Introductory lectures and addresses, on medical subjects : delivered chiefly before the medical classes of the University of Pennsylvania

Front matter

AND

ADDRESSES,

ON

Preface

Being about to withdraw from scholastic medical teaching, the author conceives that this may be a proper occasion for publishing, in a connected form, the introductory lectures and addresses, relating to medicine, which he has at various times delivered. Most of them have been already printed separately by the several classes or societies before whom they were respectively read ; but some of them now appear in print for the first time. Representing, as they do, the views and sentiments of one long devoted to the medical profession, and compelled, by the necessities of his position, to observe, investigate, and reflect upon the concerns of that profession in all its different relations, scientific, practical, ethical, and historical, they can scarcely fail to contain lessons, which may be more or less useful to the student and young practitioner. This consideration may, perhaps, be received as a sufficient excuse for their publication ; but the author confesses that he has also other views. He wishes to bring himself again to the memory of the many physicians, some of them now no longer young, who have listened to his instructions during their years of pupilage, and to leave with them a memento, by which, when he shall be no more personally among them, they may now and then recall him to mind, with kindly recollections of former intercourse.

Though the subjects are in a greater or less degree discursive, yet the discourses are so related among themselves, that they may be divided into groups, each having a certain unity of character or pur-

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PREFACE.

pose ; and the reader will notice that they have been thus arranged in the following collection. The author has occasionally added foot-notes, when the lapse of years since their delivery has been attended with changes, which render the statements in the text not applicable to the present time, and when misapprehensions might occur without such a precaution. He has only further to observe that all the discourses have a medical bearing, that most of them were delivered to audiences exclusively medical, and that, consequently, they are especially addressed to the sympathies and wants of his own profession. In this light he wishes them to be viewed ; and, should others than those for whom they are intended happen to glance over them, he hopes they may bear in mind that objects look very differently according to the medium through which they are seen, and thus be disposed, if the tints be not always such as are most natural and agreeable to their eyes, to ascribe the result, in some measure at least, to this cause. Of the friendly dispositions of his professional brethren he has received too many proofs, to allow him to have any misgivings on this score ; and he, therefore, trusts the book to the tribunal of their opinion, with every confidence that it will be kindly judged.

Philadelphia, December 21st, 1859.

Table Of Contents

I. — Pharmaceutical Addresses.

1. Address to the Members of the Philadelphia College of

Pharmacy.

I. Address To The

MEMBERS OF THE COLLEGE OF PHARMACY.

DELIVERED NOVEMBER 16th, 1824.

The following address was delivered in the interests of the Philadelphia College of Pharmacy, then a very young institution, and standing much in need of support. The College was founded in 1821, and immediately established a school, in which lectures were delivered on chemistry and materia medica during the winter. In the following year it was incorporated ; and the Trustees did me the honour to elect me to the professorship of chemistry, on which subject I had previously been lecturing to a class of medical students. The institution languished at

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first; and it was in order to excite attention to its importance, and rouse the zeal of the druggists and pharmaceutists of the city in its favour, that this address was prepared. It has been among the highest gratifications of my life, that I was able to contribute towards the expansion and permanent success of a school, which has been productive of much good, which is still in prosperous operation, and the establishment of which may be considered as the commencement of a new era in the pharmacy of the United States.

THE ADDRESS.

Gentlemen op the College: —

It may appear singular that an individual, not immediately connected with your profession, should so far interest himself in its concerns, as to request your attention to a discourse, the chief object of which is the promotion of your welfare. To escape the charge of officiousness, which might, with apparent propriety, be brought against me, it becomes necessary to preface the observations I wish to offer, by a statement of my motives for offering them.

The professions of medicine and pharmacy, though, in practice, they should always, if possible, be entirely distinct, have nevertheless a mutual dependence so complete, that the excellence and usefulness of the one are materially affected by any deficiency in the other. Physicians, however versed in the nature of disease and skilful in its management, will inevitably meet with failures and disappointments, if supplied by the apothecary with inefficient medicines. As a medical practitioner, therefore, I cannot but feel a strong interest in the profession to which you are attached, and am bound to contribute, as much as lies within my power, to its improvement in resources, and advancement in respectability; for in proportion to the real standing of an apothecary in knowledge and character, will be the confidence with which we can rely on the efficacy of his preparations.

Still it may be said, that any interference in your affairs would have come with better grace, and much stronger probability of success, from some other physician, whose more advanced age,

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and better established character, might give him a more indisputable claim to your attention. But, waving the consideration that no one, with such qualifications, has yet come forward so decidedly, I may perhaps be allowed to urge, as an excuse for the course I have adopted, the situation to which the partial suffrages of no inconsiderable number of your body have appointed me, in the institution within whose walls I now address you As one of the teachers in the College of Pharmacy, anxious for its prosperity, because regarding it as the source of great advantages to both professions, and to the community in general, I feel confident that you will not attribute my present proceeding to improper motives; either to a meddling disposition, or a vain love of display.

Before entering on the main subject of the discourse, it may not be improper, in a few words, to indicate the standard, both of attainment and character, at which every apothecary should aim. That he should have received a good general education, is necessarily implied in his acknowledged title to the rank of a gentleman. An acquaintance, to a certain extent, with the Latin language is indispensable; for, without it, he would be utterly at a loss to understand the simplest medical prescription, and might often commit mistakes, the consequences of which might be irremediable, as regards both the health of the patient and his own reputation. Equally essential is an accurate knowledge of the two extensive sciences of chemistry and materia medica. Whether in the preparation of his own medicines, or in the formation of a correct judgment relative to the strength and purity of those he procures from others, the assistance which these sciences afford is of the greatest importance; for the principles of the one are intimately concerned in every pharmaceutical operation, and an account of the sensible properties of drugs, with their effects upon the system, constitutes the very essence of the other. Botany and mineralogy, though of less importance,

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will, however, serve to enlarge his fund of useful knowledge, and procure him a profitable reputation ; while, by the facility they give to his researches in the two great kingdoms of vegetable and mineral nature, they will be found highly serviceable in his professional pursuits.

But the possession of this knowledge is by no means sufficient. The apothecary is eminently a practical man. Having accumulated a sufficient store of science, he must familiarize himself with the various modes of applying it. To become perfectly acquainted with all the manipulations of pharmaceutical processes ; to acquire that accuracy of observation which shall render the evidence of his senses certain, and a mistake as to the nature of articles submitted to his inspection next to impossible; to be able, amidst the bustle of business, to dispense his medicines neatly, and without the least variation from the formula prescribed; these attainments, which are essential to merited success, require a long devotion of time, and a close attention to the practical duties of bis profession. They require that he should have served a diligent apprenticeship to his art, under the direction of some competent instructor, and in a situation where opportunities for practice are constantly afforded.

Still, however, something is wanting to the perfection of his character. Knowledge and practical skill must serve as the main spring of his actions ; but these are insufficient without the regulating influence of correct principles. The temptation to dishonest practices is strong in proportion to their apparent advantages, and their difficulty of detection ; and the degree of their criminality may be considered as commensurate with the evil they are calculated to produce. These conditions are peculiarly incident to the profession of pharmacy; for spurious or adulterated drugs must afford immense profit in their sale, and but a small proportion of purchasers are able to judge of their efficacy; while the injury which must result from their

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employment, can be measured only by the value we attach to our health and our existence. Thus strongly tempted, and thus guilty when yielding to temptation, the apothecary is especially called on to cultivate his moral sense ; to cherish in his mind correct and virtuous sentiments ; and to watch, with peculiar care, that his conduct accord with the dictates of his conscience.

Such as I have described to you is the truly accomplished apothecary; a man of general information, of literature, of science; intimately acquainted with the principles, and skilful in the practice of his peculiar art ; upright and honourable in his dealings ; a man whom all who know him must esteem, and who will necessarily hold a most respectable station in every community, where rank is at all the criterion or the reward of merit. As a profession is generally exalted in proportion to the reputation of its members, such a man will elevate with himself the whole body to which he belongs. How grateful to the best feelings of his nature, must be the consciousness of this truth ! how powerful and honourable the motive which . it offers to strong and continued exertion for individual improvement!

But such is the constitution of human nature, that whatever, even with a view to our own good, calls upon us to overcome our habits of negligence, and natural indisposition to labour, unless the advantages to be derived are manifest and immediate, is apt to appear chimerical in our eyes, the result of wild speculation, not of sober reflection ; — or, even if the propriety of the call be undisputed, we are too often inclined to prefer present ease and gratification, to an obedience which would involve us in much painful exertion and self-denial.

I am sure you would accuse me of a base attempt at adulation, were I to exempt the members of the pharmaceutical profession from this general reproach. Though the apothecaries of Philadelphia have certainly outstripped those of any other part of the American continent in the race of improvement ; yet even here,

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the most partial of us will allow, that the goal is far distant. Instances are not wanting of extensive general information, and great scientific attainment; and the reputation of the profession for knowledge, skill, and character is highly respectable : but a wider diffusion, and more accurate knowledge of those sciences to which I have before alluded, will be admitted to be desirable; and greater skill and strictness in the practical management, by insuring to the purchaser the best possible preparations, and to the physician an exact compliance with his directions, will have a most beneficial influence on the general credit of the art, and the private advantage of its members. It becomes, therefore, a matter of no little importance, to discover and adopt some comprehensive system, by which, at the same time, stronger motives and more extensive means of improvement shall be afforded to the student, and a controlling and regulating influence exerted over the whole profession.

A strong and general sense of the usefulness, if not the necessity, of such a system, has already induced the apothecaries of this city, with a spirit which does them honour, to unite their exertions for the establishment of a college ; — the first attempt of the kind made on this side of the Atlantic. That an institution of this nature, properly regulated and supported, is calculated to contribute greatly to the attainment of the ends proposed, will be admitted by all who can be induced to examine the subject coolly, and with candour. My principal object, in the present address, is to call your attention to the College already established. Most of you are not ignorant that it stands in need of assistance; and, if I should be so fortunate as to impress you with a conviction, that great advantages must result from its successful operation, and that your honour as a body would suffer by its fall, I am confident that your zealous efforts will not be wanting, to augment its strength, and infuse increased vigour into its movements.

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It has long been a well-established principle, that in all attempts to ameliorate the condition, extend the information, or exalt the character of large bodies of men, the greatest success may be expected from those efforts which are directed to the rising generation. The habits and opinions engrafted upon us in early life, and at first but feebly attached, become, as we advance in years, more and more closely united with our thoughts and affections, till at length they seem to form a portion of ourselves, and to be almost identified with our existence. They may indeed sometimes be torn away, as a limb may be torn from the body ; but the whole mental constitution will be agitated to the centre, and any substitute which may be supplied, will seldom be characterized by the strength and symmetry of a natural growth. Besides, there is, in age, a great ivant of spirit and enterprise. The mind has settled down into consistency and firmness ; but its elasticity is gone. New projects, even though their utility may be undisputed, as they require vigorous exertion, are received with coolness, and treated with neglect. Youth, on the contrary, while it is open to correct impressions, possesses also that vivacity of spirit which leads it to despise difficulties, and that energy of action which enables it to overcome them.

In aiming, therefore, at the improvement of your profession, your eyes should be especially directed to those who are yet in their state of preparation. In a few years they will constitute the majority of your number, and will give the tone of their own character to the whole fraternity. Make them scientific, skilful, honest, enlightened apothecaries, and you will have done more than could be effected by any other means, towards the advancement of your art in respectability and importance. For the accomplishment of this purpose, I know of no instrument so effectual as a collegiate institution, properly organized and supported.

To give full efficiency to such an institution, two great objects

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should always be held in view; the one, to provide competent means of instruction, the other to offer such inducements to the student as shall overcome his natural love of ease, and dispose him to the full exertion of his faculties.

The first of these objects is most readily attainable by the establishment of lectureships, with the auxiliary aid of a good cabinet of specimens, and a well-selected library. Universal experience has adopted the mode of instruction by lectures, as decidedly the most appropriate for conveying scientific information. The solitary student, who pursues his inquiries unassisted by those better informed than himself, meets with a thousand impediments, which, if they do not totally discourage him, will materially retard his progress. Almost all works of science contain much that is of little comparative importance, which, however, as the learner is unable to exercise proper discrimination, he feels himself bound to load upon his memory, equally with that which is most essential. In this way much time is lost; and facts most deserving of remembrance, being mingled and diluted with trilling matters, and useless speculation, make a less vivid and lasting impression on the mind. There are, moreover, other disadvantages which attend the unassisted student. In the commencement of his studies, he will often encounter passages that are to him totally unintelligible, because they suppose a degree of knowledge which he has not yet attained ; and throughout his whole course, the description of unknown substances, and the history of phenomena with which he is not familiar, as they are unaided by the evidence of his senses, will present to his mind inadequate or erroneous conceptions. A competent lecturer will have it in his power to obviate these difficulties. From a great mass of materials, he may select all such as bear most immediately on the particular subject of his lecture, rejecting what is of little or no interest or practical utility, and placing in a prominent point of view those facts most

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essential to the learner. Whenever any difficulty occurs, he may enter into familiar explanations adapted to the capacity of the most uninformed of his hearers. He may draw from every source appropriate illustrations, and, without losing- sight of the main design of his course, may endeavour to attract and fix the attention by just and pleasing reflections, entertaining anecdotes, and the beauties of an easy and spirited style. In the experimental sciences, the lecturer has the additional advantage of illustrating facts, and enlivening their detail, by the actual exhibition of interesting phenomena, which, by placing the objects of his attention immediately before the senses of the learner, renders the impression they make both more exact and permanent.

There can be little difficulty in deciding upon the most appropriate lectureships in a school of pharmacy. Those sciences should be taught which I have before mentioned as either essential or highly useful to the apothecary ; and materia medica and chemistry, being exceedingly copious, will each afford abundant occupation for the time and talents of one individual. To these two lectureships might be added another on botany and mineralogy, which, being less important, and requiring, as regards the apothecary, less minuteness of detail, might readily be united without imposing too heavy a burden on the lecturer.

I have mentioned, among the advantages of a collegiate establishment, the facility which a good library and cabinet of specimens will afford to the student, in extending his knowledge, and forming an accurate acquaintance with the materials of his business. On this head I need not enlarge. Their utility is too obvious to need illustration; and I am happy to be informed that, in our own College, no inconsiderable exertions have been made for their attainment.

Professorships on the two most important pharmaceutical sciences have also been instituted, and regular courses of lectures

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on chemistry and materia medica have been delivered for the last three winters. It would give me great pleasure to be able to tell you, that this department of the College is in an equally flourishing condition ; but most of you are aware that such an assertion would be an empty boast. The fact is, that, during the last winter more especially, the labours of the lecturers were rewarded by little more than the consciousness that their own share of the necessary duties had not been entirely neglected. The slender expenses incident to the chemical course absorbed, within a very trifling sum, the whole receipts from the students of pharmacy; and the lecturer was denied the pleasure he himself would have derived from the exhibition of more numerous experiments, by the apprehension of actual private loss. He might, indeed, be disposed to attribute this want of encouragement to his own imperfections as a lecturer; but surely the same reason could not be assigned for an almost equal desertion of his colleague. The lectures of the professor* of materia medica have never been accused of deficiency, either as to the value of the knowledge they inculcate, or as to the manner in which that knowledge is conveyed. We must, therefore, look to another source for at least a portion of this neglect; and may we not find it in the apathy of a great majority of the members of the College ? Considering it a probable circumstance that this apathy may have arisen, in some degree, from an imperfect appreciation of the importance to an apothecary of an acquaintance with the sciences alluded to, or at least from a belief that a sufficient knowledge of them could readily be attained by private and industrious study, I attempted, early in the discourse, to impress you with the conviction of their great utility, and subsequently to exhibit the superior advantages of the mode of in-

* Dr. Samuel Jackson, now Emeritus Professor of the Institutes of Med icine in the University of Pennsylvania.

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struction by lectures. IIow far the attempt has proved successful, you are certainly the most competent to decide.

It may, indeed, be urged, that even allowing the great importance to the student of the opportunities which the lectures afford him, still, as no immediate profit can accrue to those at present established in business, they cannot be expected to incur much expense, either of time or money, for their maintenance. But supposing, for a moment, that this department of the College can be productive of advantage only to the future apothecary ; are there no other motives than the mere prospect of pecuniary profit which can excite a man to action ? Are we not under a strong moral obligation, to provide for those committed to our care the most ample means of instruction in the art we profess to teach them ; and are we not, in some measure, answerable for the evils which must result from their deficiencies ? Can we feel no gratification in contributing to exalt the character, and brighten the prospects of our younger brethren by profession ; and thus giving to the profession itself an increase of consequence and respectability ? When, moreover, we have introduced ourselves to the notice and applause of the world, by originating a project, noble in its objects, and calculated to produce the most beneficial results, is there no disgrace in abandoning it without an effort ? in allowing it to perish from neglect in the very infancy of its existence ? Are not these considerations alone sufficient to counterbalance the pain and inconvenience of a little exertion, or a trifling pecuniary sacrifice ? I am confident that you feel them so. I am satisfied there are very few among you, who would not willingly contribute, to any reasonable extent, towards the attainment of objects so praiseworthy in themselves, and so closely connected with your own honour.

It may justly be expected, that, while I am thus calling for your active interference in support of the school you have established, I should also indicate the path in which your efforts may be most

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successfully directed. At present, I allude only to the lectures. You will admit them to be an essential part of the institution ; and you are aware that, without further support than they have hitherto obtained, they must either be entirely abandoned, or drag on a feeble, languid, and almost useless existence. The question then is, in what way can assistance be most conveniently and effectually afforded. Extensive pecuniary contributions, though a powerful agent of improvement, cannot, in the present instance, be justly demanded. The profession of pharmacy, like that of medicine, abounds more in honour than in profit. I know what it is to feel a spirit of enterprise cramped by the narrow bounds of a slender income; to find all the resources which industry can supply, absorbed by the necessities of daily support. There are other methods by which the desired end ma}r be more conveniently attained. Within the limits of Philadelphia, the number of young men who annually engage as apprentices to the apothecary’s business is certainly sufficient, if their attendance upon the lectures could be secured, to afford the lecturers a compensation, not indeed veLy ample, but such as might at least prevent the discouraging reflection, that their labours, as regards themselves, are totally fruitless. To these your efforts should be directed. Your relation with them is of such a nature, that your opinions must be highly respected, and your advice influential. Endeavour to impress them with the belief, that their own reputation aud consequent success will be essentially promoted by a diligent cultivation of the opportunities afforded by the lectures ; represent to them that no policy is more absurd, than, from the fear of incurring a slight expense, to build on an insecure foundation ; and that a small sum, appropriated to the enlargement of their professional knowledge, will yield, in the future prosecution of their business, a most ample interest. Lay before them the prospect, so attractive to the ambitious and generous spirit of youth, of contributing by their labours for self-improvement, to

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elevate the dignity, and augment the influence of their art ; and, having thus addressed yourselves to their interest and honour, appeal also to their sense of duty, by inculcating their strong moral obligation to enter fully prepared upon a business, in which it is easy to err, but difficult and often impossible to retrieve the consequences of error.

Thus far, your efforts are individual and private. You may also contribute much to the prosperity of the school, by engrafting upon it such regulations as shall offer strong motives to the young apothecary to come forward, and avail himself of its advantages. This brings us to the consideration of the second object, which I before stated to be essential in the institution of a school of pharmacy.

In all great seminaries of learning and science, it is a practice sanctioned by the experience of centuries, to reward, by some public testimonial of approbation, those students, whose industrious application and correct deportment have given satisfaction to their instructors. The hope of distinction is, perhaps, the strongest passion of the youthful mind; and even that honour, which an ordinary degree in the arts confers, is sought after with an ardour and perseverance, which they who have forgotten the feelings of their earlier years can seldom fully appreciate. Of the thousands whom the prospect of such an honour has attracted into the paths of study, many have subsequently attained to great literary or scientific eminence, who, in all probability, without this original motive, would have passed through a life of contented ignorance. Of this principle in human nature, wise men will always avail themselves in their plans for its improvement. They will not only open the doors of knowledge to the young ; but will entice them to enter by the prospect of those trophies which exert so strong an influence over their imagination. The power of conferring degrees, attached to all collegiate institutions, may be considered almost

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an essential part of their constitution ; and the practice is certainly essential, as a general rule, to their successful operation. The School of Pharmacy cannot be regarded as an exception. I do not think I am going too far when I say, that it will never flourish until this practice is adopted.

To the young apothecary, a degree from the College would be desirable, not only as an honour, but also as an effective instrument for the promotion of his success in business. When the public are generally informed, as they some time undoubtedly will be, of the nature and designs of the institution, it cannot but happen that a preference will be shown for those, to whose knowledge and skill its testimonial can be advanced ; and, at some future period, a degree in pharmacy may be as indispensable to the apothecary, as that in medicine now is to the physician. In order, however, that the degree may have the greatest possible weight in the opinions of men, it should never be conferred on the student, till he shall have passed through a certain course of study and practice united, and, by an examination before competent judges, shall have shown himself worthy of the honour. It should, moreover, be confined to those whose moral character is unexceptionable.

The honour and advantage which I have hitherto stated as likely to accrue to the student from the adoption of this plan, are calculated strongly to attract his attention to the College, and to entice him within its walls. Another very important result will be the promotion of increased diligence in his studies, and carefulness in his conduct, and consequently, his essential advancement in knowledge and respectability of character. They only can estimate the influence which the prospect of being submitted to a formal scrutiny, preparatory to the attainment of a highly prized honour, will always exert over the young expectant, who are able to revert to their own feelings under similar circumstances. , It has fallen to my lot to experience in myself,