seems to him to require, steadily and undeviatingly, whether it be much or little. As much decision may be shown,-nay, I think, much more,-in doing nothing, than in doing a great deal. Patients and their friends are seldom uneasy, when they see a great many means put in requisition for their relief; but it requires a rare combination of intelligence and moral force to keep them quiet, and to keep one's self also composed, when, amidst danger and pain and perhaps the fear of death, we feel ourselves called upon to adopt only palliative or negative

means.

There is one other consideration relating to the formation of the medical character, to which also I wish to call your attention. At the present day, a new and strong impulse has been given to the investigation of medicine as a science. New and more accurate methods of studying the history of diseases have been put in practice. Nothing can be more desirable than that each one, according to his opportunity, should devote himself to this species of study. But there is apt to exist in the mind, when it becomes deeply interested in such pursuits, a tendency to confine the attention to the investigation for its own sake, without sufficient regard to the ultimate purposes for which it has been undertaken. Thus, the botanist becomes engaged in examining and classifying plants, and feels no interest except in studying them as parts of a certain system of arrangement. It is the same with the entomologist and the mineralogist. And so, too, the physician may get engaged in the study of disease solely as a branch of natural history. He may come to look on patients, as the botanist does on his plants or the entomologist on his insects, merely as objects whose characteristics he is to investigate, and not fellow-beings whose diseases he is to cure. There is, I say, a tendency to this, which every man feels more or less when he becomes deeply interested in the study of the history of disease. He almost learns to feel,-indeed he may, unless he guard against it, quite learn to feel, as if the sufferings, the health, and even the life of the patient were of secondary importance, when compared with the success of his investigations. It surely seems as if some men would

be chagrined by a recovery, which should falsify their prediction as to the result of a case, or deprive them of the means of determining the accuracy of their diagnosis. It is no doubt desirable, that medicine should be thus studied. It is in the power of those who apply themselves to the natural history of diseases strictly, to confer great benefits on the profession by the treasures of knowledge which they accumulate, and which can be only thus accumulated. But though all may make an approach to the same method of observation, yet all cannot do it to the same extent, nor ought any one to do it at the sacrifice of the more pressing duties which belong to his calling. It is well that one should look at diseases, and study them as objects of science; but the sick must not be treated so as to feel that they are regarded only in this light. He ought never to forget the higher duties which he owes them, as fellow-men labouring under sufferings, which they believe him able to relieve. Nothing will more certainly deprive him of their confidence, and prevent his gaining their affection, than the exhibition of a spirit of this kind. Patients often evince much tact in fathoming the motives by which we are actuated in our treatment of them. And although they would, other things being the same, confide most in him who seemed to study most deeply their case; yet, did they imagine that the interest was of a purely selfish and scientific kind, suspicion would take the place of confidence, and they would apprehend that they were to be made the subjects of experiment, and not of a rational mode of

treatment.

The considerations I have presented, have grown out of the remark made at the outset, that medical success is not uniformly in proportion to medical desert, and that various other circumstances contribute to the progress made by an individual in medicine, considered, as an art, or profession. It might now perhaps be asked, if these circumstances contribute so much to success, why should we devote so much toil and time to the acquisition of medical knowledge, which, after all, is of so little avail. I answer, in the first place, that we have ourselves to satisfy as well as the public; and this we cannot do without

understanding thoroughly the science which we profess. But, in the next place, I would repeat another remark, that, although many men fail who are, professionally speaking, well qualified, and many acquire practice and notoriety who are but indifferently qualified, yet none arrive at a truly desirable and permanent reputation, who are not well versed in the knowledge of their profession. The reason of this is, that such a reputation must be conferred on a man by the voice of the members of the profession, who alone are competent judges of the merit of a medical practitioner. It is a fact that the public are no judges of this merit. They know nothing of medicine. It is truly astonishing to find how strangely ignorant of the first principles of medical science, and especially of medical evidence, are a large proportion, I do not know but I may say, are all men out of the profession, even the most intelligent and learned. A celebrated writer on Education has remarked in substance, that all men are competent judges of the character of a physician, because any body can tell whether his patients lived or died. Perhaps a more shallow remark was never made. A physician himself, if he observe with the caution of a philosopher, may pass many years of careful observation without being able to determine with regard to the success of his practice in any one disease or with any one remedy. Nothing is more difficult, than to form such an estimate either concerning ourselves or others. But it were idle to exhibit the absurdity of the remark. When men form their opinion of a physician's character, they derive their materials from two sources. First, they judge of his capacity and attainments in medicine, by their observation of his capacity and attainments in other things. If they find a man exhibiting good sense and sufficient information on subjects with which they are acquainted, and observe him at the same time to be devoted to the business of his calling, they conclude very reasonably that he will employ the same qualities there; and they accordingly give him their confidence, although they are no judges whether he proves deserving of it or not. Secondly, they judge of a physician's character by the standing which he maintains

among his medical brethren. The effect of this is not always obvious, especially at first. But you may depend upon it as true, that few or none will rise to high and permanent reputation as physicians, who do not maintain a good standing with other physicians, and who have not their confidence. A man's permanent reputation must be given to him by the profession. No other is worth having alone.

This brings me to invite your attention to a few observations respecting the deportment of physicians toward each other. We are mutually dependent for our character and reputation. It is in our power to do much to exalt or debase others. What then should be our feelings, and what the principles which regulate our conduct, in this respect?

The occupation of medical men, and the nature of their connection with families and individuals, bring them constantly into immediate personal competition. Hence bad feelings are often excited, and we experience a constant tendency to detract from the merit of those who have succeeded to our exclusion. Whether this be the cause, however, or not, certain it is that we have always been notorious for our bad blood and bad faith. The quarrels of physicians have become proverbial; and they are constantly guilty of the most illiberal judgment of each other's principles, knowledge, and practice. Probably nowhere else would the profession, in this respect, bear so favourable an examination, as in the city and community in which we live; yet how much room is there for amendment even here.

What then should regulate our conduct toward each other? We should consider the nature of the art we profess. At best it is involved in many uncertainties and difficulties. We know a little, we guess a great deal. Of course we are liable to constant mistakes. Every man makes them, and makes them often. I would require no more certain sign of the insufficiency of a man's professional knowledge, than the boast that he was free from them. Now our constant tendency is to overlook our own, and dwell with complacency on those of others. We ought to do precisely the opposite. From a con

templation of our own mistakes, we may learn much. It is in fact the basis of experience. From that of others, we gain nothing, but an exaltation of our own pride, at the fancied debasement of another's. Where all are liable to err, charity and liberality of judgment are as politic as they are moral. We should neither disseminate nor dwell upon the slanders uttered against others, for we know how prone men are to misstatements; and the illiberality we exercise toward them may in turn be exercised toward us,-as unjustly and uncharitably. It is enough that we are liable to be mistaken and misapprehended by the rest of the world. Our reputations are assailed, our feelings wounded, by the careless, and unthinking, and sometimes perhaps the malevolent conduct of those with whom we are conversant. Our motives

are often misjudged,— —even our honesty doubted, our skill and knowledge habitually called in question. Men, women, and children, whose utter ignorance is shown by the very fact that they do not know they are ignorant, are ever ready to pass judgment upon the conduct and management of able and experienced physicians. It seems to be supposed the easiest matter in the world to form an opinion on a medical subject; and it would be sometimes amusing, were it not so embarrassing, to have the opinion of some nurse or old woman gravely quoted as ample authority against us in a case of life and death.

It is enough, I say, that we are liable to all this ;-let us not augment the evils of our calling by pursuing the same conduct toward one another, which we complain of the world for exercising toward us. We are apt to judge our brethren, when we have really as few of the materials for a correct judgment, as the world has for forming its opinions concerning us. It is not uncommon to hear peculiarities of practice, which happen to differ widely from the notions which the speaker entertains, branded as the result of gross ignorance, or perversity of intellect, or even of absolute dishonesty. When shall we learn, in this world of ignorance and darkness, where the best lights which any of us obtain, serve but to render us sensible how little we know, and how little way we can penetrate into the truths of nature,-when shall we learn