W 9 J13b 1880 
 UNIVERSITV OF CALIF0BNI4, SAN DIEGO B 
 
 3 1822 01066 9224 
 
 i.r 
 
 ilPiin
 
 
 ^M
 
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 JSIfirh M.?h in MpbirinF 
 
 WITH 
 
 ANNIVERSARY ADDRESS 
 
 BY 
 
 JOHN D. JACKSON, A.M., M.D 
 
 Member of the Kentucky State Medical Society; formerly Vice-President of the 
 
 American Medical Association; Honorary Mrmhrr of the California 
 
 State Medical Society and of the Obstetrical Society of 
 
 Louisville; Corresponding Member of the 
 
 Gynwcological Society of Boston, etc. 
 
 EDITED BY 
 
 L. S. McMURTRY, A.M., M.D 
 
 CINCINNATI 
 
 ROBERT CLARKE & CO 
 
 1880
 
 The Black Arts in Medicine was originally published 
 in pamphlet form for private distribution by the au- 
 thor, the late Dr. John D. Jackson, of Danville, Ken- 
 tucky, 
 
 The highly commendatory notices vs^hich the work 
 received from the press ; the numerous demands made 
 for it by members of the profession throughout the 
 United States; together with a valued friendship for 
 the author, have induced the publishers to issue this 
 second edition in more substantial form. It is believed 
 that the subjects discussed herein, though furnishing a 
 familiar theme to medical writers and teachers, have 
 never before been treated in such attractive and pleasing 
 style. 
 
 An address delivered upon an anniversary occasion 
 has been deemed by the editor a worthy companion 
 of the essay on the Black Arts in Medicine ; and, with 
 some unimportant alterations, is appended.
 
 '|p Plarl^ Kxh in ^pbirinp, 
 
 Probably, there is no triter axiom in our language 
 than, that " self-preservation is the first law of our 
 nature." Probably, there has never been a nation 
 whose civilization advanced to the construction of 
 even a rude form of pliilosophic thought among its 
 people, but has liad current in its society, an adage 
 embodying under some form, the same idea. One 
 of the most powerful and beautiful arguments of an- 
 tiquity endeavoring to prove the existence of a su- 
 preme intelligence in the creation of man, which 
 has come down to us, is in one of those Socratic 
 dialogues, in which the different members of the 
 body are considered with reference to their respective 
 functions, each being shown to be so admirably 
 adapted to the preservation of the integrity of the 
 entire being. This primal law is so plainly deline- 
 ated on the face of nature, that it would be wonder- 
 ful had it not been so commonly seen. But, while 
 
 vvc all admit this prime fact, the whole world does 
 
 C5)
 
 6 mn JJlacfe ^rts 
 
 not so clearly see its corollaries. There are a 
 thousand streams of human action, meandering 
 through the shadowy coverts of the social life of 
 the world, which when traced up to their fountain, 
 are seen to spring from this principle. 
 
 The great struggle for life, is indeed not that of 
 the present living world alone, but in the ages of 
 the past, as revealed to us through geological dis- 
 coveries, traces of a universal war for existence, 
 are as plainly marked, as in the living world of to- 
 day. 
 
 This instinct in man, as the highest reasoning 
 animal, exhibits itself under a somewhat different 
 phase, to the form of it developed in the brutes ; 
 for after exhausting all natural aids, the principle 
 of preservation causes him to appeal to the super- 
 natural for assistance. That carter of classical 
 fable, who when his horses failed him, appealecj to 
 Hercules for help, is but a type of the actual man 
 of the world of all ages, past and present. 
 
 To this principle, we owe the superstition of our 
 nature, a superstition, which at one time or another, 
 has infused itself into all three of the learned pro- 
 fessions, and more particularly into our own, in 
 which to-day, a close scrutiny will show a few lin- 
 gering traces. 
 
 Until a few centuries ago, the Black Arts were
 
 intimately interwoven into the fabric of medical 
 practice, so that it would have been perfectl}' in ac- 
 cordance with the spirit of truth, to have para- 
 phrased the inscription common over the doorways 
 of the Pythagorean Schools of Philosophy in an- 
 cient Greece, which read, " Let no One Igno- 
 rant OF Geometry Enter Here," and have in- 
 scribed over the archway opening into the Temple 
 of Medicine, Let no One Ignorant of Astrol- 
 ogy Enter Here. 
 
 The doctor of the period, commenced his pre- 
 scription with an invocation to Jupiter, and the 
 *' split-foot R," with which we of to-day commence 
 ours, is but the astronomical sign of that planet 
 somewhat distorted in its journey down to us through 
 ages, as any one can ascertain for himself, who will 
 take the trouble of consulting a modern quack al- 
 manac, for the original sign. Then, the apothecary 
 gathered his simples according to rule, by the wan- 
 ing and fulling of the moon ; then, the physician 
 consulted the twelve signs of the Zodiac, and pre- 
 scribed and prognosticated as Taurus, Gemini or 
 Cancer, were in the ascendant: it was then, that 
 having failed to cure by the use of such disgusting 
 farragoes, as would certainly require some ingenu- 
 ity in a physician of novv-ada3^s to conceive, that 
 the doctor would resort to prayers, charms, and
 
 8 JKfte BlacU ^rts 
 
 verses. If any one will consult the dXOBtl ^XXC^iltU 
 
 of John of Gaddesden, an authority of repute in 
 the 14th century, he will find him full of these 
 charming verses. If he will turn to his chapter 
 De Passio7iibus Auriiim* he will find that after 
 recommending " Urina tauri et ca-pri inveterata f 
 and centaury, wormwood, rue, ants, earth-worms, 
 and eels' blood boiled in wine, which he says is 
 without an equal in the cure of deafness, he will 
 find him concluding by giving him a string of verses, 
 which he declares are frequently the very best cure. 
 It was in these times that amulets and charms were 
 worn, and philters and phylacteries prescribed, and 
 the saints appealed to as presiding over special dis- 
 eases, e. g., St. Anthony over inflammation, and 
 particularly the Erysipelas, which, as we know, is 
 called St. Anthony's-fire to this day; St. V^tus 
 against madness and poisons, and at present we 
 know Chorea as his dance, in the cure of which he 
 was especially appealed to ; St. Erasmus was called 
 upon for the cure of colic ; St. Martin invoked against 
 the itch ; St. Phaire against hasmorrhoids ; St. 
 CLuentin, coughs ; St. Benedict, the stone ; St. John 
 against Epilepsy, and so on through the calendar. 
 
 * Rosa Anglica — Imprint of Bonetus Locatellus. Venici, 
 1516, p. 115.
 
 It was then that Bezoars were sought after, and 
 that moss from the skulls of dead men was pre- 
 scribed, and the thigh bone of a criminal powdered, 
 was as a remedy, held in high repute ; and then it 
 was, that the blood of vipers, the expressed juice 
 of millipedes, the white end of peacock's dung, and 
 other such delicate things were daily prescribed. 
 
 But if we of modern times, living in an age, a 
 characteristic of which is, that it is essentially ma- 
 terial, can congratulate ourselves that necromancy 
 is no longer a part of regular medicine, that the 
 doctor of to-day is not expected to be a magician, 
 that familiarity with the Black Arts is not an inte- 
 gral part of the knowledge of scientific medicine, 
 yet must we in solemnity and shame contemplate 
 the fact, that we have still to-da}'' existing in our 
 profession as Black Arts as any of a past age. It 
 is true that they are not considered to belong to 
 medicine proper — it is true that their practice is not 
 considered characteristic of the true representation 
 of modern medical science, and it is also true, that 
 the practitioners of said arts, are held in supreme 
 contempt and loathing, by all true disciples of the 
 heaven-born calling; but it is nevertheless as true, 
 that at this day and hour, there are not a few who 
 manage to have themselves classed with tiie true 
 disciples, who in secret league with the spirits of
 
 10 SThe mmi ^its 
 
 darkness, cultivate the modern Blach Arts under 
 cover, with the greatest assiduity and skill. And 
 finally, it is furthermore true, that with such, mem- 
 bers of the goodly company whom I now address, 
 are in daily intercourse, and are compelled to meet 
 as equals and honorable rivals nominally, certain 
 devotees whose astute skill, whose dexterous prac- 
 tice, and successful manipulations in the line indi- 
 cated, render them worthy of high positions in this 
 dark department of medicine. 
 
 The overcrowded state of our profession, the eas}'' 
 admission without proper preparatory learning, or 
 inquiry into their moral fitness, of all desiring to 
 enter our ranks, has much increased the numbers 
 of those who are least fitted by mental and moral 
 training to resist the temptations which beset all of 
 us in our professional rivalry, in our efforts at self- 
 preservation, in our struggle for existence, in ful- 
 fillment of the first law of our nature ; and thus it 
 is, that the land lies fallowed, favoring this luxuri- 
 ant crop of tares. 
 
 In a sentence, the spirit of materialism which 
 rules the age, has destroyed reliance on divinations, 
 incantations and charms, but the same gross spirit, 
 has inspired a reliance on certain ingenious devices 
 for gaining notoriety, and certain modes of acquir- 
 ing the patronage of the world, which while of an
 
 entirely different charncter, are infinitely more re- 
 volting. It must have been from a contemplation 
 of this phase of medical life, that a maHcious Mo- 
 liere of a fellow named Saxby, in a dispute with 
 Dr. Mark Akenside on the dignity of medicine, is 
 said to have replied to him : " Doctor, after all you 
 have said, my opinion of the profession is this : the 
 ancients endeavored to make it a science and failed ; 
 and the moderns to make it a trade, and suc- 
 ceeded." 
 
 While traveling the past winter, there fell in our 
 hands a somewhat curious document, which since it 
 well paints some of the modern phases of the Black 
 Arts in Medicine, we will not apologize for present- 
 ing. How it came into our possession, and the 
 true names of the parties, is nobody's business but 
 our own, sufficient is it for our purpose to read you 
 the following :
 
 12 mu uiacit mvts 
 
 Letter of Dr, Solomon Machiavelli 
 Sharpe, A, 5., A, M., M D,, ^c, 
 &fc,, to "John Charlatan Greene^ 
 M, D, 
 
 My Dear John : 
 
 Your epistle of recent date, has been 
 lying before me 'till now, unanswered. You tell 
 me that to the time of writing, you look on yourself 
 as having been rather unfortunate in the profession 
 which you have chosen ; the world, you say, does 
 not seem to recognize 3-our merits, and that you are 
 neglected, while you see around you men, whom 
 you deem far your inferiors, not only patronized, 
 but in some instances, taken up and much ado made 
 over them. About all of which, you seem much 
 discouraged, and ask now for some advice, as to 
 the means to pursue, by which most certainly to se- 
 cure you business, appealing to me, as " a success- 
 ful doctor, retired after a forty years practice," to
 
 give you the benefit of my experienced observa- 
 tions. 
 
 Now, my dear John, I must say to you, that I 
 look upon your failure as in a great measure attrib- 
 utable to the defects of your professional education, 
 though that as my sister's son, and therefore a gen- 
 uine chip of the famil}^ block, I doubt not, but that 
 time is all that is necessary, to see you of your own 
 innate instinctive developments, after a while 
 " flourish like a green Bay," if not like a " Cedar of 
 Lebanon." I could predict this with certainty, were 
 it not that I know that the blood of the Sharpes has 
 been crossed by that of the Greenes, which, though 
 it may hinder the development of your sharpness, 
 yet I don't think it will prevent the final, though it 
 may possibly be a little slow, maturation of the pe- 
 culiar characteristics of the maternal side of your 
 house. I have never yet known a true Sharpe fail 
 from lack of shrewdness, or from neglecting to 
 make the most of an opportunity, or to be hindered 
 by a weak modesty from boldly pushing his way on 
 every occasion offering. Now, the Greene's I 
 know to have always been more slow to appreciate 
 their own merits, and I suspect that you inherit 
 somethino- of their nature, but I have but little 
 doubt but that after awhile, the opposite traits which 
 you by right inherit, will finally assert themselves,
 
 14 ntht JJlacfe ^rts 
 
 and I know of nothing more calculated to bring 
 them to the surface than to be pushed to the wall, 
 to see as 3'ou say you do, others around you flour- 
 ishing, while 3'ou are starving. Necessity, I have 
 observed, is not only the mother of invention, but 
 among her offspring, we may certainly place the 
 development of those deeply hidden traits of char- 
 acter, which prosperity does not always bring to the 
 surface. 
 
 As I have said before, I attribute your failure 
 to the deficiencies of your medical education. Now, 
 on this point, I hold some views, which are entirely 
 my own, and these are they: 
 
 The shorter catechism of our church declares 
 that " The chief end of man, is to glorify God." 
 If I were to make a medical catechism, I should 
 write first that — the chief end of the doctor is to get 
 practice. Well, in spite of this cardinal fact star- 
 ing everybody in the face, yet I do n't know of a 
 single medical school in the world, bold enough to 
 come out and acknowledge it. What I mean is 
 this, that all the medical colleges, among the nu- 
 merous chairs founded by them, and their name is 
 getting to be legion now, for at some places they 
 will have a professor to lecture to you on the eye, 
 another on the ear, another on the throat, another 
 on the skin, another on the kidneys, and even a
 
 separate lecturer for the pox and clap ; but I do n't 
 know a single college, which among all this array 
 has had the good sense to appoint a man to teach 
 the callow brood, whom they are turning from their 
 doors, with their tender pinions ready to beat the 
 rude blasts of the world for the first time, the noble 
 art of getting practice ; and if asked for a text- 
 book or monograph on this important subject, the 
 one for which all the others were created— why I 
 could n't give you one. 
 
 Now there are two stand-points from which to 
 consider the subject, or rather on a consideration 
 of it, there are two phases presented to view. 
 
 Firstly, a man can acquire the confidence of his 
 professional brethren and the patronage of the pop- 
 ulace, by the possession of a thorough knowledge 
 of his calling, by being a really learned man in 
 his profession, knowing, and capable of applying, 
 his knowledge. Some by such possession, though 
 lacking every thing exterior and beyond this, 
 which might be deemed inclined to promote suc- 
 cess, yet succeed. Their success may be looked 
 upon as truly meritorious, for they seem to succeed 
 as it were by the mere force or gravity. Others 
 there are, and I must say that my observation 
 makes them outnumber the former far, who suc- 
 ceed from just the opposite direction. Destitute of
 
 16 mxt Miiitii ^m 
 
 all truly scientific knowledge, mere smatterers, and 
 possessing no great powers at best, they however 
 make up for lack of all real attainments, by the cul- 
 tivation of those little principles of their nature, 
 which to a certain point seem to serve them a good 
 part instead. The same thing you' can observe, if 
 you look around you, in politics. You may fre- 
 quently see the man of true statesmanship and dig- 
 nity, beaten by the shallowest of politicians, but 
 who has cultivated to perfection his bushwhacking 
 powers of shaking hands, and honeyfuggling "the 
 dear public." 
 
 I believe that the class I have first mentioned, 
 has really an easier time in reaching the goal, than 
 the latter — and this reminds me of an observation 
 I once, in my school-boy-days, heard a fellow 
 make, who was on the eve of graduating. Said 
 he in talking to some of us junior striplings : "Boys, 
 I am about graduating — I have passed my last ex- 
 amination, and am now certain of my Diploma, 
 but I will confess to you all, that I do n't know a 
 d — d thincr about what I have gone over. You 
 fellows, doubtless, wonder how I have managed to 
 get through ; well, I will say to you, that it has re- 
 quired, I think, about as much study and sharpness 
 to do so by fooling the professors, as would have been 
 equisite to have thoroughly mastered the college
 
 Xn iilctffcinc. 17 
 
 course." As all animals are not endowed bv nature 
 with the same means of self-protection, while some, 
 as the lion and tiger, openly and boldly seize their 
 prey, and attack and defend themselves, others, as 
 the jackal and jaguar, generally do so sneakingly 
 and by stealth ; while others still less blessed with 
 attacking and defensive powers, seem to have all 
 their capacity concentrated in cunning and decep- 
 tion. So have I observed it in mankind, where 
 nature has not done much for a fellow in the ordi- 
 nary way, he seems to sometimes pretty much make 
 it up, by cultivating all the little shrewdnesses of his 
 nature, which then stand him entirely instead, and 
 it is sometimes a wonder how far the intelligent of 
 the public are ready to receive such transparently 
 base counters for genuine coin. Indeed, this weak- 
 ness of the public, I have known sometimes to so 
 overwhelm professional men of merit, that they 
 have yielded to the temptation to utter themselves 
 the readily received counterfeit, rather than con- 
 tinue the painful labors of the strictly professional 
 workshop. 
 
 Quackery does not owe its spread throughout the 
 world, to the defects of medicine as a science, one 
 tithe so much as to the innate weakness of man- 
 kind. Man is certainly one of the most gullible 
 of animals ; though at times straining at gnats, yet
 
 18 5rhe Mntk ^rts 
 
 at others he readily swallows great camels. It is 
 not in medicine simply, that popular credulity lies, 
 it is equally great with reference to the other pro- 
 fessional callings. Do n't you recollect that clas- 
 sical observation of Wallenstein to his son, when 
 doubting his fitness for some mission imposed upon 
 him ? He took him into the council-chamber, and 
 having him look and listen for awhile at certain 
 shallow representatives of the nation's greatness, 
 exclaimed: Observe my son, '■'' qiiani -pauca safi- 
 entia regit mundum." Ever keep this saying in 
 mind, my dear John, a remembrance of it will fre- 
 quently serve you a good purpose, in emboldening 
 you when hesitating — do n't forget the weakness of 
 your enemies, or rather friends, the bt noUoc. 
 
 There 's an old story, which in some form or 
 other, has long been current, telling of a London 
 quack, who was upbraided by a doctor, for his char- 
 latanry, but who justified himself by asking the 
 doctor, of the thousand men who daily passed his 
 office, how many he supposed were really intelli- 
 gent and of sound well balanced judgment ; and 
 upon being answered, probably one in the hundred, 
 replied, "You may have those ten, but I will take 
 the nine hundred and ninety fools for my patients, 
 who for their folly, probably deserve to be quacked 
 upon."
 
 It is related of a certain Scotch 3^eoman, that he 
 always got such good prices for his cattle on taking 
 them to market, that his neighbors were totally at a 
 Joss to account for it, but one day, on fuddling him 
 with liquor, after much cajoling, he finally yielded 
 them up the secret by saying : " On going to sell 
 my beasties, I first finds a fooU and then I shoves 
 'em on to him." 
 
 It is well for 3'ou to hold in remembrance the 
 general fact, that the world is largely made up of 
 fools, John. 
 
 '•'•Mais nous revenons a nos motitofis,''^ which is 
 the way to get a practice. 
 
 Did you ever read the celebrated letter to Timo- 
 thy Van Bustle, which appeared more than an hun- 
 dred years ago, and was at the time attributed to 
 Dr. Mead? Knowing that it is most probable that 
 you have not, I herewith transcribe a part of it for 
 your consideration, for though it is more than an 
 hundred years old, the men of to-day, are descended 
 from those of a century ago. 
 
 ** That which gives me great hopes of you (Dr. 
 Timothy Van Bustle, M. D.), is your resolution to 
 go on, and to push into practice at all hazards. 
 Monsieur De Rochf observes, that there is nothing 
 impossible, if we have but the resolution to take 
 the right way to it. Besides, you know audaccs
 
 20 mn IllacU ^rts 
 
 fortuna juvat; and therefore above all things let 
 me as a friend advise you to take care of studying, 
 or endeavoring to know much in this way, since that 
 will render you timorous and cautious, and conse- 
 quently keep you back in your practice ; besides 
 that, the more you search the less you will be sat- 
 isfied ; and when arrived at the top of all, you may 
 with Solon conclude that all your wisdom (com- 
 paratively with real knowledge) is in knowing 
 nothing. Whereas, if you only shim the surface, 
 you will go boldly on and fancy your knowledge 
 ten times more than what it really is. Thus, then, 
 the great and principal thing you ought to be quali- 
 fied with, is t\\Q forimda -prescribendi, for form is 
 now the main chance, whether in law or physic ; 
 and without that, there is nothing to be done ; this . 
 is the business, the Alpha and Omega, the all in 
 all ; some will succeed, and some won't ; 't is hit or 
 miss, luck's all; you are paid, go which way you 
 will. And now, just having arrived in tovv'n, with- 
 out having had the benefit of establishing an ac- 
 quaintance at Oxford or Cambridge, among the 
 nobility, clergy, etc., and an absolute stranger 
 here, without the assistance of dissenting teachers, 
 relations, old women, nurses, children or apotheca- 
 ■ ries, the first thing I advise you to do, is to make 
 all the noise and bustle 3'ou can, to make the town
 
 Kn iWfetJicfne. 21 
 
 ring of you if possible ; so that every one in it may 
 know there is such a being, and in town too, sucli 
 a physician. It signifies little which way it be, so 
 it be done, and that your name be known and 
 heard of, for that is half in half, since no one sends 
 to consult him they have not heard of, that being a 
 crime sufficient not to have been talked of; where- 
 as, if accustomed to your name, you are a fit per- 
 son to be called to the sick. Thus the famous R. 
 F., 'tis said, on his first arrival, had half the por- 
 ters in town, employed to call for him at all the 
 coffee-houses and public places, so that his name 
 might be known. A very famous oculist has like- 
 wise freely told me, that he must starve did he not 
 frequently put himself in the public prints ; but this 
 is not so fashionable with physicians, ready to their 
 company, or that while they think their company 
 understands the best, or are otherwise so com- 
 plaisant, as to talk to their friends of their interest; 
 for I would suppose you have insinuated yourself 
 into their friendship. Besides that, the very seeing 
 you now and then, might put them in mind of that 
 which they might otherwise forget. The old and 
 the simple, the riotous, the whimsical, and the fear- 
 ful, are your most proper company, and who will 
 provide you with most business ; there being far 
 less to be got by the wise and sober, who are much
 
 22 m\t Blacfe ^rts 
 
 more rarely ailing. But then you will perhaps tell 
 me that such like physicians will be the most 
 proper to please, and keep company with such, 
 since similis stmili gaudet. If so, then I can only 
 say, those will probably stand the fairest for busi- 
 ness ; and if you are so wise or unwise as not to 
 ply, bend or truckle to their humors, I doubt not 
 you will be in danger of having less business ; or, 
 otherwise, if you would still continue, and be es- 
 teemed very wise, sober and grave, you should 
 learn most obsequiously to fawn and sootJie man, 
 woman and child, since few else will thrive well, 
 unless blessed with wit, in which case, they may 
 be allowed a little more liberty. To make 3'^our- 
 self known, the making friends for some public 
 lectureship, is not amiss, which serves for a feather 
 in your cap, by which you become known, and so 
 taken notice of for a fine fellow ; and then you have 
 an opportunity of haranguing your auditor}'', 
 which, though it should be snobbish, or trifling, 
 you gain your point. As to what you read or say, 
 it matters not much ; if from the more musty and 
 ancient authors, the better; if from the more mod- 
 ern, the more fashionable it will be ; and thus, con- 
 sequently, you will either be esteemed a very 
 learned, or at least a very ingenious man. If you 
 can be introduced to a hospital, your business is
 
 Xn ^etifcfne. 23 
 
 done for life, be your success what it will. If your 
 wife should happen to mind business in her way, it 
 will certainly also increase yours, for many good 
 reasons, as increasing j^our friends and acquaint- 
 ances. It will not be amiss to set up an equipage, 
 to purchase a mountain of books, and add any thing 
 by which you will acquire the reputation of being 
 a learned and ingenious gentleman. Let your re- 
 ligious and political opinions swim with the tide, 
 especially when fashionable. * * * j^q^ Que- 
 vedo is of opinion, that the best way to run 
 into business, is to run into debt, because your 
 creditor will employ you, to get paid — as to putting 
 this experiment into practice, I shall rather choose 
 to leave it to your own natural genius to direct you 
 therein, than much to persuade you thereto, since 
 there may be danger, should it not succeed. 
 
 "To these hints, I must observe to you, that 
 dancing and dressing well, are not such slight ac- 
 complishments to introduce a young physician into 
 practice, as you may imagine, because it makes him 
 acceptable to the ladies and the beau monde : his 
 fashionable gesture, and gentle manner of feeling a 
 pulse agreeably, is half the business. 
 
 " I could mention you some who got into busi- 
 ness, in physic, by writing poetry, some by divinity, 
 others by politics, etc. But should you have an
 
 24 STIie Blacfe ^rts 
 
 itching to make your name known by writing a 
 book on physic, yet so customary, I would advise 
 you to choose the subject by which you think you 
 will get most money, or that which will bring you 
 the most general business, as fevers, small-pox, etc. 
 
 "And next, then, I would advise you, whatever 
 the subject be, you write upon (if uncommon the 
 better), rather to write so that no man can make 
 anj'^ thing of it, so as neither to make downright 
 sense or nonsense thereof, than otherwise ; because 
 thus none of the ph3'sicians can well lay hold of 
 you for any particular part ; or if they should, there 
 is room for you to defend it, being as easy to be 
 understood one way as the other. This is that 
 method I commend, which Mr. Locke observes to 
 be possible enough, for one to write a tolerable dis- 
 course of well chosen and well joined words, 
 which nevertheless, on the whole, makes not up 
 any real sense, or intelligent meaning. Thus I 
 will suppose a man to write of sleep ; now if I 
 wrote in this manner, it is ten to one but that it will 
 make all who read it fall asleep, and, consequently, 
 what can be better said on the subject? 
 
 " The last thing I advise you to do, is to get ac- 
 quainted and cheerfully to keep company with all 
 old women, midwives, nurses and apothecaries, 
 since these wall still be entertaining you in the way
 
 Xtt JWetrfcCne. 25 
 
 of your business, and as the old ladies, etc., are 
 the most subject to ailings, so they will still be ac- 
 quainting you with the same ; and consequently, 
 you are to make the most of it, and never to neg- 
 lect or make slight of the least complaint. And 
 thus you will gain the reputation of being both 
 careful and skillful ; whereas, otherwise your care 
 and skill may be suspected, as well as your affec- 
 tions."* 
 
 Now, m}^ dear John, this was all written proba- 
 bly one hundred and fifty years ago, but when we 
 reflect on the fact that men of one hundred and fifty 
 years ago, are the fathers of those living one hun- 
 dred and fifty years after them, it is not astonish- 
 ing that the letter is nearly as applicable to this 
 generation as it was to that to which it was ad- 
 dressed ; and hence, I have reproduced it for your 
 benefit. Excepting that we are living in a country 
 of sojnewhat difTerent surroundings, it indeed 
 sounds as if addressed to us of the present time 
 and place, and I might not inappropriately go on 
 to comment upon it, as Van Svvieten did upon the 
 aphorisms of Boerhaave. 
 
 As the writer then said, so I would say now, let 
 
 ♦Though ascribed to Mead, the truth is, that he could never 
 have written it, save in the spirit of irony. It is not in accord 
 w'ltli the noble character of Mead.
 
 26 mu Blacfe mvts 
 
 your first care be to let yourself be known, let the 
 town ring of you, let it be known that there is such 
 a physician. Living as you do in but a village, of 
 course the expedients 3'ou will have to resort to will 
 differ from those alluded to in the letter. 
 
 One of the common stock ways among the push- 
 ing fellows of the cities of nowadays, is to be in 
 league with certain newspapers, and to, by skillful 
 management, frequently have their names in their 
 local and personal columns ; for instance, if you 
 were called to an accident, 3^ou would manage to 
 get it in the next days paper, have it reported how 
 the very skillful and popular Dr. J. Charlatan 
 Greene was called in, and how much he seemed to 
 sympathise with the poor sufferer, and with what 
 skill he dressed the woundsj and what he said about 
 the case ; and here, if you throw in as many high 
 sounding technical phrases as possible, it will tell, 
 for the less the public understand them, the more 
 will they give you credit for wisdom and learning. 
 Commcndant quod non intclligiint. 
 
 " For the dull world must honors pay to those, 
 Who, on their understandings, most impose." 
 
 This principle of human nature was well illus- 
 trated in the comments of a certain old lady upon a 
 sermon of the celebrated Bascom. Oh, said she,
 
 Kn iWetJfctne. 27 
 
 " what a fine sermon we had to-da}', and what a 
 smart man is brother Bascom, I couldn't under- 
 stand a word of it." But in the whirl and turmoil 
 of a great city, once will not do to be spoken of, 
 but keep your name before the public, until like 
 that of Hembold, John Bull, and other quack ad- 
 vertisers, the people will at last get it imprinted on 
 their minds, simply for the much seeing of it. I 
 have known an instance or two where doctors were 
 supposed to have driven over children in the streets, 
 in order to get their names in the papers in connec- 
 tion with the accident. I have heard it said of one 
 very sharp fellow, that when his name had been too 
 long absent from the public gaze as he thought, he 
 would lose his dog, and then advertise his dog in 
 connection with his own name in large capitals. 
 
 But in country practice, such as you are a candi- 
 date for, there are an hundred other little ways, which 
 may be adopted. In the first place, you might ride 
 or drive a peculiar horse, a " calico horse" or pie- 
 bald mare, or a buggy with an excessive deal of 
 red or green paint upon it, would be sure to make 
 people stare and talk, and that whether the}' at first 
 said any thing good or bad of you, is all you want. 
 As Geo. Francis Train once telegraphed to his bus- 
 iness manager prior to fulfilling an engagement to 
 lecture in a western city : " Make them" (the peo-
 
 28 mxt Ulactt ilits 
 
 pie) " say any thing about me they please, abuse 
 me if they will, but for God's sake do n't let them 
 forget me." 
 
 You must determine on the cultivation of some 
 particular style or manner. You may be either re- 
 markable for your rude, rough manner, or on the 
 other side for extreme civility. Better either ex- 
 treme than the intermediate. Strange to say man- 
 kind seem to like a certain amount of ill usage. 
 RadclifFe used to say that the secret of his hold on 
 mankind was, that he abused them well. However, 
 here I might say to you, that to keep your place in 
 public esteem, and to be of this type, requires that 
 it should be backed by some real merit. I think it 
 was probably harder for an Abernethy or a Chap- 
 man to win his way, than a Cooper or a Watson. 
 If you assume the urbane, run it into the ground, — 
 almost, but not quite. I have seen a fellow, so 
 extremely would-be polite, as to thank h.is patient 
 for putting out his tongue to him every time he 
 asked him. That was playing it somewhat too 
 fine, for it was a little nauseous to the bystanders. 
 
 In learning, you may go to either extreme, affect 
 to despise learning, and set yourself up as one rely- 
 ing entirely on your strong common-sense and great 
 experience, or pretend to be very learned. If you 
 affect the former, you will be inclined to win over
 
 K« i^etifcntr. 29 
 
 a certain number of the hard-fisted yeomanry and 
 half educated, who so generally pride themselves on 
 their common sense., which so frequently proves to 
 be nonsense. To be generally known as a com- 
 mon-sense doctor, among this class, — and they are 
 quite numerous, is to put you in repute. To illus- 
 trate what I mean, I give you the following little 
 episode : 
 
 " I had just finished my supper, and was quietly 
 enjoying my cigar on the deck (of the boat), when 
 I heard an individual declaiming in a loud tone of 
 voice to some two or three attentive listeners (but ev- 
 idently intended for the benefit of whomsoever it 
 might concern) on pathology. Being as it were thus 
 invited, I also became a listener to somethinglike the 
 following: '•There it is now! Well, some people 
 talk about seated fevers; I don't know any thing 
 about seated fever. A musquito-bite is a fever ; 
 cure the bite and the fever leaves you. So with a 
 bile, just the same thing ; there a'nt no such thing 
 as a seated fever, I tell you. The fact is, your regu- 
 lar doctor practizes according to books, I practize 
 according to common sense. Now there was Dr. 
 Rugg of our village, the Sampson of materia med- 
 iker. Well, he treats fevers according to the books ; 
 consequence is I get all the patients ; and he says
 
 30 sriie Blacit mvtB 
 
 to me one da}^ says he, ' why,' said he, ' how is it 
 you get all the fever cases !' And I told him ex- 
 actly how it was, and it is so. ' Well doctor,' in- 
 terrupted one of the listeners, ' how do you treat 
 fevers ! We/l, there it is ; you ask me how I treat 
 fevers ! If you had asked me when I first com- 
 menced practizing, I could ha' told you ; I can 't 
 tell you now. I treat cases just as I find 'em, ac- 
 cording to common sense. And there it is; now 
 there was Mrs. Scuttle, she was taken sick; all 
 the folks said she had the consumption ; had two 
 doctors to her ; did n't do her a single mossel o' 
 good. They sent for 7ne. Well, as I went into the 
 house, I see a lot o' tansy and a lot o' chickens by 
 the door ; felt her pulse, says I Mrs. Scuttle, you 
 a'int no more got the consumption than I 've got it. 
 Two weeks and I cured her ! ' Well, doctor, how 
 did you cure her?' How did I cure her? There 
 it is again ! I told you I saw a lot of tansy and a 
 flock of chickens growing at the door. I gave her 
 some of the tansy, and a fresh laid ^g^-, brought 
 her right up. Its hill or cure with me ! In fact, I 
 call myself an officer ; my saddle-bags is my sol- 
 diers, and my disease my inimy. I rush at him, 
 and ither he or me is got to conquer. I never give 
 in!'
 
 " My cigar was out, and while lighting another, 
 the doctor vanished."* 
 
 If you wish to play tlie opposite role, however, 
 you will not find it very hard to get up a cheap rep- 
 utation with a certain class of the public, for learn- 
 ing and progressiveness. In the first place, you 
 might get two or three diplomas ; the article is very 
 cheap nowadays, and easily attainable for a little 
 money and less knowledge. If 3'ou do n't frame 
 them and hang them in your office for public in- 
 spection, which might look a little vulgar, you 
 could easily let the fact of your having so many be 
 generally circulated. You might also make a pa- 
 rade of some new books, and several medical jour- 
 nals, and if among them you could put one or two 
 French, German or Italian, it would be well. It 
 does not much matter, whether you can half way 
 read them or not ; the people who come into your 
 office, will be apt to presume you can, and that is 
 sufficient. I would advise you, however, to be a 
 little sly when those come about who can read 
 them, lest you unwittingly expose yourself. You 
 might also make a good deal out of a few medical 
 or surgical instruments, for in this world it is quite 
 possible to make a great flourish over a little thing ; 
 
 ^-Knickerbocker Magazine, Editor's Table, Dec, 1859.
 
 32 jTftc mntk mvtB 
 
 for instance, I have known a fellow totally ignorant 
 of the grand principles of physical diagnosis, who 
 could n't tell heart disease from -phthisick^ and who 
 could n't have given the distinction between a bruit 
 and a sotiffle, if perdition had been staring him in 
 the face, as a penalty for his ignorance, yet acquire 
 some reputation as a practitioner in diseases of the 
 chest, by a grand flourish of Cammann's stetho- 
 scope on proper occasions. A great deal, indeed, 
 might be made out of as simple an instrument as 
 the clinical thermometer, in neighborhoods where 
 the instrument has not come into common use with 
 the profession, for I have seen some people ignorant 
 and credulous enough to suppose you could tell by 
 it, what they had eaten for dinner the day before. 
 I have known a good deal of reputation gained by 
 the hypodermic syringe, when it first came into use 
 in this country. 
 
 On giving a new remedy, if it has a good effect, 
 always tell your patient that you were the first to 
 use it. These things are for the public to recollect, 
 but if you have to meet any of your professional 
 brethren, who as you think, know more than you 
 do about such things, you will then have to be on 
 the look out, and try and open your mouth as sel- 
 dom as possible. Then it would be best for you to 
 look as grave as "an owl in an ivy bush," or an
 
 *' ape in a house porch," but to deport j-ourself with 
 a silence becoming your gravity, lest like CEsop's 
 crow, by opening your mouth the cheese should 
 depart from you. 
 
 The use of very high sounding technical terms, 
 may sometimes be played oft' to advantage, but you 
 should always study your compan}'^ here. People 
 of much sense are usually disgusted by such dis- 
 play. I knew of an instance, in which a doctor 
 after a consultation, gravely announced to the family 
 that they had agreed to pursue with the patient 
 " the cata^Iastic^ sina fistic, and enematic mode of 
 treatment." Immediately a buzz of admiration 
 passed around the group of old ladies in the room, 
 composing the auditory, but blankness, succeeded 
 by contempt, soon overspread their faces, when the 
 doctor in consultation, a little maliciously inter- 
 preted to the old crones, that in other words, they 
 expected to apply -poultices and -plasters and give 
 injections to poor Mr. Smith. 
 
 A step far forward in the way of increasing one's 
 business, is to take a wife. I have known many to 
 marry with this end in view. A married doctor, all 
 things being equal, has advantages over the single 
 one, not only in being able to bring to bear in his 
 favor increased family influence, but the public are 
 readier to trust him with family practice, and espec-
 
 34 riie 2JIacft ^rts 
 
 ially in obstetrics and ailments peculiar to females. 
 Why, God only knows, but I have long observed 
 it as a fact, that the public seem to think the pos- 
 session of a wife adds greatly to a doctor's stock of 
 morals and knowledge, and hence the taking of a 
 wife, may in a certain light be looked upon as an 
 investment — the taking of so much stock in trade. 
 Joining some church or other, is another invest- 
 ment frequently made. Should you do this, pick 
 out the most popular one, with the fewest doctors in 
 it. I have known some before now to change their 
 church once or twice, hunting for the one, attach- 
 ment to which would pay best. The old trick of 
 being called out of church in the midst of service, 
 is a very good one, and one which you might have 
 repeated tolerably frequently, — the old ladies will al- 
 vv^ays notice it, and talk some about it after meeting, 
 and will be the more apt to recollect you when they 
 have sickness at home. Always go into church 
 late when everybody else is seated, you will thus 
 be sure to be noticed by the congregation, and if 
 you do n't have a confederate to call you out during 
 preaching, you can leave yourself, just at its con- 
 clusion as if compelled to hurry away on account 
 of the urgenc}'^ of your business. Standing in the 
 doorway of the church, or just outside, and bow- 
 ing to, and shaking hands with as many of the con-
 
 gregation who pass out as you can, is also very 
 profitable in its way. It's a gentle intimation to the 
 congregation, that you are their representative in 
 physic, and that it is their doctrinal duty to employ 
 you, especially if there is no other medical man in 
 the fold. I advise you, however, to be more dis- 
 creet, than was a certain medico, in a certain city 
 west. He joined a church, and something like a 
 year passing, and but little grist coming to mill 
 from that quarter, his indignation one Sunday so 
 got the better of his discretion, that on the retire- 
 ment of the congregation, he fiercely saluted the 
 sexton : 
 
 " Well, sir, I have been a member of this church 
 ten months, and have never gotten a patient from it 
 yet, — I want to know, sir, what it means?" 
 
 The sexton indignant, and also in doubt about 
 the doctor's perfect sanity, unfortunately collared 
 him, and thereupon ensued a scramble and a scene, 
 which attracting the passers-b}^ and the police, re- 
 sulted in the bruitini*- of the thincf over the whole 
 town, and getting a recital of it into the public 
 prints. 
 
 Freemasonry, Oddfellowship, Teetotalism and 
 membership with all kinds of clubs and societies, 
 may with some address, be turned to good account 
 and be made to pay.
 
 36 mu ninth ^rts 
 
 Your politics you may make equally subservient 
 to your ends as your religion ; these are the days 
 when men trade in both. As in the selection of 
 your religion, so in the formation of your political 
 principles, select the strongest side and the winning 
 candidate, if you only can foresee it. Changes 
 here should always be made with the changing tide 
 of popular opinion. Such changes, will readily be 
 taken as patriotic convictions, and will not be so 
 closely scrutinized, or so readily attacked by your 
 enemies, as changes in .your religion, — always, as 
 I have said, so change as to be on the popular side, 
 since it pays. An activity at primary elections and 
 ward meetings, sometimes may be made to pay v/ell. 
 Give your favorite to understand that you expect a 
 quid pro quo, that to electioneer for him, you ex- 
 pect him to electioneer for you, a thing you have a 
 right to expect, since it will cost him nothing. In 
 electioneering for others, furthermore, you are be- 
 coming perfected in the accomplishments of the arl 
 for yourself. Of Saturday evenings and court 
 days, when the country people most do congregate 
 in town, you can station yourself in front of your 
 office door, and bob your head to every fellow who 
 passes, and shake hands with every one whose 
 name you can pronounce, and it will be very well 
 to hold the hands of each a long time, and take
 
 him by both hands indeed. It will show a very- 
 friendly spirit which may ultimately tell for you. I 
 recollect once, a man's coming to employ me, and 
 he told me that he had wished to do so for a long- 
 time, but that he had found it impossible to get rid 
 of his previous doctor, for says he, 
 
 *' He is so mighly friendly ^ and shakes hands 
 with me so warmly every time he meets me, that I 
 really could n't liave the heart to get any other doc- 
 tor, until my failing health compelled me." 
 
 When you have ever attended a case, and it has 
 recovered by virtue of your treatment, or in spite 
 of it, do n't omit any opportunity of reminding 
 your late patient, and his friends of the fact, en- 
 joining upon them the propriet}^ of always remem- 
 bering the bridge which has once carried him over 
 safely. 
 
 When a man employs you once, tr}^ to impress 
 him with the idea that you have personal property 
 in him, and that you shall be justly incensed, if 
 ever he shall change you, for anybody else. On 
 at any time learning of his having another doctor, 
 go to him, and ask him why he has ceased to em- 
 ploy you, and tell him that your feelings are hurt. 
 If he has not gotten totally out with you, by this 
 you may probtibly whip him back into traces. 
 
 If you are called to a case which ultimately
 
 38 mu miittii mvts 
 
 proves fatal under your charge, assert that you were 
 called in too late. This may produce some painful 
 regrets on the part of the friends of the sick 
 who may never forgive themselves after what you 
 have said, but it excuses yourself for its termina- 
 tion, and is besides inclined to increase business, 
 by making them always send for you in future for 
 the most trifling ailments. It is also a good ma- 
 neuver where another doctor has been dismissed, 
 and you have succeeded in the case. I know of 
 one instance where a young~doctor in the first year 
 of his practice, was attending a child with tuber- 
 cular meningitis, the parents concluded to substi- 
 tute a gra}' beard for youth, and sent for " a man 
 of experience." Though of course an essentially 
 fatal case, the old doctor gravely told the family 
 that if he had but been sent for in time, he would 
 have cured the little patient. The immediate conse- 
 quence was that the young man was damned, while 
 experience held its ground ; the ultimate result 
 was, that the young man disgusted with the arts of 
 acquiring practice, retired from the field, but is to- 
 day, one of the most distinguished cultivators of the 
 natural sciences in America. 
 
 Sometimes people get tired of the progress of a 
 case, although it may be toward recovery, and dis- 
 miss the attending physician. The doctor called
 
 to succeed him, now always has the advantage, if 
 he will take it, of giving an overwhelming blow to 
 his rival. Under such circumstances do any thing 
 but what the doctor before you may have done, and 
 as nearly as you can, just the opposite. Indeed, 
 if the case is one safely to leave to nature, yet to 
 make a profound impression, you must n't do it. 
 Puke, purge, sweat, blister and scarify, and thus 
 your impression will surely be profound, and 
 though the poor devil slowly emerges from bed in 
 spite of your treatment, yet you are thereafter, 
 pretty sure to have a big name in the family, and 
 the shadow of your brother practitioner, just as 
 sure, never again to darken your pathway toward 
 that house. 
 
 Another art of value is, in certain cases where 
 the opportunity presents, to substitute a grave affec- 
 tion for a simple one in your diagnosis ; thus, an 
 ephemeral fever might easily become a typhoidal 
 one, a sore throat a diphtheria, hemicrania, spotted- 
 fever, and so on to the end of the chapter. Thus 
 you may by a little art, acquire the reputation of 
 being a good typhoid fever doctor, or great on 
 diphtheria, or that you cure cases of spotted fever, 
 where the other doctors fail, etc. 
 
 I have known some doctors who never let an op- 
 portunity slip, of magnifying the value of their
 
 40 3r!ie Ulacfe ^rts 
 
 services ; they gravely inform their patients, that it 
 was lucky they sent for them just when they did, 
 for it was by their timely arrival and puissant inter- 
 vention, that a mighty fever was prevented, if they 
 had not gotten there just when they did, and done 
 the very peculiar things which they did do, the 
 bellyache would soon have run into a tyfhlo- ente- 
 ritis with intussusception^ and the child's stumped- 
 toe would probably soon have become the worst 
 kind of a case of sphacelated mortification. It is 
 a little curious, but patients seem to love to think 
 they have escaped great dangers, and when they 
 learn from the doctor how great is the danger from 
 stumped-toes, cut fingers, pin scratches and every 
 " bad cold " and bellyache, if at all timid, of course 
 the doctor is much sought after. 
 
 But it is time to stop, I have given you an out- 
 line of the " art," sketched the field, and it re- 
 mains for you to fill in the details. "There are a 
 hundred ways to kill a dog besides choking him to 
 death on butter." "The devil may always be 
 whipped around the stump." The ways and means 
 to be adopted will depend upon your individual in- 
 genuity and mother wit. A man who by a dexter- 
 ous application of the arts which have been my 
 text, can't succeed in getting practice, and yet re- 
 tain his place within the fold of the regular profes-
 
 sion — if he is so hard put to it, that he has to resort 
 to open quackery, or stoop so low as to brazen his 
 cheek, and ask a man directly for his practice, why 
 he is n't worthy of the blood of the Sharpes, and 
 that strain of the Charlatan's flowing through your 
 veins. 
 
 Now I don't tell you to "fight it out on this 
 line," indeed, as I have said above, I think the 
 doctor who relies purely upon what he considers 
 his scientific merits, and devotes all his energies to 
 the endeavor to make himself truly meritorious, 
 disregarding entirely the "arts," has the easiest 
 time of it in attaining a successful business, for he 
 is certainly freed from all those burning fears and 
 harassing anxieties, lest the scepter should depart 
 from him, which must always, more or less, be the 
 portion of those building reputations on any other 
 foundation. But the majority of those following 
 professions, will not make up their minds to the 
 adoption of this policy, or if they do, they too soon 
 get tired of pursuing the tedious and often difficult 
 paths through which it leads. 
 
 If you have it in you, John, to pursue the straight 
 and narrow path, and climb the rugged heights, 
 then I advise you to ignore all this which I have 
 written. But if not, then the hints above given, 
 may prove useful to you, in piling up pelf.
 
 In our strucTCfle for existence, in our efforts at 
 self-preservation, in accordance with the law of our 
 nature, let us pray for deliverance from temptation, 
 and let us look to it, that our Societies are kept from 
 all dark practices, our watchword being — Down 
 with the UlncU ^rtS OC Jf^CtJlCinC, and confusion 
 to all ^7'dctitioners of them.
 
 HnnitiFrsaFg ^SbbPFSs 
 
 BEFORE THE 
 
 BOYLE COUNTY (KY.) MEDICAL SOCIETY. 
 
 DELIVERED JANUARY 5, 1S69. 
 
 Gentlemen : — We meet to-night, on this, the 
 third anniversary of our Society's existence. Three 
 years ago, our association was organized ; since 
 then we have met nearly an hundred times, and as 
 often engaged in the discussion of questions per- 
 taining to our profession. Fortnighdy, for three 
 years, have we continued to assemble, despite all 
 hindrances, and now, on this triennial anniversary 
 occasion, and especially at this season, so sugges- 
 tive of reflection — when the old year has died out, 
 and we stand on the threshold of the new one, with 
 its vista of fresh hopes and fair budding promises 
 opening out before us — we may naturally ask, ctci 
 honoy what profiteth it ? Have we, by our organi- 
 zation, advantaged ourselves beyond what would 
 
 U3)
 
 44 ^titircss. 
 
 have been were we unorganized ! What is our 
 present status compared with our past, and what 
 are our prospects for the future? 
 
 These natural questions, so pertinent to the time 
 and the occasion, we stand here to-night, to en- 
 deavor to answer. 
 
 Sometime since, in conversing with an old friend, 
 a retired member of the profession, living adjacent 
 to a town not a hundred miles from here, we asked 
 him : What tidings of the sons of ^sculapius of 
 your place, and, tell me, especially, whether they 
 have yet organized a society? He replied, " The 
 sons of ^sculapius, as you are pleased to call 
 them, but rather sons of Ishmael, one from my 
 stand-point of vision, would call them, have not, 
 and I assert, never will organize a society." I 
 asked him, why. He replied, that there were so 
 many varying interests and so much discord among 
 the doctors, that, to a looker-on, it seemed impossible 
 to ever sufficiently harmonize them to organize a 
 society, founded on mutual concessions, though the 
 object might be for a common benefit. 
 
 Upon my asking him to be more explicit, and 
 give me some idea of the state of things, individu- 
 ally, he proceeded in the following strain : " We 
 have some eight or ten doctors in our midst, a suffi- 
 cient number, it is true, to form a societv, but, when
 
 ^titrress. 45 
 
 I tell you, that instead of seeming to be a band of 
 brethren, engaged in a common cause, they seem 
 to feel that they are a band of Ishmaelites, common 
 enemies, ev^ery man's hand naturally raised against 
 his neighbor's, you will at once see the foundation 
 upon which I rest my opinion." But, said I, perhaps 
 you judge them too severely, you know that we are 
 all naturally rivals, that most of us are dependent 
 upon our profession for a support, and that what has 
 been .called the first law of our nature — self-pres- 
 ervation, leads every man to prefer himself to his 
 neighbor. Tell me, said I, what are the rules govern- 
 ing them in their intercourse with one another, upon 
 what grounds do they rely for advancing themselves 
 or to get practice. Though a rivalry must exist, yet 
 there is such a thing as an honorable, indeed a gen- 
 erous rivalry. He then continued : " I believe I am 
 correct when I say, that no three of the doctors 
 speak. Let a new member of the faculty come to 
 town to settle, and they instantly view him as an 
 interloper, trespassing on their own rightful do- 
 mains, and treat him accordingly. Woe be unto 
 any of their number who may commit a mistake, or 
 have any evil to befall him in his practice, for he at 
 once becomes common prey for the balance, who 
 look upon the weakness of the rival as so much 
 strength lent to themselves. As to their code or
 
 46 ^litjress. 
 
 rules governing them in advancing themselves — 
 the prime one seems to be the old primitive one of 
 ' every man for himself and the devil take the 
 hindmost.' Another cardinal one, I think, is — 'get 
 practice, honestly, if you can, but anyhow, get 
 practice.' The means adopted to get practice are 
 multitudinous, and the preseverance with which they 
 are followed and the astuteness with which they are 
 applied by some, would do honor to any cross-roads' 
 politician. Marriage, the church, masonry, odd- 
 fellowship, teetotalism, democracy, radicalism, the 
 kukluk klan and the loyal league, are all impressed 
 for aid, and the way in which court days and Sat- 
 urday evenings are spent in the shaking of hands 
 and -palaver, a spectator would think the next week 
 an important election was to come off, and the doc- 
 tor was the candidate for office. Indeed he would 
 sometimes think the vote was surely to take place on 
 Monday, judging from certain scenes on certain 
 church steps on Sundays. To sum up the matter," 
 said he, " though I blush to tell it, I have heard a 
 doctor, without circumlocution and with unmantled 
 cheek, ask a citizen directly for his patronage." 
 
 These, and some other things, he said of the art 
 of acquiring practice adopted by the physicians of 
 his locality, which I thought would have formed a
 
 ^ntir ess. 47 
 
 worthy appendix to the celebrated letter of Mead * 
 to Dr. Timothy Van Bustle on the same subject. 
 Though my friend is rather hypercritical, and withal 
 naturally somethincr of a cynic, and therefore prob- 
 ably drew the scene with rather too heavy a hand, 
 yet we can all recognize some lines which, alas ! 
 are but too commonly visible, in any but well- 
 organized communities. 
 
 Though in localities in which no organization of 
 the medical body exists, the large number of medi- 
 cal men may act in the true spirit of the profession, 
 and while admitting that if there was no written 
 code, that yet the true physician would carry out 
 its spirit, just as the true gentleman would always 
 be found acting in accordance with the spirit of the 
 civil law, if even it was not the law of the land, 
 yet, just as the necessities of society at large de- 
 mand organic laws, so, on precisely the same prin- 
 ciple, is organization and a written code demanded 
 by every profession. With the clergy, as with the 
 military, it is indeed the fundamental rule of exist- 
 ence. 
 
 The truth is, that owing to human depravity, we 
 are all naturally a litde mean, and are instinctively 
 predisposed to be a little jealous each of the other. 
 This is, when we analyze it, but an extension of the
 
 48 ^tjTjrcss. 
 
 natural law of self -preservation beyond proper 
 limits. Now, r think I may truthfully sa}^ that 
 there is no more effectual way of repressing this 
 evil phase of our nature, in its multifarious disgust- 
 ing forms, as we see it cropping out within the folds 
 of our profession, than b}^ the accepted public ac- 
 knowledgment on the part of the better portion of 
 our profession of a written code. Let the public at 
 large once be fully cognizant of our standard, and 
 half the incentives to self-abasement have been 
 taken away ; for they, the audience before whom 
 we play our respective parts, can at once measure 
 each of us by our own rules, and the most respect- 
 able part of society learns soon to look with dis- 
 gust upon the tricks of the tradesman in the pro- 
 fessional man. Sir Benjamin Brodie once said 
 that medicine is a most noble profession, but a 
 miserable trade. Fully imbue society with this 
 idea, and any over-pushing, grasping desire for the 
 world's patronage, at the expense of honorable in- 
 dependence and the nobler feelings, or at the sac- 
 rifice of the rights of others, and the violator will, 
 by the public as by ourselves, be viewed with pro- 
 found scorn. 
 
 The foundation of all pure ethical precepts is in 
 the golden rule, " Do unto others as you would
 
 have them do unto you," and its spirit has ever been 
 breathed into all the established rules for profess- 
 ional intercourse with which we are acquainted. 
 It is infused into the grand old Hippocratic oath of 
 fifty ages agone. It permeates the noble precepts 
 of that prince of surgeons of five hundred years 
 ago, Guy of Chauliac, who summed up the char- 
 acter of the true surgeon by saying that " He 
 should be courteous and condescending, bold in se- 
 curity, cautious in time of danger, avoiding im- 
 practicabilities, compassionate to the infirm, benev- 
 olent to his associates, circumspect in prognostica- 
 tion, chaste, sober, pious, and merciful, not greedy 
 of gain, no extortioner, but looking for his fee in 
 moderation, according to the extent of his services, 
 the ability of his patient, the result of his treatment, 
 and a proper sense of his own dignity." And now, 
 in our own Code of Ethics, as written by the ever- 
 to-be-honored Percival, and adopted by the Amer- 
 ican Medical Association, we have as perfect a 
 system of rules for our government, founded on as 
 pure a system of morality as the most rigid moralist 
 could ever wish for — a code which, from its essen- 
 tial nature, must always purify and ennoble those 
 living in accordance with its precepts. 
 
 How men of our profession, of good sense and
 
 50 ^Ijtrress. 
 
 good intentions, can ever live and practice their vo- 
 cation in the same community without being on 
 good terms with each other, is not easily explica- 
 ble ; for there is certainly no other profession, the 
 inherent nature of the practice of which so inevita- 
 bly and so repeatedly demands co-operation, and 
 mutual kindly services. As has been said by one 
 of eminence in our profession : "If society does 
 treat the medical man harshly and unkindly, is lit 
 any worse than medical men treat each other? 
 Many of the worst things ever said of a ph3'sician, 
 originally came from another physician's tongue ; 
 society is often merely the whispering gallery, 
 which echoes back these utterances. Were we 
 more charitable toward each other, we would si- 
 lence half the reproaches which are brought upon 
 the profession."* It would always be well for that 
 man who should be ready to rejoice at the mishaps 
 of his neighbor, and dishonorably profit by his mis- 
 fortunes, to reflect that, being human, we are all 
 thereb}'- fallible, and that the day may not be far 
 distant when he himself may stand in sore need of, 
 and most wistfully crave, all human sympathy; 
 and, furthermore, that he who does injustice to one 
 of his peers, directly wounds his profession, and, 
 reflectively, himself. 
 
 * Dr. Theophilus Parviii. 
 
 I
 
 ^tilrress. 5i 
 
 How different was the noble conduct of Dr. 
 Mead ! He and Dr. Freind were at the head of 
 the profession in London, and were rivals in prac- 
 tice, as well as opposed to each other in politics — 
 Mead being a Whig, and possessing great influence 
 with the heads of the party then in power, while 
 the latter was a Tory, and a member of Parliament 
 for Launceston. Dr. Freind, being suspected of 
 some connection with the Atterbury plot, was ar- 
 rested and committed to the Tower, where he was 
 confined for nearly a half year. Mead was about 
 this time called to attend Sir Robert Walpole, and 
 during his professional attendance, pleaded so 
 eloquently with the Prime Minister as to effect 
 Dr. Freind's discharge on bail, he himself becom- 
 ing one of his sureties. Not only this, but he took 
 Freind aside, after his release, and presented him 
 with a purse containing 5,000 guineas, the sum of 
 all the fees he had received from the patients of his 
 Jacobite rival during his imprisonment, enforcing 
 its acceptance by saying : " I can not profit by the 
 misfortunes of a rival." What a worth}' example 
 of magnanimity was the course of Dr. Paul F. Eve, 
 who, appointed Professor of Surgery in the Uni- 
 versity of Louisville on Dr. Gross' leaving the 
 chair, to occupy a similar position in New York, 
 when the latter returned to Louisville, after a year
 
 52 ^titrress. 
 
 or two, at once resigned, telling the trustees to re- 
 appoint Dr. Gross — that he was the ablest man for 
 the position to be found in the West, and that the 
 honor of the school and the good of the profession 
 demanded his reappointment! 
 
 The practice of our profession in the proper spirit, 
 tends, of its very self, to ennoble us, and this trib- 
 ute was paid to medicine more than a thousand 
 years ago, by no less a personage than Cicero, 
 when he said, '* Homines ad Dcos nulla re ;pro- 
 ■priiis accedunt, quam salutcm honiinibiis dando.^^ 
 
 But, as the orcjanization of individuals into com- 
 munities is greatly auxiliary to individual effort, 
 whether it be for the furtherance of material inter- 
 ests, or the practice of the moral virtues, so is our 
 profession benefited by the formation of Societies. 
 Certainly one of the most powerful levers impelling 
 the advance of medical science during the past half 
 century, has been the estabHshment of the numer- 
 ous medical Societies which during that time have 
 grown up in the capital towns of Europe. 
 
 Before these, every alleged discovery with any 
 pretensions to importance, is brought up, and un- 
 dergoes the ordeal of scientific discussion by the 
 ablest minds of. our profession. Before these, a 
 thousand pretentious theories which would have 
 lived some time in the world, have promptly re-
 
 ^trtjress. 53 
 
 ceived their quietus ; and it has been, on the other 
 hand, through its ventilation here, that many an 
 opinion or method which would otherwise have 
 been very slow of development, has at once ob- 
 tained its proper standing with the profession. The 
 great medical Societies of the world are the win- 
 nowing machines of the profession, serving the 
 most useful purpose of sifting the good from the 
 bad, the true from the false. Let the Academy of 
 Medicine, or the Imperial Academy of Surgery, 
 of Paris, alone be blotted out to-day, and the loss 
 would soon be sensibly felt by the profession 
 throughout the world. 
 
 Is there a member of the Boyle County Medical 
 Society present to-night, but will agree with me in 
 affirming that, as an individual practitioner, he has 
 been instructed and elevated morally as well as 
 mentally from our united association? And, fur- 
 thermore, I believe I speak the truth when I say, 
 that as the result of the Society's organization 
 and operations, our profession as a body, and as a 
 consequence, we, as individual practitioners, have 
 been elevated an hundred per cent, in the eyes of 
 this community in whose midst we belong. 
 
 There may be mentioned — not in the spirit of 
 egotism, but for self-encouragement, and to demon- 
 strate the claim that our organization has not been
 
 54 ^tJtircss. 
 
 in vain — the effects of our Society abroad. I be- 
 lieve that the profession throughout the State, who 
 are informed as to the history of the reorganization 
 of the Kentucky State Medical Society, with one 
 accord give the credit of its revival to us, and cer- 
 tainly that the plan for its resurrection originated 
 here. I am aware of three societies within the State, 
 which, encouraged by our example, have been or- 
 ganized, adopting in the main, the constitution, by- 
 laws, and form of business governing this body, 
 and I have reason to believe that more than one 
 other association, antedating us in age, has been 
 awakened from its state of suspended animation and 
 had new vitality infused into it, by the example of 
 our prosperity. 
 
 What, gentlemen, are our prospects for the fu- 
 ture? Has our Society reached its acme of effi- 
 ciency, and is it unreasonable to expect the fruits 
 of the year just before us to excel the products of 
 the one just ended? 
 
 While acknowledging that our organization^ 
 simple as it is, is yet remarkably well adapted for 
 effecting its object, and while 1 think I can say 
 without reflecting egotism, that we have done well 
 in the past, yet truth demands that I should say 
 that there yet remains a wide margin for improve- 
 ment.
 
 Wherein we are yet lacking, and the direction 
 in which I think improvement can be effected, it 
 becomes my duty to endeavor to point out. 
 
 It has been justly said by an eminent observer 
 in our profession, "A very large class enter the 
 learned professions with no higher motives than 
 such as characterize commercial enterprises, pur- 
 suinof them as a business, and more anxious to 
 erect monuments like that of Nebuchadnezzar in 
 the plain of Dura, than such as fill the niches of 
 fame."* 
 
 " Make sordid wealth the object and sole end 
 Of their industrious aims." 
 
 But, gentlemen, though we know that while we 
 have our own, with perhaps many other hungry 
 mouths to fill, we must ever instinctively feel, that 
 to derive an income from our professional labors 
 must be one of our first objects — an object the 
 worthiness of which we have sanctioned by the in- 
 spired authority, which tells us that " he who pro- 
 videth not for his household is worse than an 
 infidel" — yet we should never forget that we have 
 it from the same authority, that "man shall not live 
 by bread alone." 
 
 Dr. George B. Wood once declared that " He 
 
 *Dr. D, Hayes Agnew,
 
 56 ^trtrt-fss. 
 
 who enters the medical profession with a mercen- 
 ary spirit, will almost necessarily come short of its 
 highest requirements. Aiming at the appearance, 
 rather than the reality of skill, he will think more 
 of the impression he may make on others, than of a 
 proper understanding and treatment of the disease. 
 When nothing is to be gained but the consciousness 
 of duty fulfilled, he will be little apt to spend time 
 and labor which might yield him more if applied 
 elsewhere, or at least would be abstracted from his 
 pleasures. For the frequent self-denial, the steady 
 devotion of thought and energy, the unwavering 
 guard over his precious charge, as well when un- 
 seen as when seen of men, which characterize the 
 right spirited practitioner, he has no sufKcient in- 
 ducement. He will be, almost necessarily, more 
 or less superficial. He never can be the true 
 model physician. Just in proportion as medicine Is 
 cultivated in the mercenary, or in the poor profes- 
 sional spirit, will be its decay or advancement in 
 efficiency, zeal, dignity and acceptance with God 
 and man. * * Get the true professional spirit, 
 and all that Is needful or desirable will be added 
 unto It." 
 
 The English Hippocrates, Sydenham, used to 
 say : "I have thought It a greater happiness to dis- 
 cover a certain method of curing the slightest dis-
 
 ^Utrress. ^ 57 
 
 ease, than to accumulate the largest fortune." And 
 the illustrious Dr. Fothergill once said : "My only 
 wish was to do what little business might fall to my 
 share as well as possible, and to banish all thoughts 
 of practicing physic as a money-getting trade, with 
 the same solicitude as I would the suggestions of 
 vice or intemperance. * * * j endeavor to fol- 
 low my business because it is m}'- duty, rather than 
 my interest ; the last is inseparable from a just dis- 
 charge of duty.'''' 
 
 Lord Bacon has said "that every man is a debtor 
 to his profession, from the which, as men do of 
 course seek to receive countenance and profit, so 
 ought they of duty to endeavor themselves, by way 
 of amends, to be a help and ornament thereunto." 
 Our code makes the same acknowledgment in the 
 paragraph which declares that "Every individual, 
 on entering the profession, as he becomes thereby 
 entitled to all its privileges and immunities, incurs 
 an obligation to the extent of his best abilities to 
 maintain its dignity and honor, to exalt its standing, 
 and to extend the bounds of its usefulness;" and 
 further on enjoins that he " should, by unwearied 
 diligence, resort to every honorable means of en- 
 riching the science." 
 
 Now, gentlemen, let us ask ourselves the ques- 
 tion direct, and let each answer it honestly for him-
 
 58 ^titrress. 
 
 self, whether during the year just closed, he 
 thinks he has been perfectly imbued with the 
 " pure professional spirit," or whether he does not 
 think we all yet have rather too much of the 
 ** mercenary sort." Have we always attended our 
 society meetings, when it was possible? Have we 
 always prepared ourselves as thoroughly as we 
 could for our debates? Have we always done 
 what we could in the way of prepared papers, and 
 written records of cases, to be read before our So- 
 ciety? Have we, in every instance possible, de- 
 manded and held a ^ost jnortem, when we had a 
 fatal case? Have we taken advantage of the op- 
 portunities we have had of cultivating anatomical 
 science, the very groundwork of our profession? 
 Have we all kept case books, and carefully re- 
 corded the progress and results of each case in our 
 practice? Have we kept as many journals on our 
 tables as we could afford to take and had time to 
 read, and purchased every new work, the perusal 
 of which was necessary to keep us abreast in the 
 present rapid march of our profession? Have we 
 provided ourselves with all instruments which the 
 exigencies of our profession and the urgency of 
 certain cases which are liable to fall into our hands 
 at any day, will not give us time to send abroad 
 for, when the occasion arises for their use, and the
 
 want of which, under certain circumstance, might 
 make us morally criminal, on the death of a fellow- 
 being? And have we always kept ourselves so 
 pure and unspotted from the world of quackery, 
 that by a refusal of private social recognition of its 
 practitioners, we take away from the public all oc- 
 casion of confounding them with us? To make 
 application of an expression of St. Paul, " Have 
 we all done what we could to magnify our profes- 
 sion?" 
 
 But methinks 1 hear some one present say. We 
 have no time for most of these things ; the toils of 
 our practice, and the domestic duties — with those 
 of us having families — so engross our time as to 
 leave us insufficient leisure for the cultivation of 
 medicine as a science. Besides, some of us are 
 growing old, and we must leave every thing of that 
 sort to the younger generation, following after. 
 
 But I would ask any so objecting, to think for a 
 few moments, and tell me, if he can, of any great 
 work which we acknowledge as of much authority 
 in our profession, which has not been prepared 
 amid just such, or more onerous duties than any by 
 which the busiest of us is now harassed. Let him 
 reflect that some of the most valuable of all the 
 works for v.hich to-day our profession is indebted to 
 Sir Astley Cooper were composed in the midst of
 
 60 ^t«tjress. 
 
 one of the largest private practices of any man who 
 ever lived, and at the time, too, when he was an 
 hospital surgeon, and daily lecturer in a medical 
 school. Let him look at those eighteen volumes 
 of Gerard Van Swieten's " Commentaries on Boer- 
 haave," the great text-book of the medical world a 
 centur}^ ago, and reflect that they were written by 
 a court physician of Joseph II., in the midst of one 
 of the heaviest and most responsible of private 
 practices, and that he still found time to originate 
 a medical school, give clinical lectures, create a 
 botanical garden, and to exert his influence suffi- 
 ciently to found a university. Let him read the 
 lives of Boerhaave and Haller and Hoff'man, the 
 bare titles of the latter of whose works fill thirty- 
 eight quarto pages, and see if they had learned 
 leisure in which to do nothing else than write. Does 
 not every one know that Hippocrates, the father of 
 medicine, wrote those immortal records which all 
 acknowledge as the foundation of our science while 
 engaged in what must have been almost constant 
 practical professional engagements. Or let him 
 come down to the present year and hour, and 
 know that the living, shining lights of our own day 
 and generation, are also the busiest privately occu- 
 pied. Let him know that Sir Thomas Watson, and 
 George B. Wood, and Austin Flint, and Sir Will-
 
 iam Ferj^iison, and Erichsen, and Gross, and Sir 
 James Y. Simpson, and Hodge, and Meigs, each 
 wrote the works which we, and generations after us, 
 shall be indebted to them for, while busier that the 
 busiest of us in this presence. No, gentlemen, when 
 we recollect that Dr. John Mason Good found time 
 to translate Lucretius' " De Natura Rerum," with 
 his book in hand as he drove or walked his daily 
 rounds, engaged in one of the largest practices in 
 London, and when we read in the preface to Dr. 
 Willis' Biography of Harve}'', together with a com- 
 plete translation of his works from the Latin, what 
 he says in speaking of the biographical part : " This 
 portion of my work I have only achieved with an 
 effort, and at something like disadvantage. Inces- 
 santly engaged, by night and by day, in the labori- 
 ous and responsible duties of a country practice, 
 enjoying nothing of learned leisure, but snatching 
 from the hours that should rightfully be given to 
 rest, the time that was necessary to composition, 
 remote, too, from means of information which I 
 must nevertheless send for and consult" — recalling 
 these, and an hundred similar examples if we 
 might, for one I think that there is not one of us 
 but should feel humiliated when refiectino- on our 
 wasted time, time which we have let slip from us, 
 never, nevermore to be repossessed.
 
 62 ^tJtrress. 
 
 But, I imagine I again hear it objected, that we 
 are but unpretentious country doctors, not aspiring 
 to lead the profession, and even if we were all 
 aflame. with ambitious hopes to do so, that our nar- 
 row sphere would make their realization an impos- 
 sibility — that the village doctor must, from the very 
 nature of things, ever be the passive follower of 
 the hospital physician of the city. 
 
 But, I would answer, gentlemen, that this is not 
 the point. I am not speaking of ambition, though 
 if we each had a little more of it in us, it would 
 probably be better for ourselves and our patients ; 
 the question is one regarding the fulfillment of that 
 injunction of that code which says that we are mor- 
 ally bound to exalt the standing of our profession, 
 and by " unwearied diligence, resort to every hon- 
 orable means of enriching the science." Because 
 the hospital presents a wider and more easily culti- 
 vated field than ours, does it follow that ours must 
 be totally barren? No, the material in each case 
 is just the same, poor suffering humanity, and 
 while the concentration of a large number of sick 
 within a small space, and the regulations of hospi- 
 tals, are such that the observer can study disease 
 more readily, have his directions carried out more 
 effectually, and record and tabulate the results 
 more easily, yet the antecedents, the surroundings. 
 
 ~\
 
 ^uuress. 63 
 
 and the very concentration of patients within elee- 
 mosynary institutions, are so different from those of 
 the patients of private life, that the uncorrected con- 
 clusions of experience drawn from the former 
 source alone, are not perfectly applicable, in every 
 respect, to those whom we attend. 
 
 I can not recollect any evidence that either Hip- 
 pocrates or S3'denham, was ever connected with a 
 hospital, and it would be well for those who would 
 despise our narrow sphere, to recall the fact, that 
 the greatest boon which our profession has yet con- 
 ferred upon humanity (vaccination), came at the 
 hands of a modest country ph^^sician, who made 
 his daily rounds just as we are doing ; and let him 
 also know, that the physician of America now re- 
 ceiving the most honors at home and in Europe, is 
 doing so because of an operation conceived, exe- 
 cuted, and perfected while laboring in precisely the 
 same character of field as our own. Why, gentle- 
 men, an operation which has made the name of its 
 originator famous throughout the world, and will 
 send it down honored to coming generations, an 
 operation by which thousands of lovely women 
 have been, and many more shall be rescued from 
 otherwise inevitable death, was first planned and 
 performed right here in this, our own little field. 
 
 Let us all use the opportunities at command, to
 
 64 ^Ktjress. 
 
 the extent of our abilities, and although our Society 
 may never be honored by one to whom the world 
 shall owe .so much as it does to a Jenner, a Sims, 
 or a McDowell, yet of one thing we may feel as- 
 sured, that we will all become better practitioners, 
 and our patients, to whom we shall be called to 
 minister, be proportionately benefited. 
 
 The plain truth is, that those who intrust them- 
 selves to our care, have the right to require of us a 
 knowledge of our profession fully up to the ad- 
 vances of the day, and for the lack of the posses- 
 sion of such knowledge, involving human life and 
 health as it does, we stand responsible before God 
 and in the presence of the law. Ours is not an ex- 
 act science, but is making regular and rapid pro- 
 gress toward a position in which it may be ranked 
 with the fixed sciences. While this rapid march 
 continues, to cease to advance is to retrograde, and 
 the day the practitioner of medicine ceases to be a 
 student, that day should see him, if a conscientious 
 man, ready to retire from the ranks of the profes- 
 sion. Unremitting study and labor vvill ever con- 
 stitute our only reliable motive power, so long as we 
 continue members of that great army, in the inter- 
 ests of medical science, warring with disease. 
 
 In the introduction to one of his anatomico- 
 physiological treatises, Galen calls his work "A 
 
 ^
 
 ^tJtirrss. 65 
 
 Hymn to the Deity," declaring that, to his mind, 
 such an offering was more acceptable in the eyes 
 of the gods, than the sacrifices of whole hecatombs 
 of oxen, or incense from the most costly perfumes. 
 Galen was but a pagan, yet the spirit of his lan- 
 guage was worthy of these most Christian times, 
 since every effort properly directed toward the ad- 
 vancement of medicine, tends to alleviate the sut"- 
 ferings of our race. I believe the true physician 
 can, of all men, most truly say — ^^laborare est 
 orare." 
 
 If we believe in the sentiment, there is one re- 
 solve which I think we should make in common 
 here to-night, that we should each of us keep a 
 case book and in it faithfully record the phenomena, 
 treatment and results of every case of any impor- 
 tance falling to our lot during the present year. 
 The keeping of an intelligible and conscientious 
 record, must necessarily improve every individual 
 keeping it, but let a dozen men in country practice 
 each keep one and the combined experience is 
 about equivalent to a large ward in a hospital. 
 Should the members of every country district in 
 the State, keep accurate records, for the next three 
 years, there would be data of the most valuable 
 cbaracter, and such as our profession stands 
 greatly in need of, data from which the statistics of
 
 66 ^trUrcss. 
 
 modern country practice separate from hospital prac- 
 tice could reliably be made out. Let us keep accu- 
 rate records 6f our practice, and we will gradually 
 lose a phase in our debates which has been entirel}^ 
 too familiar with us, and one which does not look 
 well in a scientific body, when seen too often. I 
 allude to the common expression of opinion, with- 
 out a reason for the faith in us, and which is a 
 frequent source of controversy without practical 
 benefit ; e. g. — Dr. A. saj's that he thinks a certain 
 disease less common than formerly, while Dr. B. 
 arises and declares that he thinks it more common, 
 to be followed by Dr. C, who probably thinks it 
 about as common as it has always been. Or, let 
 the question be one regarding the presence of cer- 
 tain phenomena in disease, or the results of the ad- 
 ministration of a certain remedy, and it is the same 
 thing. But if we could all draw upon the written 
 records of our experience, instead of our uncon- 
 firmed recollections, which are too often but "vain 
 imaginings," our opinions would be more nearly 
 demonstrable. " Liter a scri^ta nianct.'''' We 
 should not forget that simple opinions are not ex- 
 perience, let them be asserted ever so boldly, but 
 that, as Liston has said, "The greatest number 
 of well-assorted facts, on a particular subject, con-
 
 stitute experience, whether these facts have been 
 culled in five years or fifty." 
 
 Next in importance with us to the subject just 
 under discussion is, I think, the tnaking of post- 
 mortems and anatomical dissections. 
 
 The first has always been deemed necessary to 
 the intelligent practice of our profession, and ab- 
 solutely essential to the advancement of medicine 
 toward a perfect science. Without it, nearly one- 
 half the fruits of what we are accustomed to call 
 experience is lost ; for otherwise we have no means 
 of confirming the correctness, or correcting the er- 
 rors of judgment, regarding pathological conditions 
 supposed to exist during life, and toward which 
 our therapeutics have been directed. It is true, 
 that I have sometimes heard it objected, that prac- 
 titioners in the country are so unaccustomed to ex- 
 amining the dead, that whenever they do so, their 
 opinions are worth but little from their inability to 
 clearly discern and distinguish normal from abnor- 
 mal appearances. But this is the most futile of ob- 
 jections, being, indeed, one of the strongest argu- 
 ments in behalf of their being more frequently held. 
 It has been remarked that one of the most correct 
 indices of the true standing of our profession in any 
 locality is llie frequency o( post-mortems. 
 
 As to the latter — practical anatomy — I don't
 
 68 ^titjrrss. 
 
 know that I can adduce any arguments, or the 
 opinions of any, entitled to more authority concern- 
 ing the necessity of its cultivation b}' us, than have 
 been adduced by Sir Astley Cooper and Sir Benja- 
 min Brodie. The former has said : "Let it always 
 be remembered, that operations can not be safely 
 undertaken by any man, without his possessing a 
 thorough knowledge of anatomy. This is the real 
 ground-work of all surgical science. It has ever 
 been found that half anatomists are bungling prac- 
 titioners ; ignorance here, as it always does, gives 
 confidence without power. * * * With us the 
 march of improvement has been most rapid ; and 
 it has principally arisen from the assiduity with 
 which the modern surgeons have pursued their 
 dissecting-room avocations." The latter, when 
 once conversmg in private with a young American 
 who had just taken his degree in medicine, said: 
 " If you wish, my young friend, to give breadth to 
 your medical conceptions and confidence to your 
 hand, if 5'ou wish, indeed, to make yourself a 
 great surgeon, let me say to you, as I would to all 
 with whom I have influence, never for a moment 
 cease the cultivation of anatomical science." Now 
 it will not do to excuse ourselves by saying that, 
 being country doctors, we make no special preten- 
 sions to surgery, and that the remarks quoted were 
 
 X
 
 ^tJlrress. 69 
 
 intended to apply alone to those practicing surgery 
 purely, and that when a surgical operation is neces- 
 sary, they are the ones to whom we send our pa- 
 tients for its performance. The truth is that the 
 advice is in a great measure as applicable to the 
 pure physician as to the surgeon ; and, further- 
 more, the accomplishments demanded at the hands 
 of practitioners in the countr}'- are really much 
 greater than those of the city practitioner, who can 
 devote himself to medicine alone, or to surgery ex- 
 clusively. For we, from the nature of our situa- 
 tion, must be physicians, surgeons and obstetricians 
 — all. I admit that it is true that in probably the 
 majority of our cases we can send our patients with 
 surgical affections abroad for operations, but we 
 must recollect, gentlemen, that in many instances 
 we can not. Every country doctor must be his own 
 bleeder, cupper and leecher ; every country doctor 
 is in any liour liable to be called upon to reduce a 
 dislocation, or amputate a mangled member, or set 
 a fracture, or trephine, or operate for inguinal or 
 femoral hernia, or perform tracheotomy, or extract 
 a bullet, or cut down upon and take up an arter}' — 
 operations sometimes requiring no little degree of 
 anatomical knowledge, and which make the oper- 
 ator sigh for an opportunity of resorting to the 
 cadaver to revive his recollections. I am ready to
 
 70 ^tJ^ress. 
 
 admit that the difficuhies and dangers of dissection 
 are not small, to say nothing of its disagreeable- 
 ness, and that we are placed in the very unpleasant 
 and anomalous condition of being compelled to be 
 law-breakers to enable ourselves to obey the law ; 
 but I think it has alread}'- been satisfactorily de- 
 monstrated that the good sense of this community, 
 and its respect for our profession, are such that we 
 have no just grounds for fearing outside interfer- 
 ence with dissections, when made with discretion, 
 as, indeed, they always should be. " We must dis- 
 sect the dead, or mangle the living.''^ 
 
 What shall I say of the hated monster Q^iackery, 
 which like a hideous hydra-headed shadow, ever 
 stalks abroad accompanying our profession? As 
 the louse, the flea, and tick are the constant com- 
 panions of the canine tribe, so it would seem the 
 body-politic is destined always to be preyed upon 
 by the quack. Though the crop of medicastors, 
 charlatans, quacksalvers, nostrum-mountebanks, 
 liniment-rubbers, wind-pumpers, electric-humbug- 
 gers, ct id omnc genus, has been as plentiful 
 as usual during the past three 3'ears, yet I do n't 
 think they have flourished in this vicinity, as much 
 as was their wont in former days. 
 
 One prime source of the evil rests in the bosom 
 
 >
 
 ^titircss. 71 
 
 of our own profession, for as has been said by an- 
 other : "The quackery which is practiced among 
 medical men is a much greater evil than that vvhicli 
 is abroad in the community. When the rules of an 
 honorable professional intercourse shall come to be 
 understood by the public, as well also as many of the 
 tricks and maneuvers which are employed by those 
 physicians who, pursuing medicine as a iradc'instead 
 of a profession, study the science of patient-getting, 
 to the neglect of the science of patient-curing, one of 
 the great sources of the success of quackery will 
 be removed."* Let us see to it that our own es- 
 cutcheon shall be kept clean, if we wish to avoid all 
 danger of its being confounded with the dirty banner 
 of the enemy. As I once heard a very eloquent di- 
 vine say, in a revival sermon, from the pulpit: "If 
 we had but a revival within the fold of the church, 
 a great and blessed revival indeed would it be." 
 So might we paraphrase him and declare that if 
 the profession proper, were perfectly purged of 
 quackery, what a riddance there would be. In 
 proportion to the high and trusted stand, which our 
 profession takes m a community as a scientific and 
 ethical body, is the difficulty of quackery's obtaining 
 a foothold, but when torn witli dissensions among 
 
 *Dr. WorUiington Hooker.
 
 72 0[ljt>rcss. 
 
 ourselves, chaos prepares a rich field for its prolific 
 growth. 
 
 Our code declares it to be our duty as " physi- 
 cians who are frequent witnesses of the enormities 
 committed by quackery, and the injury to health, 
 and even destruction of life, caused by the use of 
 quack medicines, to enlighten the pubHc on these 
 subjects, and to expose the injuries sustained by the 
 unwary from the devices and pretensions of artful 
 empirics and impostors." To this end, I think that 
 it is the duty of each of us, on every proper occa- 
 sion, to endeavor to reason and explain away the 
 prejudices and misconceptions of the more intelli- 
 gent portion of society, for it is this part, after all, 
 which furnishes the main pillar of its support. I 
 think that not infrequently the mistake is made of 
 treating the subject with some simple ejaculation 
 of contempt, which proves ineffectual, when, if we 
 took the trouble of reasoning a little with those who 
 are intelligent and honest, though misinformed, our 
 efforts to eradicate error would more frequently 
 prove successful. 
 
 If legislation could be brought properly to bear 
 upon the, evil, much would be done toward its re- 
 pression. With this object in view, one of our 
 legislators has promised, during the coming session, 
 to introduce a bill into the Legislature similar to
 
 ^utiress. 73 
 
 the medical act recentl}' passed in the neighboring 
 State of Ohio. 
 
 In conclusion, gentlemen, we ought always to 
 remember that " of unity cometh strength;" and 
 that, as whatever of individual honors come to us 
 are reflected upon our Society, so as individual 
 members composing the Society, whatever of 
 honors or glory cometh to her is reflected back 
 upon us. Let us never forget that the preamble 
 of our constitution declares a prime object of this 
 organization to be "the cultivation of amity among 
 us;" recalling which, let us foster toleration, char- 
 ity, forbearance, the spirit of forgiveness, and all 
 the kindlier feelings, which I think, considering 
 every thing, have pre-eminently characterized our 
 association in the past ; and, as greatly promotive 
 of this end, 1 would suggest that we meet more fre- 
 quently around the social board. 
 
 And now, may I say, in the name of every mem- 
 ber here present to-night, that whatever of joy or 
 sorrow the future may bring us, nerved to a triple 
 resolve by the recollections of the three years just 
 expired, may the coming three always find us true 
 and worthy worshipers at the altar of science, ever
 
 74 enuresis. 
 
 lending the best powers of head, heart and hand 
 toward adorning and keeping clean the little niche 
 in the great Temple of Medicine which has fallen 
 to the lot of the Boyle County Medical Society.
 
 JULY, 1881. 
 
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