering thoughts, appeared to 
 get momentary glimpses of his real situation. 
 He did not seem to shrink from the view, but 
 was unable to keep it before him from failure in 
 his physical strength. In one of these moments 
 he said very distinctly and solemnly, " God, par- 
 don me." That he had sins which called for 
 this petition at all times there is no doubt. That 
 he was deeply sensible of his own frailties and 
 imperfections I well knew, for no son was ever 
 more frank than he was in communications to a 
 father. That the prayer from a heart like his, 
 not now uttered for the first time, was freely 
 
 * See note D. 
 
62 MEMOIR OF 
 
 granted, it was impossible for me to doubt. His 
 own humble penitence was highly proper. But 
 for me, there was no fear that he would find any- 
 thing but bliss in the new state of existence into 
 which my mind seemed almost capable of fol- 
 lowing him ; almost, of seeing his admission. 
 It was for my own loss, for that of my house- 
 hold, I had to grieve. And that grief, sincere as 
 it was, found solace from the first in the delight- 
 ful recollection his life had left on my mind. 
 These recollections have constantly hung about 
 it, and how grateful they have been may be seen 
 by what I have transcribed in the preceding 
 pages. 
 
 As I have not very strictly followed the plan 
 which I laid down, there remain to be traced 
 more distinctly some of the features of my son's 
 character. His cheerfulness and gaiety of heart 
 have been before mentioned. The influence of 
 these on the society around him was often recog- 
 nised by his friends. It was heightened among 
 those, who had become acquainted with his purity 
 and the sincerity of his interest in others. He 
 was described very appropriately by one, who 
 knew him well and loved him much, as having 
 a " morning freshness," which shed gladness 
 
JAMES JACKSON, JR. 63 
 
 where he went."^ He never took the lead among 
 his friends, and his influence was not manifest ; 
 of course it was not offensive, nor annoying. 
 It was nevertheless great and extensive, so that 
 each one was surprised at last to find that there 
 were so many besides himself whose happiness 
 was promoted by him. The number of friends, 
 by whom he was admitted to intimacy, was large. 
 The reason was that he loved men for different 
 good qualities, and showed his interest in those 
 he loved. He did not shut his eyes to their 
 faults ; he examined them critically, but not for 
 purpose of reproach ; he regarded those faults 
 as misfortunes, which he should assist his friends 
 to overcome. I suspect thas he often performed 
 the hardest duty of friendship ; he told their 
 faults to many. If he had not done it gently 
 and in love they would have been offended. 
 They were not oflfended. His most intimate 
 friend has told me that he exercised a salutary 
 influence in certain cases, where friends of a 
 sterner character were not listened to. 
 
 In the society of the young he would give 
 himself up to sport, so that it might have been 
 doubted whether he could think soberly ; and 
 from the warmth of his feelings it might have 
 
 * See note E. 
 
64 MEMOIR OF 
 
 been argued that he could not exercise his 
 judgment coolly. Yet he was exact and dis- 
 criminating in the investigation of facts, which 
 related to science, and rigid in his deductions 
 from them. This union of coolness of the head 
 with warmth of the heart is rare, and this partly 
 explains the circumstance of his finding favor 
 with persons of very different character. 
 
 There was something agreeable in his man- 
 ners certainly, which recommended him to good 
 men ; for he quickly gained the favor of good 
 men Avherever he went. Though he had acquir- 
 ed sufficient polish of manner while abroad, 
 there was not enough of it to be a peculiar 
 recommendation. So far as his manners w^ere 
 agreeable then it was not from any polish ; it 
 was from their manifestation of the good feelings 
 already described. 
 
 I cannot omit remarking here the sincere rev- 
 erence for age, which he imbibed very early in 
 life and always maintained ; which, far from 
 checking his intercourse with the aged, made 
 him seek it, both that he might minister to their 
 comfort, and that he might gain by their wisdom. 
 
 The principle of gratitude was very strong in 
 him. He did not easily forget the slightest 
 favor, and his heart was burning with affection 
 
JAMES JACKSON, JR. 65 
 
 toward those, who had rendered him important ser- 
 vices. He deemed no services so great as those, 
 by which his heart was made better ; and hence 
 arose his strong feelings toward his English 
 friends, among whom he was placed at a moment 
 when his heart was truly hungering for the things 
 which could elevate and purify it. 
 
 What shall I say of his ambition ? The word 
 is an equivocal one. Or, perhaps, the question 
 should be of what was he ambitious. I think 
 his young friends and associates will agree that 
 he was not anxious for honorary distinctions. 
 He had not such a spirit of emulation as leads 
 one to study hard, so that he may get the highest 
 rank among his fellows. He could rejoice most 
 sincerely in seeing his friends gain honors, while 
 he remained unnoticed. Envy, I think, scarcely 
 sprouted in his breast ; I, who knew him well, 
 could never see the slightest evidences of that 
 baneful feeling. But he had the strongest ambi- 
 tion to be worthy the esteem and love of the wise 
 and good. He rejoiced openly when he made 
 any acquisition in knowledge ; he thanked God 
 reverently when he thought he had made any 
 advance in virtue. But so far from wishing 
 that others might be less that he might be great, 
 he would labor to communicate to his fellows, in 
 5 
 
66 MEMOIR OF 
 
 a mode, not offensive to their self-love, every 
 acquisition he had made. He even took pains 
 to manage this in some cases, so as not to seem 
 to be bestowing what he was very anxious to 
 give. He made it his aim to go as far in the 
 branch of his profession, to which he particularly 
 devoted himself, as any other man ; and he said 
 to me, after his return from abroad, that he had 
 at some periods indulged hopes of such honors 
 as our profession could afford ; but that he had 
 then totally renounced all such hopes and wishes 
 for that, which he deemed of much more impor- 
 tance, the being truly useful to his fellow-men. 
 As to wealth, he loved the good uses of it, but he 
 indulged no anxiety for it ; and he was not prone 
 to such extravagance in his expenses, as made 
 it necessary for him. 
 
 During his college life he had made some at- 
 tainments in general literature ; not such as to 
 give him claims to any distinction on that score, 
 yet enough to give him a taste for more. He 
 hoped to have a period in which he could do 
 more in this way. But, in the few years he 
 devoted to professional studies, he did not feel at 
 liberty to spare many hours to other subjects. — 
 To politics he gave very little attention, and this 
 only to what he could learn in conversation. 
 
JA3IES JACKSON, JR. 67 
 
 During moments of political excitement in France 
 and England, in 1S32 and 1833, he could not 
 avoid taking some notice of passing events ; 
 and, like all young men of ardent tempers, he 
 sided with those who thought more of the attain- 
 ment of liberty, than of the security which it 
 requires to render it a real blessing. 
 
 I may seem to have said enough of his indus- 
 try in the earlier pages of this memoir, yet I 
 must state some of the evidences that in Europe, 
 when left to himself, it was even greater than 
 when under my roof. While he was abroad, 
 with three necessary exceptions, he wrote to me 
 by every regular packet to New York, from Ha- 
 vre or from Liverpool. The letters were not 
 ordinarily short ; some of the extracts which 
 follow will prove that they w^ere not always so. 
 They were frequently four full sheets. These 
 letters, with some to other persons, w^ere so volum- 
 inous, that I have thought it right to enumerate 
 them among the proofs of his industry. But 
 they amount to nothing in comparison with the 
 papers of other kinds, which occupied his pen 
 while abroad. These were, 1st. His cases, taken 
 at the bedside in brief notes, many of them in 
 French, and which amount I believe to fifteen 
 hundred pages at least, and some of these were 
 
68 MEMOIR OF 
 
 copied and stated in full in the French language ; 
 2d. Many notes from books and from conversa- 
 tion with distinguished persons, accompanied 
 often by his own reflections, making not less 
 than eight hundred pages in his common-place 
 book ; and 3d. The translation of a large portion 
 of Andral's Clinique Medicale. 
 
 During the same period he made himself 
 familiar with the French medical literature of 
 the present day, studying a large number of vol- 
 umes with great care. It would thus seem that 
 no small portion of his time must have been 
 devoted to books and writing. He however 
 attended lectures on different subjects, but par- 
 ticularly and carefully two long courses by M. 
 Andral. Yet his attendance on hospitals would 
 seem alone to have afforded him sufficient occu- 
 pation ; while, except his notes of cases, the 
 occupations above-mentioned could not have been 
 carried on except at his lodgings. The time 
 spent by him in hospitals while in Paris, a period 
 of eighteen months, was not less than five hours 
 a day, and for many months it amounted to six 
 and seven hours a day. This time too was not 
 spent in a holiday service ; a large part of it 
 was occupied in examining cases for himself, 
 strictly scrutinizing their history by the interro- 
 
JAMES JACKSON, JR. 69 
 
 gation of patients and by examining for the 
 physical signs of disease ; and a portion of it 
 almost every day in the autopsy room, where, 
 on the cold and wet floors, he usually tested by 
 his personal examination all the minute changes 
 of structure to which disease had given rise, so 
 as to have become perfectly familiar with the 
 common chans'es of this sort, to which the 
 human body is liable. In thus reviewing his 
 labors it seems strange that he could find, as he 
 did, any time for society, for exercise and for 
 relaxation. I am almost tempted to blot out the 
 lines I have written on this topic. My heart 
 bleeds almost in thinking how arduous were his 
 labors and how much more my happiness might 
 now be, had they been much less so. I believe 
 the statement to be quite within the truth, and it 
 makes a part of his history ; but I cannot recom- 
 mend to any young man to follow his example, 
 to its full extent, in this respect. 
 
 In the enumeration of his labors while abroad, 
 I have omitted to notice that he had first to 
 acquire the art of speaking the French language, 
 which he could not do, when he first entered 
 Paris, and for which he devoted two hours a day 
 for some weeks, though he at once went into the 
 hospitals and learned to talk among the sick ; — 
 
70 MEMOIR OF 
 
 that he gave a portion of thne to the study of 
 practical anatomy under a private teacher ; that 
 he attended to instruction on obstetrics, and con- 
 nected himself with three private institutions at 
 the same time, so as to increase his opportuni- 
 ties for practice in this branch ; and that he 
 devoted one whole month industriously in Lon- 
 don to the copying and arranging his cases of 
 cholera, which formed a book in octavo of two 
 hundred pages ; and lastly, that his whole sum- 
 mer in Great Britain was spent in travelling, 
 conversing with medical men, not idle conversa- 
 ion, and in a critical study of their collections of 
 preparations of comparative and morbid anatomy. 
 
 Of the professional acquirements, which were 
 the fruits of his industry at home and abroad, I 
 have perhaps said enough ; but I am tempted 
 to point out more particularly what those acquire- 
 ments w^ere ; the more, as I think his attention 
 was directed to the points which a medical stu- 
 dent should principally regard. 
 
 Every thinking physician finds more and more 
 as he gains experience, that his greatest difficulty 
 is in what we term the diagnosis and the prog- 
 nosis. He wishes to ascertain by examining his 
 patient precisely what is his present difficulty, 
 and what course his disease is likely to pursue. 
 
JAMES JACKSON, JR. 71 
 
 He wishes in short, to be acquamted with every- 
 thing, which goes into the natural history of 
 diseases. For this purpose he finds the specula- 
 tions of the closet as useless as such speculations 
 would be to a gardener, who should desire to 
 know one plant from another and the manner of 
 gro^vth of each. Further, to understand the 
 natural history of diseases, he must have a know- 
 ledge of what appertains to the living body in 
 health ; in other words, of physiology. Facts 
 and facts only are useful to him. Close obser- 
 vation alone will serve his purpose. It is some- 
 times not until after the experience and disap- 
 pointment of years, that the physician fully 
 realizes all this ; but if he is an honest and intel- 
 ligent seeker for truth, he discovers it more or 
 less clearly at last. 
 
 Impressed as I have long been with these 
 principles, it will be supposed that I endeavored 
 to fix them in my son's mind. He was willing 
 to receive them and soon came under their full 
 influence. But it was away from me that he 
 learned how to apply them more rigorously 
 and with the greatest benefit. This he did 
 from M. Louis ; who, I hesitate not to say, has 
 been the most successful as well as the most 
 rigorous, in pursuing this mode of studying dis- 
 
72 MEMOIR OF 
 
 ease, of any physician in ancient or modern 
 times. 
 
 The resuh was, as respects my son, that he 
 returned to this country already possessed of 
 uncommon skill for his age, in the examination 
 of cases of disease and in distinguishing in each 
 case the actual morbid affection ; and also well 
 taught in the best mode of pursuing his investi- 
 gations, so as to promote the cause of true science. 
 In the examination of the thorax by percussion 
 and auscultation he was peculiarly well versed, 
 as likewise with the diseases of this region of 
 the body. He was also familiar with the vari- 
 ous morbid changes, to which the several organs 
 and textures are liable. Wlien he went to 
 France, I urged upon him the importance of 
 getting a knowledge of the morbid changes, to 
 which the various membranes, and particularly 
 those of the alimentary canal, are subject. In 
 no other place could this knowledge be obtained 
 so perfectly. The occurrence of the cholera in 
 that country furnished at once occasion and 
 inducements to pursue these inquiries, as to the 
 alimentary canal ; and he did so with success. 
 He did not overlook the morbid changes which 
 occur in the brain and in other parts. But he 
 seemed early to fix upon the thorax as the sub- 
 
JAMES JACKSON, JK. 
 
 75 
 
 ject of his particular study. He was led' to 
 this, perhaps, by my frequent remarks on the 
 obscurity of the diseases of this great cavity in 
 many instances, and on the large proportion of 
 cases in which they were fatal. 
 
 He was not ignorant of the common methods 
 of treating diseases both in this country and in 
 Europe, though less informed as to the reputed 
 virtues of some medicines than many others. 
 But he considered therapeutics as a branch of 
 medical science which he had yet to study. He 
 was very sceptical as to the utility of many 
 practices commonly adopted, believing that they 
 rested on insufficient authority, and he wished 
 to bring them to the test of experiment. He did 
 not feel a reliance, in respect to the influence of 
 medicine, on the experience of men, who could 
 not tell what would be the result of a disease 
 without the use of remedies. He was never- 
 theless ready to follow to a certain extent the 
 course adopted by physicians of sound judgment, 
 until he should have opportunities to decide by 
 his own experience. For his scepticism there 
 certainly is some ground in the actual state of 
 our science ; and, if either extreme must be 
 chosen, I would advise a young physician to 
 adopt the expectant mode of treatment, recom- 
 
74 
 
 MEMOIR OF 
 
 mended by some physicians of France, rather 
 than to employ on every occasion the heroic 
 remedies of some of our countrymen. The pro- 
 fuse use of these remedies, and the abundant 
 use of even mild articles in endless combinations, 
 too often witnessed among us, cannot be too 
 openly, nor too loudly reprobated. These errors 
 are disgraceful to our profession. But, if that 
 were all, one might be silent. They cause need- 
 less and often great suffering to those, who are 
 already afflicted enough. 
 
 At the suggestion and request of one of my 
 most judicious brethren, I shall add, that my 
 son's influence on the profession here, in the 
 short time he was with us, was of a very salu- 
 tary description. This gentleman states that 
 my son not only caused others, who had not yet 
 read the works of M. Louis, to study them with 
 care ; but that he induced among the rising 
 members of the profession in our own city the 
 habits of thorough observation of the phenome- 
 na of disease in the living and in the dead, 
 which he had learned from the same great pathol- 
 ogist. He also taught us much in respect to the 
 physical signs of disease in the thorax, with 
 which we were imperfectly acquainted before ; 
 at least I may say, this was true as to myself. 
 
JAMES JACKSON, JR. 75 
 
 Indeed I ought to say more ; for he aided me 
 very much in regard to the diagnosis of the 
 more obscure diseases of that region, derived 
 from the combination of the physical and rational 
 signs. On emphysema of the lungs he threw, 
 for me, quite a new light. 
 
 These good impressions will not be lost. Al- 
 ready we have with us one of his fellow students 
 under M. Louis, who is abundantly able and 
 will not fail to keep them alive. And others are 
 soon to follow, who will, I am sure, carry forward 
 the good work with the same disinterested love 
 for science. 
 
 I have mentioned the sensibility of my son 
 to the kindness he had experienced from his 
 friends during his fever. I cannot close this 
 memoir without some notice of the extent of 
 that kindness. It was in truth so great that 
 I never stated to him the full amount of it ; 
 waiting till he should recover more strength and 
 be better prepared to acknowledge it. While his 
 life was thought to be in danger, not only friends 
 and neighbors, but those who were personally 
 strangers to me, manifested a great interest in 
 his welfare and the utmost readiness to afford to 
 him and to me any assistance in their power. 
 Every aid was proffered from the most respecta- 
 
76 MEMOIR OF 
 
 ble sources ; and my son had for his night- 
 watchers, during all the critical period of his 
 disease, the most busy and most experienced 
 physicians of our city. So great indeed was the 
 public sj^mpathy on this occasion, that I could 
 not consent to have it roused again in his last 
 illness ; and hence I represented his case to all, 
 except my most intimate friends, in the brightest 
 possible colors. I cannot omit to make this ac- 
 knowledgment of favors which I can never repay, 
 though its statement involves so much of egotism. 
 I would say something of the religious princi- 
 ples of my son. He began early to look at reli- 
 gion with real solemnity, yet without fear. At 
 the very outset he acquired a conviction of and 
 a confidence in the unbounded goodness of his 
 Maker. It is from the views adopted on this 
 fundamental point, whence issues so much light, 
 that the religious principles of most persons take 
 their color. He could love and did love supremely 
 the Father of all things. He loved w^ith fear, a 
 fear that he himself should do wrong ; but he 
 loved also with confidence. He listened with 
 delight to those instructions from the pulpit, 
 which called on him to think worthily of his own 
 nature, that he might act in accordance with it. 
 The sublime character of our Saviour and of 
 
JAMES JACKSON, JR. 77 
 
 his teachings was regarded by his heart, as well 
 as his mind, with the greatest possible respect. 
 He viewed that character and those teachings as 
 strono: evidence of his mission from God. In 
 regard to the external evidence he saw that it re- 
 quired long and careful study, which every man 
 could not undergo. He was willing to believe 
 that it was sufficient, on good authority, until he 
 should be able to examine it for himself. He 
 would not however profess to believe, as if he 
 had already exaniined it. Meanwhile he enter- 
 tained no fears of death ; satisfied perfectly that 
 that event would be decided by wisdom beyond 
 his comprehension. Such, almost literally, were 
 the sentiments which he expressed to me, shortly 
 before the first sickness, of which I have given 
 an account. 
 
 With such characteristics as I have attributed 
 to my son, he seemed calculated to be highly 
 useful in the world. I never anticipated that he 
 would have a commanding influence in society, 
 but I did think that he would have an agreeable 
 and useful influence. Why he should have 
 been permitted to go so far, to give blossoms of 
 so fair a promise and of so sweet a flavor, and 
 just then be cut down, it is not for us to say. It 
 is one of those events, which show us that we 
 
78 ME Mom. 
 
 know very little of the designs of our own 
 being, at least while we regard this world only. 
 I do not consider it as singular, because to me it 
 was so afflictive ; because I was disappointed of 
 the most cherished hopes, just when I was almost 
 ready to think my life well spent in having 
 learned how to educate one, who could be much 
 more useful than I had ever been. I need not 
 look far from home to find those who suffered in 
 like manner, almost at the same moment. The 
 instance is not singular ; and because it is not, 
 we must infer that the end of our existence is 
 not merely to be useful in this world ; and we 
 must be comforted by the assurance that a good 
 life, however short, is the great blessing which 
 alone should satisfy all our desires, as respects 
 our children. Almost unnatural it may seem, 
 at least against the ordinary course of nature, for 
 a father thus to erect a monument for his son. 
 But surely he should be solaced, if the life of his 
 son has furnished at once the solid materials for 
 its erection and flowers for its ornament. 
 
NOTES TO THE MEMOIR 
 
 Note A.— Page 33 
 
 It is due perhaps to M. Louis to state why his 
 urgent advice in respect to my son's course of 
 life was not adopted by us. I will first mention 
 that I left my son to decide for himself, only 
 placing before him the objections which I saw 
 to the plan proposed by his excellent and wise 
 friend. This I communicated to him, while 
 abroad, desiring only that he would not decide, 
 until after his return. It was not long after his 
 return that he decided that he could not adopt 
 M. Louis's plan in its full extent, but he deter- 
 mined to conform to it as far as he should find 
 practicable, and I was very ready to aid him in 
 so doing. He decided to engage in business, 
 but to take no pains to be fully engaged in it, and 
 thought that for several years he could be occu- 
 
so NOTES 
 
 pied principally in the course of observation, on 
 which he had already entered. 
 
 But why could he not adopt the plan fully ? 
 Because in this country his course would have 
 been so singular, as in a measure to separate 
 him from other men. We are a business doing 
 people. We are new. We have, as it were, 
 but just landed on these uncultivated shores ; 
 there is a vast deal to be done ; and he who will 
 not be doing, must be set down as a drone. If 
 he is a drone in appearance only and not in fact, 
 it will require a long time to prove it so, when 
 his character has once been fixed in the public 
 mind. 
 
 This view of the subject is too vague, at least 
 for those who belong to other and older coun- 
 tries. Let me then state the matter more defi- 
 nitely. Among us, w^here the hands are yet 
 few in proportion to the work to be done, every 
 young man engages as soon as he can in the 
 business of life. The public estimation of his 
 character is decided early in his life ; earlier 
 than in Europe. In our learned professions men 
 certainly come forward too young in most instan- 
 ces. They do not ordinarily keep at work so 
 long, nor do their work so well, as if they had 
 made more thorough preparation for it. But, if 
 
TO THE me:.ioir. 81 
 
 an individual were to go very far in the other 
 extreme, his reputation would be fixed, as one, 
 who perhaps loved knowledge and knew how to 
 acquire it ; but who was not disposed to use it, 
 and who perhaps did not know how to apply it. 
 Most of our physicians go into business after 
 three years of study ; some, by visiting foreign 
 schools, protract the period of study to five or 
 six years. If now, after this longer period, one 
 shoald at the present day, spend four or five 
 years longer in the acquisition of professional 
 knowledge, before he should begin to engage in 
 professional business, and this in the society 
 where he meant ultimately to be so engaged, he 
 ivould be regarded as a singular being, governed 
 by a peculiar taste ; and it would probably be 
 thought that he would never be fit for the active 
 business of life. He might become a teacher 
 and attract pupils, but he might find it difiicult 
 to get patients. 
 
 In Europe it would not be so ; but at present 
 iny fears would be that such would be the result 
 in this country. It should be added, that my son 
 like most other professional men among us, 
 necessarily looked to his own labors for his 
 support. I should with great pleasure have 
 supported him, while going through his four or 
 6 
 
82 NOTES 
 
 five years of medical observations. But I could 
 not give him the means of support for life, be- 
 cause I had not them to give. He must then, 
 at the end of those years, have come forward as 
 a candidate for practice, with young men who 
 had started in life many years after him ; while 
 his former companions would be already immers- 
 ed in business, and could hardly sympathize 
 with him in any respect. He would be regarded 
 as in a false position because he was in a singular 
 one ; and because so regarded, he would be kept 
 there. He w'ould come forward with the habits 
 and feelings of a student, while his early com- 
 panions would have acquired the habits of men 
 of business. In this way he would both fail lo 
 obtain a support for himself, and fail to be useful 
 to others. He would have acquired the habit 
 of dependence on others, instead of that habit of 
 dependence on one's self for support, \vhich in 
 this country seems almost necessary for every 
 man. Such at least were my fears. 
 
 It was from considerations of this sort that I 
 hesitated to encourage the plan proposed by M. 
 Louis to my son. He himself saw the subject 
 in the same light, and, though with reluctance, 
 relinquished the plan. Perhaps we were both 
 too timid. I now advert to the subject to show, 
 
TO THE MEMOIR. 83 
 
 that we did not refuse to follow the advice of his 
 excellent friend, without a consideration of it. 
 
 Note B. — Page 41. 
 
 ' I am not willing to mention the names of pri- 
 vate individuals, to whom my son had the honor 
 of being introduced ; nor to adduce evidence of 
 the claims to much more praise than I have giv- 
 en, on the part of the select circle, among whom 
 he was admitted as a friend in London. One 
 circumstance only I shall state which may be 
 regarded by many as such evidence, and I state 
 this partly for the sake of a quotation from my 
 son's letter of June 12th, which relates to this 
 circle. It is that in this same circle, the Rajah, 
 Ram Mohun Roy, was in the habit of visiting 
 familiarly and unceremoniously, like an old 
 friend. My son speaks of his introduction to 
 this most excellent Hindoo as among the benefits 
 w^hich were conferred on him by one of his 
 friends ; and subsequently adds substantially as 
 follows : " When I reflect upon the character and 
 regard the lofty front and nobly intelligent and 
 benevolent countenance, which, could it but be in 
 
84 NOTPIS 
 
 the station, would almost exercise the influence 
 of a moral sun, and read the works of Ram 
 Mohun Roy, and then remember that I was born 
 in an enlig-htened and he in an unenlightened 
 country, I blush for my own imperfections and 
 make resolutions for the future. A new feeling, 
 a new passion has been awakened in me. '^ ^ 
 It \vill be the object of my life, not singly, but 
 much more than it would have been had I not 
 seen this circle, to aid in the work to spread 
 knowledge and happiness." 
 
 Xote C— Page 19. 
 
 P. Ch. A. Louis, physician of the Hospital de 
 la Pitie, is a man, whose labors and whose writ- 
 ings must become more and more known for ages. 
 I should deem it service enough to my brethren 
 in this country, if I could induce them, one and 
 all, to read and to study the works of this great 
 pathologist. M. Louis is the founder of the nu- 
 merical system, as it has been denominated, in 
 respect to the science ( f medicine. It is the ob- 
 ject of this note to state what that system is, and 
 
TO THE MEMOIR. 85 
 
 briefly to advert to the successful application of 
 it by its founder. 
 
 How many will be ready to turn aside, when 
 they hear of a new system. Has not system 
 followed system, it will be asked, ever since the 
 days of the four humors ? Facts, it will be added, 
 observations, exact observations are wanting, not 
 systems, in order to carry forward the science 
 of medicine. Be it so; it is the last point on 
 which I would disagree with my reader. If, 
 however, that reader has not had much experi- 
 ence on the subject, he may not be aware of the 
 difficulty of making good observation, as regards 
 both pathology and therapeutics, and of the cau- 
 tion which is requisite in m.aking deductions. 
 These difficulties should not deter us from adopt- 
 ing the right course ; they should only make us 
 study to find out what this course is. M. Louis 
 certainly will not direct us to turn from observa- 
 tion to speculation. 
 
 But to remove the objection, let me say at 
 once that M. Louis has not brought forward a 
 new system of medicine ; he has only proposed 
 and pursued a neiv method in prosecuting the 
 study of medicine. This is nothing else than 
 the method of induction, the method of Bacon, 
 so much vaunted and yet so little regarded. 
 
86 NOTES 
 
 But, if so, where is the novehy ? If any one, 
 after patiently studying and practising the method 
 proposed by M. Louis, denies the noveUy of it, 
 I will not dispute with him a moment. Perhaps 
 he will then agree with me that it is a novelty to 
 pursue the method of Bacon thoroughly and 
 truly in the study of medicine ; though it is not 
 new to talk of it and to laud it. 
 
 A little history of one part of M. Louis's life 
 will throw some light on this subject. This gen- 
 tleman went abroad, and I believe had some 
 appointment in Russia, after he had gone through 
 the usual course of professional education. Re- 
 turning to France at the age of thirty two, he was 
 about to engage in private practice. He was then 
 led to examine anew the state of the science of 
 medicine, and was dissatisfied with it. He now 
 decided to abandon the thoughts of practice for 
 a time, and to devote himself to observation ; 
 that is, to the study of medicine, as it actually 
 presents itself. With this view he went into 
 the Hospital la Charitc in Paris, and followed 
 the practice of M. Chomel, now a physician at 
 the Hotel Dieu and Professor of Clinical Medi- 
 cine, and highly esteemed as an author. M. 
 Louis passed nearly seven years in studying med- 
 icine in this way. The first part of this time 
 
TO THE MEMOIR. 87 
 
 he was learning how to make observations. 
 When he thought he had attained this art, he 
 threw away, as I have understood, the notes he 
 had already collected, and began anew to accu- 
 mulate exact observations of the phenomena 
 presented by the sick and of those derived from 
 an examination after death in the fatal cases. 
 In this course of observation he did not make a 
 selection of cases, but took them as they were 
 presented, indiscriminately. He was not in a 
 hurry to make deductions from his cases, satis- 
 fied that he was gathering the materials, from 
 which truth must ultimately be elicited. He 
 was only careful that his observations should be 
 correct, and had not any general principles or 
 doctrines, for which he sought support, or con- 
 firmation. 
 
 To estimate the value of his observations, it 
 is necessary to understand the plan, on which 
 he collected them. First, then, he ascertained 
 when the patient under his examination began 
 to be diseased. Not satisfied with vague answers 
 he went back to the period, when the patient 
 enjoyed his usual health ; and he also endeav- 
 ored to learn whether that usual health had been 
 firm, or in any respect infirm. He noted also 
 the age, occupation, residence, and manner of 
 
88 NOTES 
 
 living of the patient ; likewise any accidents 
 which had occurred, and which might have influ- 
 enced the disease then affecting him. He ascer- 
 tained also, as much as possible, the diseases 
 which had occurred in the family of his patient. 
 Secondly, he inquired into the present disease, 
 ascertaining not only what symptoms had marked 
 its commencement, but those which had been 
 subsequently developed and the order of their 
 occurrence ; and recording those, which might 
 not seem to be connected with the principal dis- 
 ease, as well as those which were so connected ; 
 also, measuring the degree or violence of each 
 symptom with as much accuracy as the case 
 would admit. Thirdly, he noted the actual 
 phenomena present at his examination, depend- 
 ing for this not only on the statement of the 
 patient, but on his own senses, his eyes, his ears 
 and his hands. Under this and the preceding 
 head he was not satisfied with noting the func- 
 tions, in which the patient complained of disor- 
 der, but examined carefully as to all the functions, 
 recording their state as being healthy or otherwise 
 and even noticing the absence of symptoms, which 
 might bear on the diagnosis. Thus all secondary 
 diseases, and those which accidentally co-existed 
 with the principal malady, were brought under 
 
TO THE MEMOIR. 89 
 
 his view. Fourthly, he continued to watch his 
 patient from day to day, carefully recording all 
 the changes which occurred in him till his resto- 
 ration to health, or his decease. Fifthly, in the 
 fatal cases he exercised the same scrupulous care 
 in examining the dead, as he had in regard to 
 the living subject. Prepared by a minute acquain- 
 tance with anatomy, and familiar with the chan- 
 ges wrought by disease, he looked not only at the 
 parts where the principal disorder was manifest- 
 ed, but at all the organs. His notes did not state 
 opinions, but facts. He recorded in regard to 
 each part, which was not quite healthy in its 
 appearance, the changes in color, consistence, 
 firmness, thickness, &c. ; not contenting himself 
 with saying that a part was inflamed, or was 
 cancerous, or with the use of any general, but 
 indefinite terms. 
 
 Without presuming that I have described in 
 the most exact manner the course pursued by 
 M. Louis, I have said enough to make his plan 
 inelligible to men of sagacity. Others have taken 
 down cases in like manner. In the first volume 
 of the " Transactions of a Society for the Im- 
 provement of Medical and Chirurgical Know- 
 ledge," published 1793, there is a paper by Dr 
 Fordyce, entitled, " An attempt to improve the 
 
90 
 
 NOTES 
 
 evidence of medicine." In this paper Dr For- 
 dyce recommends the careful collection of cases, 
 as the only foundation for the improvement which 
 he wished to see. Dr Fordyce goes into many 
 details, and gives two cases in a tabular form by 
 way of illustration, and states that he has many 
 cases collected upon this plan. In his plan some 
 matters are insisted upon more than by M. Louis 
 perhaps ; others less. But Dr Fordyce does not 
 insist upon the examination after death, a most 
 important part of the plan adopted by M. Louis. 
 If however the attempt proposed had been fol- 
 lowed by vigorous efforts, most important ben- 
 efits would have resulted from it. Many no 
 doubt thought of doing it. I myself thought 
 seriously of it more than thirty years ago, and 
 had blanks printed for my cases according to the 
 plan of Fordyce. But the difficulties attending 
 the plan in private practice discouraged me too 
 soon. So far as I have known, M. Ljuis is the 
 only physician who has devoted himself for 
 years together, at a mature age and after a suffi- 
 cient education, to simple observation, without 
 the distraction of medical practice, and without 
 having any share in the treatment of the cases 
 under his observation. 
 
 It was only when he had accumulated a great 
 
TO THE ME3I0IR. 91 
 
 mass of cases, that M. Louis began to deduce 
 from ihem any general principles. He then 
 arranged the facts he had collected in a tabular 
 form, so as to facilitate a comparison of them. 
 How much labor this required will be in some 
 measure conceived, when I state that, while going 
 through one class of his observations, those, I 
 believe, which relate to acute diseases, he retired 
 to a distance from Paris and occupied ten months 
 in making out his tables. This statement is, I 
 believe, substantially, if not precisely correct. 
 
 Let the reader conceive of these tables draA\ii 
 out with accuracy, having columns devoted, with 
 proper discrimination, to each function and to its 
 various derangements, as manifested during life, 
 and to each organ and its lesions as ascertained 
 after death ; let him then go to these tables and 
 inquire, under what circumstances certain signs 
 of disease arise, and with what pathological 
 changes in the dead body they are found to cor- 
 respond ; let him ask under what circumstances 
 certain morbid changes of structure occur, and 
 with what symptoms they are found to be con- 
 nected ; he may find the answers and he may 
 obtain them numerically. That is, he m.ay learn 
 in hoAV many cases out of a hundred of any 
 particular disease he will find a certain derange- 
 
92 
 
 NOTES 
 
 ment of a particular function, or a certain change 
 in structure of a particular organ ; and he may 
 also learn how often the same things may be 
 noticed in other diseases, with which that under 
 consideration may be compared. ^ ^- ^ 
 
 The experience of one man is necessarily lim- 
 ited, and more extensive researches may give 
 results different from those at which M. Louis 
 has arrived. But I am disposed to think that 
 the difference will not be material in many instan- 
 ces. His observations were made only in the 
 hospitals of Paris. Other observations made in 
 different climates and among persons of different 
 habits, will probably discover differences of some 
 kind, and perhaps some which are material. But 
 in most respects, since the works of M. Louis 
 have been known to me, I have found his obser- 
 vations confirmed by my experience here ; and 
 indeed in many respects they accord with my 
 own previous observations, being, however, more 
 precise than mine had been. # =?^ ^ ^ 
 
 I am not, however, engaged in reviewing the 
 works of M. Louis. I have not guarded myself 
 in all points in stating his observations. I wish 
 to induce others to read his books, and they will 
 then see the prudent caution, with which he 
 offers all general remarks, and the scrupulous 
 
TO THE MEMOIR. 93 
 
 care which he exercises in making his deduc- 
 tions. He studies nature with a full faith in the 
 uniformity of her laws, and in the certainty that 
 truth may be ascertained by diligent labor. It 
 is truth only he loves ; not anxious to build up a 
 system, nor pretending to explain everything, he 
 says to his pupils. Such and such have been my 
 observations ; you can observe as well as I, if 
 you will study the art of observation, and if you 
 will come to it with an honest mind, and be 
 faithful in noting all which you discover, and 
 not merely the things which are interesting at 
 the moment, or those v\'hich support a favorite 
 dogma ; I state to you the laws of nature as 
 they appear to me ; if true, your observations 
 will confirm them ; if hot true, they will refute 
 them; I shall be content if only the truth be 
 ascertained. 
 
 I wish to add that M. Louis has inspired a 
 gallant band with his spirit. They have com- 
 bined to form the Society of Medical Observa- 
 tion at Paris ; M. Louis is their President and 
 MM. Chomel and Andral are the Vice-Presidents. 
 They meet to report their observations and to 
 be corrected by each other and by their president 
 when their observations are inaccurate or defi- 
 cient, or when their inferences are broader than 
 
94 NOTES 
 
 their premises. The members are selected with- 
 out reference to their country ; they are from 
 different nations ; they are scattered, and will in 
 succession be scattered over the world ; and all, 
 who carry with them the true spirit, must con- 
 tribute to the advancement of real science. Men 
 who devote themselves thoroughly to labor in 
 whatever department, must be felt and known in 
 society. Let the members of this society go on 
 and throw the fruits of their labor into a common 
 stock, and they must all of them be enriched, 
 and all around them be enriched at the same 
 time. ^ ^ =^ ^ ^ 
 
 I venerate M. Louis greatly. As the heir of 
 my son I love him most sincerely. But it is not 
 with the vain hope, nor even with the desire to 
 promote his fame by my feeble commendations, 
 that I have written this note. I regard it as 
 certain that his fame, and what he will regard 
 much more, the truths which he has discovered, 
 will be extended and will live for ages. My 
 sole expectationis to lead some, who might other- 
 wise be ignorant of them, among my brethren 
 of the present day, to study works which I esteem 
 as among the most valuable certainly, if not 
 the most valuable, which any age has furnished 
 us in regard to medicine. Unlike the systems, 
 
TO THE MEMOIR. 95 
 
 which are always spoken of in the history of 
 medicine, as successively rising with splendor 
 and falling into oblivion, the principles published 
 by the founder of the numerical system are not 
 an artificial network, where the cutting of one 
 thread may cause the whole to drop away ; these 
 principles may be added to, they may be enlarg- 
 ed, limited and modified, and yet the system 
 may be maintained ; and it will still derive its 
 support from the first labors devoted to its erec- 
 tion as much as from the last. If, for instance, 
 M. Louis has observed a certain symptom, such 
 as the enlargement in the region of the spleen, 
 to be present in fortyfive out of fifty cases of 
 tj^phus ; the exceptions will be ten per cent. 
 Should subsequent observers find, that in a hun- 
 dred and fifty cases there have been twenty 
 exceptions, it will then appear that these in the 
 two hundred amount to twelve and a half per 
 cent. As far as I know, there are very few of 
 M. Louis's numerical inferences, which have 
 hitherto required to be modified so much as in 
 the instance here supposed, since the publication 
 of his great works ; although ten years have 
 now elapsed since that on phthisis and six years 
 since that on typhus was published ; and although 
 he himself has continued, during this period, to 
 
96 NOTES 
 
 devote a great portion of his time to the collec- 
 tion of noAv observations. Were it otherwise, 
 however, it would be glory enough for one man 
 to have led the way into the true path, and to 
 have inspired others with the courage to follow 
 him. I repeat the idea ; — it is the spirit of bold 
 and hardy enterprise, which is the glory of M. 
 Louis. 
 
 I must add a few remarks on another point. 
 It is objected by some to the labors of M. Louis 
 and of others of the French pathologists, that 
 they labor indeed with ardor on the subject of 
 diagnosis, that the study with they zeal of ento- 
 mologists to discriminate minute changes of 
 structure in the various textures of the human 
 body, but they do nothing to advance the proper 
 business of the physician, the art of healing. 
 Their therapeutics are decried, as showing an 
 ignorance of what has been thought certain in 
 England and in this country ; and they them- 
 selves are regarded even as indifferent to this 
 branch of science. Can this objection need a 
 reply ? I have long been satisfied, for thirty 
 years I have been satisfied, that the physicians 
 of Paris were laying the firmest foundation for 
 the science of therapeutics, by studying the nat- 
 ural history of diseases ; and by thus giving us 
 
TO THE MEMOIR. 97 
 
 rules for diagnosis and prognosis. The course 
 they have pursued has not always been the 
 most satisfactory, and one at least among them 
 has gone over to the dogmatic philosophers, 
 though he has tried to disguise his desertion of 
 the true course. But the course they have pur- 
 sued has led honest spirits to be more and more 
 exact in their observations, until now, when one 
 has arisen, who has vigorously undertaken all 
 the toils, to which the method previously adopted 
 would rightly lead them. Let them proceed in 
 the same spirit, aided, but without any spirit of 
 rivalry, by the pathologists of other countries ; 
 let us all learn what may be looked for, when art 
 does not interfere in the diseases of the human 
 body ; that is, let us study the rules of prognosis 
 which are only inferences from the natural his- 
 tory of diseases ; then we shall be prepared to 
 study therapeutics. Let M. Louis, or men like 
 him, test the effect of remedies in the same spirit, 
 with which he has pursued his pathological 
 researches. Having determined the average 
 duration, fatality, &c., of typhus, for example, 
 by an observ^ation of a sufficient number of cases 
 through a series of years, such cases not having 
 been actively treated, let him then employ in 
 the same disease the different remedies which 
 7 
 
98 NOTES 
 
 have been thought useful. One physician extols 
 the advantages of bleeding ; another commends 
 antimonials employed on the lEirst days of the 
 disease, in emetic doses, and for a few days 
 afterwards in doses just short of nauseating; 
 another contends that cinchona is the best anti- 
 dote to the deadly tendencies of this malady. 
 Let each mode of treatment have its fair trial ; 
 and let the results be compared with each other 
 and with similar cases, treated at the same time 
 upon the expectant method. 
 
 This is substantially the mode, in which ques- 
 tions in therapeutics are beginning to be treated 
 in Paris. So, no doubt, they have been treated 
 elsewhere. But it is in proportion as we arrive 
 at precision, in respect to the natural history of 
 diseases, that this mode will be pursued with the 
 greatest advantage. It is because we are ap- 
 proaching to that precision that I think it scarcely 
 rash to predict, that in fifty years the art of heal- 
 ing will be grounded on many exact rules, which 
 we and our predecessors have not known. These 
 rules will not be brought forward as derived from 
 grand principles of physiology, or pathology ; 
 they must be deduced from the aggregate of 
 careful, faithful observations of individual facts, 
 made by men of enlightened minds. A love of 
 
TO THE MEMOIR. 99 
 
 truth, an unflinching love of truth is the first 
 requisite in those, who engage in this holy call- 
 
 • .A/, .AA, .A/. .iL. 
 
 in2" tp ^ "T? TV- 
 
 Note E.— Page 63. 
 
 The quotation, to which this note is append- 
 ed, was from an obituary notice published in the 
 Boston Daily Advertiser and Patriot, of March 
 29th, 1835. It was understood to be written by 
 a class-mate of my son's, one of his most inti- 
 mate and dearest friends, and a man of whose 
 friendship any one may be proud. My quota- 
 tion from this article was made from memory, 
 and was not literally correct, but I leave it as it 
 is. On submitting the memoir in manuscript to 
 the supervision of a friend, just when it was 
 going to the press, he begged me to insert this 
 article in a note. I wanted no persuasion to add 
 a testimonial, and an offering of pure friendship, 
 so grateful to my own feelings. 
 
 From the Daily Advertiser and Patriot. 
 
 Died, in this city, on Thursday, Dr James 
 Jackson, Jr., aged 24. 
 
100 NOTES 
 
 There are circumstances which give this event 
 prominence, even among the severest afflictions 
 with which it is the plan of God's Providence to 
 try us in the world. A few months ago, Dr 
 Jackson returned from Europe, where he had 
 been engaged more than two years in the dili- 
 gent study of his profession. The praise of his 
 uncommon attainments and his ardent devotion 
 to medical science, had already reached us from 
 across the sea. He was welcomed home by the 
 wide circle of his kindred and friends whose 
 warmest expectations he satisfied. There was 
 nothing in him which they wished to alter ; and 
 they had everything to anticipate from his suc- 
 cess in that benevolent province of duty, to which 
 from childhood he had wished to dedicate his 
 life, and to which he now brought with him such 
 rich accomplishments and resources. 
 
 He had scarcely ceased receiving congratula- 
 tions on his return to his native land, or had time 
 to take the steps preparatory to commencing 
 practice as a physician, before he was called off 
 from his pursuits, and laid prostrate by disease. 
 The hearts of those, in whom he had excited 
 just pride and eager hope, were now agitated 
 with all the alternations of feeling, with which 
 we wait the issue of a mali<rnant and insidious 
 
TO THE MEMOIR. 101 
 
 disorder. At length they were relieved from 
 the load of fear, by his apparently complete res- 
 toration to health. He came back to us as one 
 recalled from the gates of the grave, and we felt 
 grateful that our prayers in his behalf had been 
 answered. We little thought for how short a 
 space he was spared to us ; how soon the treas- 
 ure, we had taken anew into our keeping, was to 
 be required at our hands. 
 
 He applied himself after his recovery, with 
 unabated earnestness, to the science and art to 
 which his whole soul was wedded ; and it did 
 not fail to strike some of us, who visited him 
 during his convalescence, with astonishment, to 
 see how quickly and tenaciously his mind resum- 
 ed its grasp of its darling subject. The degree 
 of Doctor of Medicine was conferred on him in 
 the month of February, and it was but a day or 
 two after he had publicly entered on the practice 
 of his profession, that he was seized with the 
 disorder which proved rapidly fatal to him. 
 
 In the death of this young man, a thousand 
 expectations are shattered. We have no right 
 to use the language of private and exclusive sor- 
 row. He belonged to the public, to whom he 
 had already given pledges of rare eminence in 
 his profession ; and to the troops of friends whom 
 
102 NOTES 
 
 he had bound to him by the charm of his pure 
 and enthusiastic character. Indeed, he was so 
 well known to this community, where he had a 
 sort of hereditary claim to men's affections, that 
 we feel restrained from any attempt to draw the 
 character of our friend. He does not need our 
 inadequate eulo^. Short as was his life, it has 
 left imprinted on our memories, with perfect dis- 
 tinctness, the beautiful traits of mind and tem- 
 per, which made him the favorite of all who saw 
 him. To his near and intimate acquaintance, 
 his death seems like withdrawing part of the 
 general light -which fell on their daily walk. 
 For, not only was he one among those whom 
 they chiefly loved and trusted ; the ornament of 
 their social circle ; one whose idea never came to 
 them, but they felt more respect for themselves 
 that they enjoyed his confidence ; — but he had 
 in him so large a soul ; a spirit of such morning 
 freshness ; an interest so unexhausted in whatso- 
 ever was good and true, in manners, opinions, 
 persons, that, in losing him, our whole connexion 
 with society, our whole delight in living, seems 
 to be loosened and impaired. 
 
 We hardly dare intrude, even in our thoughts, 
 on the sacredness of the bereaved home. What 
 
TO THE MEMOIR. 103 
 
 sorrow is like their sorrow, who mourn the sep- 
 aration from such a son, and such a brother ? 
 
 "Where is Timarchus gone 1 
 His father's arms were round him, 
 And when he breathed his life away. 
 The joy of Youth had crowned him. 
 
 Old man, thou wilt not forget 
 
 Thy lost one, when thine eye 
 
 Gazes on the glowing cheek 
 
 Of Hope and Piety. 
 
 o 
 J) 
 
 Thus early has the shadow of the dark valley 
 settled down over the human prospects of him, 
 who seemed to be the child of a prosperous for- 
 tune. Thus hastily has he gone away to con- 
 verse with what is spiritual and eternal. It is 
 well with ki??i. But ive who had promised our- 
 selves many years to rejoice in his friendship, 
 and to witness the harvest of true honor he 
 should reap in the large field of his usefulness, 
 zve, who stand sadly looking into his sepulchre, 
 what is to console and cheer us ? God forbid 
 we should distrust His infinite love ! No : we 
 lay in the earth the dust of otit friend, full of 
 gratitude for all that he was in himself, and for 
 all the happiness and virtue to which he minis- 
 tered, like a good angel, in others. He has gone 
 while the dew of his youth was on him ; we 
 
104 NOTES. 
 
 shall no more see his face, nor hear the sincere 
 elo(iuence of his voice. But the beauty of his 
 life, and the sweetness of his memory are ours. 
 And ours too is the faith in the immortality of 
 the soul ; the assurance that the parting is not 
 forever ; that we shall again greet our brother 
 in the blessed employments and inseparable 
 union of Heaven ! 
 
EXTRACTS 
 
 FROM 
 
 LETTERS FROM JAMES JACKSON, Je> 
 
 TO HIS FATHER 
 
EXTRACTS FROM LETTERS, 
 
 It will readily be understood that in letters 
 WTitten in such entire confidence, as the follow- 
 ing manifestly were, there must have been many 
 things improper for the public eye, and many of 
 temporary and personal interest only. Hence, 
 there is scarcely one entire letter in the following 
 collection ; and hence, I have omitted to print 
 many, which might be interesting to some minds. 
 Wherever individuals are mentioned, unless 
 such as may be called public men, I have sup- 
 pressed the passages ; and, from the connexion, 
 the whole letters have in some instances been 
 suppressed. This has not been because such 
 individuals have not been mentioned favorably ; 
 on the contrary, in most cases I remarked that my 
 son avoided speaking of those, whom he could 
 not praise, unless from peculiar and rare circum- 
 stances. 
 
108 
 
 EXTRACTS 
 
 It may be thought more necessary, perhaps, 
 for me to apologise for printing so many, than 
 for not printing more of these letters. I can 
 only say that I have admitted none, which I 
 did not believe would interest some of my son's 
 friends. It cannot be supposed that each one of 
 them will be interested in all the letters. 
 
 The ardor, the impetuosity and the freshness 
 of youth, will be sufficiently obvious to the cool 
 and dispassionate, in these letters. They were 
 written by a young man, principally in his 
 twenty-second and twenty-third year. It will not, 
 I think, be by persons of experience and reflec- 
 tion, that these qualities will be regarded with 
 the least charity ; or, if by any such, they will 
 be those who are not fathers. If I am wrong on 
 this point, I fear not but that I shall be readily 
 excused. 
 
 I wish to add that these letters are published 
 as they were written, obviously not for the press, 
 with the exception of the few verbal corrections, 
 which such compositions must always require. 
 I have avoided these even, when not absolutely 
 necessary. 
 
FROM LETTERS. 109 
 
 Paris, October 28, 1831. 
 MY DEAR FATHER, 
 
 I feel almost disposed to cover a sheet or two 
 in enumerating the difficulties of auscultation. 
 If Laennec has added an important aid to our 
 insufficient means of exploring diseases of the 
 chest, he has, at the same time, rendered the 
 study of those diseases more difficult, more labo- 
 rious I would say, to the learner. Perhaps we 
 may better say, in other words, that this great 
 observer has so far extended our knowledge upon 
 this subject, by his accurate distinctions, that the 
 labor, requisite to obtain all that is known, is 
 much greater than it has hitherto been. I have 
 just returned from the Hopital des Enfaiis. where 
 I have been experiencing the difficulties and the 
 uncertainties of auscultation. I have been em- 
 ployed for nearly an hour in examining two chil- 
 dren, in both of w^hom there is some reason to 
 suspect the existence of tubercles. In both, the 
 chest resounds w^ell on percussion on each side ; 
 in both, there is one side where the respiration is 
 natural, strong, vesicular ; in both, upon the other 
 side, is an absence, or at least a great deficiency 
 of the vesicular respiration ; while, together 
 with a mucous and perhaps a crepitous rale in 
 some points, there is also what seemed to me 
 
110 EXTRACTS 
 
 and my friend, the interne, the bronchial respi- 
 ration. But if this last supposition be true, the 
 diseased lung must be in each case, in a great 
 measure, either hepatized or very full of tuber- 
 cles. If this were the case, we should certainly 
 expect to find a great difierence in the sound of 
 the two sides by percussion, whereas, the differ- 
 ence, if there be any, is very slight. I have 
 not mentioned all the circumstances of these 
 cases ; I shall keep notes of them after future 
 examinations, and should I ever know their end, 
 you shall hear of it. You see there is no doubt 
 which is the diseased side in either case ; the 
 difficulty is to pronounce upon the exact seat and 
 nature of the disease. By the by, one of the 
 cases is complicated with the contraction of the 
 side to a very considerable degree, though the 
 child dates his disease to six weeks only, has 
 not had the ordinary symptoms of pleurisy, and 
 says he has been well from his infancy. This 
 last, I should doubt. I have mentioned these 
 cases in order to introduce the subject of bron- 
 chial respiration. I was not at all aware, or 
 rather I was not fully aware, of the very im- 
 portant distinction between this and vesicular 
 respiration, before I left home. I knew the dis 
 tinction from description ; I had once or twice 
 
FROM LETTERS. Ill 
 
 recognised it ; I knew generally what was 
 indicated by it ; but I was not by any means 
 aware in how many cases it was to be heard, 
 and under what circumstances it was to be sought. 
 It has been pointed out to me here much oftener 
 than I expected. First, I heard it last summer 
 in several cases in Andral's ward, during the 
 second stage of pneumonia ; and from him I 
 learned to distinguish it from vesicular respira- 
 tion. I remember well one case, in which he 
 said you will hear upon the right side the bron- 
 chial respiration at the same time with the vesic- 
 ular, and on the other the bronchial alone. I 
 listened, and could make this distinction ; was 
 confident of it. The difference consisted in a 
 slow expansion of the vesicles by the air in the 
 one, and an absence of this in the other. From 
 that moment I thought myself master of it. 
 Unhappily, I was deceived ; and I have often 
 had melancholy occasion to find that my know- 
 ledge is not yet perfect on this point. I have 
 since had frequent occasion to hear this bronchial 
 respiration, and to distinguish it with great con- 
 fidence from the vesicular. At this moment 
 there are two patients in Louis's ward at la Pi tie, 
 where I feel confident of making the full distinc- 
 tion. There is also a child at the Hopital des 
 
112 EXTRACTS 
 
 Enfans, in whom the difference between the two, 
 in the whole extent of each chest, is most decid- 
 ed. Another has just left, in whom I thought 
 the distinction also sure ; but, unhappily, besides 
 these there are other cases, like the two which I 
 have related, which are very doubtful. Next to 
 the bed in which is placed the child, where the 
 distinction is so marked, lies another, in whom 
 I feel almost sure of a bronchial respiration on 
 one side, and yet I am distrustful of myself. 
 Let me remark, en passant, one important point 
 of difference between the two cases ; the first is 
 chronic, breathes slowly in comparison, although 
 the whole right lung is hors de combat ; while 
 the other is acute, its respiration is immensely 
 rapid, seventy while awake and ninety while 
 asleep. This rapid respiration greatly increases 
 the difficulty of auscultation, especially on this 
 one point, with children; because, where the 
 respiration is thus rapid, the air hardly reaches 
 the vesicles, or rather their expansion is so mo- 
 mentaneous, as hardly to be distinguishable from 
 the sound of the air passing through the bronchia ; 
 so that the respiration in the healthy lung comes 
 greatly to resemble that in the hepatized. I 
 speak on this subject, because it is one w^liich has 
 interested me much. Andral in his lecture-room 
 
FROM LETTERS. 113 
 
 and by his book, has turned my attention very 
 strongly to it. As I tell you, I have occasionally 
 found very great satisfaction from it ; at other 
 times, I have been almost in despair ; but I say 
 to myself daily, " listen for that slow, full expan- 
 sion of the vesicles, which ought to exist in a 
 sound lung, and strive to distinguish it from the 
 mere passage of the air into the bronchia." I 
 am convinced that this is one of the most impor- 
 tant distinctions that can be made by the stetho- 
 scope. 
 
 The knowledge to be gained by the ausculta- 
 tion of infants is much greater than I had sup- 
 posed. There are certain points of great difficulty 
 like that I have mentioned ; but as to others, on 
 the contrary, there is a great facility. The cre- 
 pitous rale I think, is more easily distinguishable 
 in them, than in adults ; they are examined with 
 greater ease and more profit upon the dorsal 
 region; and the immediate is much more easily 
 practised, than the mediate auscultation with 
 them. For my part, I can never henceforth 
 examine a child under disease without bringing 
 to my aid this means. By the by, you would 
 be much surprised, my dear father, to see how 
 much more the immediate auscultation is used 
 here, than the mediate. There is one other 
 8 
 
114 EXTRACTS 
 
 point, we are too apt to neglect at the Massachu- 
 setts General Hospital ; it is the examination of 
 the dorsal region. The French examine the 
 back more than the front ; we do the contrary ; 
 both err, but they the least. 
 
 Paris, November 28, 1831. 
 I am still following at la Pitie. I have made 
 two or three efforts to follow Chomel at Hotel 
 Dieu ; — but it is impossible to do so with advan- 
 tage. One may hear the clinique to be sure, 
 and a very good one too ; but he cannot see the 
 patients. This, especially in my present situa- 
 tion, is the most important by far. My great 
 object is to accustom my ears to stethoscopic 
 sounds ; in order to this I must see the patients. 
 The visit at Hotel Dieu is commenced an hour 
 and a half before clear daylight, by candle-light, 
 indeed ; — there are from two to three hundred 
 pupils in the wards at the same time, and one is 
 fortunate if he sees four patients, and examines 
 one in the course of the visit. Whereas, the 
 visit is made at la Pitie by daylight ; there are 
 not more than fifteen students, and I call it a, 
 
FR03I LETTEKS. 115 
 
 black day, in which I have not examined as many 
 as six patients at least, who present stethoscopic 
 phenomena : — ordinarily I examine as many as 
 ten. Besides, as I have told you before, Louis 
 gives a little clinique at each bed. You see that 
 I do right in giving the preference to la Pitie. 
 I think I am becoming daily more able to distin- 
 guish the signs which indicate commencing 
 phthisis. They are not one but many. 
 
 Paris, December 1, 1831. 
 ^ '^ ^ Are not these cases replete with 
 interest ? "Will you not forgive your pupil for 
 darins" to write his master such a letter ? It is 
 only from the fulness of the heart, that the 
 mouth speaketh. But good by, my dear father, 
 for the present. I am daily, hourly expecting 
 to hear from you ; it is fifteen or sixteen days 
 since I have had any letters. I hope for a clin- 
 ique ; — but as far as I see, you get more clin- 
 iques than I, from our correspondence. Unfor- 
 tunately such is the fashion of the present day. 
 Our talkers and writers are those who want expe- 
 rience, the unlearned; w^hereas, those who are 
 able to speak wisely, are silent. 
 
116 EXTRACTS 
 
 Paris, December 14, 1S21. 
 
 I have been lately much interested in diseases 
 of the brain. Cruveilhier excited me upon the 
 subject. I have since read an excellent work by 
 Rostan, on the ramollissement of the brain ; 
 and am now reading, with very great pleasure, 
 a most learned and talented work by Lallemand 
 of MontpeUier, upon diseases of the same organ. 
 This last is truly a master-work. The author 
 differs from Rostan as to ramollissement. I have 
 read the arguments of both and am inclined to 
 agree with Rostan. I find that Andral, in his 
 Anatomical Pathology, does the same. There 
 is still another standard author upon diseases of 
 the brain, — Bouillaud, whom I intend to read 
 next. That, with Andral's promised volume 
 upon the brain, which will probably appear 
 shortly, and which I look for impatiently, will 
 give me a pretty good knowledge of what the 
 French have learned upon the subject. But, 
 happily, I am not left solely to books. We have 
 now some very interesting cases of cerebral dis- 
 ease in Louis's wards ; — one has particularly 
 engaged my attention within a day or two. 
 
 A young man, headache for some days ; con- 
 siderable febrile excitement ; eyes quite sensible 
 
FR03I LETTERS. 115 
 
 to light, and ears to sound ; face flushed, coun- 
 tenance very serious, almost melancholy ; — 
 intelligence perfect, but answers short, as though 
 disturbed by the effort to speak ; no trouble in 
 chest, none, or but very slight, in alimentary 
 canal ; — no local symptoms then, but those of 
 cerebral affection, and those slight; — still, hot 
 skin and excited pulse, which must be accounted 
 Tor. On the whole, the probabilities were in 
 favor of an inflammation of the brain, or mem- 
 branes. He was twice bled and is much better ; 
 but the sensibility to light still continues. This 
 does not seem to be an extraordinary case upon 
 paper, — and yet to a mere hospital observer, it 
 is so ; — because it shows him the disease in its 
 very forming stage., which is in every disease by 
 far the most interesting, the most important, and 
 the most worthy of close attention and study. 
 It is from this circumstance that I have been 
 much interested in it. 
 
 Is it not deplorable, my dear father, that our 
 science is yet so impotent, as to the means it 
 affords us to discover the first morbid changes, 
 be they of function, or structure ; which last is 
 indeed but a continued change of function, or 
 rather a result of that change ? Is it not deplo- 
 rable that we are obliged to rest satisfied with 
 
lis EXTRACTS 
 
 the discovery of the existence of an aneurism, 
 or a schirrous pylorus, or of tubercles in the 
 lungs, or some tumor in the brain, only at a time 
 when they are so far advanced as to be beyond 
 our aid ? Have not the public a right to demand 
 something more of us than this ? But there are 
 limits set to the advancement of our knowledge 
 by nature herself. She will not always indicate 
 by appreciable signs her commencing disordered 
 actions. Have we yet reached these limits ; 
 and is there not a portion of cases, in which ap- 
 preciable signs do really exist, did we but know 
 how to seize them ? Has not this subject been 
 too much neglected, my dear father ? Have we 
 not too many books devoted to the nice diagnosis 
 of advanced disease, inevitably fatal ; and too 
 few upon that of commencing disease, which 
 may be stopped in its progress ? It is the most 
 difficult, and yet surely the most important of 
 all the subjects, to which the medical observer 
 can turn his attention. I do not forget that the 
 diagnosis of an advanced disease, a cancerous 
 pylorus, for example, is useful ; that we are bet- 
 ter able to give proper advice to our patient, than 
 if we did not know that such a disease existed ; 
 — but, surely, it would be far better if we could 
 be apprised of the first disorder of the vessels 
 
FROM LETTERS. 119 
 
 engaged in this morbid process. I know well 
 we can never become perfect in this respect ; — 
 yet I cannot but hope that the time will come, 
 when we shall be far in advance of our present 
 knowledge. At present, the discovery of even 
 far-advanced disease, which is soon to destroy 
 life, is often beyond our power. 
 
 My mind has been turned to this subject for a 
 day or two from reflecting upon two cases, now 
 in our wards ; — one, that I have just related, of 
 commencing cephalitis discovered at its debut, in 
 which life was saved by active treatment ; and 
 a second, of aneurism of the thoracic aorta, which 
 is but lately discovered and will shortly prove 
 fatal ; • — an exceedingly interesting case. 
 
 Pabis, February 16, 1832. 
 " Laennec has rendered a gTeat service to sci- 
 ence by his description of emphysema of the 
 lungs," said Louis, yesterday evening ; and I 
 may add, Louis has rendered me a great, a very 
 great service, by teaching me the characters of 
 this disease, during life and after. His two last 
 lessons upon this subject were invaluable. I did 
 
120 EXTRACTS 
 
 not know the disease when I left you, except in 
 the pages of Laennec. I now know that it is 
 common, and that a knowledge of it is very im- 
 portant. Shall I give you the proof that it is 
 common ? I have seen at least ten cases within 
 six we^s ; and I speak of those only, which I 
 have myself examined either before or after death. 
 Shall I prove to you that an acquaintance with 
 this disease is practically useful ? I can do it 
 in more ways than one ; but I choose to illustrate 
 its utility by telling you of a false diagnosis of 
 my own. 
 
 Yesterday morning I examined by ausculta- 
 tion a young man, with whose history I was not 
 acquainted, without having first practised percus- 
 sion in a careful manner. He is emaciated and 
 coughs ; this was all I knew of him, and, in 
 truth, my examination was made very much €7i 
 passant. I found the respiration much more 
 feeble under the left clavicle than the right, and 
 suspected at once the existence of tubercles. 
 Having requested one of my friends to examine 
 him, he came to the same result, and in the even- 
 ing we mentioned to Louis our suspicions that 
 the subject was tuberculous. He said he did not 
 believe it. On careful examination we found 
 that the percussion was more sonorous under 
 
FROM LETTERS. 121 
 
 the left clavicle than the right, but at the same 
 time the murmur of respiration was much fee- 
 bler under this left clavicle, as it was indeed over 
 the whole extent in front, where the sound on 
 percussion was still quite sonorous. We now 
 saw our mistake and immediately recognised an 
 emphysema. On inquiring into the history of 
 the case, we found that it accorded with this last 
 supposition, but not with that of a tuberculous 
 affection. Here would have been a very grave 
 error in the diagnosis, on my part ; and the les- 
 son was a very useful one. I cannot doubt that 
 many a case of emphysema has and will be 
 mistaken for phthisis by those, who are but par- 
 tially acquainted with the science of ausculta- 
 tion ; — unless they are so well acquainted with 
 the natural history of phthisis, so as to be able 
 in a great measure to supply thereby their defi- 
 ciencies in the " musical science." I asked Louis 
 whether he had often seen emphysema mistaken 
 for phthisis ; — he answered, very frequently. 
 
 ^ # ^ But I have almost forgotten to tell 
 you of a case, which shows me of what use 
 auscultation and percussion are to be to me in 
 practice. 
 
 I observed, a few days since, that one of my 
 young friends here looked rather unwell, rather 
 
122 EXTRACTS 
 
 more so in fact than is common from a sli2:ht 
 catarrh, which was all he complained of. I told 
 him, I should come and see him at night, and 
 went accordingly. We laughed and talked for 
 some time, he appearing pretty well. On my 
 questioning him, I found he had a little pain on 
 the right side on coughing and on full inspira- 
 tion. He thought nothing of it, however, and 
 said he had nothing but a slight bronchitis. I 
 examined his chest not expecting to find anything, 
 so slight were the local and general symptoms. 
 On the right back, however, I found evidence, 
 by percussion and auscultation, of a considerable 
 pleuritic effusion. I bled him freely ; he has 
 recovered and the fluid absorbed. I mention the 
 case to you, because it is the first time that I have 
 been obliged to practise upon the evidence of 
 auscultation, in an acute case ; and because cases 
 of this sort cannot be too often cited, so frequent, 
 so latent and so important are they. How many 
 thousands of pleurisies pass unnoticed. Not so 
 in Louis's wards, however ; and thanks to him, 
 not so many will escape me, as would have, with- 
 out his example and instructions. In the present 
 case, perhaps, indeed, almost certainly, this young 
 man would have recovered without any treat- 
 ment. But, if the disease had not been discov- 
 
FROM LETTERS. 123 
 
 ered, it would probably have been aggravated, as 
 he would have contmued his dissections in a cold 
 room^ and in other ways have exposed himself; 
 and the inflammation might then have extended 
 from the serous to the cellular tissue. 
 
 Feb. 17. How unhappily imperfect are our 
 histories of even the most common diseases ! 
 How often have exceptional cases been mistaken 
 for ordinary ones ! ^Yhat false descriptions 
 have authors given us of pleurisy and pericardi- 
 tis, for example ; taking for the type of those 
 diseases a few rare cases, which were attended 
 with very positive and striking symptoms, and 
 overlooking the vastly more common cases, in 
 which these symptoms are far less marked and 
 sometimes entirely absent ! I have been espe- 
 cially struck with this in pericarditis; — and 
 what have been the causes of this error ? Perhaps 
 chiefly two ; — first, owing to an insufficient 
 examination, a large majority of cases are over- 
 looked during life. This you know to be liter- 
 ally true in the case of pleurisy, and I believe it 
 to be so in pericarditis. I often think of your 
 recital of the case of pericarditis in a certain 
 cook, since I have attended to this subject ; and 
 when you have received one of my letters of 
 about a month since, I do not doubt you will 
 
124 EXTRACTS 
 
 remind me of it. Second, because practitioners 
 have not been in the habit of counting their 
 cases, preferring to trust to their memories and 
 what is called general observation. Louis is the 
 father of the numerical system, and will at some 
 time publish to the world the tables containing 
 the results of his practice. There can be none 
 more valuable for diseases of the chest, at least ; 
 for he is the most exact in his investigations and 
 diagnosis of any living man. 
 
 ^ ^ ^ « But," says the practical physician, 
 " this is all nonsense ; why trouble yourself about 
 a disease, which nature will cure without your 
 help, as she will all, or almost all those cases of 
 undiscovered pleurisy, and pericarditis too ?" 
 The practical man here forgets what should be 
 the first principle of every good practitioner in 
 medicine, or morals ; — to treat disease success- 
 fully, we must attack it at the commencement ; 
 and many of these cases, which begin with such 
 latent symptoms, and which are, in very truth, of 
 themselves comparatively unimportant, become 
 very severe and fatal from a neglect of even h^^- 
 gienic rules. A man continues to expose himself 
 while affected with a latent attack of pleurisy, 
 and in a week he may have an extensive pneu- 
 monia which shall destroy him. But, again, the 
 
FROM LETTERS. 125 
 
 man who enters into the field of pathology with 
 his eyes open, and does not love truth for truth's 
 sake in his scientific researches, may possibly be 
 a moral man, though I should almost doubt it ; 
 at any rate, he will make livery poor practitioner. 
 I must indeed work for my bread, but, in work- 
 ing, if you take from me the interest which 
 search after pathological truth inspires, I can no 
 longer work well. 
 
 Paris, February 27, 1832. 
 ^ ^ ^ The truth is Louis is a remarkable 
 man, and his system of pursuing medical sci- 
 ence a most excellent one. There are without 
 doubt many questions that cannot be resolved by 
 counting ; but to draw a description of the natu- 
 ral history of diseases, you cannot proceed with- 
 out it. What is the chance that such a disease 
 will prove fatal ? How often does such a symp- 
 tom occur ? What part of an organ is most often 
 affected in a certain disease ? How often is such 
 and such a lesion found after death, when such 
 and such symptoms have preceded ? These are 
 all questions of immense importance, and they 
 
126 EXTRACTS 
 
 can be decided in no other way than by an accu- 
 rate observation of all the cases which occur, and 
 a counting of them with respect to each point. 
 You state that pneumonia occurs oftener on the 
 right than on the left, that it affects the lower 
 oftener than the upper lobes ; suppose some one 
 chooses to doubt it, and demands of you what is 
 the proportion, in order that he may know wheth- 
 er your knowledge be exact. You have made 
 no table ; you can only tell him such is your 
 general experience. General experience has for 
 this once told you the truth ; but it would be 
 much more satisfactory for your student, if you 
 could give him the result in numbers deduced 
 from exact observation. And, in fact, what is 
 this general experience ; it is the result of an 
 enumeration of the cases, seen by an individual, 
 in his own memory. But how much better 
 would this enumeration have been made on 
 paper ; for who can tell that from some peculiar 
 circumstance or association, one class of cases 
 may not have excited his attention, and, there- 
 fore, left a more permanent impression than 
 another ; — so that a greater number of these 
 first would enter into the calculations of the mem- 
 ory than of the last. Had medicine been studied 
 for one hundred years, as Louis now studies it, 
 
FROM LETTERS. 127 
 
 our knowledge of the natural history of disease 
 would be placed upon an infinitely more certain 
 basis ; and diagnosis, and prognosis, and conse- 
 quently therapeutics vastly more advanced. On 
 my return I will prove to you the adv^antages of 
 this system. Inspired with this belief, viz. that 
 the only way to place our knowledge of disease 
 upon a true basis, is to make rigorous observa- 
 tions, and to count them under their various bear- 
 ings and relations, — a set of young men, who 
 have for a long time followed Louis, (and some 
 of whom I know, or believe to be the most intel- 
 ligent of the French students, my colaborators, 
 of whom I wrote yesterday,) intend forming a 
 society, whose main purpose is to make exact 
 observations over the whole world, as far as may 
 be : and from these, properly arranged and sub- 
 mitted to the numerical method, to arrive in the 
 course of years at certain and fixed laws. Those 
 who have followed Louis, the father of this meth- 
 od, are alone to become members ; and of those 
 I trust only a select corps ; for the majority are 
 not fit to make accurate pathological investiga- 
 tions. As yet, I am the only American who 
 knows of their plans, and I certainly shall with 
 great pleasure become a member, promising in 
 all honesty to elicit from our public institutions 
 
128 
 
 EXTRACTS 
 
 whatever is in my power. I shall love to work 
 for such a society, because it will be useful not 
 only to myself, but to all : and again, by so doing 
 I shall keep up an acquaintance with these Eu- 
 ropeans who will be the most distinguished in 
 medicine during my day. Say nothing of this 
 as yet, for it is not made public, — I shall write 
 you as soon as the society is organized and ex- 
 plain in full its objects, &c. It is to me a new 
 spur to study ; — for I am now learning how to 
 observe. 
 
 Paris, March 1, 1832. 
 ^ # ^ You write so warmly of Hodgkin's 
 museum and Hunter's, as to excite in me a strong 
 desire to enjoy these promised pleasures. But 
 I shall not hurry while Louis calls me to listen 
 to his interesting clinique, in which he gives us 
 the thread, whereby to walk through the laby- 
 rinth of pulmonic disease ; and while he deigns 
 to teach me in a more familiar manner in his 
 wards. Neither do I feel inclined to tear myself 
 from the eloquent course of Andral, of which I 
 have as yet taken most copious notes ; nor to fore- 
 go the delight of his clinique, which will com- 
 mence in May. 
 
FROM LETTERS. 129 
 
 Paris, March 20, 1832. 
 
 # ^ # You see I am getting to make nice 
 distinctions in auscultation, perhaps you will 
 think, too much so. But I assure you, you can- 
 not at ail judge of m.y knowledge of this subject 
 now by what it was when I left you. Louis 
 chooses for us the most delicate cases ; — makes 
 us examine and report to him the result, without 
 telling us his opinion, and even without allowing 
 us to learn anything of the history of the case, 
 lest we should be prejudiced. I am exceedingly 
 happy to add that it very rarely happens that we 
 differ in opinion from this master of his science. 
 
 I feel confident that our " Society of Medical 
 Observation" will be a useful one, and am sorry 
 that I, cannot pass one year in sharing its labors 
 under the direction of Louis. The object, as 
 you know, is the exact ohsertation of diseases, 
 and from the cases afforded, to deduce what gen- 
 eral facts may be rigorousl}?- deduced. 
 
 The numerical method, luithout care^ may lead 
 into error ; — but, first, it must lead to a vast deal 
 of good ; — and second, as for the care to avoid 
 those errors conse<[uent on an omission of a full 
 consideration of all the circumstances, if any 
 man will, and does secure himself, it is Louis, 
 the father of the system. His wards are the 
 9 
 
130 EXTRACTS 
 
 only ones I have ever seen, except your own, 
 where the facts were all truly, fairly and scru- 
 pulously noted ; and on one branch he necessaril'g 
 surpasses you, viz. morbid anatomy ; for in out 
 country it is impossible to follow this subject 
 with such freedom, owing to the prejudices exist- 
 ing among us ; and at our hospital our cases are 
 necessarily imperfect, as we do not retain our 
 chronic cases, as they do here, till death. 
 
 # :^ ^ There are two or three young men 
 whom I should be proud to see in Boston, espe- 
 cially Maunoir and Lacaze. They are young 
 men whom I shall always remember with pleas- 
 ure and respect. 
 
 March 29. — Little did I think, my dear 
 father, when I began this letter, that I should be 
 obliged to close it with such umvelcome news. 
 The cholera is in Paris ; — or, to say the least, 
 it is generally believed to be so both by the public 
 and by physicians ; and I fear the evidence is 
 too strong to deny it. Of facts, I as yet know 
 very little ; — I have heard and read in the jour- 
 nals of several (from ten to fifteen) cases at Ho- 
 tel Dieu and in this city. I have conversed with 
 those, who have seen some of these patients dur- 
 ing life, and with others who have been present 
 at some of the autopsies of those, who have 
 died. 
 
FROM LETTERS. 131 
 
 * # ^ I believe the case to be cholera, from 
 the suddenness of the death, the history of the 
 symptoms, and the coincidence of several similar 
 cases in other parts of the city. I know well 
 that it admits of question, but cannot here dis- 
 cuss it. 
 
 Shall I leave Paris because the cholera is 
 here ? If I do, where shall I go? These are 
 my two important questions. And I can answer 
 neither as yet. Surely, in the present state of 
 affairs, I should regard it as very useless to leave 
 the city, for I do not feel that I am in danger. 
 Should circumstances change, I shall act accord- 
 ingly. The disease has left Edinburgh, and 
 should it prevail here to such a degree that An- 
 dral and Louis think me exposed to real danger, 
 I will leave. In the mean time, all the students 
 see the disease, and, though I shall not run much 
 after it, my curiosity is excited, and probably I 
 shall see it. I am in full health, have no fears, 
 will lead the most simple and hygienic life, and 
 be assured I will be prudent. Were you on the 
 spot, you would not regard my situation as in 
 any way dangerous ; — of this, I am sure. — 
 Should my motions, or any other circumstance 
 require it, I shall write you a duplicate by the 
 Liverpool Packet of the 8th. But I beg and 
 
132 EXTRACTS 
 
 pray of you not to allow yourself a moment's 
 anxiety. I will be prudent, and there is not 
 one chance in five thousand that I shall suffer by 
 the disease. 
 
 "-" Paris, April 1, 1832. 
 
 MY DEAR FATHER, 
 
 I lament to tell you that the cholera which was 
 yet a little doubtful when I last wrote, (three 
 days since,) is now reigning in Paris; and I 
 must add to a frightful degree. You will learn 
 details from the journals. To this moment there 
 are at least three hundred cases, and a full half 
 already dead. But you are anxious for me ; — 
 you suffer because I still remain here ; — perhaps 
 you even reproach me with an undue inattention 
 to the rights and feelings of my family. A word 
 upon this subject. 1st. What is my actual dan- 
 ger ? I do not deny that the first blow is very 
 strong, in truth frightfuUy so. But who are the 
 subjects affected? Up to this moment exclu- 
 sively the lower classes. I have inquired of 
 many physicians and among them of those 
 whose practice is extensive; — they have not 
 
FROM LETTERS. 133 
 
 seen a man in easy circumstances affected ; — 
 the journals say the same. Thus as yet my 
 langer is very slight, though living in the midst 
 nf disease ? But again, why should I stay in 
 Paris ? In the first place, the disease came upon 
 us so suddenly that we had no time to leave. 
 On Wednesday I first heard of its existence, and 
 .already, Sunday, there are three hundred pa- 
 tients. We could not have left the first day, for 
 we were not yet assured ; and now what are my 
 circumstances ? I am here with perhaps thirty 
 American students, and of them all, I may say 
 with truth, my mind has not been the least occu- 
 pied with medicine for some years. We are in 
 a city where we may see a disease of the most 
 frightful nature, — which will, in all probability, 
 soon reach our own dear country. We are 
 bound as men and physicians to stay and see this 
 disease ; — as a physician you know it and feel 
 it ; — as a father you dread it. For myself, I 
 confess I should be unwilling to return to Amer- 
 ica, and not have at least made an effort to learn 
 the nature and the best treatment of this destroyer 
 of life. I feel bound to remain with the rest ; 
 — for no one thinks, as yet, of leaving. As yet 
 the probability is that it will continue and even 
 increase; — but this is not sure. Should it 
 
134 EXTPACTS 
 
 thus continue, I probably shall not stay here 
 more than one or two weeks ; I shall have seen 
 enough of the disease, and if it reigns as now, 
 all clinical instruction will continue to be, as it 
 actually is, interrupted. Wherefore then stay 
 longer ? But we may hope that a little calm will 
 soon follow, and that this severe debut will be 
 followed by a rapid march and prompt termina- 
 tion. If so, all my instruction will be continued ; 
 I need not lose the remainder of my lessons 
 from Louis, &c. As it is, then, though there is 
 some danger, it is very slight. I shall therefore 
 stay. Again, feeling it to be a duty, and really 
 having my mind greatly interested and excited, 
 I do and shall see the disease. But should the 
 danger become truly great, I shall leave at once 
 for Scotland ; and should the disease so continue 
 that, after a fortnight, I cannot recommence my 
 ordinary studies, I shall likewise leave the city. 
 In the meantime I shall today engage lodgings 
 with my two Philadelphia friends, on the other 
 side of the river, in the most healthy part of Pa- 
 ris, where the disease has not yet appeared ; — I 
 shall live simply, sleep and rise early, and in 
 every way pursue the most strict hygienic rules. 
 Thus much for myself, and I hope you are sat- 
 isfied. I forgot to notice that I am in perfect 
 
FROM LETTERS. 
 
 135 
 
 health, and that, although my mind is necessarily 
 excited, yet I have neither fear nor anxiety. 
 
 Now, for the disease ; — one word ; — it is 
 death. Truly, at Hotel Dieu, where I have seen 
 fifty and more in a ward, it is almost like walking 
 through an autopsy room ; — in many nothing 
 but the act of respiration shows that life still 
 .exists. It is truly awful. — As for treatment, 
 nothing is yet decided. I cannot find that any 
 of the thousand different modes essayed is in 
 truth very powerful ; — and certainly, whatever 
 be their potency, the effect is almost null. The 
 physicians are in a state of the greatest incerti- 
 tude, not knowing which way to turn. I cannot 
 pretend to give you any detailed account of 
 symptoms or treatment. 
 
 I can only say that the disease is in truth al- 
 most a conversion instantaneously from life to 
 death. 
 
 In my next, by Liverpool on the 8th, you shall 
 receive something more precise. — My head is 
 now, as one may say, montee, and I haste for the 
 estafette. 
 
136 EXTRACTS 
 
 Paris, April 8, 1832. 
 MY DEAR FATHER, 
 
 I almost weep to write you again from Ptiris. 
 It is now the first moment of my life that I have 
 been placed between two duties, each strong, 
 each binding, and where my great difficulty is to 
 decide which is the most so. But I have de- 
 cided, as I know, against your wishes. God 
 grant that circumstances may be such that you 
 shall soon accord with me, when the time is pass- 
 ed. A medical man has duties ; — I am a boy 
 in medicine ; — granted ; — but I am like the 
 other Americans here about me. An opportunity 
 is offered us to study a disease, which will prob- 
 ably visit our hitherto untouched countr}?-. Were 
 the disease about you, would you fly ? You 
 could not, for the public would look to you ; — 
 you would not, for your sense of duty would 
 prevent you. I am in a measure in the same 
 condition. From a week's accurate, patient, la- 
 borious study of the disease, before and after 
 death, as to its nature and the effect of treatment 
 upon it, I am now assured that there is much to 
 be learned and much that is therapeutically im- 
 portant. I doubt whether our profession will 
 ever be able to divest it of its greatest horrors : 
 — this I do not hope for ; — for I see no ground 
 
FROM LETTERS. 
 
 137 
 
 for such hope. But I do believe that an exact 
 study of the latter part of this disease, after the 
 reaction is established, and observation of the ef- 
 fects of treatment upon it, may lead to much that 
 is useful. Persuaded of this as I am, I feel it a 
 duty thus to study. If I can be the means of 
 directing the attention of our physicians to certain 
 -points, an attention to which will enable them to 
 save one in twenty of those affected, and that one 
 would have died without it, — what is my duty ? 
 to stay and study. As an individual I do not hes- 
 itate thus to answer ; —but when I remember 
 you, my dear father, I tremble that I have thus 
 answered. 
 
 I am with Andral. During five days we 
 have had eleven very exact autopsies ; with 
 which, with the whole history of the cases, 
 besides numerous others, some dead, some living, 
 now to die, some in fact dying now around m.e, 
 (for I write in the ward of la Pitie,) some I am 
 happy to add in a fair way to recovery, I will ac- 
 quaint you hereafter. But I will write no details 
 now ; — I purposely avoid them. 
 
 I will but add two circumstances which shall, 
 or ought to serve to diminish your anxiety. — 
 1st. As yet, aUhough the disease increases in a 
 truly awful manner, there are but few cases in 
 the upper classes. 
 
138 EXTRACTS 
 
 2(1. Of those affected with the disease, there 
 are very few of my age, or near it. I must have 
 seen five hundred patients, at least, and of those 
 not ten under thirty. I cannot indeed recall 
 five ; — and not one have I seen in the dissect- 
 ing-room. 
 
 The only young man under Andral's care now 
 lies in the bed behind me, convalescent. Yet, 
 there is some danger ; it is in vain to deny it ; 
 but it is not great. And I am happy to add that, 
 since the appearance of the cholera, I have been 
 in a little more perfect health than before, though 
 that had seemed impossible. Most of my friends 
 have had a little diarrhoea, or cramps, &;c. ; I 
 not any. Not one of my acquaintance has been 
 seriously sick. I live as usual, but with exces- 
 sive care. I work harder than ever in my life 
 before. A month hence, I will send you the re- 
 sults on paper ; — but it will be a year before I 
 can show you the full results ; for I am learning 
 more on the pathology of mucous membranes 
 (intestinal and gastric) than ever before. But of 
 this by and by. I have determined to send you 
 no details as yet ; — but I keep a daily record for 
 you, which will be long, and probably, unless the 
 disease becomes such, that I esteem myself in 
 essential danger, I shall send you one hundred 
 
FROM LETTERS. 139 
 
 detailed observations, (of which I have already 
 thirty,) and forty or fifty of the most thorough 
 and accurate autopsies that you ever read. From 
 these, when collected, I propose to draw what 
 conclusions I can as to the nature and treatment 
 of the disease, in making a nice analysis and 
 synthesis of all the circumstances. I flatter my- 
 ■ self that I can do this in such a manner as will 
 be truly useful. I shall do it in England, taking 
 my papers with me, and devoting my first one or 
 two weeks there to this work. I would prefer 
 vastly to have sent you one of the half dozen 
 sheets I have written this day ; but it has been 
 my determination to avoid advancing an idea 
 till all is done. Not a single fact has yet occur- 
 red to show that the disease is contagious ; — not 
 a physician, nor interne, nor student of the hos- 
 pital has been affected. A week or two, my dear 
 father, and you will hear from me in England. 
 
 Havre, April 25, 1832. 
 
 On my way to London, as you see, my dear 
 father, and perhaps will wonder why ; surely, 
 when I last wrote you, I expected to stay in Paris 
 
140 
 
 EXTRACTS 
 
 a fortnight longer. I have left because the 
 cholera has almost ceased, not because it had 
 increased in severity. I have left for want of 
 cases to study. In very truth during the last 
 three days, in a service of fifty beds under Louis, 
 we had not a single new case of any severity ; 
 and he advised me as I was beginning to suffer 
 from fatigue, (for never in my life have I worked 
 so laboriously,) to leave, contented with the sixty 
 or seventy cases and more than thirty autopsies. 
 In London, as you know, the disease is about 
 extinct, (seven cases a day). In Paris it still 
 exists ; I saw cases and deaths till the very last 
 moment, but much fewer and much less severe. 
 You have no conception of the mortality ; and 
 allow me, your son and pupil, to say to my father 
 and master, you have no conception of the dis- 
 ease, and will not have, till you have seen it. 
 The Frenchmen even, who look upon death and 
 dying with as much sang froid as any people, 
 were thrown off their balance. Never shall I 
 forget Louis's altered face and aspect for the first 
 week; — emaciated, wan, wretched, like one 
 who had received a blow from which he had not 
 recovered. There are few men living so familiar 
 with death, or the dead. 
 
FROM LETTERS. 141 
 
 Liverpool, June 30, 1832. 
 MY DEAR FATHER, 
 
 I received last night with great pleasure yours 
 of May 19th — 25th. The last releases me from 
 all apprehension as to your judgment upon my 
 stay in Paris. I rejoice that you view it as I do. 
 A word on cholera, and then I will dismiss it. 
 Not a day passes, that I do not picture to myself 
 the possibility of its actual or future existence on 
 our own side of the Atlantic. Of course I keep 
 myself always ready to see if there be any 
 truth in the reports of the new modes of treat- 
 ment of it. In London, as I told you, I saw a 
 few cases vdth Dr Stevens, but none of them 
 were at all satisfactory, for various reasons which 
 you shall have in detail in your own study, or in 
 mine, by-and-by. In passing through Yorkshire, 
 where the disease is prevailing, I inquired, when- 
 eA^er'I had an opportunity, of the success of the 
 saline injections. At York I was enabled to 
 visit the cholera-hospital, and saw three or four 
 patients, among whom was a boy aged seven or 
 eight, who had been thus treated and was conva- 
 lescent. How bad his case had been, I know 
 not. They assured me it was very severe ; but 
 I have seen so many mistakes upon this head, 
 that I feel inclined to question the authority of 
 
142 EXTRACTS 
 
 those who have not seen more than fifteen or 
 twenty cases, when I know that, even after an 
 accurate study of hundreds, the prognosis, or, in 
 other words, the estimation of the real severity 
 of a case, is very difficuh. Be that as it may, 
 I am anxious and willing to hope that this boy 
 recovered through the agency of the saline treat- 
 ment. I next saw a young woman, aged twenty- 
 two, who had been three times injected, and 
 whose case was accurately detailed ; whereby it 
 was clearly shown that she was pulseless, that 
 blood could not be obtained at the debut, and, 
 from the notes, I cannot doubt that it was a 
 severe case. Well, what was her present state ? 
 You shall hear. They thought she would pretty 
 certainly recover ; — I would bet ten guineas 
 she is dead at this moment. Face flushed ; skin 
 everywhere hot ; lips and tongue getting dry and 
 brown ; respiration much embarrassed ; a sort 
 of fainting or sighing ; pulse one hundred and 
 twenty, hard ; some disposition to drowsiness, 
 fell asleep while we talked to her ; respiratory 
 murmur loud and vesicular in front ; could not 
 be raised to examine her behind, where I suspect 
 we should have found crepitous rale. Compare 
 this, if you will, with the cases of two women 
 under Andral, infirmieres of the hospital, in St 
 
FROM LETTERS. 143 
 
 Rosaire, Nos. 20 and 22 ; their result leads me 
 to anticipate death here,"^ 
 
 Again, in Leeds, I inquired if this treatment 
 had succeeded, and was answered in the nega- 
 tive. My conclusion, so far as I am able to form 
 one, is, that this injection undoubtedly produces 
 a temporary excitement, but that, as yet, we have 
 no proof that it arrests the disease. It does not 
 strike at the cause ; and how can we suppose 
 that it should ? This chemical rage enrages me. 
 I shall see medical gentlemen here tomorrow, 
 and learn what has been their experience. You 
 shall have it by the next packet. 
 
 ^ # ^ I have been nearly a fortnight reach- 
 ing this place on my way to Edinburgh, and I 
 would that every fortnight of my life had been 
 as well employed. At Oxford we staid three 
 days to see the great men collected together at 
 the British Association, in imitation of the Ger- 
 man Society of Naturalists. Of this, more by- 
 and-by. Thence, through Leamington, War- 
 wick, Kenilworth, &c., to Birmingham, in each 
 of which places I saw and learned much that 
 was new to me. Through Derbyshire, Derby, 
 
 * The reference here is to the writer's " Cases of 
 Cholera in Paris," which he had sent me a month be- 
 fore this letter. 
 
144 EXTRACTS 
 
 Matlock, Chatsworth, Castlcton into Yorkshire, 
 ShefTicld. Here S. and I parted, much to our 
 mutual reirret. He is a fine fellow. I went to 
 York, and to give you an idea of the hospitality 
 which I everywhere experience, I will draw a 
 little sketch of my Yorkshire expedition. 
 
 Arrived at the capital of this rich and exten- 
 sive county, I called on Mr K. with Mr W.'s 
 letter. He and his wife received me with kind- 
 ness ; I spent the evening and breakfasted with 
 them the next day. He pointed out to me all 
 that was interesting to a stranger, and introduced 
 me to Mr Phillips, the curator of their Museum. 
 This gentleman gave me what I may call a lec- 
 ture of nearly an hour upon the outlines of 
 geology, of which they have a very fine cabinet, 
 so arranged as to speak itself of the beauty and 
 order of the system ; and, I assure you, I would 
 travel over twice the distance for the sake of 
 gaining the clear view which this gentleman 
 gave me of this interesting subject. I felt quite 
 indebted to him ; he has raised a new cabinet in 
 my mind, and so raised it, that whatever accident 
 throws in my way, I may easily attach there. 
 Not satisfied with this politeness, he gave me a 
 letter to the curator at Leeds, Mr Hey, grandson 
 of the celebrated Hey. Here I added to my 
 
FROM LETTERS. 145 
 
 knowledge, which was so newly acquired, and 
 was treated by this gentleman more like an old 
 friend, whom he was glad to see again, than as an 
 entire stranger. Had you seen us together and 
 listened to our conversation the next day, you 
 would not have supposed our acquaintance of 
 only twenty-four hours' date. While walking 
 with this gentleman, he happened accidentally to 
 mention the name of Dr Teale, as a friend of 
 his. I at once asked if it was the neuralgia Dr 
 Teale. He said, yes, and I begged to see him. 
 He asked him to tea with us ; we had an hour 
 or two of free pathological conversation. Dr 
 Teale promised to show me some interesting 
 cases and morbid specimens, if I would stay and 
 dine with him the next day. Though anxious 
 to get on, I consented ; and glad am I that I did. 
 Dr Teale invited two medical gentlemen to meet 
 me, brother professors in their new college in 
 Leeds, and I spent from four to eleven P. M. 
 most agreeably in their society. I have not 
 talked so much pathology for a long time. Dr 
 Teale is a very sensible, enthusiastic man ; not 
 inclined to theory ; apparently a good and vigo- 
 rous observer ; industrious and well informed ; 
 weighs and values well his evidence before he 
 admits truth ; in fine, a man in whom I should 
 10 
 
146 EXTRACTS 
 
 place confidence. You see I passed a pleasant 
 evening. ^ ^ =^ I do not regret passing 
 through Leeds ; my mind worked three days' 
 worth, while there. I learned some new things 
 and had a great, general review of much patho- 
 logical ground. We walked fast, turned into 
 many pleasant lanes and bye-paths, and midnight 
 came before I suspected it. 
 
 All this from Mr W.'s letter to Mr K. Thus 
 it is in England ; and Dr Teale begged m.e to 
 come again. How boundless is their hospitality. 
 
 Of my papers on cholera ; of course I am 
 anxious to know if you will publish them. You 
 will see that I had to restrain a strong desire to 
 enter more fully into the pathology of the dis- 
 ease But I am young ; and what I have con- 
 demned in others who are older, would have 
 been doubly guilty in myself. 
 
 Mr F. calls, and I must close to go out with 
 him. Hospitality again, hospitality ! Quel 
 peuple ; je vante que nous sommes d'Angleterre. 
 J'aime ce pays, comme notre mere, d'ou vient 
 notre bonheur. Good bye, my dear father. 
 
 Your son, J. J. 
 
FROM LETTERS. 147 
 
 Edinburgh, July 10, 1832. 
 MY DEAR FATHER, 
 
 If you are not heartily tired of cholera, I must 
 beg you to read what I have seen in this city. 
 I was informed on my arrival, that the disease 
 had re-appeared here, and with increased force ; 
 yet twenty cases a day is the outside. On the 
 following morning, Dr Alison introduced me to 
 the Cholera Hospital, when I recognised the old 
 and familiar, but appalling features of the mon- 
 ster, I had so much observed in Paris. The 
 most interesting object of inquiry was, of course, 
 as to the success of the saline injection ; — and 
 the following is, in few words, the sum of infor- 
 mation I have been able to obtain. 
 
 It is derived from several physicians of rank 
 here, and three or four young men. 
 
 1. They employ this remedy only in the bad 
 cases, viz. when the system is prostrated ; pulse- 
 less, blue, cold, &;c. ; collapse. 
 
 2. In such cases the effect is to produce ex- 
 citement of the circulation, &c. 
 
 3. After this excitement is produced, it is some- 
 times of short duration, and recourse is had a 
 second or third time to the injection. 
 
 4. This excitement is sometimes followed by 
 a second collapse, during which the patients die. 
 
148 EXTRACTS 
 
 5. It is again, and not un frequently, from their 
 statements I should say very often, followed by 
 too great a re-action, and the cases close with 
 cerebral symptoms and death, unless venesection, 
 leeches, &;c. prove successful. 
 
 6. The efTect of this injection seems to be, not 
 to cure the disease of itself, for, first, a majority of 
 those injected die ; second, those who have sur- 
 vived, most, if not all, have taken calomel and 
 opium in full doses ; third, the cerebral affection 
 just noticed, almost always or very often suc- 
 ceeds the injection and proves fatal, if it be not 
 immediately overcome by antiphlogistic treat- 
 ment. 
 
 7. So far as the injection is proved to be use- 
 ful, it seems to be by producing reaction, and 
 thus allowing time for the employment of alter- 
 atives ; or bringing on the stage of excitement, 
 which, though very dangerous, is sometimes to 
 be overcome by antiphlogistic treatment. This 
 last, which is the result of the observation of 
 these gentlemen, coincides exactly with the opin- 
 ion I expressed to you in a letter from Liverpool. 
 Each of these gentlemen assured me, that he did 
 not doubt having seen a, few cases recover under 
 this treatment, followed, as I have before said, by 
 antiphlogistics and alteratives, which would have 
 
FROM LETTERS. 149 
 
 proved fatal without the injection ; because then 
 the last could not have been employed. 
 
 8. The injection employed is composed as fol- 
 lows : R. Sodas Muriat. 5 ij, Sodas Bicarbonat. 
 B ij, Aquae octant: v, — misce. This is used 
 
 at the temperature of 112® — Ho® ; — its heat 
 is preserved during the operation, by allowing the 
 vessel containing it to stand in another contain- 
 ' ing hot water. The injection has been contin- 
 ued until the object w^as obtained ; viz. return of 
 pulse, warmth and natural color. The opera- 
 tion is performed with a small syringe, and quite 
 slowly ; for example, ten or fifteen minutes, to 
 five or eight pounds. 
 
 9. After the injection, the following is given, 
 varying pro re nata : R. Hydr. Submur. gr. iv, 
 Op. gr. i, — misce, every two hours. I am not 
 sure as to quantities and times, but the object is to 
 salivate as quickly as possible, and for this pur- 
 pose mercurial frictions are added. I have said 
 nothing of vapor baths, hot cloths, &c., w^hich of 
 course, in some form, are constantly employed. 
 
 10. After all this, they w^atch for reaction, and 
 at the first symptom of excess, bleed locally or 
 generally. 
 
 11. One woman is well, and now about, who 
 had some time since fifty-one pounds of saline 
 
150 EXTRACTS 
 
 fluid injected, besides a solution of quinine and 
 morphia. There were, of course, several injec- 
 tions in this case. 
 
 Thus I have given you, in a hurried manner, 
 (for my time is much engaged,) what I believe 
 to be the essentials of what I could obtain from 
 these gentlemen. Yet once more. 
 
 12. Dr G. insisted very strongly upon the great 
 temporary relief to suffering, even if the cases 
 afterwards proved fatal ; saying, he should deem 
 himself culpable for neglecting it, even if this 
 were the only ground. I shall next giv^e you 
 what I myself have seen, continuing a daily 
 report till I send my letter. 
 
 [Here follows the records of three cases treat- 
 ed by injections, which are omitted, as not inter- 
 esting at the present day.] 
 
 July 12. — =^ ^ I dined today with Dr S — , 
 he tells me has used the injection in eight suc- 
 cessive cases ; they all were fatal. Dr C. says 
 he has seen it tried a good deal, but is by no 
 means sure of having seen it once successful. 
 
 The truth is, that its immediate effects are so 
 strikino:, and there is often in cholera such a false 
 convalescence, that it is really very difficult to 
 prevent one's mind from receiving an impression 
 in favor of this remedy. "We see the patient 
 
FROM LETTERS. 151 
 
 revive ; good pulse, good countenance ; every- 
 thing promises well for twenty-four or forty-eight 
 hours, and then death soon follows. I have 
 already seen three cases in Edinburgh, which 
 were regarded as nearly convalescent, or quite 
 safe ; — one of them is dead, and I am almost 
 confident, from present appearances, the other 
 two will die. I forgot to mention the testimony 
 of another gentleman, with whom I have con- 
 versed, against the injection; — Dr B. ; as also 
 Dr T., by whose learning and familiarity with 
 medical literature, late and old, in such an elderly 
 gentleman, I have been as much surprised as 
 entertained and instructed. 
 
 ^ ^ ^ Let me suggest one measure to be 
 adopted in our own dear city in case the disease 
 reaches it ; and we have reports that it is already 
 at Quebec, though God forbid it be true. Let 
 each of our physicians take a certain part of the 
 town under his charge ; — let it be his duty, not 
 only to visit ail the poor when they are sick, but 
 tioice a day, while the disease remains ; let him 
 call at each house,and inquire if any be sick, i. e., 
 have lost their appetite, have diarrhoea, or any 
 premonitory symptoms ; in this way you will 
 get at the disease early among the poor. For 
 the rich, there is no danger ; they will call you 
 
152 EXTRACTS 
 
 from your beds often enough, with false alarms 
 and vain fears. If you wait for the poor to 
 come to you, it will be too late ; you must, there- 
 fore go to them ; and the labor will not be great, 
 when divided among so many. I know of no 
 means so likely to lessen the mortality. 
 
 Dublin, August 19, 1832, 
 MY DEAR FATHER, 
 
 I would to God I knew how it is with you at 
 this moment. When awake, I do not allow my- 
 self to think much of cholera in America, and 
 never to fancy that my friends can be touched 
 by it; — but in sleep, it occurs in my dreams, 
 and they are such as sometimes alarm me. I 
 must await the end. I have not received any 
 letters from you for some time ; — as I have been 
 wandering and uncertain, I directed them to be 
 detained at London, after I left Edinburgh, and 
 this circumstance will hurry me back to London. 
 I am already repaid for coming to this city, by 
 a few hours' study yesterday at the museum of 
 pathological anatomy, at the college of surgeons. 
 I have added to the stores of my knowledge, 
 
FROM LETTERS. 153 
 
 memory and note-books upon this subject. It is 
 my intention, so to have seen everything in the 
 morbid ivay^ that you cannot find me at fault on 
 the most close examination. I have already seen 
 much, that from books I had longed for, and only 
 regret that you are not at my side, that we might 
 burn together, as we looked upon the riches of 
 the science we love. Do not imagine that I am 
 going to allow myself to become a mere patho- 
 logical anatomist, instead of a pathologist in the 
 more liberal sense of the word. . Eemember, 
 though I now write mainly of specimens, prepa- 
 rations and paintings, that from Paris I wrote 
 much of symptomatology, aye, and studied it 
 much, too. That I do not much expect in Eng- 
 land ; — it is almost impossible. I may see 
 practice, you will say ; I will, but I expect fully, 
 very often to be much in doubt as to the nature 
 of the case, in which the practice is exercised. 
 
 I was very much delighted with the Giant's 
 Causeway, of which I would give you a descrip- 
 tion, but that in print you will find so many 
 superior to anything I can give you. The coun- 
 ties of Antrim, Downe, Derry, &c., in the north 
 of Ireland, through which I rode, are beautifully 
 cultivated ; and in them are some of the neat- 
 est, best built villages I have ever seen, inhab- 
 
154 EXTRACTS 
 
 ited by people whose dress, countenance and 
 whole aspect, indicate comfort and prosperity. 
 The mud hovel is there scarcely to be seen. In- 
 deed, to my eye, these little towns are superior, 
 most decidedly to most of those I passed through 
 in Scotland, either north of Edinburgh, or west 
 of it. Such an appearance of prosperity and 
 comfort in Ireland, was to me as surprising as it 
 was grateful ; for I don't forget my Tracy blood ; 
 — but I am told, that at the south it is quite dif- 
 ferent ; and if I can possibly get three or four 
 days, I shall ride through it to see for myself. 
 I am here struck, as I was in Switzerland, with 
 the difference between the protestant and catholic 
 counties ; — the first prosperous, the last wretch- 
 ed J in the first, rich fields and good roads, indi- 
 cating that time was precious and well-spent 
 also ; — the last uncultivated, or poorly so, with 
 bad roads ; a token of the very opposite. I can- 
 not forget having made the same remarks some 
 years since, when travelling from New England 
 into catholic Canada. 
 
 The anatomical department at the College Sur- 
 gical Museum, is so arranged here, and with so 
 excellent a catalogue, that with a little study I 
 may fix some very important general principles) 
 illustrated by preparations on the subject of com- 
 
FROM LETTERS. 
 
 155 
 
 parative anatomy of the internal organs. I shall 
 devote as much time as possible to this, after I 
 have finished the morbid anatomy : — every spe- 
 cimen of which I examine, taking a note of all 
 that is new or peculiar. 
 
 The finest institution I have yet seen in Eu- 
 rope, is the Lying-in-Hospital in this city ; — it 
 is very extensive, extremely neat and comforta- 
 ble, almost vying with the Massachusetts Gene- 
 ral Hospital ; and I should imagine more truly 
 useful than almost any other, as affording cer- 
 tain and positive relief to sufferings, which, 
 uncomplicated with cold and hardship, are suffi- 
 ciently severe. I trust we shall soon have a 
 similar institution. I shall endeavor to procure 
 what I can of the regulations and reports of this, 
 so far as they have been published. The citi- 
 zens, especially the professional men, are extreme- 
 ly, and very justly proud of this, their favorite 
 establishment. 
 
 As to cholera, the experience of the gentlemen 
 I have conversed with here is the same as else- 
 where, viz. that art is vain against it. I have 
 seen one new thing upon this subject; — a pa- 
 tient of Mr Cusack's, in whom mortification of- 
 half of both feet followed the disease. He has 
 seen a second case of the same. They have suf- 
 
156 EXTRACTS 
 
 fered here most sadly, but the cases are now 
 reduced to six or eight a day. ^ =^ ^ 
 
 Aug. 21. Still in Dublin, my dear father ; 
 neither do I regret it. I have picked up a good 
 deal at the museum, — having examined each 
 specimen of morbid anatomy ; and a fine collec- 
 tion it is, though there are defects. 
 
 The collection of comparative anatomy of the 
 internal organs is so admirably arranged, cata- 
 logued, described and labelled, that I cannot 
 resist the opportunity to study the subject by 
 means of it, and with text book in hand, am now 
 employed in examining with care these speci- 
 mens. My thoughts are now on tongues and 
 stomachs, instead of diseased hearts, &c. I can 
 learn more from this than from J. Hunter's even, 
 because there is neither catalogue nor label, 
 there. — Again, this will prepare more for the 
 other. 
 
 London, September 14, 1832. 
 I have today finished my study of the muse- 
 um at Guy's, which has cost me many hours. 
 It is certainly the finest I have seen in Europe, 
 
FROM LETTERS. 157 
 
 and does great honor to Dr Hodgkin ; who, by 
 the by, is one of the deepest men in reading and 
 observation that I have seen. ^ =^ ^ 
 
 London, September 22, 1832. 
 MY DEAR FATHER, 
 
 I received a few days since yours of August 
 20, — Cholera had just commenced ; — sloioly ; 
 — how has it been since ? I anxiously await the 
 arrival of papers to inform me. It is useless to 
 speculate upon it ; I cannot but hope and believe 
 that the precautions and general character of 
 the Bostonians (than whom I have seen no peo- 
 ple at home or abroad, more marked for solidity 
 of judgment and good common sense) will pre- 
 vent it from being excessively severe. =^ =^ ^ 
 
 ^ # ^ ]VIy purposed occupation for the week, 
 the examination of Hunter's museum, has been 
 interrupted by a most melancholy accident. ^ ^ 
 
 It is truly grievous that there is no catalogue 
 of this superb collection, — I would give more 
 for one during the next fortnight than for any 
 book I know of. — I can understand the general 
 plan, and many of the individual specimens; — 
 
158 EXTRACTS 
 
 the more from having studied as I did at Dublin. 
 The more, too, I could have said, had I stud- 
 ied as I ouofht to have done at the Garden of 
 Plants. And when I can understand the pecu- 
 liar object of an individual specimen, it is so 
 beautiful and so demonstrative, so speaks of its 
 great Designer, that I am only the more vexed 
 that the greater part are as a dead letter. You 
 can judge of the immense disadvantages under 
 which I must study it, and the comparatively 
 little knowledge I can obtain from it, when I de- 
 scribe to you in what manner a catalogue is now 
 being made by Mr Owen. He has devoted him- 
 self to this task for the last year and a half, and 
 really his zeal and industry are quite proverbial. 
 Well, in this year and a half he has advanced 
 about four hundred specimens ; just about be- 
 ginning with the organs of digestion now. In 
 order to this, he tells me he has already dissected 
 more than two hundred species of animals. His 
 only resources are a very meagre catalogue of 
 Hunter's, which is so mingled with a false and 
 
 pretended one by as to render its authority 
 
 very doubtful. When he does not know a spe- 
 cimen, therefore, he begins to dissect all the ani- 
 mals from which he has reason, from his previ- 
 ous knowledge or reading, to suspect that it was 
 
FROM LETTERS. 159 
 
 taken. He tells me he has sometimes dissected 
 thirty animals to ascertain a single specimen. 
 By so doing he is constantly adding to the riches 
 of the museum ; but the fact that this is neces- 
 sary will show you how lamentably limited must 
 be the advantages I can enjoy in this study. 
 Yet, as I tell you, I find myself able to recog- 
 nise many things, which would have been a per- 
 fect secret to me, but for my study at Dublin. 
 Again, that study teaches me how vastly superior 
 is this museum of Hunter's, though much less 
 useful to the student from the want of a cata- 
 logue. "^ ^ "^ 
 
 ^ ^ ^ I have just come from Bartholomew's 
 hospital, where I have seen Lawrence, Earle, 
 &c., and the museum, which is small, but neat 
 and instructive, — mostly devoted to surgical 
 diseases. In it is a specimen of diseased lung, 
 similar to one at Guy's, in which emphysema 
 exists to a very marked degree, with tubercles. 
 
 I think I wrote you of a puzzling case in 
 Louis's ward last spring, where I could not come 
 to a diagnosis of anything but a combination of 
 these two affections. These two specimens have 
 been very interesting to me, as proving the coin- 
 cidence of the two things, and rendering the 
 diagnosis probable. 
 
160 EXTRACTS 
 
 London, September 23, 1832. 
 
 Would you were here, my dear father, to enjoy 
 with me the study of John Hunter's works, and 
 to kindle with me in my admiration of his ge- 
 nius ; the elevation and extent of which I know 
 not even now ; nor does any man living, though 
 my conceptions of his vast and comprehensive 
 mind have been greatly elevated within the last 
 fortnight. His museum is intelligible to no one 
 in its full extent. The materials there collected 
 and arranged, are often indicative of peculiar 
 ideas, which are lost to the world for want of 
 their great interpreter. This is especially true 
 as I suspect, upon the subject of generation, 
 on which the museum is peculiarly rich in the 
 number and variety of its preparations. Diges- 
 tion, respiration and generation have been the 
 most interesting departments to me ; and beauti- 
 ful indeed is the endless variety of means to ob- 
 tain these several ends, varying as they always do 
 in accordance with the nature and circumstances 
 of the individual cases. The collection at Dub- 
 lin, on the subject of circulation, is even better than 
 that of Hunter's, so that I did not meet with so 
 much that was new to me on that score. While 
 visiting the museum, I have been reading those 
 valuable papers in Hunter's work on the animal 
 
FROM LETTERS. 161 
 
 economy, which Dr Hodgkin, among his numer- 
 ous other kindnesses, procured for me. Will 
 you believe it, in London, the theatre of this 
 great man's life, I found considerable difficulty 
 in procuring this work. ^ ^ ^ 
 
 # ^ ^. Sept. 29. Let me give you an ac- 
 count of some new ideas of Dr Carswell's upon 
 the seat of tubercles, which he has been unfold- 
 ing and illustrating to me this morning. I am 
 anxious to keep his arguments in mind, and can- 
 not do better than write them you ; — the present 
 exercise will impress them upon my mind, and 
 the sheet will serve me for notes at my return. 
 
 London, October l, 1832. 
 ^ ^ ^ I dined with Dr M. Hall, and was 
 indebted to him for one of the grandest specta- 
 cles that human eye can behold. I witnessed 
 the circulation in the web of a frog, under a mi- 
 croscope of one hundred magnifying power. — 
 I know not whether you have ever seen this or 
 not ; if not, you have no conception of its beauty. 
 With what ideas does it fill the mind I — the 
 whole animal world thus teeming with life and 
 11 
 
162 
 
 EXTRACTS 
 
 motion, and this motion in the most defined and 
 regular vessels, and regulated by unvarying laws. 
 The artery is distinct, constantly dividing into 
 smaller arteries, until it is at last separated into 
 two capillary vessels. These are always of the 
 same size, and thus differ from the arteries in 
 this respect. They run in every direction and at 
 last terminate in veins, between which and them- 
 selves, as to form and size, there is again the 
 same distinction. In the second place, the blood 
 is seen to move with different velocities in each 
 of these three order of vessels. As it courses 
 its way along the artery, rapid as lightning, you 
 cannot distinguish the globules ; these become 
 quite apparent in the capillaries, and yet more 
 so, I thinks in the veins ; at any rate, you see 
 them very distinctly in these two last series of 
 vessels, whereas, in the arteries, they succeed 
 each other so rapidly, as to form a continued line 
 to the eye. It is a most glorious sight, and most 
 ennobling to see the blood thus actively pursuing 
 its course till it reaches the great and common 
 reservoir, the capillaries ; there delaying its 
 progress in order that the formative vessels may 
 make what use of it they will ; and then slowly 
 making its way back to the organs, where it is to 
 be replenished with what it has lost, or give up 
 
FROM LETTERS. 163 
 
 what it has acquired. When the web was wet 
 with alcohol, and inflammation had commenced, 
 the capillary circulation stopped entirely after a 
 while ; the blood was stagnant in these vessels, 
 while it continued to flow in the others. Upon 
 this, (which is a phenomenon I know to be true, 
 for I saw it,) Dr Hall forms an hypothesis con- 
 cerning inflammation. 
 
 Paris, November 1, 1832, 
 
 ^ ^ ^ The glory of the week has been An- 
 dral's introductory lecture on diseases of the 
 brain. It was the most eloquent I ever heard, 
 one speech of Mr Webster's and a sermon or two 
 of Dr Channing's excepted. I could scarcely 
 restrain myself, it was so grand and beautiful. 
 What powers of mind and vastness of compre- 
 hension has this man ! What gave me peculiar 
 pleasure also, he declared boldly and freely for 
 the numerical method, saying, it was the only 
 mode of advancing the science of pathology. 
 
164 EXTRACTS 
 
 Paris, November 13, 1832. 
 * # # What Louis has given us is positive, 
 and it is a matter of astonishment to see to what 
 beautiful and unexpected results his mode of 
 studying has led him. Will you have an exam- 
 ple, now before my eyes ? I could give many, 
 but will limit myself to the following. One of 
 his laivs, drawn from the study of his facts, is, 
 that in the adult subject whenever tubercles exist 
 in any part of the body, they of necessity exist 
 also in the lungs. A second laio is, that every 
 chronic peritonitis, chronic from its debut, is tuber- 
 culous ; i. e. he has never seen one that was not 
 so. Ergo, if one discovers by symptoms, during 
 life, a chronic peritonitis, one may be sure that 
 the patient is tuberculous, and that he has a 
 tuberculous affection of the lungs ; and he may 
 safely diagnosticate this, although there may 
 be no symptoms whatever of pulmonary dis- 
 ease. I must have Avritten you last year of 
 one case, in which I saw him make the diag- 
 nosis correctly. A second is now in the ward, 
 of which I will give you the details on my 
 return, as I have taken the observation at Louis's 
 request. To me the case is interesting in anoth- 
 er view, as being one of those, of which I wrote 
 you in my last, where I had observed the form 
 of bronchial expiration then alluded to. 
 
FROM LETTERS. 165 
 
 Paris, November 24, 1832. 
 
 # # # Morbid anatomy, then, does not tell us 
 all ; far, far from it ; and, I may add, that if I 
 have learned better to appreciate what this 
 science can teach us, by a more extended obser- 
 vation than it was possible for me to enjoy in 
 America, I have not the less learned that it is by 
 no means the only mode in which we are to 
 study the intricacies of pathology. How much 
 chemistry is to yield, how much a more inti- 
 mate knowledge of physiology, how much a 
 more exact appreciation of the various influences 
 of the different physical agents upon us, it re- 
 mains to be decided. This last subject interests 
 me much at this moment, as I am now reading 
 Edwards' work on the influence of the physical 
 agents upon life ; one of the most remarkable 
 works I have ever read, both on account of the 
 subject, and the peculiarly vigorous and philo- 
 sophical mind of the author. I hope to see him 
 soon ; Dr Bostock gave me a letter to him. But 
 our poor pathology and yet worse therapeutics ; 
 shall we ever get to a solid bottom ? shall we 
 ever have fixed laws ? shall we ever know., or 
 must we be ever doomed to suspect, to presume ? 
 Is perhaps to be our qualifying word forever and 
 
166 EXTRACTS 
 
 for aye ? Must we forever be obliged to hang" 
 OUT heads, when the chemist and natural philos- 
 opher ask us for our laws and principles ? Must 
 we ever blush to see the book of the naturalist, 
 his orders and his genera, with their character- 
 istics invariable^ w^hile we can point to nothing 
 equivalent ? Our study is that of nature, as well 
 as theirs ; the same cause acting upon the same 
 materials must ever produce the same effect with 
 us, as with them. But they know all their ele- 
 ments. Do we ? In their calculation no figure 
 need be left out. Is it so with us ? If honest, 
 must we not confess that we are ignorant of ma- 
 ny circumstances, which must, however, vary the 
 result ? [f honest, must we not acknowledge 
 that, even in the natural history of disease, there 
 is much very doubtful., which is received as sure ? 
 And in therapeutics, is it better yet, or worse ? 
 
 Have we judged, have we deduced our results, 
 especially in this last science, from all., or from a 
 selection of facts ? Do we know, for example, in 
 how many cases such a treatment fails for the 
 one time it succeeds ? Do we know how large 
 a proportion of cases would get well without any 
 treatment, compared with those which recover 
 under it ? Do not imagine, my dear father, that 
 I am becoming a sceptic in medicine ; it is not 
 
FROM LETTERS. 
 
 167 
 
 quite so bad as that ; — I shall ever believe at least 
 that the rules of hygeia must be and are useful, 
 and that he only can well understand and value 
 them, who has well studied pathology. Indeed, 
 I may add that, to a certain extent, I have seen 
 demonstrated the actual benefit of certain modes 
 of treatment in acute diseases. But is this ben- 
 efit immense ? When life is threatened, do we 
 very often save it ? When a disease is destined 
 by nature to be long, do we often very materially 
 diminish it ? I doubt not, that we do sometimes 
 and under certain circumstances. But on the 
 other hand, I must acknowledge that, what I have 
 seen here of disease and its issues, has rather 
 inclined me to believe that I individually over- 
 valued the utility of certain modes of treatment 
 in America. You cannot conceive of my im- 
 patience to get home and see again, what I once 
 saw, and what a second time I shall look at with 
 new eyes. I have been led into these reflections 
 (and I hope you will read them as they are, pass- 
 ing, conflicting doubts, which must ever arise 
 in the mind of man on every subject, upon which 
 he has not determined facts, as the basis of his 
 opinion) by the study of, or rather the look I 
 have been taking at physics and chemistry and 
 natural history. 
 
168 
 
 EXTRACTS 
 
 I have been led into them too, by the study of 
 these darkest of all dark subjects, diseases of the 
 brain. There I look in vain for a constant and 
 fixed effect, so far as our senses and present modes 
 of exploration enable its to appreciate the causes 
 and the effects. There, again, even after we 5ec?7z 
 to have fixed upon some almost characteristic 
 distinctions, which will translate with compara- 
 tive certainty the causes, I am condemned to 
 read that having thus discovered the cause, we 
 can go no further. There is a ramollissement, 
 there is a tumor ; but we can remove neither. 
 There is a haemorrliage ; but some facts, of which 
 I have been eye-ioitness, teach me that, even with- 
 out treatment, these sometimes advance toward 
 a certain degree of cui'e, and the symptoms 
 thereof disappear to a certain extent; and beyond 
 that, the art of man can never, or almost never 
 go : the lesion remains ; the individual is 
 maimed for life, and that life is not worth the 
 having. Is it not true, my dear father ? Your 
 life, which has been so long and so extensively 
 useful, has it not been so more through hygienic, 
 prophylactic, than through strictly therapeutic 
 means ? 
 
 Think for a moment of the diseases, which 
 prove fatal to the life of man in our country. — 
 
FROM LETTERS. 169 
 
 Probably nearly a fourth die of tubercles ; cer- 
 tainly a fourth, if we except those who die of 
 old age. After this fourth, how large a propor- 
 tion dies of some confessedly incurable organic 
 disease. 
 
 Will you know to what results reflections of 
 this sort have driven me ? I am brought to think 
 that the medical man's life may be most usefully 
 spent in the collection of facts, which shall throw 
 light upon the causes, internal and external, (I 
 mean those which exist within and around the 
 individual,) producing or leading to organic dis- 
 eases, tubercles and the rest. How can this be 
 done and what will be its effects ? Let me say 
 a word upon each of these heads. It can be 
 done, well done, scientifically done, in one way 
 only. Numerous histories of the lives of indi- 
 viduals, from the uterus to the grave, must be 
 carefully collected. Their weight, and size, and 
 parentage ; their comparative growth and devel- 
 opment ; the care of their infancy; length of 
 time at the breast, &c. ; their mode of physical 
 education as to diet and exercise ; and their dis- 
 eases, all in detail ; their idiosjmcrasies in every 
 particular ; and a host of things, which appertain 
 to every individual and influence his physical 
 existence. 
 
170 EXTRACTS 
 
 This cannot be done by one man ; — there 
 must be a society, — a body of men, all impress- 
 ed with a sense of its importance, all feeling 
 and knowing that without it we cannot reach 
 truth. Reflect for a moment upon the delights 
 of such an association. Suppose there were ten 
 of us in Boston and its environs, who should 
 thus associate and observe carefully during ten 
 years or twenty ? We begin with the children, 
 who are born under our care ; each of us keeps a 
 record of all thus belonging to him; these rec- 
 ords are to be copied by a clerk into a book, 
 which is the property of the society. Each 
 month we meet together ; the subject of the 
 evening is the additional material during the 
 past month, which appears upon the pages of 
 our book. What would be the advantages of 
 such a society ? Call it Utopian, call it ideal, if 
 you will ; I '11 not deny it. I fear it may, nay, 
 perhaps, must be so ; but again I ask, what might 
 be the advantages of such a society ? 
 
 1. We meet, so many students^ so many prac- 
 titioners, all inspired with the holy desire to dis- 
 cover truth and to turn it to advantage. We 
 meet, each presenting to the whole what has 
 occurred to him, receiving the light and aid which 
 the combined efforts of the whole can afford. 
 
FROM LETTERS. 
 
 171 
 
 Every individual case, then, of disease will be 
 more fully considered and have an opportunity 
 of being better treated. 2. We create a school 
 of accurate observers, and the good effects of this 
 alone are endless. 3. We amass materials, 
 from which may be deduced a good and connect- 
 ed general history of the most unknown diseases, 
 those of children, not painted by the imagination, 
 but rigorously deduced from facts. 4. We col- 
 lect in time a vast quantity of material, which 
 shall go to prove incontestably some of the most 
 important points of hygiene. We show, for 
 example, that children nursed only ten months 
 have only half the chance for a continuance of 
 life to the adult age that those have, who are 
 nursed sixteen or eighteen. We show that of 
 two families, equally disposed to phthisis, in one, 
 who from infancy, led an inactive life, &c., all 
 are dead at an early age ; while in the other, 
 where means were taken to invigorate the sys- 
 tem, all live, &c. 
 
 We will suppose that these, or similar and 
 equally important truths, could be rigorously 
 deduced from the facts we had collected ; that 
 we could prove them, and show our proof to the 
 world, as the public treasurer renders his annual 
 account to the public, by figures and columns 
 
172 EXTRACTS 
 
 not to be mistaken. 5. Again, in tlius learning 
 what description of individuals and what sort of 
 life predisposed to such and such diseases, we 
 may arrive at an earlier diagnosis, and thus be 
 able to procrastinate, if we cannot prevent the 
 occurrence of disease. But the advantages, both 
 to the parties and to the public, which might 
 result from such a course are too obvious. 
 
 I have shown how I think this may be done 
 and what would be some of its effects ; but there 
 is yet another and a more important one in my 
 mind than any, which would be produced imme- 
 diately upon and through the physician. I speak 
 of the effect upon the public mind, — the influ- 
 ence it would upon the education of youth and 
 the public hygiene in general. What mother 
 would dare tear her child from the breast at 
 eight or ten months, after we had shown her and 
 made it accepted truth, that one of two children 
 thus treated would meet with a premature death ? 
 How many parents would be stimulated to in- 
 crease their efforts to give vigor to their children, 
 when it was made as clear as that twice two is 
 four, that without it a wretched life and an early 
 death would be the consequence ! 
 
 I may deceive myself upon this subject ; — 
 though I have not yet Avritten you half I feel and 
 
FROM LETTERS. 173 
 
 think ; — I may overvalue its advantages ; but 
 on my honor, I do now believe it would be both 
 for science, pure science, for utility, and conse- 
 quently for the only two highest ends of action 
 to men in our profession, the noblest thing that 
 could be done. Imagine, for a moment, that 
 such a society should spread from its little centre 
 at Boston ; that after a few volumes from New 
 England, Philadelphia and New York, then 
 London and Edinburgh, &;c., should raise their 
 societies ; — that the work should go on ; — look 
 forward only fifty years ; — imagine a man like 
 Andral to bring together and to extract the truth 
 from the immense mass of materials collected : 
 would there not be truth and useful truth there ? 
 To set such a wheel in motion would it not be to 
 have been useful ? 1 long to talk with you upon 
 this subject, my dear father. For two months past 
 it has occupied many a musing hour in my mind. 
 And yet I beg you '11 say nothing of it. Don't 
 think me crazy ; I don't expect all that I write. 
 I only hope that an idea has struck me which is 
 practicable, and if practised will lead to good. 
 
174 EXTRACTS 
 
 Paris, Dece3ibeb 26, 1832. 
 
 ^ * ^ Having made this accurate analysis of 
 the characters of this morbid part, and having 
 arrived at this more nette idea, than I ever had 
 before, of the true distinction of the first stage 
 of inflammation from mere congestion, I was 
 proud and delighted ; showed it to my friends ; 
 repeated it half a dozen times, and do not abstain 
 from writing you in full, for I was truly happy 
 over it. I pray keep the letter. You may say 
 I should have known it before, but if you look 
 at my cases of cholera described by Louis and 
 Andral, or at Laennec, or at Andral's clinique, 
 you will see that nowhere is the thing drawn 
 out so clearly as I have done it in the last page, 
 by comparing together the two lungs. 
 
 Paris, January 16, 1833. 
 ^ ^ # In very truth I look forward with fear 
 and trembling to the day when I must employ 
 my time to earn money, instead of to learn truth. 
 I once laughed when I was told the student's is 
 the happiest life. Persuaded as I am that there 
 is very much in the exercise of our profession, 
 
FROM LETTERS. 175 
 
 that developes and satisfies the affections, — that 
 delights the moral man, — yet I must acknow- 
 ledge that, had circumstances favored it, I should 
 have been pleased to pass at least eight or ten 
 years in the study of the sciences of pathology 
 and therapeutics, in the hopes of establishing 
 some important truths. I am afraid, my dear 
 father, that we are in the habit of regarding 
 many things in both these sciences as axioms, 
 which are very far from being proved. As an 
 individual I can be satisfied of a therapeutic truth 
 but in one of two modes. 1. I must see the 
 treatment employed in a large number of cases, 
 which are in no way selected; I must know and 
 observe all the peculiarities of the disease, not 
 only so as to know what it is ; but what is the 
 history and nature of the individual who has it, 
 the history, or the general issue of the diseases 
 of the season, &c. &c. These cases, being col- 
 lected, are my raw material ; I must study and 
 class them. I must then count and see how often 
 under such and such circumstances the treatment 
 has been successful. This I have never done 
 with regard to any disease but cholera ; but until 
 it is done, my belief as a scientific man, is, and 
 must be insufficient to satisfy my mind. Such 
 evidence is not necessary to prove that relief of 
 
176 EXTRACTS 
 
 symptoms follows treatment of various sorts ; — 
 of this no one can doubt ; he sees it, who looks. 
 But I speak of arresting, or materially shorten- 
 ing disease. On this point general impressions, 
 such general impressions as my mind is capable 
 of receiving, amount to nothing ; for they are for 
 a thousand reasons most deceptive ; especially 
 upon a subject like this, where we are pre- 
 viously inclined by our hopes, our interest, our 
 humanity, coupled with those of the patient and 
 his friends, always to look upon the bright side. 
 Such then must be my mode of determining the 
 truth with respect to any subject that I investi- 
 gate myself. Look to the history of cholera 
 through the world; the successful remedies, 
 almost as countless as its victims, that have been 
 vaunted ; the assured fronts and language of 
 those who talk of their hundreds and thousands, 
 and none lost ; or yet worse, of the man who had 
 one hundred patients, and saved one hundred 
 and three. 
 
 We live indeed in darkness, and it costs more 
 time to discover the falsity of pretended truth, 
 than it would, perhaps, to reach something truly 
 valuable. Am I wrong ? Is there any other way 
 of establishing truth ? 2d. Here, my dear father, 
 is the only second mode, in which my mind (I do 
 
FROM LETTERS. 177 
 
 not say my will, — for it is not an affair of voli- 
 tion) will be persuaded ; i. e. that if I do not see, 
 he, who has seen, should write me such an ac- 
 count as to prove that he has investigated the 
 subject in the same way. 
 
 This is to me a ])ainful subject, for I would 
 fain believe in all the therapeutics which you 
 believe in; and yet the evidence that it is true 
 must be derived from your and my general im- 
 pressions. Now, when I have had such ample 
 opportunity to see the futility of such evidence ; 
 when I hear men like Andral and Louis both 
 declare, that they have been misled nine times 
 out of ten, when they have trusted to such evi- 
 dence ; and that on a minute examination of the 
 very facts, upon lohich and from which these 
 general impressions have been founded and de- 
 rived, they have discovered their error ; when I 
 come to examine English boolv's, from which we 
 receive the great mass of evidence with respect 
 to therapeutical success, and see how they min- 
 gle, even the best of them, diseases vastly dis- 
 tinct in their natures ; I ask myself, honestly, 
 how far can I trust all this ? Do I believe that 
 bleeding arrests inflammation, as I believe that a 
 certain combination of symptoms indicates such 
 and such a lesion ? Is not the last proved by 
 12 
 
178 EXTRACTS 
 
 numerous demonstrations ? Have I ever seen 
 one instance of what the books talk so easily of 
 as to the first ? I assure you, my dear father, in 
 the present state of my knowledge, in my pres- 
 ent view of the existing state of medicine, I 
 believe that we admit many things in America 
 as axioms, which are very far from being proved. 
 We have too long believed that, because dem- 
 onstration, on many points, was impossible in 
 medicine, it was not worth while to study it like 
 an exact science. It is a very false position. 
 Just reflect for a moment of what materials our 
 therapeutic literature consists ; almost without 
 exception, chosen cases to prove the efhcacy of 
 such and such remedies. Is this the way to 
 proceed ? Suppose the chemist went to his 
 laboratory hoping to find oxygen in everything, 
 and made known to the public those cases only 
 in which he found it ; would his science advance ? 
 What a pity is it that ours is a mixture of sci- 
 ence and trade ; or what a pity, scientifically 
 considered, that we cannot be entirely indifferent 
 as to results ; then we might walk securely. 
 But when we are hoping, and our patients are 
 hoping, we are deceiving ourselves, and often the 
 patients themselves, and us also. How difficult 
 is it ? shall we, dare we, can we trust to general 
 
FROM LETTERS. 179 
 
 impressions received from such sources, and in 
 such a state of mind ? If on any subject rigor- 
 ous proof is absolutely necessary, it surely is to 
 establish a fact in therapeutics. But enough ; 
 though when with you I wish to enlarge more 
 upon this subject, and were it not for two 
 reasons ; 1, that I must earn my bread ; 2, that 
 I too dearly love that world of the affections to 
 which our profession introduces us ; I would 
 devote my life to the accurate determination of 
 some essential points of therapeutics. Remem- 
 ber, I do not deny the utility, in its fullest extent, 
 of all the pov/erful agents which I have seen you 
 employ ; — on the contrary, I am inclined to be- 
 lieve in them to a certain extent ; — but my mind 
 (not my will) cannot receive the scanty evidence, 
 which experience, lectures, and books have fur- 
 nished as proof that all is true. 
 
 Paris, January 25, 1833. 
 ^ # ^ How sad is this auscultation ! these 
 positive physical signs ; which, though in them- 
 selves not enough, yet put the seal of certitude 
 upon what before was doubtful ; destroy the 
 
180 EXTRACTS 
 
 plausibility of many a willing interpretation of 
 other symptoms ; and leave us to fold our hands 
 and await the event. But it must not be so. 
 It is time that the pathological world should turn 
 its attention to the causes ; those things which 
 precede and lead to the various organic diseases, 
 and especially to this one which counts so many 
 victims. It is time that we should begin to col- 
 lect those new observations, which alone can 
 furnish evidence upon this point; I mean the 
 circumstances of the natural history of individ- 
 uals. For shame upon us, that the antiquarian 
 can spend years of toil and labor to decypher an 
 Egyptian hieroglyphic, the naturalist a life of 
 hardships and privations to ascertain minute 
 
 ■ points of no practical interest, and that we should 
 pass our lives getting money, when, by study 
 
 • and devotion to what is intrinsically of equal 
 interest, simply as an exercise of the human 
 mind, we could reach such results of essential 
 importance to the happiness of millions. I sug- 
 gested this thing to Andral at his house, a week 
 since. We have learned to diagnose tubercles 
 early, said I ; we can tell a man that he has 
 cencer of the stomach ; but, that done, what 
 must we add ? — that a certain death awaits him, 
 and that we can neither shorten, nor alleviate it. 
 
J-HOM LETTERS. 181 
 
 Is this the end of our studies ? Arrived at this 
 shore, shall we land and be idle ; or, like honest 
 and enthusiastic explorers, shall we advance into 
 the country and look farther ? I added, the only 
 mode of advancing is to have the lives of a great 
 number of individuals ; see under what circum- 
 stances they have lived, and what has been their 
 end ; from these premises we may have, indeed, 
 we must have important conclusions. He an- 
 swered, " yes ; but men will not do that." I 
 know well that they will not ; I know well that 
 I have got to be exposed to a thousand tempta- 
 tions, and to nine hundred and ninety-nine, at 
 least, I shall yield. But I pray God I may have 
 strength to pursue this subject. There is none, 
 which seems to me so important. La verite est 
 dans les faits. On this subject, as on every 
 other, facts properly collected, must lead to good« 
 My dear father, I am very serious on this point ; 
 I wish you would write whether you sympathise 
 with me upon it. The question is not, is it easy ? 
 Nothing is easy to do well. The only question 
 iSi will it be useful ? The only question is, is 
 there any other mode of arriving at the truth ? 
 
 Jan. 29. My dear father, I have just received 
 yours of December 20th, and in it there is one 
 sentiment, as to which I most heartily agree 
 with you. You say, " in spite of all they say 
 
182 EiTRACTS 
 
 of the wickedness of this world, you often re' 
 fleet how many excellent men and women you 
 have been acquainted with in this world. '"^ I 
 am rejoiced to read from my dear father an ex- 
 pression of my own experience ; each day I see 
 it verified ; and my principle is, instead of al- 
 ways acting upon the defensive, to be willing to 
 show my colors, and make friends with any 
 worthy man. From this circumstance, my 
 friends are numerous, and I have and do enjoy 
 the acquaintance of many, who reward richly 
 one's confidence and sympathy. ^ =^ =^ 
 
 ^ ^ ^ I have not heard from , since I 
 
 last wrote you. His wife was then not very 
 well, but I trust she is now better. I love to 
 speak and write of them. Each day con^ inces 
 me that the true happiness of man consists in a 
 due and active development of his intellect and 
 affections. Neither alone is sufficient ; with a 
 happy development of the two, how much hap- 
 piness is there in this world, 
 
 * I have printed the above for the sake of what fol- 
 lows, as that throws light on the character of the 
 writer. In truth, the occasion of my remark, which 
 he has quoted, was my felicitating him on having 
 formed an acquaintance, and, in some cases, a friend- 
 ship, with so many excellent people in Europe. I 
 remarked to him, that il was an evidence, that this 
 world is not so bad, as it is often represented. 
 
FROM LETTERS. 1S3 
 
 Paris, February 6, 1833. 
 
 ^ # ^ Seriously, my dear father, I see that 
 my life has got to be in future a little different 
 from what my imagination loves to paint it. I 
 must exercise a profession to get bread ; whereas, 
 willing to work, with a horror of inactive life, I 
 still would love to work solely to satisfy two 
 ,passions, a love of science and an exercise of the 
 affections. And yet I presume, the auri sacra 
 fames will touch me ; curse the day that it com- 
 mences-. 
 
 Paris, April 5, 1833. 
 
 ■^ -^ -^ Up to the time of Louis the same dis* 
 tinction had not been made, as now, between an 
 acute disease, in a previously healthy subject, 
 and in one who was already diseased. The pa- 
 thological laws, which reign over the acute dis- 
 ease in these two instances, are very different 
 however. Again, I mean previous to the light 
 which Louis has thrown upon our science, the 
 force and beauty of which I feel daily more and 
 more, attention was not paidtoaZZ the functions 
 during life and all the organs after death ; at 
 
184 EXTRACTS 
 
 least by the French and English authors who 
 have written ; for it is with pride and delight 
 that I each day repeat to myself, " Yes, my fa- 
 ther examined in every disease, all the functions ;'* 
 he felt the importance of knowing the state of 
 all, in each disease ; of each of them. But did 
 he examine all the organs after death ? No ; 
 this is peculiar to Louis. He can tell yon in 
 each disease not only the lesions of the organ 
 originally affected ; but also the proportion of the 
 secondary lesions, which follow each disease. 
 This is perhaps one of thegi'eatest services, which 
 my French master has rendered to science ; and 
 as I begun, so I finish, from an inattention to it, 
 as well as to some other essential points, many 
 of the observations of the best authors lose one 
 half their value. May I give you a single ex- 
 ample of the beautiful results, to which Louis 
 has arrived by this scrupulous examination of all 
 the organs in every disease ? Variola, — which, 
 thank God, I shall not see at home as I have 
 here, — what is the usual cause of death in this 
 disease when it proves fatal ? Authors talk of 
 the exhausted system, inflammation of alimentary 
 canal, inflammation of the brain, &c. — all this 
 is nonsense ; for it cannot be proved. But what 
 
FROM LETTERS. 
 
 185 
 
 tas Louis found to be the cause of death ? 
 While at la Charite (six years since) of twenty 
 cases, sixteen died of laryngitis ; false membrane 
 lining the larynx; swelling, &c. of mucous 
 membrane ; great diminution of calibre of glot- 
 tis. This he has seen confirmed at least as many 
 times more ; as I have also six or eight times at 
 la Pitie. Well, why was not this essential and 
 all-important lesion known before ? simply be- 
 cause pathologists did not open the larynx of 
 variolous subjects. They were, in respect to this 
 point, in the same condition as the ancients with 
 respect to morbid anatomy in general. 
 
 I choose this example because it is striking ', 
 but both of my beloved master's works^ are full 
 of similar ones. 
 
 Paris, June 6, 1833. 
 
 # ^ # I must not forget to tell you that I 
 have this moment seen a new case of Bright's 
 kidney, the second which Andral has found 
 
 * The reference here is to Louis on phtliisis and 
 on typhus. 
 
186 EXTRACTS 
 
 since I showed him mine. But what especially 
 fills my mind at this moment is the most superb 
 case of pneumonia I ever saw, now in our ward. 
 Superb ! why ? from its therapeutic interest. 
 How delicious is it, among the mass of dying 
 and dead, when the only occupation is to describe 
 the phenomena during and after life, and now 
 and then to palliate ; how delicious it is I say, 
 to see here and there a severe case of acute dis' 
 ease, dangerous from its nature, arrested ; its 
 duration reduced from twenty to four, or five 
 days. Listen. A man ast. 36, on the night of 
 the 3d of this month, at eleven P. M. was aroused 
 suddenly from his sleep by severe pain in left 
 side; to which were added oppression, cough, 
 and pneumonitic expectoration. He w^as per- 
 fectly well when he went to bed, worked, &c. as 
 usual during the day. No more sleep that night ; 
 increase of symptoms with heat, anorexy, thirst, 
 &c. Entered hospital in state of extreme dys- 
 pnoea, &c. at nine, A. M^ next day : then 
 bronchial respiration over the middle third 
 of left chest behind, with a little crepitous 
 rale and bronchophony. (Hepatization of large 
 portion of left lung already at tenth hour of the 
 disease). Bled to twenty ounces, when he 
 fainted. I saw him again at two, P. M. Tiie 
 
FROM LETTERS. 
 
 ist 
 
 crepitious rale had disappeared, — nothing but 
 bronchial respiration. Respiration, thirty-six a 
 minute ; (I forgot to mention flatness on percus- 
 sion over same space ;) still much fever, anxiety, 
 pain, dyspnoea, although great relief since morn- 
 ing. Next morning, the 5th, same condition, 
 except that the general symptoms, as also the 
 rational symptoms, had decreased in intensity, 
 whereas the bronchial respiration was still more 
 distinct ; as yet no return of crepitous rale. 
 Venesection to fifteen ounces. In evening at six 
 o'clock great relief expressed by patient as to all 
 symptoms. Respiration twenty-two instead of 
 thirty-six, as last evening ; — bronchial respira- 
 tion almost disappeared, and its place supplied 
 by the returning crepitous rale, wdth some vesi- 
 cular expansion, although still a little of the 
 bronchial character ; — flatness less. This morn- 
 ing, 6th, the man expresses a state of " perfectly 
 well ;" says he can turn in every direction ; 
 in spite of thirty-five ounces of blood lost, is 
 infinitely stronger than at entrance; — pulse 
 seventy-six, instead of one hundred : respiration 
 twenty-two, instead of thirty-six ; no pain, nor 
 other symptoms ; asks for food ; vesicular ex- 
 pansion abundant at the left, behind, with crep- 
 itous rale and scarcely any bronchial respiration. 
 
188 
 
 EXTRACTS 
 
 The man is nearly convalescent, and here wd 
 are at the fifty-fifth hour of a ^rave pneumonia, 
 which occupied the two inferior thirds of the 
 left lung behind, which began severely, which 
 had already reached hepatization at its tenth 
 hour, which was attended with such severe 
 symptoms as to make patient enter at that early 
 hour. My dear father, I rub my hands with 
 joy. I hope for treatment during the first hours. 
 I say hope ; for although I may safely say I have 
 passed one quarter of the hours of daylight, 
 indeed half, in the wards of la Pitie for six 
 months, and although this is No. 21, of my 
 cases of pure pneumonia, which I have collected 
 in the greatest detail there, still it is also the first 
 that I have seen apparently controlled by vene- 
 section ; — the first bled under less than twenty 
 four hours. I have no time to write another 
 sheet, and ought almost to beg pardon for filling 
 this with so rapid and abridged a history to an 
 American physician, to whom such cases are not 
 rare. 
 
FROM LETTERS. 189 
 
 Paris, June 27, 1833. 
 % ^ # J received your letters of the 13ih and 
 21st ult., three nights since, together. They 
 cost me thirty drops of laudanum, for my heart 
 beat so hard and my head worked so fast, in con- 
 sequence of the thoughts, speculations, castle 
 building, &c. to which they gave rise, that I 
 could not sleep, and knowing I must be up at six, 
 A. M. I could not afford to play the dreamer with 
 my eyes open, all night. So you consent to my 
 observing a certain number of years, if I see fit, 
 after a due consideration of the matter, and you 
 advise me not to decide until upon the scene of 
 my future life I may better know, weigh and 
 appreciate the circumstances w'hich should gov- 
 ern me. My dear father, I thank you equally 
 for the permission and the advice, and promise 
 as implicitly to follow the one as I gratefully 
 accept the other. I know well, there are a thou- 
 sand circumstances to consider relative to this 
 subject ; perhaps some occur to me which strike 
 you with less force : perhaps my life here and 
 my experience of the men in the first places may 
 have given me certain hopes, and at the same 
 time certain horrors, which you do not realize so 
 strongly as I do. I say perhaps, and perhaps 
 only ; — for you are so apt to look at every side 
 
190 EXTRACTS 
 
 of a question, that I dare hardly presume. Cer- 
 tainly on the other hand, certainLij you will pre- 
 sent to my mind views of the subject, which I 
 neither see nor feel ; and it would be only to 
 continue in the sad way I have always followed 
 to listen too little to the wisdom and kindness of 
 the best of fathers, did I allow myself to decide 
 on any important point of life without his aid 
 and instruction. Be assured then, my dear 
 father, that my mind shall be kept open to con- 
 idction. I ask only that, once there, you shall 
 endeavor to keep my mind in a right state, and 
 not let the judgment be biassed by desires and 
 temptations, laudable in themselves, but baneful 
 to him who would for a while make science his 
 sole mistress. The more I advance in life the 
 more I see and feel convinced that its great and 
 chief happiness is self-education ; self-develop- 
 ment, intellectual and moral. God knows I have 
 enough of both to do. May I only be industri- 
 ous at the work ! I tremble when I reflect upon 
 the number of subjects as yet unknown, but 
 which must be known to me. 
 
FROM LETTERS. 191 
 
 The two letters which follow, were addressed 
 to a medical friend, who kindly sent them to me. 
 The playful style of controversy will be readily 
 understood from the extracts here printed ; though 
 it would be more so, if the letters were given 
 entire. I have, how^ever, erased all personal 
 allusions. I trust that the letters will not be 
 thought devoid of interest. J. J. 
 
 Paris, December 9, 1833. 
 MY DEAR DOCTOR, 
 
 If you w^ill deign to receive a word from a 
 poor youth, who strives to estimate morbid anat- 
 omy at its true value, placing it neither above 
 nor below its proper rank, he will be happy to 
 say a word in self-defence. But, first, let me 
 thank you for your kindness in writing me such 
 a good long letter, full of pleasant Avords and 
 kind rebukes and w^holesome counsel. 
 
 I am glad that you are not displeased with my 
 Utile memoir upon cholera. I grieve that you 
 misunderstand me upon some points, and that 
 we cannot agree upon a few others. 
 
 1st. You misunderstand extremely my esti- 
 
192 EXTRACTS 
 
 mation of morbid anatomy. I see I must make 
 a rapid confession of faith in order to let you 
 see in what light I consider this science. 1. I 
 conceive it to be OTie of the modes by which we 
 are to obtain a knowledge of the phenomena of 
 disease, — but by no means the only one. 2. I 
 conceive and know that in some cases it affords 
 very important positive knowledge as to the 
 nature of disease. 3. I am equally aware that 
 in many cases it affords negative information 
 only. But this ?iegative information is as 
 important, perhaps, as the positive. It is as 
 useful to know that a thing is not as that it is : 
 each is a truth in nature : each enters equally, 
 as an element, into science : to omit either, is to 
 be guilty of an equal omission. 4. Besides 
 those cases, in which morbid anatomy teaches us 
 nothing positive, are yet many others, in which, 
 although from it we may gain positive know- 
 ledge, we are still sure that something more has 
 existed, and has influenced the organs and the 
 economy during life. 5. Indeed, in all cases of 
 disease, there is ever an unknown something 
 which morbid anatomy can 7iever teach us : viz. 
 that state, or condition of the parts, which pre- 
 cedes, and is the immediate cause of, the mor- 
 bid process ; and which we know must exist, 
 though we can neither see nor feel it. En resume, 
 
FROM LETTERS. 193 
 
 then, I esteem morbid anatomy as always afford- 
 ing evidence, either positive or negative, which 
 must be taken into the account by every rational 
 pathologist ; but, on the other hand, there lives 
 not the man, who is more firmly persuaded than 
 myself of its insufficiency to afford us an answer 
 to all that we must look for in this dark science 
 of pathology. It is but last w^eek that I wrote 
 my father very much in these words : " If my 
 life in Paris has enabled me to appreciate, much 
 more fully than before, the advantages of morbid 
 anatomy, my mind has not been the less struck 
 with this all important truth, that morbid anatomy 
 is very far from sufficient to satisfy all the desid- 
 erata of the pathologist." I take the trouble to 
 go a little into detail here, because I regard the 
 man, who esteems this science as the " fons et 
 origo," and the only true one, of important and 
 well established truth in pathology, I regard such 
 a man, I say, as taking a very limited view of 
 this science, and as being very deficient in his 
 mode of pursuing it. I am unwilling that you 
 should regard me as such. 
 
 But although you will be pleased with this 
 
 avowal, you will ask me, what other evidence I 
 
 am willing to admit in order to decide the nature 
 
 of disease. I am ready to answer, two other 
 
 13 
 
194 EXTRACTS 
 
 modes of evidence are admissible ; but both arc 
 to be used with extreme caution, most especially 
 the last. 1. The symptoms; — these it is evi- 
 dent, will be variously esteemed according to the 
 Y3iTying physiological views of the observer. The 
 ground, then, is dangerous ; for there are theo- 
 ries upon the animal economy, so mechanical, so 
 chemical, so wanting in beauty, leading so 
 little to the delightful views of God and his 
 power, which certain others do inspire us with, 
 that I thank God, my mind is made to admit the 
 last rather than the first. It must be allowed 
 that the evidence afforded of the nature of a 
 disease, by the symptoms of that disease, is to be 
 adopted with great circumspection. I could cite 
 examples of an abuse of this species of evidence ; 
 but to you this is useless. 2. Analogy ; how much 
 may we trust to analogy ? I doubt not it is useful. 
 Each day I employ it ; indeed without it I could 
 scarcely live. But I fear it greatly; I know 
 how liable it is to abuse. 
 
 And, now, my dear doctor, that I have spent 
 half a sheet upon this subject, I will begin 
 another to answer your second complaint against 
 your humble servant. A few words will suf- 
 fice. 
 
 2d. You abuse me because I will not geTieral- 
 
FROM LETTERS. 195 
 
 ize : in other words, because I will not adopt, as 
 my sworn creed, those opinions which originated 
 with your ever to be respected friend and master, 
 and which have been confirmed and strengthened 
 by your own laborious observation and research. 
 In the first place, I know that you would despise 
 me more than any other could, did I pretend, 
 through a desire in every respect to coincide 
 with a man to w^hom both my reason and my 
 affections have so much attached me, to adopt 
 all his opinions, when I was not satisfied that 
 they w^ere true. I do not yet know the facts. 
 I am by no means in a condition to decide the 
 question, whether fever be only a local or a gen- 
 eral disease ; and, if either, whether it has 
 always one seat, or always consists in the same 
 phenomena. Instead of not generalizing enough, 
 I have done so too much ; many questions are 
 now doubtful in my mind, to which I w^as in- 
 clined to give a very positive answer before I 
 came to Europe. And why have they become 
 doubtful ? Simply because I have learned facts 
 which I did not, then, know ; and I think it wise 
 to wait till I have become yet better acquainted 
 with them, and to search for others, before I form 
 any general opinions upon some most important 
 
196 EXTRACTS 
 
 subjects. Instead of being in a hurry, I sincerely 
 hope that I shall yet wait ten years or more : and 
 above all, I trust I shall always be of my present 
 mind upon one point, viz : to prefer to acknow- 
 ledge myself in doubt, where the nature of the 
 subject necessarily renders it doubtful, than to 
 attach myself to any opinion, the truth of which 
 I know to be very far from demonstrable. My 
 mind is so constituted that I enjoy more to say, 
 " well, this point is unsettled ', there are such 
 arguments or such facts for one view, and again 
 such others for the other ; we cannot yet decide ;" 
 than to cry with the ardent and restless theorist, 
 " I know that there is a certain degree of doubt ^ 
 but I mill believe, for on the whole it seems to 
 me true." It may be politic, or even useful at 
 times to suppress the little doubts, which arise 
 against what we regard as important truth, which 
 is to affect the public ; — as we may say nothing 
 about our fears of the possible ill effects of a 
 bold course of medical treatment, which we 
 think on the whole useful ; and yet, as scientific 
 men, in both cases, it would be the height of folly 
 for us not to distinguish hQiwQen probable and cer' 
 tain, demonstrated truth. I apply this to myself, 
 the student, who am not yet sufficiently advanced 
 in my knowledge of facts to form an opinion 
 
PROM LETTERS. 197 
 
 upon certain subjects. There are several in 
 which my father has and I had implicit belief, 
 but which now I doubt : he knoios them to be 
 true ; I do not. It is the same with you ; you 
 have studied your subject, long, fully, in all its 
 details ; you have arrived at an opinion ; but 
 tliat does not necessarily make me a subscriber 
 to it ; because you are learned, it does not make 
 me the less a mere learner ; because you have 
 run the course and attained your end, and exam- 
 ined closely your object, and thus fixed firmly 
 your opinion, it does not prove that I am not 
 simply on the road, as yet unacquainted with 
 much that you are familiar with. In other 
 words, because you, from your abundance or 
 knowledge, have a right to generalize, I, in the 
 depth of my ignorance, have no such right. I 
 might possibly have taken the liberty of trying 
 to prove to you that you generalize too soon, as 
 you have accused me of the contrary extreme ; 
 but I fear your heavy cannon, and I ^\^^, there- 
 fore, be silent, preferring to answer by the defen- 
 sive, instead of answering your question with 
 another, as the robber says to Alexander, or 
 Alexander to the robber in one of my school 
 days' dialogues, for I forget which. 
 
198 EXTRACTS 
 
 Paris, June 18, 1833. 
 MY DEAR DOCTOR, 
 
 We had yesterday the pleasure of seeing your 
 friend A. ; and, aUhough our interest with the 
 Northern Courts is not so immense as your 
 words would seem to imply, we shall endeavor 
 to render what little services are in our power to 
 Mr A., whom I see to be a good fellow, because 
 he seems duly to appreciate your character. =^ ^ =* 
 
 Do you mean to overwhelm me with ridicule ? 
 When I have chosen my science, and you 
 yours, do you think it just to take it for granted 
 that, because the one is eminently calculated to 
 develope the mind's best powers and the soul's 
 best affections, the other cannot and is not equally 
 so ? As a scientific man, you must surely forget 
 yourself, when you attempt to prove that botany, 
 or geology, or any other of the sciences, as a 
 science, is better calculated to improve the intel- 
 lect, or to afford pleasure to the student, than is 
 medicine ; or, rather, the accessory sciences 
 which compose it. What is the pleasure, what 
 the occupation of a truly scientific man ? Surely, 
 from an exact and detailed observation of what 
 his senses can demonstrate to him, upon a given 
 subject, to trace the great general laws of nature 
 upon that subject. This I maintain to be the 
 
FROM LETTERS. 
 
 199 
 
 fundamental attraction of every science, to one 
 who will view the subject as a man of science 
 should. This being taken for granted, and I 
 think you will hardly deny it me, I would beg 
 you to point out the real distinction, scientifically 
 spealdng, between tracing the pollen tubes to the 
 ovula of an asclepias, with the eye, and follow- 
 ' inff with the ear the various modifications of 
 sound produced in the chest by a pneumonia. 
 Why with my telescope, may I not as much 
 enjoy a crepitous rale, (of the first order,) or a 
 bronchial respiration of the purest tone, as Brown, 
 with his microscope, a little channel leading from 
 one part to another of his flower. In both cases 
 what do we do ? Appreciate, by the nice use of 
 our senses, the phenomena appreciable by them, 
 and then from these phenomena, connected with 
 our previous knowledge, arrive at some law of 
 the exis^tence of these two beings; an asclepias 
 on the one hand, a pneumonia upon the other. 
 Perhaps I deceive myself ; but I think not ; if 
 any distinction exists between these two things, 
 point it out I pray of you. The reason that 
 medicine, (or, to use a better term, the reason 
 that pathology and therapeutics, or the natural 
 history of disease before and after death, and the 
 influence of external agents upon the march of dis- 
 
200 EXTRACTS 
 
 ease,) is so despised as a science, is, that it has 
 never yet been studied as a science. But the time 
 has come ; it actually now takes rank with the 
 other sciences ; only it is the least advanced of 
 them. 
 
 We have learned that ^o^zYii^e knowledge may 
 be gained, where we formerly admitted the most 
 loose assertions of each popular author, as he 
 came along. Studied as a science, I maintain 
 that it has as strong a claim as any other, upon 
 the best heads ; and upon any one, whose object 
 is to develope to the utmost his intellectual pow- 
 ers. Why, then, abuse me for studying it ? 
 Should I make duty my guide ? My duty is to 
 prepare myself, as well as lies in my power, upon 
 this obscure and difficult subject, which is to be 
 the practical subject of my life. Is it enough 
 for me to know what the books can teach me ? 
 They contain more falsehood than truth ; and I 
 cannot distinguish between them without study- 
 ing nature. My duty, then, reduces me to the 
 necessity of observing nature in her diseased 
 operations in the human economy. But how 
 much time shall I give to it ? As much as possi- 
 ble, is the only answer ; because even that will 
 not suffice. Again, shall we leave duty to those 
 who follow its dictates more than myself; shall 
 
FROM LETTERS. 201 
 
 I ask of taste, shall I take pleasure for my guide ? 
 Same answer; my education and habits of life 
 have so constituted me, that it is my greatest 
 pleasure to pursue disease in its myriad wan- 
 derings. It is : I do not say it ivill be. Since, 
 then duty and pleasure lead me to one object, 
 why should I turn my back upon it ? But again, 
 frankly I will acknowledge one thing, viz. that in 
 my castle building for future life, I sometimes 
 tremble ; and your sentence, of " pity poor Jack- 
 son's wife," has made me tremble anew. To 
 effect what I propose to myself, and what I truly 
 think v\'-ill be the best possible use of my means 
 and time, will occupy me most intensely for 
 years. I do not mean that I shall not have min- 
 utes at my disposal and hours too ; but that, in 
 all the best and brightest of those minutes, when 
 my mind is truly awake, it will inevitably recur 
 to the subjects of my study. All this need not 
 be ; I can put bounds to what I propose. I can, 
 from the moment I reach home, devote but a 
 given time to the objects of science. But, my 
 
 dear , as a kind friend, you should look, 
 
 with a little of your heart's as well as your 
 mind's eye, upon my situation. You should 
 reflect upon my father, what he is, and where he 
 is, and what will be his disappointment if I fall 
 
202 EXTRACTS 
 
 short in the race. It must, then, be my object 
 so to follow my studies, as best to secure what 
 he desires and depends upon. Upon this point? 
 I believe, honestly, that I am better able to judge, 
 than either yourself, or he. I believe so, because, 
 pursuing the science later than either of you, I 
 know and feel more deeply what is to be its 
 march for the next half century. I know how 
 it will be followed by those, who are to rank as 
 masters. But, again, if pleasure, happiness, be 
 the only end of life, I do not agree with you as 
 to the means of gaining it. I do not here refer 
 to any difference as to the estimation of domes- 
 tic enjoyments ; I always appreciated them most 
 highly. I refer to science as a source of happi- 
 ness. In what way should a man cultivate it, 
 so as to obtain the greatest possible individiial 
 pleasure from it ? Should he be superficially 
 acquainted with several branches of science, 
 reading what others have observed, or, perhaps, 
 observing in general what others have pointed 
 out in detail ; or should he be one of those, 
 who himself observes and describes for others '? 
 In other words, is the happiness, which may be 
 derived from the contemplation of the laios dis- 
 covered by others, to be compared with that, 
 experienced by him who discovers them ? Is a 
 
FROM LETTERS. 203 
 
 knowledge of generals, which, after all, a man 
 who knows not the details intimately, must re- 
 ceive partly on trust, — is that knowledge, I ask, 
 productive of the same pleasurable emotions, as 
 a knowledge of details ; of those details upon 
 which the generals are founded ? We all admire 
 the beautiful laws of gravity, of electricity, of 
 chemistry. But have w^e ever experienced a 
 millionth part of the elevation (" exaltation") of 
 Newton, or Franklin, or Davy ? Surely not. 
 The same is true upon a smaller scale. I am 
 much happier in pursuing my science in a strictly 
 scientific manner, i. e. by an actual observa- 
 tion of all diseased phenomena by my own 
 senses, than if I read for years the results of the 
 labors of Cuvierand Brown, and Decandolle, &c. 
 &c. Really, to study any science, with the 
 hopes of at all advancing it, requires all one's 
 time, and all his mind ; but, if he loves that sci* 
 ence, he will be repaid by what he discovers. 
 
REMINISCENCES 
 
 or 
 
 JAMES JACKSON, Jr. 
 
 BY A FELLOW STUDENT. 
 
REMINISCENCES. 
 
 James Jackson, Jr. was my school-mate at the Pub- 
 lic Latin School in Boston, my class-mate at Harvard 
 University, ray fellow-student in medicine while in Bos- 
 ton and in Paris, and I spoke to him often duiing many 
 years, but I never knew him until we met in Europe. I 
 shall now speak of him as I saw him there. He was in 
 England when I arrived at Paris, and I did not meet him 
 until four months had elapsed. During the following 
 winter we were together every day. As his connexion 
 with Louis had perhaps greater influence upon his cha- 
 racter than almost any other circumstance he met with 
 abroad, it may not be uninteresting to trace the connex- 
 ion between them in its origin, its progress and its termi- 
 nation. Jackson arrived in Paris in the spring of 1831. 
 He had read of and heard of Louis, and had formed a 
 very high opinion of him, but he learned to respect 
 him much more after he became acquainted with the 
 powers possessed by that great pathologist. He heard 
 his clinical lectures during the winter of 1831-2, and 
 for three months previously had attended his clinical 
 visits occasionally, without becoming personally ac- 
 quainted with the professor. He was not aware that the 
 latter had noticed him, until one day a friend told him 
 
208 REMINISCENCES. 
 
 that Louis had asked wlio he was, in these words, 
 " What is the name of the young American, who at- 
 tends my visits — I mean that one who discovers every- 
 thing which I do when auscultating our patients? I 
 sfiould be pleased to know him, for he has a fine mind." 
 About tliis same time also, Jackson was one day stand- 
 ing at the foot of the bed of a patient affected with some 
 pulmonary disease, and Louis, after having examined 
 liitnself, requested several who stood by to do so, and 
 make their report to him. After they had returned un- 
 satisfactory answers, he looked towards my friend, and 
 told him to come, for, says he, you are " great in aus 
 cultation." Jackson mentioned this fact and said the 
 deep pleasure he experienced at that moment, almost 
 took from him the power of examination. 
 
 He became afterwards more acquainted, and used to 
 walk occasionally with his preceptor. At length, he with 
 two other Americans asked him to give them private 
 instruction in auscultation and percussion. This made 
 them quite intimate, and his love and respect increased 
 daily, though still he felt always a kind of reverence, 
 which kept him at a distance (as he told me) from the 
 professor, until after his return from England, in the 
 autumn of 1832. Jackson often mentioned to me the 
 great pleasure he experienced at the reception he met 
 with from Louis on his return. He arrived and imme- 
 diately went to the hospital, where the professor was 
 then engaged in making his visit. To use the words of 
 Jackson — "he came from the patient lie was examin- 
 ing, shook hands with me, and said he was glad to see 
 me again ; and when we came out the hospital, he put 
 liis arm within mine and we walked home together." 
 
OF JAMES JACKSON, JR. 209 
 
 From tliis moment, Louis and Jackson were near friends. 
 Scarcely ever did a day pass that they did not leave 
 the hospital together. It was quite curious to the stu- 
 dent of human nature, to mark the peculiar feelings 
 which existed between them. It was a mingling of 
 parental and filial tenderness, with those friendly feel- 
 ings that may spring up between equals in age, from 
 respect for each other's talents and hearts. They had 
 much influence over each other. Louis persuaded 
 Jackson to give up his intended visit to Germany. 
 Jackson would, by his ingenuousness, lead Louis to 
 lay before him the whole feelings of his heart. His 
 young zeal, guided as it was by a philosophical mind 
 and pure heart, served to animate even his master. 
 
 Louis, I have said, had much influence upon Jackson 
 in exciting him to continued ardor in his profession, 
 and as member of the Society for Medical Observation, 
 of which he had become one of the original associates 
 at the special request of Louis. This society, of which 
 my friend was a most active member, is composed of 
 young physicians in attendance upon the Paris hospitals 
 and of Louis who is President for life. The object of 
 the society is to make good and careful observers of the 
 phenomena of disease, and by their united exertions they 
 hope to benefit the cause of medicine. They hold their 
 meetings every Saturday evening. One or two cases 
 or observations are read and placed in the archives of 
 the Society. After a case has been read, each mem. 
 ber has a right to criticise it; and generally the rod is 
 applied with great severity and yet all is harmony. 
 Every individual is supposed to be a more ardent ad- 
 mirer of truth than of his own works. Consequently, 
 each takes his brother's remarks with kind feelings. 
 ]4 
 
210 REMINISCENCES 
 
 Jackson did much wood to the Society by the many 
 observations he presented to it, and by his criticisms 
 upon those of otiiers. He seemed quite to forgot that 
 Jie was speaking a fortjign tongue, but attacked and 
 replied witli great fluency. 
 
 During six months after his return, Jackson visited 
 daily the wards of LaPitie under the charge of Louis ; 
 he never failed to go there in the afternoon, after hav- 
 ing passed sometimes three or four liours in the usual 
 morning attendance. Sometimes this afternoon visit con- 
 tinued from one until five or six P. M. ; often did he re- 
 main until long afttr dark, and he frequently spent one 
 or two hours in endeavoring to learn fully the history of 
 one patient. Nothing restrained him ; the elements 
 had no influence over his spirit on these occasions ; but 
 onward he pursued his career — always hoping, always 
 animated by a holy love of his profession, and an eager 
 desire of coming at truti). We often thought he exert- 
 ed himself too much, but he smiled at our fears 1 
 well remember one afternoon, about five P. M. that after 
 having already made two visits he started again for La 
 PiMe, after having attended Andral's lecture at the School 
 of JVIedicine. 1 accompanied him. His step was elastic 
 and full of buoyancy, but his cheek was pale and his 
 countenance thin. He passed rapidly through our often 
 trod paths and when near the great entrance gate of La 
 Pitic, he suddenly exclaimed," If I did not feel so vve!l 
 I should think I had a pleurisy, so severe a pain is there 
 at this moment in my side.*' He however made his 
 visit 
 
 We often walked together in the Garden of Plants 
 and in the vicinity of Paris, and on these occasions our 
 
OF JAMES JACKSON, JR. 211 
 
 conversations were mostly upon medical topics, but very 
 frequently they were upon other subjects, " When 1 
 meet a stranger I always shmo my colors,'' said he to 
 me on one of these occasions. " T tell hitn all I feel 
 and thus I persuade a man to open his heart to me — 
 and in this way I have gained many sincere friends, 
 whilst youj by pursuing an opposite course, have not. 
 How much pleasure have I enjoyed which you have ne- 
 ver felt!" His remark reminds me of two great pecu- 
 liarities of his mind. I allude first, to his power of 
 winninof the confidence of those connected with him 
 so far as to learn their sentiments upon almost every 
 subject, and second, to his frank manner of telling his 
 friends their faults. A young gentleman of great talent 
 was residinar near him while in Paris, and mv friend 
 was much annoyed at the waste of opportunities which 
 this gentleman was guilty of. At length he spoke very 
 plainly to him, and I was very mucli amused at the 
 naivete of the young man as he related the interview 
 he had just had with Jackson. " I never was so severely 
 scolded in my life as I was last evening by your friend 
 Jackson. He told me that I ought to be ashamed of 
 wasting my time, talents and opportunitj' as I was doing 
 and that I ought to be up and studying something. I al- 
 most felt inclined to be angry, but in truth I could not, 
 for everything he said was expressed in such words, 
 that 1 found it impossible to be provoked." 
 
 If to any one the beautiful epithet of the ancients, 
 " pius" could be applied, I know of no individual more 
 worthy of it than Jackson. No one I ever knew, reve- 
 renco(' his parents as he did His heart seemed too full 
 of deep feelings when speaking of his fcither; he could 
 
 * 
 
212 REMINISCENCES. 
 
 not express them. " If there be any one thing truly 
 delightful to me," said he one day when we were stroll- 
 ing in the Garden of Plants, '' it is this : I feel as if 
 since my arrival in Europe I have done all, ay, more 
 even than my father ever hoped I would do. I have 
 given him much true pleasure 1 am sure from the kind 
 letters 1 receive from him daily." It was quite wonder- 
 ful and delightful to see how this intense love of his 
 father influenced every action of his life. Often did he 
 say '' I did not so because I knew my father would not 
 
 wish me to do it." Again ; " Come, , and hear a 
 
 part of the delicious letter I received today from my 
 father." The slightest hint from his parent was enough 
 to create intense pleasure or pain in his bosom. I re- 
 member perfectly his strong expression in relation to a 
 letter received in answer to his request to be allowed to 
 visit Germany. The father expressed regret at the idea 
 that his sojourn in Europe would be lengthened. Jack- 
 son's eyes glistened when he said to me — " I seized 
 my pen and wrote back immediately to my father, tell- 
 ing him I was on my knees, imploring him to forget 
 my request." 
 
 He many times spoke of the pleasure he experienced 
 whenever Andral,the greatest Professor of the Medical 
 School in Paris, coincided in the views advanced by his 
 father in relation to certain points in medicine. 
 
 Walking one day through the yard of La Pitie togeth- 
 er, we met one of the sisters of charity who was a nurse 
 of the hospital. Her face was beaming with mildness. 
 " There," said he, " is a face I dearly love to look upon. 
 I watched the bearer of it durincf the fearful times of 
 the cholera; I saw her devotion to the dying and the 
 
OF JAMES JACKSON, JR. 213 
 
 dead, and now I dearly Jove to look upon her, for by 
 doing so I am always reminded of home." 
 
 These strong feelings of attachment to his family, his 
 deep sympatliy in their joys and sorrows sprang too 
 fretily from his pure heart to need any separation from 
 them to have them heightened. xMost j ersons are not 
 fully sensible of the blessed joys of home until separat- 
 ed from them. Jackson,! am sure, always felt most 
 sincerely the holy relation of a child to a parent, of a 
 brother to a sister. But though it was not necessary U r 
 him to leave his father's hearth in order to learn to 
 value it, still he did have his affectionate feelings excited 
 in the strongest degree by this separation and by the 
 union which he formed with the gified minds and sym- 
 pathising hearts he met in Europe, but he always looked 
 homeward as to his place of joy and of ultimate rest. 
 
 " ," said he to me one day when on one of our 
 
 accustomed walks in the environs of Paris, " , if 
 
 there is one circumstance I hope for more than all else, 
 it is that I may be allowed to die at home among my 
 own family." God be praised, his wish was graated. 
 The hands of those dearest to him ministered to him in 
 his last hour, and from society arose the voice of weep- 
 ing as his light went out. 
 
 While in Paris I never heard any one who did not 
 speak kindly of him j he won all hearts The patients 
 of the hospitaV whom he visited twice a day loved him 
 very much He spoke kindly to them, and if any were 
 in distress, hid purse was like his heart, open for their 
 relief. Many pleasant questions were asked about the 
 " jeune Americain," when I returned from England 
 afler Jackson's return home. How attentive, too, was 
 
 ft- 
 
214 REMINISCENCES 
 
 lie to all of lis during illness ! — or when in anxiety Iiow 
 full of sympathy ! how expressive his eye and his words 
 of kindness ! I could appeal lo some and they would 
 tell nie how well Jackson understood the proper mode 
 of giving consolation to them in suspense or deep grief. 
 He possessed much of that quality which Mrs Sigourney 
 describes as almost a peculiar attribute of woman, 
 " the very poetry of tenderness, breathing not speaking 
 a knowledge both when to be silent and when to speak." 
 1 delight in dwelling upon this part of the character of 
 Jackson, for I think it useful. VVe are too apt to decry 
 this exquisite sensibility ; we think it incompatible with 
 highly intellectual merit, but Jackson is a noble refuta- 
 tion of this assertion. 
 
 As love and respect for the Deity are nearly connected 
 with holy feelings towards man, I shall now speak of 
 Jackson's religious sentiments. 
 
 Deep and holy was his love of the Deity and right 
 reverently did he worship him. His was no time serv- 
 ing worship: it was a continual stream of gratitude. — 
 During the first yrar he spent in Paris he was a regular 
 attendant upon the Unitarian Church, under the direc- 
 tion of an Engli.'^h Dissenter. About this time he spent 
 certain hours in writing commentaries upon the bible. 
 This chuich ceased just before his return from En- 
 gland. But is it necessary to be at church in order to 
 feel one's heart glow with gratitude for God's goodness ? 
 Oh no! Jackson never had a day [)ass without feeling 
 his reliance upon iheal! vvise and benevolent Deity who 
 rules all. Speaking to me one day he said, " I have 
 tried much not to do so ; I have made it often iu the 
 mc:r-ing the subject of prayer to the Deity." He used 
 
OF JAMES JACKSON, JR. 215 
 
 to say he was first led to think seriously and act from 
 principle by the perusal of Milton's Paradise Lost while 
 in college. When in Paris we both attended the lectures 
 of the eloquent Jouffroy f and from him he learned more 
 fully to analyse his own mind, and to see in what happi- 
 ness consists in this world, and the next. He made up 
 his determination to strive in this lower world to fit him- 
 self for a future one, that would be purer and grander, by 
 cultivating to the utmost his intellect and his affections. 
 , I cannot pass over his ardent love of the beauties of 
 nature. When travelling among the Highlands of Scot- 
 land, and he had reached the shores of Loch Katrine, he 
 was very much excited. I fear some would have 
 thought him too warm in his enthusiasm when they 
 know that after having remained some time at this spot 
 which, bv its own native beauiies and the poetry of 
 Scott, has become a shrine to which many pilgrims bend 
 their steps, he left it, and passed over the surrounding 
 mountains, but the desire for return was so great, that 
 suddenly he began to retrace his steps, and again sought 
 the far-famed place in order to gather in a now store of 
 those holy influences which Nature sheds upon any 
 true lover of her beauties, at the foot of Loch Katrine. 
 The return of Jackson would be called extravagance 
 by many, nay, downright folly ; but no : it was a 
 hio-h and ennobling love of nature ; it was natural reli- 
 gion that brought him once more back to this fair spot 
 of God's earth, in order to offer with more fervent feel- 
 ings his prayers to the God of Nature. Smile not, then, 
 
 * See Note -2. 
 
216 REMINISCENCES 
 
 at the enthiisiasm of Jackson. It would be well for all 
 of us, if we could like him, 
 
 •' Find tongues in trees — books in tiie running brooks — 
 Sermons in stones, and good in everything." 
 
 " ," said he to me when I was speaking of my 
 
 intended journey into England and Scotland ; *' Go to 
 Loch Katrine, it is worth everything else you will find 
 in Great Britain." He wore always, when in Paris, a 
 breast-pin composed of two stones gathered, as he told 
 me, from the two spots which had interested him the 
 most deeply — Mont Blanc, and Trenton Falls in 
 America. From nature he drew consolation and sup- 
 port. The opening flower excited in his glowing 
 heart sweet and kind thoughts which he brought back 
 into the world in his intercourse with it. From the 
 massive and sublime scenery of our own country and of 
 Switzerland, lie gained vast conceptions of the Deity. 
 He was then a true lover of nature. He proved in his 
 own person thnt a deep, holy, even a romantic love of 
 it, is not inconsistent with the perfect fulfilment of 
 all the duties incumbent upon him as member of society, 
 and of the highest intellectual acquirements. 
 
 Allied to the love of Nature is that of the fine arts. 
 Jackson could almost worship a Madonna of Raphael; 
 and his sense of the beautiful in music was exquisite. 
 There are some who knew how much he depended 
 upon music for his recreation in Paris. The sad and 
 soul-subduing air of Weber's last thoughts when played 
 with taste would make his tears flow. 
 
 But perhaps it will be allowable for me to hint at what 
 he gained in his profession during his sojourn in Paris, 
 
OF JAMES JACKSON, JR. 217 
 
 and especially during tlie last six months of his slay. 
 A gentleman who has been long in the profession, one 
 who is highly respected by his brethren and the com- 
 munity at large, said to me one day — '• I know of no 
 person who is his (Jackson's) equal in the diagnosis of 
 disease, and I make no exceptions either from among 
 the young or old, when I say that James Jackson knows 
 more about disease than any man in the community.' 
 This may seem extravagant, but he who made the 
 remark, knows too well the criterion by which medical 
 merit is to be judged of, to make a mistake. I fearlessly 
 say, Jackson had gained powers of recognising diseases 
 in their early stages, wliich were wonderful. I have 
 been eye witness of one case, at least, in which he dis- 
 cerned commencing consumption before Louis did. He 
 attended much to auscultation and percussion, and 
 pointed out important circumstances to be attended to in 
 their application to diseases of the lungs. One of these, 
 Louis mentioned several times during the course of 
 clinical lectures delivered by him during the winter 
 after the departure of Jackson; he always alluded to 
 our friend as the one who first pointed it out. 
 
 At length the hour for his leaving Paris arrived. It 
 was one of deep feeling for many. He had already 
 taken leave of his well loved instructor, being satisfied 
 he could not do so at the last moment. Few friends 
 were with him as he was too much overcome by their ap- 
 proach. He felt that he was leaving, perhaps forever, the 
 spot where he had passed many happy, profitable hours ; 
 he had seen for the last time, one who had been to him 
 as a dear father, when separated from his parents and 
 family ; he had set his eyes for the last time upon the 
 
21S REMINISCENCES 
 
 friend who fiad pointed out to liini witii tender interest 
 a high and noble way of pursuing what Jackson es- 
 teemed the noblest of all professions, and who had 
 breathed into his soul that same ardent love of truth 
 which animated himself; he had parted from his " sec- 
 ond father." Tlius terminated the intercourse of Jack- 
 son with Louis. I met Louis in 1834, soon after the 
 news of Jackson's death had reached him. The worthy 
 professor's voice choked as he spoke of his young friend, 
 the " poor young man." He could hardly utter the 
 words "poor Jackson." His tenderness of manner 
 towards me as friend of his friend 1 shall long remember. 
 " Adieu, my dear," said he, " and yet I dislike to say 
 the word, for perhaps we shall never see each other 
 again." 
 
 Jackson took his way towards England, in order to 
 make his farewell visit upon his beloved friends of 
 Great Britain. 
 
 He sailed, and arrived in happiness and health, and 
 in the bosom of his family, he drank his cup of joyous- 
 ness. I saw a letter written soon after his return. 
 Every word teemed with dear affection towards his 
 father and his family; beautifully simple were his ex- 
 pressions, and full of pure, almost child-like delight. 
 
 Not many weeks after his return, having been 
 intensely occupied in his profession, — he fell ill with 
 fever, and I doubt whether he did not receive then his 
 death blow. But he recovered, in some measure, and 
 on his convalescence, he wrote me pirt of a letter, 
 which afterwards was sent unfinished as he had left it. 
 1 give below the translation of most of it, leavinor out 
 merely a few sentences, which would be uninteresting 
 to a general reader. It was written in French. 
 
OF JAMES JACKSON, JR. 219 
 
 " Boston, Febbuahy 27, 1334. 
 
 MY DEAR 
 
 Do you wish me to commence with excuses for not 
 having written to you previously ? No, 1 am sure that 
 your kind feelings towards me are so great that you 
 will readily excuse me, as I have recently been ill. I have 
 just received yours of January 4, and for it 1 return you 
 many thanks although it is written in a barbarous tongue 
 instead of the beautiful French you still have the hap- 
 piness of speaking. I have received likewise two more 
 letters from you. One of them 1 did not see for some 
 days, as at the time of its arrival my health did not allow 
 of my reading; in fact I could not have understood your 
 pathological morsels. I thank you most sincerely, and 
 I thank all my Paris friends for the kind sentiments they 
 had toward me during my illness. I shall never forget 
 
 the interest they have taken in me. But, my dear 
 
 you cannot conceive of the extreme debility of one af- 
 fected with typhus fever, nor of the delirium which 
 brings up before the mind reminiscences the most 
 strange and inconsistent, the weakness of intellect which 
 comes on after convalescence, which excites in the pa- 
 tient a fear that he will never be able to pursue his pro- 
 fession. 1 will tell you something of all these if you 
 would like to have me do so. After spending a month 
 (during the prevalence ol" typhus) and having observed 
 many cases of the disease; after I had made examina- 
 tions of eight or ten bodies, and two days after having 
 
 watched with young ■ I began to feel rather ill. 
 
 At first I had pain in the head on rising in the morning, 
 with a little vertigo. The day on which these symp- 
 toms first appeared, I made two examinations, one of 
 typhus the other of cancer. I found that 1 was much 
 
220 
 
 REMINISCENCES 
 
 more fatigued than usual, and I suffered very much 
 from pain in the back. On the same or the next day I 
 lost completely my appc^tile, » * * I experienced much 
 debility and an indisposition to undertake my usual occu- 
 pations. This was 2'vd of October, and in the evening 
 the pains were still more eevere. I thought immedi- 
 ately of typhus, but I was unwilling to believe that 1 
 was about to liave that affection. That night I passed 
 most wretchedly, in terrible dreams and great restless- 
 ness, &c. For three days I was very nearly in the same 
 state, always out and about my various engagements and 
 yet in doubt whether 1 was going to be really ill. In 
 fact as it seemed to me, until the 2Gth, and even on the 
 morning of that day my symptoms seemed to decrease. 
 I breakfasted with a tolerable appetite and afterwards 
 went to the hospital, but after spending a half hour there 
 I felt too ill to finish the visit. I returned home. * * 
 In the evening 1 found my pulse accelerated, my skin 
 hot. 1 no longer doubted, and my father had already 
 become satisfied that the disease was typhus fever. 
 Here I was, fully taken with a disease, the many sad 
 cases of which I had seen in Paris, I did not then 
 forget 1 assure you. Towards evening of the next day 
 I begged my father to bleed me, and he did so to eigh- 
 teen ounces. From that moment, of more than three 
 weeks I have lost entirely all recollection ; my weak- 
 ness increased daily, so that very soon the attendants 
 were obliged to lift mo from one bed to another and to 
 turn me from one side to the other ; I could do nothing for 
 myself. I had alternately delirium and stupor. 1 dreamt 
 of everything. Frequently I was at Paris; and was mak- 
 ing a visit at La Pitic. 1 was dining with M. Louis at 
 
OF JAMES JACKSON, JR. 221 
 
 the Palais Royal, or was walking with him through 
 the streets of Paris. One night 1 exclaimed, it is 
 all over, I shall die tomorrow. Almost the last circum- 
 stance I remember clearly was that 1 was suffering from 
 very severe pain, so intense that I thought I was going 
 
 to die instantly ; I shrieked aloud, and begged 
 
 who watched with me to call my father, after having 
 given me some laudanum. My father soon appeared and 
 I observed on his countenance an expression such as I 
 had never seen it bear before and may the good God 
 grant that I may never see it again. I immediately per- 
 ceived his suspicions. He seized my arm; my pulse 
 was not more accelerated than it had been on the evening 
 previous. He gave me this information and immediately 
 his features began to resume their natural expression. 
 Except during this night I never suffered anything but 
 very trivial pains, until my appetite began to return very 
 gradually about one month from the beginning of the 
 attack ; then 1 began to wish for food, and I had 
 pains in the limbs which almost made me shriek aloud. 
 The spots were very abundant, rose colored and of an 
 elliptical shape over the whole body ; I had two crops 
 of sudamina — more copious than I had ever seen be- 
 fore. The last one was at tlie time of convalescence, so 
 that I was able to enjoy the sight of them. During the 
 few days at the commencement of the disease whilst I 
 possessed my reasoning powers, I told my father I 
 experienced a troublesome sensation in the abdomen, in- 
 dicating for myself that the seat of the disease was 
 there. It was a kind of pleasure to know by actual 
 sensation the truth of what has been discovered by our 
 honored master, and the proof of which rests upon ex- 
 ternal evidence. 
 
222 REMINISCENCES 
 
 But if you cannot understand the misfortune of being 
 entirely dependent upon others, of being incapable of 
 making any efforts for yourself, of being deprived at 
 the same moment of the use of mind, of muscles, and 
 of internal organs, of everything in fact which com- 
 poses the physical and moral being; of being placed 
 upon the back during three or four weeks without being 
 able to turn from one side to the other, dying with thirst 
 without having the ability to procure water, and suf- 
 fering a thousand little inconveniences from continuing 
 too long in one position, &c. ; neither do you know the 
 delights one experiences from the constant and unwea- 
 ried kindness of friends to us while ill ; the pleasure of 
 observing one's self watched with anxiety by those 
 from whom one has no right to expect such friendship ; 
 of finding those to be our true friends whom we thought 
 to be mere acquaintances ; neither can you have any idea 
 of the paradise produced by a few flowers in the sick 
 chamber, or by a little daylight, or by new faces after 
 one has been deprived for some time of the light of day, 
 of the company of friends and of everything which this 
 world produces, which is so full of interesting objects. 
 I am sure that it must rarely happen that a traveller even 
 in Italy can be so much excited by the sightof the beau- 
 tiful paintings in that country as I was when looking at 
 the St Bernard dog which M. Louis had presented me. 
 My box containing it arrived during my convalescence 
 and my happiness was almost too much. 
 
 Have the goodness, my dear , to express to 
 
 the society my thanks for the interest it feels in me. I 
 am well pleased that it goes on prosperously, for I am 
 convinced that it is the bestof schools, and that M.Louis 
 would do a great service to the world if he could collect 
 
OF JAMES JACKSON, JR. 223 
 
 in it young men from every civilized country of all 
 
 quarti^rs of the globe. You tell me that is quite 
 
 well, but I should doubt much whether he is entirely 
 out of danger. Please write to me more particularly 
 about his health, 
 
 I shall tell you nothing about what I discovered in re- 
 lation to the fever patients of our city, for I shall write all 
 to M. Louis; in fact I should not have delayed so long 
 writing to him had I not expected to receive a letter 
 from him, but perhaps he has written to me, though 
 I have never received anything. 
 
 I will now tell of a case which I know will be inter- 
 esting to you, and ifyou wish you may read it to the 
 
 society. You doubtless remember the carpenter, 
 
 aged about 35, who was at our hospital many times, who 
 had his left side contracied and an aperture communi- 
 cating with the cavity of the chest near the edge of the 
 ribs" 
 
 Here the letter abruptly closes and probably Jackson 
 did not write much afterwards, as six days from that time 
 his last illness came on. 
 
 He had just met all his friends around his father's 
 table to congratulate him on his happy return to health. 
 The finger of God pressed upon him even at that hour 
 of hope and rejoicing ; and he soon died. 
 
 Thus did this pure, and generous spirit take leave 
 of us. And who was there among the community who 
 did not feel the loss society had sustained ? The ways 
 of Providence aie inscrutable; sometimes almost in- 
 comprehensible. So it seems to many that the death of 
 our friend is. He had just entered upon the active 
 
224 REMINISCENCES. 
 
 duties of a noble profession, well prepared for the prac- 
 tice of it by the great acquirements gained wliile in 
 Europe. He brougijt to this dear object of his life, his 
 whole soul, burning as it was with a love of truth. But 
 he had a nobler aim than eminence in his profession. 
 Jackson's feelings were too elevated to be satisfied with 
 merely earthly ambition. His object was to ennoble his 
 own nature; or, I should say, he felt most deeply the 
 nobleness of man's nature, and he was satisfied that we 
 are placed here for intellectual and moral improvement, 
 and he therefore strove, by the cultivation of his intel- 
 lect and of his affections, to gain this end. 
 
 Jackson was one to lead mankind, not to follow its 
 dictates. And why was he taken away if thus able to 
 direct mankind ? He knows little of human nature, 
 who is not sensible how much good, nay, absolute 
 happiness, is produced by God, even in his most dread- 
 ful decrees. How many are led to think more seriously 
 upon the high destiny awaiting them, if they be true to 
 themselves.* 
 
 Regarding man as placed in the world for his own self- 
 development, Jackson was ready to leave us. His was 
 an early growth, but it was a rich one ; and he has left 
 behind a pure, a noble example for his friends, his young 
 associates in medicine to look to. Long will his mem- 
 ory live with those who knew him, even when they 
 have ceased to weep at the mention of his name. 
 His zeal will recur to them in every act of their lives ; 
 and in the hour of sickness and of trial, his kindness of 
 heart, and powers of giving consolation will come up 
 before them like the visions of past joys, " sweet though 
 mournful to the soul." 
 
 ♦ Sec Note 1 
 
NOTES. 
 
 Note 1. 
 
 1 cannot forbear publishing the following, which was 
 written by the same friend who penned the character of 
 James published in the Daily Advertiser (page 99). He 
 has gone now to assert his " claim to the friendship of 
 Jackson in heaven." The death of this young man was 
 as striking and mournful as that of my friend. iNay, for 
 some reasons it was more deeply touching. Some one 
 will ere long I trust portray before us, his fellow pilgrims, 
 the beauties and energies of his fair character. I would 
 merely state that having been failing in strength for some 
 weeks, he by medical advice went to visit his friends in 
 New York. Arrived there, he was not improved, though 
 he did not suffer, but his strength diminished daily. One 
 day he rode out with his mother ; he returned, 
 " And sinking — passed away." 
 
 Concord, June 17. 
 Dear Sir — Dr Jackson has been so kind as to send 
 me the memoir and letters of James. I could not have 
 believed that the book would give me the feeling 1 have 
 
226 NOTES. 
 
 had while reading it. I am ashamed to confess that it 
 has enlaiged my idea of the character of my friend. 
 To be sure, I had no means of judging of liis professional 
 attainments; but I ought not to have suffered the trans- 
 parent simplicity and candor of his mind to have de- 
 ceived me as to its depth. My only excuse is that as 
 Goethe, I be lieve, said of his friend Schiller, " he grew 
 go fast, he strode forward with such rapidity that if you 
 failed to see him f<)r a little while, you were surprised 
 to find how far advanced he was beyond the ground on 
 which you had expected to meet him."* 
 
 Especially is the religious tone of his letteis different 
 from what I had supposed. The recognition of God is 
 more constant and distinct. From what he himself said 
 when he told me that he had been wholly absorbed in 
 other studies, that beyond iiis conviction of moral obli- 
 gation all his faith was yet to be formed, that he wanted 
 to study religion as a science; — I foolishly supposed, 
 his thoughts had been unexercised about the relation of 
 man to God. I did not enough allow for his singular 
 modesty and frankness, nor for the rigorous discipline 
 which he was wont to prescribe to himself in any study. 
 1 now see that he was impatient of lingering amongst 
 the first principles of the Christian faith, and desired 
 intimately to know and receive it. 
 
 Do not misunderstand me. I did not imagine him 
 irreligious; but I thought his religion was more uncon- 
 scious, that like the sunlight of his beautiful temper it 
 
 * The quotation above given is not exactly correct. " He strode 
 farward with awful rapidity. If 1 was a week without seeing 
 him, wlioa we met [ was astounded and knew not where to lay 
 hold of him, I found him so much farther advanced." — OoUke's 
 C(fnDCrsations with Felix Mendelsonhe. 
 
NOTES. 227 
 
 was more a " life of God in his soul" than anything 
 that had been with him the subject of reflection. 
 
 I am glad, very glad, this book has been made. Such 
 a monument was owed to him ; and to all of us who 
 are consoled by it and instructed what manner of per- 
 sons we must be if we would assert our claim to his 
 friendship in heaven. 
 
 Very sincerely, 
 
 Your friend and servant, 
 
 Chas. C. Emersox. 
 
 The above letter was the first one I ever received from 
 Emerson, and it was written in consequence of an argu- 
 ment we had held in relation to the character of Jackson, 
 during which I stated that I did not think my friend's 
 most important qualities were appreciated by the com- 
 munity — that he had grown vastly in consequence of 
 his sojourn in Europe, and that he had had no opportu- 
 nity of showing the capabilities of his spirit. Emerson 
 did not agree to this assertion, and like almost every one 
 else was delighted and at the same time surprised when 
 the memoir appeared. 
 
 Note 2. 
 
 Theodore JoufFroy is at present about forty years of 
 age, and is Assistant Professor of Modern Philosophy at 
 the Sorbonnein Paris. He believes all forms of religion 
 to be developments in the human mind of that principle 
 which exists in all and teaches men to look for something 
 better, holier, grander than can ever be found in this world. 
 Christianity he regards as the most perfect form ever yet 
 
22S NOTES. 
 
 exhibited to the world. He is a man of great eloquence. 
 His language and manner are beautifully simple. His 
 powers of reasoning are very acute — his arguments 
 well planned. I never shall forget his lecture on the Im- 
 mortality of the Soul. It was, at that time, like balm to 
 my spirit. With in two years he has been appointed to 
 a professorship in the College of France, and is becom- 
 ing every day more popular with the young French stu- 
 dents. They crowd his lecture room. They are inter- 
 ested in his discussions on the most sublime topics of re- 
 ligion and morals. They talk of them afterwards. I 
 consider France as in the process of regeneration. The 
 country underwent a total overthrow of all religion du- 
 ring the horrors of the revolution, but no w it is reviving. 
 Religion is natural to man, and France led on by her phi- 
 losophers, will ere long stand in the foremost rank as a 
 supporter of Christianity. By Christianity I mean not 
 any opinion of a sect, but the development of the princi- 
 ples of Christ which for eighteen hundred years have 
 made so small advances compared with what they are 
 destined to make, and will make when they are rightly 
 understood. 
 
 Erratum. —Page 199, line 10, for telescope read stethoscope. 
 
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