AN ADDRESS, &c.

IT is with much diffidence that I offi⯑cially preſume to deliver a few de⯑tach'd thoughts, chiefly reſpecting MEDI⯑CAL IMPROVEMENT; as an addreſs in⯑troductory to the commencement of our literary buſineſs in this place. Your in⯑dulgent candour which I have ſo often experienced, I flatter myſelf, will, on this occaſion, impute the faults which you will doubtleſs diſcover, not to intention, but inability or miſconception.

I chearfully embrace this opportunity to expreſs the moſt grateful impreſſions I [8]entertain of the great and unſollicited honour you have been pleaſed to confer upon me, by twice calling me to the of⯑fice of PRESIDENT. Had my powers been equal to my wiſhes, no part of my con⯑duct in that elevated character, had been unworthy of you, or of this chair. Al⯑tho' indiſpenſible avocation permits me no longer to hold any office among you; yet will I loſe no opportunity of being preſent, and, as far as I may be able, of aſſiſting in your inſtructive ſpeculations; and of promoting to the utmoſt of my power, the general proſperity of a Society to which I ever have been ſo much at⯑tached.

In the commercial world, it is allowed by all, that the comparative rate of ex⯑change, is a juſt index of the proſperous or adverſe ſtate of trade in different countries individually, or relatively con⯑ſidered. [9]With no leſs truth, in my opnion, the comparative degree of cultivation to which Belles Lettres and philoſophy, or the fine and uſeful arts, arrive in different kingdoms may be re⯑garded as demonſtrative of their re⯑lative civilization.

Judging by this criterion, altho' in this reſpect CALEDONIA may not juſtly boaſt of being the firſt, ſhe is by no means the laſt of the European nations: Her progreſs in the walk of general ſcience and liberality is rapid, and I hope will long continue ſo. Juſtice, however, conſtrains me to confeſs, that long, too long, in a great degree, ſhe had neglected the MEDICAL PHILOSOPHY. In an Aera not beyond the recollection of ſome preſent, the immortal honour of planting a medical ſchool in this Metropo⯑lis; now indeed ſecond in fame and erudition to none in Europe, was reſerv⯑ed [10]to a diſtinguiſhed, a fortunate MON⯑RO. To his memory conſenting nations pay that juſt tribute of applauſe, which his country in general, but this City and its Univerſity in particular, ought to perpetuate by a ſtatue.

By a WORTHY SELECT BAND of the numerous ſtudents, who flocked from all quarters, allured by the riſing fame of the Edinburgh Univerſity; this MEDICAL SOCIETY in 1737, was happily inſtitu⯑ted. Of its various progreſs and preſent flouriſhing independent ſtate, I preſume you to be well informed; and there⯑fore avoid attempting any particular hiſ⯑torical narration of theſe circumſtances at preſent.

THE BUILDING^* in which we are now [11]aſſembled is a grand phenomenon of medi⯑cal ardor, unparallelled in any country; and may juſtly be regarded as a temple ſacred to AESCULAPIUS, reared by the virtuous zeal of his youthful votaries, for purpoſes the moſt liberal and praiſe⯑worthy. The FRIENDS OF SCIENCE, not of your number,^* who have generouſly contributed towards its ſtructure; are entitled to our moſt grateful thanks.

Contemplating this FABRIC, and the many other aids which the preſent ad⯑vantageous ſtate of our ſociety affords to facilitate ſtudy; you muſt have anti⯑cipated me in this reflection, that, while our minds are gratefully affected to our MERITORIOUS PREDECESSORS, our [12]every power ought to be exerted, if not to advance, at leaſt, to maintain our ex⯑tended reputation: that, the verdant lau⯑rels they have tranſmitted may not wi⯑ther in our hands, overwhelming us with indelible ignominy and diſgrace.

'Tis with the higheſt pleaſure, I per⯑ceive, without being chargeable with adulation, I can fairly aver, that this So⯑ciety at no period of its exiſtence has been more ſecure of progreſs than at preſent: the learning, genius and manly liberality of ſentiment, which I know you poſſeſs, and which, with much ſatisfac⯑tion and inſtruction, I have ſo often ob⯑ſerved animating your debates; conſtitute the foundation on which this aſſertion reſts.

You are not to be informed that the com⯑bined powers of GENIUS and INDUSTRY muſt perſeveringly operate thro' the courſe of ſeveral years, that a tolerably [13]complete knowledge of even the elemen⯑tary parts of the ſcience of medicine, as already aſcertained and taught, may be acquired. To have proceeded ſo far in medical ſtudy, is indeed to have made no deſpicable progreſs: But I truſt your ardent ambition is more aſpiring than to remain ſatisfied with the acquiſition of a bare acquaintance of the dogmata of this, or the other MEDICAL SECT or PROFESSOR, i. e. of the preſent ſtate of the healing art. It would be offering an undeſerved inſult to your ſagacity, were I but once to imagine, that you could entertain a be⯑lief, that the Medical Philoſophy had al⯑ready attained the utmoſt perfection of which it is ſuſceptible. You well know, that the unexplored regions of the terra incognita Medicinalis, ſo to ſpeak, ſtill af⯑ford abundant ſcope for your moſt pro⯑tracted labours; ſo juſt is the obſerva⯑tion, ars longa, vita brevis.

ANATOMY, as being the grand baſis of the Medical Fabric, from the earlieſt periods of ſociety, in every civilized coun⯑try, has been cultivated with the moſt unrelenting ardor of inveſtigation, which many moſt material improvements have from time to time rewarded. Are there not ſtill, however, many very intereſting parts and circumſtances of the ſtructure of the ANIMAL AUTOMATON which we but little know? and many others of great importance, of which we are total⯑ly ignorant? What anatomiſt has hither⯑to been able ſucceſsfully to evolve the texture of the SPLEEN; an organ of conſiderable ſize, and probably of pro⯑portional importance in the animal oeco⯑nomy? Very lately it has been ſuppoſed the ſole fabricator of the globular part of the blood^*. The ſame queſtion may be put with reſpect to the ſtructure of the MUSCULAR FIBRE, or LIVING SOLID; [15]and that SPECIFIC CONFIGURATION of the ſeveral orders of the SECRETORY ORGANS, upon which ſuch a wonderful variety and oppoſition of ſecreted liquors probably depends. But, above all, it may be put with reſpect to the BRAIN, and ITS APPENDAGES; parts eſſential to life, often the ſeat of diſeaſe, evidently variouſly organized, of great volume and ſurprizingly diverſified in their external form.

I will be pardoned for expreſſing my fears, that few anatomical improvements are to be expected from you while reſi⯑ding in this country; at leaſt, while its preſent TONE continues, however great your ability and ardor: becauſe an inſu⯑perable barrier is oppoſed to your pro⯑greſs; I mean the WANT OF PRIVATE DISSECTION. In the end of the eight⯑teenth century, when philoſophical libera⯑lity is diffuſed from Pole to Pole, what a [16]pity, or rather what a ſhame, that, even in the Metropolis of a kingdom, not un⯑civilized, and in its principal Univerſi⯑ty too, where the circle of education is otherwiſe tolerably complete; this GRAND and almoſt ONLY AVENUE to the AESCULAPIAN Temple, ſhould re⯑main moſt barbarouſly blocked up!

A public courſe of anatomical demon⯑ſtration, exceeded by none, and equalled by few, is, I confeſs, annually made here; by a learned, diſcerning, accurate, inde⯑fatigable Profeſſor: whom none of you can more reſpect than I do. I, notwith⯑ſtanding, heſitate not to declare it as my poſitive opinion, and I will venture to ſay it is not ſolitary, that, no public anatomi⯑cal exhibitions, where the ſtudent is mere⯑ly a PASSIVE SPECTATOR, are ſufficient to convey and impreſs thoſe preciſe and multifarious ideas of this important branch of natural knowledge, abſolute⯑ly requiſite to complete the medical [17]character; throwing diſcovery altogether out of the queſtion.

To acquire a tolerable knowledge of even the great outlines of anatomy, it is indiſpenſibly neceſſary to take the knife in hand, and, with the moſt unremitting attention, diſſect a variety of bodies of different ſizes, ages, and ſexes, properly choſen, and prepared for the purpoſe: Much more muſt this plan be followed, if it be propoſed to ſoar in the regions of diſcovery and improvement. I can ex⯑perimentally aſſert, that more anatomical information will be reaped from the well conducted diſſection of one body, than from repeated public courſes.

If this opinion be well founded, it is a ſelf-evident conſequence, that attending one or two public courſes of anatomy, muſt be much inadequate to accompliſh the medical philoſopher; eſpecially, if the practice of ſurgery, the moſt evident⯑ly uſeful part of the healing art, be his [18]deſtination. Humanity revolts at the idea of the many unavoidable, and, I fear, too often fatal blunders that muſt reſult from this capital defect of the me⯑dical education to be obtained in this country. It is abundantly mortifying indeed, to obſerve thoſe who wiſh to at⯑tain a proper degree of anatomical know⯑ledge, after ſpending ſeveral years at our Univerſities, and probably attaining their higheſt honours, reduced to the alterna⯑tive of either undertaking expenſive ex⯑peditions into foreign countries, in this reſpect more civilized than ours; or of remaining dangerouſly uninformed.

If one ſhould attempt to adjuſt the wheels and ſprings of a nice and delicate mechaniſm, he, perhaps, had never be⯑fore ſeen, or, at leaſt, never minutely conſidered; with what indignant contempt would we treat the rude audacious pre⯑tender? Thouſands, alas! are daily ſub⯑jected [19]to the unpractiſed knife of opera⯑tors of neceſſity aukward, I had almoſt ſaid unſkilled; becauſe they never could enjoy the requiſite opportunity, of either acquiring proper dexterity to perform any propoſed operation with due addreſs; or full knowledge of the parts concern⯑ed: from the want of acceſs to the dead human body.

This alarming conſideration is ſurely of ſufficient force to conquer the vulgar prejudices againſt private diſſection, whe⯑ther the offspring of ſuperſtition or igno⯑rance. The violation of the ſepulchre or the clandeſtine robbery of the tomb, is moſt juſtly regarded as a crime of a deep dye; but certainly private diſſecti⯑on, under proper regulations, is compa⯑tible with the moſt abſolute ſecurity in this reſpect. Of this the practice of moſt of the European countries is an ir⯑refragable proof; viz. of theſe countries to which our ſtudents are compelled to [20]reſort, to obtain opportunities of diffec⯑ting which might ſo eaſily be afforded at home. Were a proportional number of dead human bodies annually furniſhed by authority, to the medical Students in the different towns of Scotland in gene⯑ral, and to thoſe attending our Univerſi⯑ties, in particular, for private diſſection: the ſalutary conſequences would ſoon ſurpaſs conception. It is truly aſtoniſh⯑ing, that a matter of ſuch endleſs impor⯑tance had not, long e'er now, challenged the notice, and rouſed the attention of the HONOURABLE SUPERINTENDANTS of our Police, or even of the LEGISLA⯑TURE itſelf.

The Criminal and Flagitious, whether they expire under the hands of the exe⯑cutioner, or by diſeaſe; ought always to be conſigned to the anatomical knife: that thus, in ſome degree, when dead, they may attone to ſociety for their de⯑predation [21]and turbulence when alive. Public utility ſeems likewiſe to have a good title to the uſe of the dead bo⯑dies of thoſe who by idleneſs and diſſipa⯑tion, have rendered themſelves objects of public charity; and conſequently, per⯑haps for many years, have been cloathed and fed at the public expence.

Humanity, Patriotiſm, and even ſelf-intereſt conſpire, to ſtimulate every in⯑dividual to promote, at leaſt, not to op⯑poſe the eſtabliſhment of a meaſure ſo pregnant with the moſt ſolid advantages to mankind. The advancing liberality of this country, affords the ſtrongeſt rea⯑ſons to hope that the auſpicious Aera is not very diſtant, when medical improve⯑ment ſhall be no more retarded by the impoſſibility of acquiring anatomical in⯑formation in the only way that it can be acquired; a miſchief hitherto ſo op⯑probrious, fatal, and gigantic.

If Anatomy be defective, PHISIOLOGY which teaches the functions of the va⯑rious organs and parts detected by ana⯑tomy, muſt neceſſarily be proportionally defective. Not only is this the fact, but the uſes even of many parts which the anatomiſt has deſcribed with tolerable ac⯑curacy, are far, very far, from being ſuf⯑ficiently explained by the phiſiologiſt; e. g. Of ſeveral of the GENERATIVE ORGANS, of the DIFFERENT SUB⯑STANCES and PROTUBERANCES of the BRAIN, of the GANGLIONS, &c.

In like manner, many of the gene⯑ral laws and principles of the living ſyſ⯑tem are not illuſtrated with ſatisfactory preciſion; while one phyſiologiſt affirms that MENSTRUATION depends on TO⯑PICAL, another refers it to GENERAL PLETHORA. Some contend that NUTRI⯑TION is effected by the NERVES, others by the VESSELS: and a variety of facts [23]are artfully adduced, to eſtabliſh theſe oppoſite doctrines. With reſpect to many other phyſiological diſquiſitions the ſame contrariety of opinion exiſts.

If the queſtion be put, "What ſhall be ſaid when Doctors diſagree?" I reply, recur to nature, collect uſeful facts, from them draw manly, liberal, chaſte con⯑cluſions; diſregard ideal, cobweb, flimſy theories, the baſeleſs fabric of a viſion. GENERAL PRINCIPLES, rationally de⯑duced as corrollaries from eſtabliſhed facts, only, in my opinion, can juſtly claim the dignified appellation of THEO⯑RY.

PATHOLOGY, you know, treats of the MORBID STATES of animal nature, with a view to effect their PREVENTION, AL⯑LEVIATION or CURE. Many anatomical and phyſiological ſpeculations are more curious than uſeful, and may, therefore, altho' not ſtrictly juſt, have the merit [24]of being innocent. Pathological diſqui⯑ſitions, on the contrary, muſt always pro⯑duce the moſt ſerious conſequences; be⯑cauſe they influence the medical conduct of diſeaſe. Our ſmall knowledge, or rather our great ignorance, of this depart⯑ment, affords but a melancholy theme to the anxious philoſophic inquirer. The va⯑riety and oppoſition, the abſurdity and confuſion of numberleſs futile conceits, wild imaginations, fanciful opinions, dig⯑nified forſooth with the name of DOCT⯑RINES, are the opprobrium of the medi⯑cal profeſſion: and preſent to the con⯑templative mind, the idea of primaeval Chaos, when darkneſs brooded over the great abyſs.

Altho' I poſſeſſed ability, neither your time nor patience permit me to attempt a particular enumeration of the ſtriking abſurdities, which have, in a great de⯑gree, hitherto overwhelmed pathology, [25]depreſſing medicine far beneath the rank of her ſiſter arts; becauſe theſe arts are eſtabliſhed in the evolved un⯑alterable laws of nature.

One claſs of pathologiſts have recourſe to the SENSIBLE QUALITIES of the AT⯑MOSPHERE, as chiefly contributing to create the numerous and important tribe of febrile diſorders; and endeavour to ſupport their reaſonings by meteorologi⯑cal regiſters and obſervations without end. With equal confidence, another tribe, diſregarding in a great meaſure, this opinion, muſter up INVISIBLE MIAS⯑MATA and FLOATING POISONS, to untie every gordian knot; either as principal agents, or complete efficients. In like manner, while the favourite ſyſtem of one period, refers us, with much plauſibility, to the FLUIDS, and MORBIFIC MATTER there exiſting, for the SEAT and CAUSES of many diſeaſes; that of another, with [26]at leaſt equal probability, directs our at⯑tention almoſt ſolely to SPASM and other AFFECTIONS of the SOLIDS.

I cannot avoid here to remark, that were the ſcience of medicine like fluxi⯑ons, infiniteſimals, the quadrature of the circle, &c. i. e. purely a matter of curious unintereſting ſpeculation; we might view the FLUCTUATING INSTA⯑BILITY of its DOGMATA or DOCTRINES, as they are called; with the ſame Tone of mind with which we contemplate the fantaſtic ſhiftings of the aurora borealis, or viſions of the night. But how diame⯑trically oppoſite muſt be the feelings of humanity, reflecting that theſe ſucceſſive doctrines have reſpectively, during their faſhionable periods of domination, greatly influenced the medical management of diſeaſe; compelling the paſſive entramel⯑led, bewildered practitioner, to employ the moſt oppoſite curative means, in the [27]ſame morbid ſtates: the conſequent ha⯑vock, devaſtation, and maſſacre of man⯑kind is more eaſily imagined than deſcri⯑bed.

The ancient maxim ‘"in medio tutiſſi⯑mus ibis,"’ ſhould perhaps never be en⯑tirely neglected. It ſeems exceedingly probable a priori, that, the fluids being made or elaborated by the ſolids; and theſe, on the other hand, ſupported by the fluids; their affections will not long remain diſtinct, but rather always be re⯑ciprocal: However, ‘"Non noſtrum tantas componere lites."’

Moreover, how little we do know with tolerable certainty, reſpecting the IM⯑PRESSIONS made on the SENTIENT PARTS of our bodies, by what are named the potentiae nocentes; or of the DERANGE⯑MENT of ORGANIZATION; or of the NUMBER and NATURE of the MORBID ALTERATIONS thence conſequent! yet [28]it ſeems abſolutely neceſſary that theſe particulars be marked with the utmoſt poſſible preciſion. For inſtance, we are told, that there are two ſpecies of FE⯑BRILE DELIRIUM, requiring the moſt oppoſite treatment; but who has hither⯑to pointed out, with ſufficient accuracy, the ſymptoms aſcertaining their important diſcrimination? If, therefore, in ſuch a perilous predicament the GENIUS of blunder ſhould but for a moment over⯑cloud the practitioner's diſcernment, which is a very ſuppoſable, but I hope, a rare occurence; conclamatum eſt.

'Till pathology, therefore, is more de⯑termined and complete, don't caſes beſet with dubiety and peril, ſeem juſtly to de⯑mand a ſuſpenſion of hoſtilities (ſo to ſpeak) or of our therapeutic efforts; which, permit me to ſay, may often with juſtice be termed the impertinence of art? Theſe daring practitioners, who in [29]the advanced critical febrile ſtates, which they by no means underſtand, exhibit FEBRIFUGE NOSTRUMS,^* with a teme⯑rity that equally ſhocks our feelings, and alarms our fears; may not ineptly be compared to the nonplus'd ſtateſman; who, to ſmother diſſention and broil, of which his mal-adminiſtration is probably the cauſe, riſks the very exiſtence of the ſtate itſelf, by plunging it headlong into general combuſtion, and foreign war.

It is with much pleaſure I acknow⯑ledge, that, in this moſt eſſential depart⯑ment of the medical philoſophy, light and order happily begin to diffuſe their genial influence over darkneſs and con⯑fuſion. The GENIUS and LABOURS of ſome whom this Society can reckon among her honorary ſons, have al⯑ready contributed, in no ſmall degree, [30]to this moſt deſirable purpoſe. I am confident I ſpeak your ſentiments, and moſt aſſuredly my own, when I mention with the moſt particular gratitude, the great advantages we have ſo often and ſo happily reaped in our inquiries, from the CULLENIAN NOSOLOGY: a work per⯑ſpicuous tho' conciſe, elaborate yet not voluminous, in every part demonſtrative of the liberal views, and extenſive medi⯑cal erudition of its very reſpectable and accompliſhed author, who with truth may ſay, ‘"Exegi monumentum aere perennius."’

Suppoſing juſt indications of cure to be formed, in conſequence of an advan⯑ced and chaſte pathology, to be then provided with proper and active AGENTS or REMEDIES to fulfil theſe indications; becomes a matter of moſt important con⯑cern. The jarring opinions of authors [31]reſpecting the nature, activity, doſe and mode of exhibition, of almoſt every ar⯑ticle of the MATERIA MEDICA; preſent a moſt extenſive field for uſeful experi⯑ment and inveſtigation.

With reſpect to medical improvement, I ſhall only in general add, that, your ex⯑pectations, in my opinion, are leſs likely to be fruſtrated, if you look for it to re⯑ſult more from anatomical phyſiological and pathological progreſs, than from the diſcovery of any addition to the Materia Medica. This part of the medical ſci⯑ence is by no means to be neglected, altho' it be probable, that advancing but a ſingle ſtep in any of the other walks, may be productive of more real and ſolid im⯑provement and utility, than the acquiſi⯑tion of a thouſand ſimples; if it be true, that it is an eaſier buſineſs to fulfil, than inſtitute proper curative indications.

Be aſſured that the PHYSICIAN towers above the Empiric, the nurſe and old wo⯑man almoſt only in proportion to his ſu⯑perior information reſpecting the PARTS, the LAWS, and MORBID STATES of ani⯑mal nature; the more perfect his acquire⯑ments in theſe particulars, the higher his pre-eminence among the ſons of Aeſcu⯑lapius. No mode of inauguration how⯑ever ſolemn, no academic rites or autho⯑rity however great or antient, can elevate to the honourable rank of Phyſician, a perſon of an oppoſite deſcription. Such a one could only be regarded as an EMPTY DIGNIFIED FORM, around whoſe blighting temples, the VENAL, the SURREPTITIOUS, the PROSTITUTED LAURELS of APOL⯑LO muſt baſely fade to the utter diſcredit of all concerned; a more melancholy conſequence ſtill would be, that his prac⯑tice could not fail to prove the bane of ſo⯑ciety, operating the deſtruction of ſuch in⯑dividuals [33]as might become the unfortu⯑nate ſubjects of his temerity.

If therefore to become a Phyſician, (i. e. to be qualified to mark with preci⯑ſion, the almoſt infinitely various affec⯑tions of animated matter, ſo as to direct, as far as may be, its movements to the bliſsful abode of longaevity and health,) be a taſk only terminating with life, to be exhauſted by no labour, and to which the moſt diſcriminating mental powers are not ſuperior; the folly, not to ſay criminality of attempts^* to incite vulgar vanity to tamper with the moſt precious intereſts of mankind, needs no illuſtration.

In every ſpecies of philoſophical inveſ⯑tigation, particularly thoſe of a medical nature, where certainty is ſo difficultly attained; to guard againſt CREDULITY, is a counſel, I deem of ſuch infinite im⯑portance, that, before I put an end to this [34]addreſs, I cannot help tendering it in the moſt earneſt manner to the particular no⯑tice of my YOUNGER SOCII. In all caſes, where there is not abſolute de⯑monſtration, or at leaſt as high a degree of evidence, as the nature of the argu⯑ment admits; to ſuſpend belief or to ex⯑erciſe a proper degree of ſcepticiſm, till mature examination and reflection ſhall compel aſſent: I regard as a meaſure pru⯑dent, rational and philoſophic. The un⯑ſupported ipſe dixit of any man, however great his name in ſcience, I always con⯑ſider as a very weak argument: Recan⯑tation at beſt is exceedingly diſagreeable.

The conſtitution of our Society, or its preſent ſyſtem of laws, I am far from reckoning perfect; many meliorations, I doubt not will be made from time to time. No good reaſon can be aſſigned why our meetings ſhould be ſuſpend⯑ed during half the year: In ſummer in⯑deed [35]they might probably be thin; but it does not follow, that your ſpeculations on that account would be leſs inſtructive, or your eſſays more imperfect.

I conclude by congratulating you up⯑on your affairs being now happily in ſuch a proſperous train, as to afford the moſt flattering proſpects. I contemplate the riſing glory, and future greatneſs of the Medical Society, with no ſmall degree of pleaſurable ecſtaſy and expectation: Methinks, I hear its TOWERING GENIUS with the moſt complacent exultation ex⯑claim ‘"ſublimi feriam ſidera vertice."’