medical essays-第49章
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eference to this virtue。 He was as much to be depended upon at the appointed time as the solstice or the equinox。 There was another point I have heard him speak of as an important rule with him； to come at the hour when he was expected； if he had made his visit for several days successively at ten o'clock； for instance； not to put it off； if be could possibly help it； until eleven； and so keep a nervous patient and an anxious family waiting for him through a long； weary hour。
If I should attempt to characterize his teaching； I should say that while it conveyed the best results of his sagacious and extended observation； it was singularly modest； cautious； simple； sincere。 Nothing was for show； for self…love； there was no rhetoric； no declamation； no triumphant 〃I told you so；〃 but the plain statement of a clear…headed honest man； who knows that he is handling one of the gravest subjects that interest humanity。 His positive instructions were full of value； but the spirit in which he taught inspired that loyal love of truth which lies at the bottom of all real excellence。
I will not say that； during his long career； Dr。 Jackson never made an enemy。 I have heard him tell how； in his very early days； old Dr。 Danforth got into a towering passion with him about some professional consultation； and exploded a monosyllable or two of the more energetic kind on the occasion。 I remember that that somewhat peculiar personage； Dr。 Waterhouse； took it hardly when Dr。 Jackson succeeded to his place as Professor of Theory and Practice。 A young man of Dr。 Jackson's talent and energy could hardly take the position that belonged to him without crowding somebody in a profession where three in a bed is the common rule of the household。 But he was a peaceful man and a peace…maker all his days。 No man ever did more； if so much； to produce and maintain the spirit of harmony for which we consider our medical community as somewhat exceptionally distinguished。
If this harmony should ever be threatened； I could wish that every impatient and irritable member of the profession would read that beautiful； that noble Preface to the 〃Letters；〃 addressed to John Collins Warren。 I know nothing finer in the medical literature of all time than this Prefatory Introduction。 It is a golden prelude； fit to go with the three great Prefaces which challenge the admiration of scholars；Calvin's to his Institutes； De Thou's to his History； and Casaubon's to his Polybius；not because of any learning or rhetoric； though it is charmingly written； but for a spirit flowing through it to which learning and rhetoric are but as the breath that is wasted on the air to the Mood that warms the heart。
Of a similar character is this short extract which I am permitted to make from a private letter of his to a dear young friend。 He was eighty…three years old at the time of writing it。
〃I have not loved everybody whom I have known； but I have striven to see the good points in the characters of all men and women。 At first I must have done this from something in my own nature； for I was not aware of it； and yet was doing it without any plan； when one day； sixty years ago； a friend whom I loved and respected said this to me； 'Ah； James； I see that you are destined to succeed in the world； and to make friends； because you are so ready to see the good point in the characters of those you meet。'〃
I close this imperfect notice of some features in the character of this most honored and beloved of physicians by applying to him the words which were written of William Heberden； whose career was not unlike his own； and who lived to the same patriarchal age。
〃From his early youth he had always entertained a deep sense of religion； a consummate love of virtue； an ardent thirst after knowledge； and an earnest desire to promote the welfare and happiness of all mankind。 By these qualities； accompanied with great sweetness of manners； he acquired the love and esteem of all good men； in a degree which perhaps very few have experienced； and after passing an active life with the uniform testimony of a good conscience； he became an eminent example of its influence； in the cheerfulness and serenity of his latest age。〃
Such was the man whom I offer to you as a model； young gentlemen； at the outset of your medical career。 I hope that many of you will recognize some traits of your own special teachers scattered through various parts of the land in the picture I have drawn。 Let me assure you that whatever you may learn in this or any other course of public lectures；and I trust you will learn a great deal；the daily guidance； counsel； example； of your medical father； for such the Oath of Hippocrates tells you to consider your preceptor； will； if he is in any degree like him of whom I have spoken； be the foundation on which all that we teach is reared； and perhaps outlive most of our teachings； as in Dr。 Jackson's memory the last lessons that remained with him were those of his Old Master。
THE MEDICAL PROFESSION IN MASSACHUSETTS。
A Lecture of a Course by members of the Massachusetts Historical Society； delivered before the Lowell Institute； January 29； 1869。
The medical history of eight generations； told in an hour； must be in many parts a mere outline。 The details I shall give will relate chiefly to the first century。 I shall only indicate the leading occurrences； with the more prominent names of the two centuries which follow； and add some considerations suggested by the facts which have been passed in review。
A geographer who was asked to describe the tides of Massachusetts Bay； would have to recognize the circumstance that they are a limited manifestation of a great oceanic movement。 To consider them apart from this； would be to localize a planetary phenomenon； and to provincialize a law of the universe。 The art of healing in Massachusetts has shared more or less fully and readily the movement which； with its periods of ebb and flow； has been raising its level from age to age throughout the better part of Christendom。 Its practitioners brought with them much of the knowledge and many of the errors of the Old World； they have always been in communication with its wisdom and its folly； it is not without interest to see how far the new conditions in which they found themselves have been favorable or unfavorable to the growth of sound medical knowledge and practice。
The state of medicine is an index of the civilization of an age and country；one of the best； perhaps； by which it can be judged。 Surgery invokes the aid of all the mechanical arts。 From the rude violences of the age of stone；a relic of which we may find in the practice of Zipporah； the wife of Moses；to the delicate operations of to…day upon patients lulled into temporary insensibility； is a progress which presupposes a skill in metallurgy and in the labors of the workshop and the laboratory it has taken uncounted generations to accumulate。 Before the morphia which deadens the pain of neuralgia； or the quinine which arrests the fit of an ague； can find their place in our pharmacies； commerce must have perfected its machinery； and science must have refined its processes； through periods only to be counted by the life of nations。 Before the means which nature and art have put in the hands of the medical practitioner can be fairly brought into use； the prejudices of the vulgar must be overcome； the intrusions of false philosophy must be fenced out； and the partnership with the priesthood dissolved。 All this implies that freedom and activity of thought which belong only to the most advanced conditions of society； and the progress towards this is by gradations as significant of wide…spread changes； as are the varying states of the barometer of far…extended conditions of the atmosphere。
Apart； then； from its special and technical interest； my subject has a meaning which gives a certain importance； and even dignity； to details in themselves trivial and almost unworthy of record。 A medical entry in Governor Winthrop's journal may seem at first sight a mere curiosity； but； rightly interpreted； it is a key to his whole system of belief as to the order of the universe and the relations between man and his Maker。 Nothing sheds such light on the superstitions of an age as the prevailing interpretation and treatment of disease。 When the touch of a profligate monarch was a cure for one of the most inveterate of maladies； when the common symptoms of hysteria were prayed over as marks of demoniacal possession； we might well expect the spiritual realms of thought to be peopled with still stranger delusions。
Let us go before the Pilgrims of the Mayflower； and look at the shores on which they were soon to land。 A wasting pestilence had so thinned the savage tribes that it was sometimes piously interpreted as having providentially prepared the way for the feeble band of exiles。 Cotton Mather； who； next to the witches； hated the 〃tawnies；〃 〃 wild beasts；〃 〃blood…hounds；〃 〃rattlesnakes；〃 〃infidels；〃 as in different places he calls the unhappy Aborigines； describes the condition of things in his lively way； thus： 〃The Indians in these Parts had newly； even about a Year or Two before； been visited with such a prodigious Pestilence； as carried away not a Tenth； but Nine Parts of Ten （yea't is said Nineteen of Twenty） among them so that the Woods were almost cleared of those pernicious Creatures to make Room for a better Growth。〃
What this pestilence was has been much discussed。 It is variously mentioned by different early writers as 〃the plague；〃 〃a great and grievous plague；〃 〃a sore consumption；〃 as attended with spots which left unhealed places on those who recovered； as making the 〃whole surface yellow as with a garment。〃 Perhaps no disease answers all these conditions so well as smallpox。 We know from different sources what frightful havoc it made among the Indians in after years；in 1631； for instance； when it swept away the aboriginal inhabitants of whole towns；〃 and in 1633。 We have seen a whole tribe； the Mandans； extirpated by it in our own day。 The word 〃plague〃 was used very vaguely； as in the description of the 〃great sickness〃 found among the Indians by the expedition of 1622。 This same great sickness could hardly have been yellow fever； as it occurred in the month of November。 I cannot think； therefore； that either the scourge of the East or our Southern malarial pestilence was the disease that wasted the Indians。 As for the yellowness like a garment； that is too familiar to the eyes of all who have ever looked on the hideous mask of confluent variola。
Without the presence or the fear of these exotic maladies； the forlorn voyagers of the Mayflower had sickness enough to contend with。 At their first landing at Cape Cod； gaunt and hungry and longing for fresh food； they found upon the sandy shore 〃great mussel's； and very fat and full of sea…pearl。〃 Sailors and passengers indulged in the treacherous delicacy； which seems to have been the sea…clam； and found that these mollusks； like the shell the poet tells of； remembered their august abode； and treated the way… worn adventurers to a gastric reminiscence of the heaving billows。 In the mean time it blew and snowed and froze。 The water turned to i
