With the reception of your diplomas this evening you now belong to what is therefore probably the oldest profession in the world. In welcoming you into it let me call your attention particularly to the fact that the history of our profession can be traced back to the very beginning of the course of time, for as long as we have any account of men's actions in an organized social order.
We are very prone in the modern time to think that what we are doing in each successive generation is of so much greater significance than what was accomplished before our time that it is really scarcely worth while to give much attention to the past. This self-sufficient complacency with regard to the present would be quite unbearable only that each successive generation in its turn has had the same tendency and has expiated its fault by being thought little of by subsequent generations. We shall have our turn with those we affect to despise.
It is supposed to be particularly true in every department of science and, above all, in medicine that there is such a wide chasm between what we are doing now and what was accomplished by our forebears, no matter how intelligent they were in the long ago, that to occupy ourselves seriously with the history of medicine may be a pleasant occupation for an elderly physician who has nothing better to do, but can mean very little for the young man entering upon practice or for the physician busy with his patients. Medical history may be good enough for some book-worm interested in dry-as-dust details for their own sake and perhaps because he rejoices in the fact that other people do not know them, but can have very little significance for the up-to-date physician. This is an impression that is dying hard just now, but it is dying. We are learning that there is very little that we are [{353}] doing even now that has not been done before us and that, above all, the great physicians, no matter how long ago they wrote, always have precious lessons for us that we cannot afford to neglect, even though they be 300 or 600 or 1,800 or even 2,500 years ago. At all of these dates in the past there were physicians whose works will never die.
In every department of human history the impression that we are the only ones whose work is significant has been receiving a sad jolt in recent years, and perhaps in no branch of science is this so true as in medicine. We are coming to realize how much the physicians and surgeons of long distant times accomplished, and, above all, we are learning to appreciate that they approached problems in medicine at many periods of medical history in the best scientific temper of the modern time. Of course there were abuses, but, then, the Lord knows, there are abuses now. Of course their therapeutics had many absurdities in it, but, then, let us not forget that Professor Charles Richet, the director of the department of physiology at the University of Paris, declared not long ago in an article in the best known of French magazines, the Revue des Deux Mondes, that the therapeutics of any generation of the world's history always contained many absurdities--for the second succeeding generation. The curious thing about it is that some of these supposed absurdities afterward come [{354}] back into vogue and prove to be precious germs of discovery, or remedies of value that occasionally even develop into excellent systems of treatment.
Of course there were superstitions in the old days, but, then, there have been superstitions in medicine at all times. Any one who thinks that we are without superstitions in medicine at the present time, superstitions that are confidently accepted by many regular practising physicians, must, indeed, be innocent. A superstition is in its etymology a survival. It comes from the Latin superstes, a survivor. It is the acceptance of some doctrine the reasons for which have disappeared in the progress of knowledge or the development of science, though the doctrine itself still maintains a hold on the minds of man. Superstition has nothing necessarily to do with religion, though it is with regard to religion that doctrines are particularly apt to be accepted after the reasons for them have disappeared. In medicine, however, superstitions are almost as common as in religion. I shall never forget a discussion with two of the most prominent physicians of this country on this subject.
One of them was our greatest pathologist, the other a great teacher of clinical medicine, who came into medicine through chemistry and therefore had a right to opinions with regard to the chemical side of medicine. We had been discussing the question of how much serious medical [{355}] education there was in the Middle Ages and how, in spite of the magnificent work done, so many superstitions in medicine continued to maintain themselves. I remarked that it seemed impossible to teach truths to large bodies of men without having them accept certain doctrines which they thought truths but which were only theories and which they insisted on holding after the reasons for them had passed away. I even ventured to say that I thought that there were as many superstitions now, and such as there were, were of as great significance as those that maintained themselves in the Middle Ages. My chemical clinician brother on the right side said, "Let us not forget in this regard the hold the uric acid diathesis has on the English-speaking medical profession." And the brother pathologist on the left side: "Well, and what shall we say of intestinal auto-intoxication?"
Perhaps you will not realize all the force of these expressions at the present time, but after you have been five years in the practice of medicine and have been flooded by the literature of the advertising manufacturing pharmacist and by the samples of the detail man and his advice and suggestion of principles of practice, if you will listen to them, perhaps you will appreciate how much such frank expressions mean as portraying the medical superstitions of our time.
Surely we who have for years been much occupied with the superstition, for such it now [{356}] turns out to be, of heredity in medicine, will not be supercilious toward older generations and their superstitions. Until a few years ago we were perfectly sure that a number of diseases were inherited directly. Tuberculosis, rheumatism, gout, various nutritional disturbances all were supposed to pass from father to son and from mother to daughter, or sometimes to cross the sex line. For a time cancer was deemed to be surely hereditary to some degree at least. Now most of us know that probably no disease is directly inherited, that acquired characters are almost surely not transmitted, and that while defects may be the subject of heredity, disease never is. Not only this, biological investigations have served to show that what is the subject of inheritance is just the opposite,--resistance to disease. A person whose father and mother had suffered from tuberculosis used to think it almost inevitable that he too should suffer from it. If they had died that he too would die. Our experts in tuberculosis declare now, that if tuberculosis has existed in the preceding generation there is a much better chance of the patient recovering from it, or at least resisting it for a long time, than if there had been no tuberculosis in the family. We had been harboring the superstition of heredity, the surviver opinion from a preceding generation, until we learned better by observation.
Let us turn from such discussion to the [{357}] beginnings of the story of our medical profession as it has been revealed to us in recent years.