Study nature for facts; study lives of great men for inspiration how to use them
Never have I more earnestly craved the gift of eloquence than on occasions like this, when young men are about to leave the halls in which and the men with whom they have grown into man's estate, in order to assume the solemn and weighty responsibilities not only of their own lives but those as well of others. The day upon which you are thus released from duties of one kind to assume those of another, welcome and joyous though it may be, should nevertheless be interspersed with some serious and earnest thoughts and resolutions. Old Yale sets now her stamp upon you. It will prove a passport to many homes, but must never be abused. It will entitle you to the society of the cultivated and to the respect of scholars everywhere. It will admit you to the ranks of the learned and cause you to be treated with respect and equality by some of the profoundest and most scholarly thinkers the world has even known. Yale has now furnished you with that which her ripe experience has shown to be requisite for young men commencing professional careers. As contrasted with the total of human knowledge its aggregate is not large, but it has not for centuries been the custom for men to grow gray in studies before undertaking to practice medicine, and when your own qualifications are compared with those which we of the passing generation possessed at the corresponding period of our lives, the comparison will furnish at the same time the most startling illustration of the rapid advance of medicine in the past twenty-five years.
Yale has always been eminent for the versatility and originality of her teachers. Her medical history has been so well told during the past year by one of her most honored sons, Dr. Welch, that it is not necessary nor wise to go now into such historical details. The trend of science to-day is along the lines of comparative investigation, and the Bible is by no means the only literary collection which to-day is being subjected to the "higher criticism." The inspiration claimed for the contributors to that great ancient Collection is denied to the writers of great modern works, where, nevertheless, fundamental truth is as requisite for the welfare of the body as in the other for that of the soul. Only by painstaking research, laboriously repeated, do we clear the old paths of the rubbish of centuries or discover totally new ones.
Pathfinders of this description have always abounded in this great institution, drawn by common impulses or attracted by some centripetal force. And though it were perhaps invidious to mention names, I nevertheless must select two of Yale's great teachers whose names are still green in the memory of all men, and ask you to note how the examples they have set and the work they have done may furnish the line of thought in which I wish you to follow me for a little while.
The science of comparative philology would seem to be far removed from that of medicine. Still, it is based upon an ultimate analysis of parts of speech, and men like Professor Whitney were, not only the comparative anatomists, but even the histologists—if I may use the phrase—of words. Comparative philology then is to medical terminology what embryology and comparative anatomy are to a study of the structure of the human body. The philologist loves to dissect words and trace them back through rudimentary stages and roots to their earliest forms. He loves also to study the evolution of an idea as conveyed by a word, and trace atavism or reversion in human speech.
Again you have here at Yale a wonderful collection of extinct animal remains restored with marvellous accuracy to semblance of their original form and appearance. The indefatigable industry and wonderful ability of Professor Marsh and his co-workers have enabled us to form ideographs of the living forms of earlier geologic ages upon this earth, which could not have been furnished had it not been for their remarkable knowledge of morphology and skill in synthesis. Indeed, where have powers of analysis and synthesis been more brilliantly displayed than by these men. It used to be said of Cuvier, the great French comparative anatomist, that if given a tooth from any beast, past or present, he could describe the animal and its habits as well as reconstruct his skeleton, so wonderfully are minute differences perpetuated, and so familiar was he with them.
Let us see, then, if it be possible to take some of our common medical words and by applying to them the methods of Whitney and of Marsh follow them back to their early forms and significances, and then construct from them ideographs of the customs, habits and superstitions of the men who used them. Such a plan systematically carried out might furnish both a fitting and a novel introduction to the history of medicine. Coleridge, you know, said we might often derive more useful knowledge from the history of a word than from the history of a campaign.
Take, for instance, our word idiocy. The Greeks, especially the Athenians, were a race of politicians. Private citizens who cared little or naught for office were the idiotai, as distinguished from the public officials and office holders. It came about in time that men of such retiring habits and modest tastes were regarded as persons of degraded intellect and taste. And so the iviwrai were considered of inferior intellectual capacity. In other words, the idiot of those days was the man content with private life. How different from the present day when conditions seem so nearly reversed.
Our kindred word imbecile has also present reference to those of feeble, dwarfed or perverted intellect, and refers rather to mental than physical defects, though both must often be associated. But originally the lame and the deformed who were obliged to use artificial support, walked as it was said, in bacillum, upon a stick or crutch, and from this expression we derive our word imbecile.
Let us trace, for instance, again, the etymology of our word palate. The Latin palatum is the same as balatum, that is, the bleating part. The ancient shepherds of the region of the Campagna watched the sheep as they went bleating (balatans) over those hills, one of which subsequently became the Palatine.
Or take again our word mania. It is derived from unv the moon, meaning the moon-sickness, and corresponds to lunacy from luna. You see the ancient superstition concerning the influence of the moon abides in the name. This brings up again the old ideas concerning the metal silver which was sacred alike to Diana and the moon, and consequently feminine in sex and attributes. Hence comes the mediæval alchemistic term lunar caustic, and hence, too, comes its use in the treatment of epilepsy for which it was formerly much in use, since epilepsy was regarded as a form of mania caused by the evil influence of the moon.
By the way, this may also remind us of the peculiar views of the alchemists of the middle ages, who believed that the property of sex inhered in the metals. They believed, for example, that arsenic was masculine in sex, and so named it from arsen, male, and arsenikos, masculine. Medical, like comparative philology, is the more or less direct outcome of the earth's physical features as they have influenced the commingling of races and the conquest of nations.
Medicine seems a science of Aryan parentage; in the Sanscrit the literature of medicine is rich; it was cultivated by the Greeks, but it lost much of its original significance by virtue of Roman supremacy, as the Latin races took it over. Under the Arabians it flourished after a fashion. With the revival of Greek learning there was a restoration of much that had been lost, but the supremacy of the Church kept it within extremely narrow limits, though the clericals could not eliminate all the Arabian words which had crept into its terminology. Greek is to-day the language to which we turn for aid when it becomes necessary to invent new terms by which to indicate fresh discoveries or concepts.
The debt of medicine to our Aryan forefathers is great. Surgery was then a dignified branch of the science. Their autoplastic methods were conceived with great ingenuity and carried out with much, albeit with crude skill. The so-called Indian method of reconstructing a nose bears witness to their ability in plastic art. Their itinerant surgeons performed many capital operations; i. e., lithotomy and cœliotomy. There is good reason to believe that Hippocrates knew nothing of practical anatomy, whereas, long before him Susruta urged that all physician priests should dissect the human body in order that they might know its structure; and gave, moreover, directions for the selection of suitable subjects. The Sanscrit writers knew the properties of many plants and of at least five of the metals. Many Greek names of drugs are derived from the Sanscrit, or else they had a common Aryan origin. Thus the Greek equivalents for our words castor, musk, cardamon, chestnut, hemp, mace, pepper, sandal-wood, ginger, nerve, marrow, bone, heart, and head, are unmistakably of much older, i. e., Sanscrit or Aryan stock, several of them coming down in Romanized form, but almost unchanged—e. g., os, cor, moschus, cannabis, castorion.
Although many of the ancient Greeks visited India, it appears that but relatively few words have come to us from this ancient source.
Our word sulphur, though, is of Sanscrit origin, the Greek word theion indicating its divine or god-given purifying power, with possible allusion to its utility in that lower world with which the theologians most often associate it. The Greek word appears in our chemical nomenclature as dithionic, trithionic, etc.
We note also an almost complete absence of Egyptian words, though many cultured Greeks visited Egypt. Nevertheless, the latter looked with small favor on barbarisms of speech, and our word pyramid is one of the very few which they thus adopted. The term surgery is of very distinct Greek origin, and meant handwork as distinguished from the action of internal remedies. Medicine seems to be derived from medeo to take care of, to provide, and physic and physician from phusis, i. e., nature. The physici were originally naturalists, or scientists, like Aristotle, medical science being but a part of their study. Campbell in his book ("The Language of Medicine") gives a list of at least two dozen common terms of to-day which were employed by Homer. In addition to these, many other Homeric terms are still in use, but with more or less altered or perverted meanings; for example, æther, when used in the sense of its being a narcotic agency; astragalus, which originally meant a die, since the analogous bones of the sheep were used for dice; amœba, from amoibe, change or alteration, alluding to constant change of shape. Ammon originally meant a young lamb, iris a halo, meconium has reference to the juice of the poppy, from mekon, opium; molybdenum was so named from its resemblance to lead, narcosis originally meant numbness; the pleura was the side; the original phial was a saucer; the phalanges were so called because they were arranged side by side as it were in a phalanx; our troche was at first a wheel; and our tympanum was the original Greek drum, the word still persisting in musical terminology. The arteries were so named because they were supposed to contain air, while the veins were the gushers, from phleo, to gush or flow. The original confusion of nerves and tendons appears in the term aponeurosis.
Long ago there were two rival medical factions among the Greeks, the Empirics, from empeirikos, meaning experimental—who believed there were no philosophic underlying principles of medical science, and that experience alone was the safe guide,—and the Methodists, from methodos, who believed it better to follow the hodos, or "middle of the road." The present use of the word empiric shows the contempt with which the former came to be regarded.
As cure (curo) meant to care for, so did medicus have the same meaning, as already remarked, while the Greek slave, therapon, who waited on his master, became later the therapeutist who cared for his ailments. Our word to heal has also a somewhat similar dislocated meaning, since originally it meant protection, i. e., covering. The same root persists in hell, i. e., hades, referring to a certain supposititious locality so well covered that from it there is no escape.
Note, too, the influence of ancient mythology in medical phraseology. Jupiter Ammon, the horned god, is recognized in hartshorn or ammonia. Mars, the god of war, whose symbol is iron, persists in the so-called martial preparations or ferruginous tonics. Venus and Aphrodite naturally appear in venereal and aphrodisiac, while Vulcan's rôle is indicated in the heat to which caoutchouc is subjected in vulcanizing rubber. Mercury appears not only in Roman form as a metal, but in his Greek rôle as Hermes, not to be forgotten when receptacles are hermetically sealed. Let us cut short a longer list by simply noting in passing how the Greek Cupid Eros and his mate Psyche are perpetuated in our terms erotic and psychiatry, while Morpheus, the god of sleep, can never be forgotten so long as morphine is in use. That the wrath of the gods was to be dreaded is indicated in our word plague, from plege, meaning a blow from that source, that is their vengeance. You thus see the antiquity of the notion that epidemics were a divine visitation, and not due to bad sanitation.
Melancholia, melas and chole, meant originally black bile. In ancient physiology the bile played a very important part, and the results of hepatic insufficiency were not only indicated by this name, but the advantages of the use of calomel were amply emphasized by its name, kalos and melas, for it was a beautiful remedy for this blackness. Another condition indicating trouble with the liver, which we call jaundice to-day (from the French jaunisse), was known as icterus from ikteros, a yellow bird. The poultice which the average housewife of to-day is so fond of using, was originally a poltos, or pudding, or perhaps a bean porridge.
In the days of ancient sacrifices one part of the animal was not placed upon the altar as an offering to delight the gods. It was that now known as the sacrum, which is usually defined to have been considered the sacred bone. The adjective sacer (sacrum), had not only the meaning generally ascribed to it, but meant also execrable, detestable, accursed. The sacrum meant then rather the part that was not acceptable to those to whom it was offered. The word calculus, like the term to calculate, must remind us of the presence of pebbles and their early use in facilitating reckoning, while our common terms testimony, testify, must necessarily recall the ancient sacred but phallic methods of oath-taking. Another superstition connected with deity is perpetuated in the term iliac passion, formerly applied to volvulus, or one form of acute bowel obstruction with its violent pain, which has been compared to that produced by the spear-point as part of the suffering upon the cross.
A keen analysis of the situation at the beginning of the Christian Era reveals the subtlety of the Greek character. The names of those organs which called for deep investigation or dissection are taken directly from the Greek, e. g., hepatic, sphenoid, ethmoid, the aorta, while many of the superficial parts have Latin names, e. g., temporal, frontal.
It is to the Greek that all nations almost invariably turn when they seek to fashion new terms with which to characterize or name new discoveries. The Romans showed their appreciation of that which was good when they so readily adopted the science and learning of the Greeks, and were willing to take over even their gods. The Latin races have always been good imitators but poor originators, save perhaps in war and politics. Had they been willing to imitate the Greeks in these their history might have been very different. When the Latin translators of Greek medical literature lacked for a word they cheerfully took the original, sometimes giving it a Latin dress. For instance, that which we now call the duodenum, meaning only twelve, was originally the dodekadaktulon, meaning that it was of a length equal to the width of twelve fingers, while they twisted the name eileon, the twisted intestine, into ileum. But the names of most diseases, like those of the more concealed parts, they copied almost exactly.
While in later ages the Church completely dominated, then subordinated, and then finally almost terminated the study of the natural sciences, it is yet of no small interest to note the effect of the rise of Christianity upon the study of medicine. It has been well said that the same "cross which brought light to religion cast a gloom over philosophy" (Campbell). Certain it is that the creed and the tenets which were for centuries the mainstay of Christianity, and which did so much for the uplifting of mankind, were made the excuse for the gradual suppression of all tendency toward investigation of natural phenomena, and the monasteries, where scholars congregated, became the graves of scientific thought and study. And so in time knowledge was exiled from Christian domiciles and transplanted to a Mohammedan environment. With Christian mythology and mysticism soon came also Christian demonology, and disease was generally regarded as an evidence of diabolical possession. This gave rise then, as even now, to the imposters who pretended to cure it by exorcism of evil spirits or invocation of divine or superhuman aid. It has always been a sorry time for rational medicine when superstition is rife. Even under the Arabians science flourished to but a limited extent. Their religion forbade the portrayal of any living object, animal or vegetable, consequently their works contained mere descriptions, never any illustration of any kind. This, by the way, is the explanation of their fondness for geometric tracery and of the richness of their ornamental designs. They professed the same horror of the dead body that was later inculcated by the Church and most of them scorned dissection. What wonder then that under Christianity and Islam alike our profession fared badly.
But very little now remains in our terminology to remind us of the period of Arabian supremacy. The Arabic words naphtha, sumach, alkali, alcohol, elixir and nucha (neck) are almost the only ones which have survived the renaissance. How different the monkish Latin sometimes is from the classic may appear in the use of the two words os and bucca for mouth, or os frontis and glabella for the frontal bone.
But this enumeration must not be prolonged unduly. Let us select three or four more examples almost at random and then pass on. But few will associate Christianity with cretinism. The early Christian inhabitants of the Pyrenees were known as Christaas, or in French, as to-day, as Chretiens. A mountainous region did for them what it has done in Switzerland for the races of to-day, and dwarfed the intellects of many while their thyroids underwent great enlargement. Such degenerates are known everywhere to-day as cretins, i. e., Christians.
Tarentum was the old Calabrian city later known as Tarento, where during the middle ages the dancing mania appeared in aggravated form. The frenzy was known in consequence as tarantism, while the spider whose bite was supposed to cause it was called tarantula, and a rapid dance music which alone would suit such rapid movements is still known as the tarantella.
Nightmare has reference to the old Norse deity or demigod Mara, who was supposed to strangle people during sleep.
The Sardonic grin has reference to a tradition that in Sardinia was found a plant which when eaten caused people to laugh so violently that they died.
But turn we now from words to those deeds which are reputed to proclaim yet more loudly the manner and the worth of their authors. Where may one look for a profession which shall afford greater opportunities? And where may he find one in which incentives are so small? The world's great rewards have been paid to the great destroyers of our race rather than to its saviors. Do you suppose that if Napoleon had saved as many lives as he lost he would have figured in history with his present lustre? It is true that Lister's discovery has saved many more lives than Napoleon took. If so, the Hôtel des Invalides should, when the time comes, contain Lister's monument and not that of a great murderer.
Personal courage is one of the noblest characteristics which any man can display, particularly so when it combines the moral and the physical type. Public bravery brings nearly always its meed of public recognition. In fact, publicity is often the stimulus to a kind of bravery which without it would hardly respond to the tests. But your really courageous man is he who cares not for a search-light to reveal his deeds, one who dares and does within the quietude of his own environment that from which his weaker brothers would shrink.
The soldier stirred to frenzy by the intensity of his passion will accomplish with but little dread that which might easily baffle the resolution of a reasoning man in a calm mood. The religious fanatic, be he Mussulman or Christian, may permit himself to be rent asunder rather than recant; but his motives are essentially selfish, since he looks forward to the Mohammedan's or the Christian's paradise, and so they are far from altruistic. But for that quiet heroism which shuns publicity, which calls for the highest quality of both mental and physical courage, which looks forward neither to the golden present nor the mystical yet sensuous future, commend me daily, yes hourly, to the sick rooms of patients suffering from diseases which menace the welfare of others, the infectious, the dangerous, the loathsome. One may read of late many stories of army surgeons doing heroic deeds under fire, and one's heart naturally thrills with emotion as he imagines the scenes and wonders what manner of daring may lead a man to risk his life after this fashion. But I submit to you, that brave as is such a deed and worthy of all possible honor, it has been hundreds of times for one exceeded in the actual devotion to duty and the resolution required to brave the elements, or to face death elsewhere than on the battlefield, or to surrender strength or mayhap life itself, or to invite disaster by infection, or to wear out and work out life in the constant grinding altruistic work of doing for others, who perhaps have violated every known sanitary law and forfeited their every right to live.
Here is a theme that might well stir the most eloquent poet or orator that ever lived. How then shall I do it justice? Joanna Bailie has well put it:
This recognition of our profession was accorded much more unstintingly nearly two thousand years ago, at a time when it was much less deserved, when Cicero wrote (De Natura Deorum) "Homines ad Deos nulla re propius accedunt, quam salutem hominibus dando." (Men are never more godlike than when giving health to mankind).
But we can hardly delay longer here and at this time with the subject of heroism in medicine. I shall not have completed the matters which I wish to present to you to-day until I invite your attention to a short sketch of the careers of four or five of the men who, during the past two or three hundred years have set the example for men of all times and most climes, whose lives are so replete with that which is interesting, instructive or important that they may be well held up before a graduating class as illustrations of everything which may be advantageously imitated. They belong to that class of whom Longfellow wrote:
One of those was Jean Fernel, who was born in France about 1497 and died in 1558. I do not know that his life history offers anything so very startling, although he came to be regarded as the most memorable physiologist of his generation, but he adopted a motto which I think we all might well select for our own, and it was because of this motto that I have mentioned his name at this point. It was this: "Destiny reserves for us repose enough." If each of you will take this individually to himself he will find in it stimulus enough for all kinds of hard work.
The first of the eminently great men now to be mentioned in this connection was Herman Boerhaave, born in 1668 and died in 1738. He enjoyed the reputation of being perhaps the most eminent physician who ever lived. The eldest son of a poor clergyman with a large family, he was originally intended for theology, and with this in view studied philosophy, history, logic, metaphysics, philology and mathematics, as well as theology. A mere accident, resulting from intense party spirit and doctrinal differences, prevented his devoting his life to theology, and he turned next to mathematics and then to chemistry and botany, subsequently studying anatomy and medicine. He graduated in 1693 and began at once to practice in Leyden, with such success that he was early offered the position of ordinary surgeon to the king, which, however, he had the moral courage to decline. Subsequently he taught medicine and botany, to which chairs was also added later that of chemistry. This fact of itself will show to you something of the condition of medical science of that day, when one man could teach chemistry, botany and medicine. His rarest talents, however, were developed in the direction of clinical instruction, and in this particular field he won such repute that hearers were attracted to Leyden from all quarters of the world and in such numbers that no university lecture-room was large enough to contain them. His practice grew in extent and remunerativeness in pace with his reputation, and when he died he left an estate of two millions. So famous was he that it is said of him that a Chinese official once sent to him a letter addressed simply "To the Most Famous Physician in Europe." That he had fixed convictions and practices may be better understood from the fact that so little difference did he make between his patients that he kept Peter the Great waiting over one night to see him, declining to regulate his visiting list by the means or position of his patients.
Boerhaave was universally regarded as a great student and a great physician, but it was probably his qualities as a man which led to the astonishing extent of his reputation. Essentially modest, not disputatious nor belligerent, he had a remarkable influence over the young men who came near him, while he had a habit of speaking oracularly or in aphorisms, which are not always so profound as they sound and yet often make a man's dicta celebrated. Save that he introduced the use of the thermometer and the ordinary lens in the examinations of his patients, his teachings do not form any really new system. In the classification of men he would be regarded as a great eclectic, in the purer sense of the term. Probably his greatest service to medicine was in the permanent establishment of the clinical method of instruction, and perhaps his next greatest real claim to glory is the character of the instruction and the inspiration which he gave to two of his greatest scholars, viz.: Haller and Van Swieten. He was not the founder of a school. He left no great nor memorable doctrines for which others should contend, but he left a name for studiousness, honest and logical thinking, which was a priceless heritage for the university with which he was connected.
The next great scholar to whose life and works I would invite your attention for a moment, is Morgagni, born in Italy in 1682, died in 1772. He was a pupil of Valsalva, whose assistant he became at the age of nineteen. Brought up in this way, as it were in the domain of anatomy, it is not strange that he devoted his attention throughout his life especially to the anatomical products of disease. It matters little to us now that he was wont to regard these products as the causes of disease and thus neglected their remote causes. He it was who taught us to apply to pathological anatomy the same scrupulous attention to tissue alterations and changes which the ordinary anatomist would note in dissecting a new animal form. He was scarcely the founder of the science of pathological anatomy, for this credit belongs to Benivieni, but he did very much to popularize the study and to show its importance. More than this, he wrote a work which for his day and generation was colossal. It bore the title "De Sedibus et Causis Morborum per Anatomen Indagatis." It consisted of five books. The first appeared in Venice in 1761. This proved a perfect mine of information to which one may often turn even to-day, and read with wonder the observations published one hundred and fifty years ago. They stamp Morgagni as a great scientist as well as anatomist. His industry will be indicated by the fact that even after he became blind he did not cease to work.
Perhaps the most wonderful figure in the whole history of modern medicine is that of Albrecht von Haller, of Berne, born 1708, died 1777, and often known as the Great. No more versatile genius than his has ever adorned our profession. A most precocious child, he developed remarkable abilities in the direction of poetry and music, as well as medicine, and the only wonder is that he lived to such a ripe old age, enjoying the fruits of his labors, having displayed throughout his entire life an industry and productiveness which were most remarkable. Before he reached the age of ten he had written a Chaldee grammar, a Greek and Hebrew vocabulary, and a large collection of Latin verses and biographies. During the next few years he translated many of the Latin authors, and wrote an original epic poem of some four thousand verses on the Swiss Confederacy. All of this work he had completed by the age of twenty-one. It is not strange that among those who knew of his precocity he was generally known and regarded as a "wonder child." It will thus be seen, too, that medicine was but one of the many subjects of his study. He studied a year in Tübingen, where the riotous living of his fellow students repelled him; then he went to Leyden, falling there under the influence of the illustrious Boerhaave. How much he drew from this source no man may accurately say at present, but a more brilliant example he certainly could not have had. He finished his studies in Leyden before he was twenty and then traveled through England and France, but was compelled to flee from Paris to escape arrest for hiding cadavers in his room for purposes of dissection. This will prove an evidence of taste for study if not of taste in other directions.
Suddenly developing a passion for mathematics, he went to Basle and worked so hard as to almost ruin his health. This necessitated a trip to the mountains and here his interest in botany was aroused and indirectly that in medicine continued. Soon after he returned to Berne to take up the practice of medicine. Here he studied and worked so hard as to arouse a suspicion of his sanity, but he kept up his health by frequent trips to the Alps in search of flowers. His fondness for botany and his taste for poetry seemed to grow with equal pace and he seems to have been among the first of modern students to appreciate the beauty and grandeur of Swiss mountain scenery. When he was twenty-five years of age appeared the first edition of his poems, many editions appearing later. Here in Berne also he published so many essays on botany, anatomy and physiology that widespread attention was attracted to his eminent learning, and he was called to fill the chair of anatomy and botany in the new university of Göttingen, where he spent seventeen years of extraordinary mental activity, publishing countless papers and at the same time continuing his poetic and his nomadic habits. He established in Göttingen a great botanic garden, founded scientific societies, published five books on anatomy, all elaborately illustrated, printed a series of commentaries on Boerhaave's lectures, and is said to have contributed altogether thirteen thousand articles relating to almost every branch of human knowledge. It is not strange that the fame of the University of Göttingen depended largely upon Haller's reputation.
But Haller developed a clear case of nostalgia, and after being fêted by the nobility, honored by almost every monarch in Europe, and receiving every honor that universities and philosophic societies confer, he resigned from his chair in Göttingen and returned to Berne, to his fatherland. Here, amid his old home surroundings, he worked for twenty years more at the same tremendous rate, discharging diverse duties of state and private citizenship, founding and promoting industries and asylums, and serving constantly upon commissions of all kinds. While thus engaged appeared that phenomenal work, his great Treatise on Physiology, so full of original observations that it has been stated that should discoveries which have been re-discovered since Haller be collected they would fill several quarto volumes. The physiological institute of Berne is to-day known as the Hallerianum, as it should be, for it is distinctly the product of his genius. He died at a ripe age, after having performed an incredible amount of work, the greatest scholar of his own or perhaps of any century, revered and honored, faithful to the last and exhibiting in his last moments that "philosophic calmness of the cultivated intellect" of which Cicero loved to write. It is related of him that on his deathbed he kept his fingers on his own wrist, watching the ebbing away of his own existence and waiting for the last pulsation from his radial artery. Finally he exclaimed, "I no longer feel it," and then joined the great majority.
Perhaps Haller's greatest contribution to physiological lore was his doctrine of irritability of tissues. It took the place of much that had caused previous discussion and is accepted to-day as explaining, as nearly as we can explain, numerous phenomena.
In this same great wonder-century lived also John Hunter, the greatest of England's medical students, the most famous surgeon of his day and the most indefatigable collector in natural history and natural science that ever lived. He was born in 1728 and died in 1783. He was led to study medicine by the fame of his illustrious brother William, and began his studies by acting as prosector for him. He soon became a pupil of Cheselden, perhaps the most famous English surgeon of his generation. Hunter developed very early those extraordinary powers of observation and that originality in investigation which later made him so famous. Early in his medical career he came for a time under the influence of Percival Pott. This was at a time when surgery had emerged from barbarism and when the French Academy of Surgery had erected it into the dignity of a science. He entered St. George's Hospital in 1754 as a surgeon's pupil. Later he became a partner with his brother in the latter's private school of anatomy, but John, being a poor lecturer, was distinguished by his services in the dissecting-room rather than in the amphitheater. The customs of his time and the jealousies of the various medical factions then existing in London led to numerous acrimonious disputes, in the literary part of which William Hunter, who was much the more cultured student, took the lead, while John, who lacked in scholastic ability and had much less education, was relied on to supply the anatomical data. John was painfully aware of his deficiencies in literary culture and is said once to have replied to the disparaging remarks of an opponent: "He accuses me of not understanding the dead languages, but I could tell him that on the dead body which he never knew in any language living or dead."
It was in this way that he was led into unseemly encounters with the Munros, of Edinburgh, and with his late teacher, Pott. The same sort of dispute finally separated the two brothers, and they parted company after a very unseemly exhibition of jealousy and fraternal discord.
After studying human anatomy for several years, John Hunter became profoundly impressed with the need for much larger knowledge of comparative anatomy, but about this time ill health compelled a temporary change and so he went into the army as a staff surgeon. This was at the time when Europe was engaged in the sanguinary Seven Years' War, and so it happened that Hunter had ample opportunity for studies and observations in military surgery—at the siege of Belleisle and later in the war in the Peninsula. Here he made many of those observations on gunshot wounds which he published at various periods later and which helped to make him famous.
He resumed his work in London in 1763, and here again he had to undergo a long trial of those qualities of passive fortitude and active perseverance under difficulties which were his prominent characteristics. His personal needs were small but his scientific requirements were large, and to these latter he devoted every guinea which he could earn in his small but slowly growing practice. His own manners were so brusque, and he was so lacking in the refinement of many of his colleagues and competitors, that it took rare mental qualities to force him to the front, to which he nevertheless rapidly advanced. Bacon has said, "He that is only real had need of exceeding great parts of virtue, as the stone had need be rich that is set without foil," and this was never more true than in John Hunter's case. His leisure hours were never unemployed. He obtained the bodies of all animals dying in the public collections in London and so began to form that enormous collection which became known later as the Hunterian Museum. As his means afforded it he built and added to his accommodations and carried on those vast researches into animal anatomy and physiology to which the balance of his life was devoted. Although his practice gradually increased and he became in time the most famous surgeon and consultant in London, he used, nevertheless, to spend three or four hours every morning before breakfast in dissection of animals, and as much of the rest of the day as he could spare. Pupils and students who wished to consult him had to come early in the morning, often as early as four o'clock, in order to find him disengaged. He had that rare ability to do a maximum of work with a minimum of sleep which has been so conspicuous in the case of Virchow. Before he died, Hunter attained to a large competence, and his anatomical collection, consisting of some ten thousand preparations, made largely with his own hands, was purchased after his death by the Government, for seventy-five thousand dollars, and presented to the College of Surgeons where it forms the chief part of the so-called Hunterian Museum.
Hunter's principal claims to greatness obtain in this, that he not only brought the light of physiology to bear upon the practice of our art, but by his writings and teachings and especially by his example led men to follow along the paths he cleared for them. It is no small claim to glory to be known by such pupils as Hunter had. By these, by his colossal industry in building up his museum, and by his writings, he will ever be known as the most prominent figure in the medical history of Great Britain.
The fifth man in this quintette of geniuses which I am presenting to you to-day was Francis Xavier Bichat, who was born in France in 1771, and died in 1802. Although he was thirty-one years old at his death, his career was so phenomenal, almost meteoric, that it deserves to be held up as showing what one can do in the early period of his life, if he will but work. As one reads of his originality and talent one is led almost insensibly to compare them with those of some of the world's famous musicians who, also, have died in early manhood after giving to the world their immortal works, e. g., Schubert, Mozart and Mendelssohn. Bichat was the son of a physician and applied himself early to medical studies in Nantes, Lyons, Montpellier and finally in Paris, where he became the pupil and trusted friend of Desault, then the greatest Parisian surgeon. When Desault died, in 1795, this young man began lecturing for him, at the age of twenty-four. He displayed a wonderful, almost feverish scientific activity, more particularly in the direction of general and pathological anatomy. He was the originator of the phrase which he made famous: "Take away some fevers and nervous troubles, and all else belongs in the domain of pathological anatomy." Coming upon the stage shortly after Morgagni left it, he was able by his genius, his logical acumen and his graces of speech and manner, to give an attractiveness and importance to this subject which it had hitherto lacked.
It was his great service to more clearly differentiate closely related diseased conditions and to insist upon a study of post-mortem appearances in connection with previously observed clinical phenomena. He also established the tendency of similar tissues to similar anatomical lesions. In fact our view of what we call general tissue systems we in reality owe to him, since without use of the microscope he distinguished twenty-one kinds of tissue, which he studied under the head of general anatomy, while he held that descriptive anatomy had to do with their various combinations.
To Bichat was largely due the overthrow of purely speculative medicine because he placed facts far in advance of theories and ideas. Books he said are or should be merely "memoranda of facts." That he made many such memoranda will appear from the fact that before his untimely death he had published nine volumes of essays and treatises, nearly all bearing on the general subject of anatomy, normal and morbid. He also had not only his limitations but his faults. He strangely denied the applicability of so-called physical laws to body processes, he minimized the importance of therapeutics, and he sought to place the vitalistic system upon a realistic basis. Nevertheless he set an example not only for the young men of France, but of all times and climes, which should be often held up before them.
And so I have thus placed before you five bright and shining illustrations of what brains and application can accomplish, selected from different lands in order to show that medicine has no country, and from a previous century in order that you may the better realize how meagre was their environment in those days as compared with that which you enjoy. Perhaps you will say, "there were giants in those days." True, but the race has not entirely died out. While Spencer and Virchow live one may not call the race extinct, nor can the times which have produced such men as Helmholtz, DuBois-Reymond, Darwin, Huxley, Leidy or Marsh, fail to still produce an occasional worthy successor.
But it is time now to draw this rather rambling discourse to an end. The effort has been partly to attract your attention to some of the side lights by which the vista of your futures may be the more pleasantly illumined, and partly, by placing before you brief accounts of the careers of some of your illustrious predecessors, to show that eminence in medical science inheres in no particular nationality nor race, neither comes it of heredity nor by request. Like salvation it is available to all who fulfill the prerequisites. It is a composite product of application, direction, fervor in study, logical powers of mind, honesty of purpose, capability of observation, alertness to improve opportunities, all combined with that somewhat rare gift of tact, which last constitutes the so-called personal equation by which many humanitarian problems are solved. Study nature for facts; study lives of great men for inspiration how to use them.