Alfred Stillé

“ It is a custom as universal as civilization to celebrate a new era in the history of a public institution, by assembling its friends together to rejoice with one another and unite in wishing it prosperity. It has fallen to my lot to-day to represent the Medical Faculty of the University in the dedication of its new Hall, and in their name and behalf to offer you an earnest and hearty welcome. Honor to the government of the University, and gratitude to its benefactors, that we are enabled to exhibit to you a building so noble in its proportions and complete in its appointments! ”

“ To one who is not content with the simple observation of facts, but seeks to learn their causes and mutual relations, it seems at first a dark problem how science and art shall be mad to harmonize with one another. He knows that perfection in the one should correspond to perfection in the other, since both are essentially but different modes of the same truth; that science should be prepared to explain the phenomena produced or observed by art, and that art, in like manner, should be competent to reduce into practice all the conclusions of science. ”

“ If I have seemed to dwell upon the idea that the Medical Department of the University owes its success and reputation to a wise balance of the powers which control it, let me, I beg, be excused, since I am convinced by the history of the times we live in, that the great defect of political, educational, and even scientific movements in the present day is—haste. The slow and deliberate progress of travellers in other days compared with the present lightning-like swiftness of their movements, illustrates in many points a similar contrast in the intellectual world. ”

“ The appetite may be satiated, the passions may be consumed in their own fire, but the love of knowledge is an appetite which grows by what it feeds on, and a passion that burns forever. It seems to be the only faculty of the human intellect, as distinguished from the human heart, which faith and reason unite in assuring us must be immortal. ”

“ Let them go their ways; but let us endeavor so to exalt our own profession by improving it, that they who may hereafter bear the name of physician shall by that very title be recognized as being thoroughly educated; learned that they may know what has been done before them, solidly grounded also in the science of medicine, before attempting to build upon it the superstructure of medical art, and so enriched by knowledge, that when they go out into the world they may feel assured of securing the confidence of society in themselves, and in the art which they practise. ”

“ This is, indeed, the very reason why the profession of medicine exists. Health is one essential condition of human happiness, for all possessions lose half their value if the ability to enjoy them is wanting. But it is life, as well as health, that will be entrusted to your keeping; life, with its hopes and plans, its loves and friendships, its duties and responsibilities, that will often depend upon your knowledge and skill, and the sense which you may here acquire of the dignity of your office. ”

“ Or shall I speak of the physician no longer as a naturalist or a pathologist, but as a man, whose moral, not less than his intellectual nature, must be exercised in his calling? What are drugs and what are ingenious instruments but so many material agents, essential, perhaps, for the cure of the sick; but what is their power, when used alone, compared with that they display when vivified and potentialized by the spirit of humanity guiding a keen insight into the secret places of the heart? Hope is often no less enlivening than the most stimulating elixir ”

“ In certain countries of Europe in which the institutions of science and learning have for centuries given but little evidence of life either in activity or in fruit, it is easy to trace their intellectual lethargy to political and ecclesiastical tyranny; and it is equally plain that in the freest nations, and especially in our own, an infinite amount of talent and labor is frittered away, and its results are shaken off like untimely fruit. Genius is often dwarfed in its growth for want of nurture and protection ”

“ There is no human side to his science, and therefore, however it may enlighten the understanding, it leaves the moral sentiments uncultivated. But the charm of medical studies is that their tendency is the very opposite of this. They include the most varied and dissimilar elements, stretching from the abstract and impersonal on the one side, to the opposite and material limits of the field of knowledge; for the physician has to deal with the living body and the immortal soul, with the physical heart and the moral heart. ”

“ In this process who shall say where art ends and science begins? In truth it is only a question of degree. In the wards of a hospital where the instruction is confined to the elucidation of individual cases, it is just as scientific as in the didactic lectures in which the attempt is made to present, in a single view, the results of innumerable cases of the same kind in every civilized country, and at every epoch of medical history. ”

“ To which I answer the greatest men are both at once; men of a somewhat lower rank are able to embrace the abstract elements of science only, feeling repelled by the often wearisome details of observation; in a lower stratum still are they who concern themselves about details alone, and work out from these more or less empirical rules which serve them instead of principles; while the humblest grade of all consists of men but little apt to generalize or reason, and whose chief aim is to learn from scanty compends what is “good” in this or the other disease. ”

“ Yet we regard clinical medicine as illustrating art, and didactic medicine as representing science. What figure, think you, would the hospital professor make who should come before you with a patient, and be unable to determine with what disease the person was suffering, the organs affected by it, the nature of their functional disturbance, why some functions rather than others were disordered, how these various elements affect the issue of the attack, what that issue will probably be, and finally, what means should be taken to render it favorable? ”

“ The longer one teaches medicine the better acquainted does he become with the inherent difficulties of the subject, and the more deeply impressed with the grave responsibility which rests upon those who teach and on those who learn it. I shall, therefore, perhaps be pardoned for the practical character of my discourse, and for its barrenness of those rhetorical flowers which might have seemed more appropriate to a day of jubilee like the present.
The life of man may be measured by the years of a generation, or by the threescore years and ten which form the ordinary term of longevity. ”

“ With the mathematician he can calculate the forces which man exhibits as a living machine, and with the chemist study the generation of those forces by the conversion of dead matter into living tissue. This and vastly more it is the tendency of medical studies to do; it is all implicitly included in them, and of no others can the same be so truly said. If the physician often fails to attain the height which these statements imply, the fault, even in the case of the most gifted and zealous, is in his finite powers, the shortness of life, and the thousand human cares which harass his career. ”

“ The judicious student of history is apt to discover that the longevity of institutions, like that of animal organisms, depends first of all upon their inherent vitality, the perfection of their structure, and the freedom and regularity of its action, and then upon the external circumstances to which it stands related. Whatever nation or institution develops its natural powers by a diligent cultivation of whatever will promote their growth tends to become strong and independent. It is not so much the form as the acts of its government that develop the resources of a nation or an institution. ”

“ But if you now devote yourselves to the acquisition of professional knowledge, energetically and systematically, you will be secure of public confidence and professional esteem; and whether you are destined to be eminent leaders in medicine, or merely honorable members of the profession, you will enjoy that reward which is independent of fame and wealth—the consciousness of having done your duty. ”

“ It is he that tolls us which are the waters that restore the sick, and which distil poisonous vapors; he that distinguishes the wholesome from the noxious plant; that discovers the virtues that lie hidden in the mineral, and extracts from it and from organic products the weapons with which he banishes suffering and triumphs over death. It is the physician whose investigations reveal the marvels of the animal structure, amazing even when it lies lifeless before him, putting to shame the utmost ingenuity of human mechanism ”

“ So far as medicine is really a science it does not solicit but commands our belief. It does not permit us to hold opinions about the constitution of the body, nor about the mechanical elements of the various functions, either in health or disease. On the other hand, it leaves us free to adopt whatever judgment reason dictates regarding the cure of diseases. In this department absolute demonstration is impossible, since the physical events in disease are being perpetually modified by a thousand influences which act through the minds of the sick. ”

“ The history of medicine is marked by successive periods in which empirical and scientific methods have by turns prevailed, and a study of them both must satisfy impartial inquirers that neither can be relied upon exclusively to establish principles or to found a method of practice. Of the two the empirical is unquestionably the most fruitful in lasting results; and the successive rise and fall of systems opposed to one another proves that a trust in them as an end, and not as a means, is delusive. ”

“ The planets revolve around the sun in virtue of the counterpoise of gravity and the centrifugal force; life, as Bichat expressed it, is the sum of the powers that resist death; the social system is the equilibrium between barbarism and civilization. Just as certainly is the most perfect system of laws, the wisest administration of public affairs, the most efficient method of education—not that which is instrinsically the best, but that which is in most perfect harmony with the condition of the people where it exists. ”

“ Will you allow me then to endeavor to present to you some notion of the place which medicine appears to occupy in the field of knowledge, the limits of its power, and the attractions which it possesses for the liberally cultivated mind.
Every profession or pursuit in which a man is long trained, not only leaves its impress upon his mind, but more or less moulds it in a peculiar form. The more exclusively it is cultivated the more visible does its power become. ”

“ In whatever institution the forces which move it are duly co-ordinated and balanced, the most perfect results are obtained; whenever they are wanting, the results are apt to be irresolution in council, unsteadiness of action, immaturity of production, and an ephemeral existence. It has been admirably said that “the secret of free movement in the universe is equipoise.” Every normal act in the physical and in the vital domain, and not less in the moral world, is the result of a balance of power. ”

“ They know that medical pretenders, without honor themselves, are filching honor and health from their deluded victims. They know that in medicine, as in other professions, there is a tendency to cut loose from the principles which have hitherto saved the State from anarchy, and society from dissolution ”

“ How much soever of these it may confer, yet, if they do not tend to give us happiness, of what value are they? Therefore, let it be understood that the culture of knowledge for its own sake, and quite independently of any material reward that it may bring, is in itself a happiness so pure and so high that it may well be doubted if there is any richer source of pleasure upon earth. ”

“ The more sagacious and thoughtful of those who receive it know best of all how unfit they are to perform the duties of medical practitioners, and even when experience has made them familiar with these duties, they grow every year less absolute in anticipating favorable results, and less confident in the efficacy of art as distinguished from nature. ”

“ I have in this discourse held before you, as motives for acquiring a thorough professional education, the love of knowledge, and the happiness it confers; but it must not be forgotten that a still higher motive is to be found in the benefits it will enable you to confer upon your fellow men. ”

“ If your time is misspent in idleness and frivolity, or in pursuing a false method of study, your after life will seem to you a perpetual mistake, will be a life of failure, perhaps mingled with self-reproach, and possibly of disgrace. ”

“ Strength in a complex structure depends upon the strength of its component parts, and if these are weak, and loosely put together, the building, the monument, the plant, the animal, or the mind will be proportionately feeble, and liable to destruction under the first strain or storm. It never has been and never will be that a mind hastily stuffed and overladen with knowledge will profit by it to grow in stature and strength. ”