medical essays-第60节
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g 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 ice on their clothes； and made them many times like coats of iron。 Edward Tilley had like to have 〃sounded〃 with cold。 The gunner； too； was sick unto death； but 〃hope of trucking〃 kept him on his feet；a Yankee； it should seem； when he first touched the shore of New England。 Most； if not all； got colds and coughs； which afterwards turned to scurvy； whereof many died。
How can we wonder that the crowded and tempest…tossed voyagers； many of them already suffering； should have fallen before the trials of the first winter in Plymouth？ Their imperfect shelter； their insufficient supply of bread； their salted food； now in unwholesome condition； account too well for the diseases and the mortality that marked this first dreadful season； weakness； swelling of the limbs； and other signs of scurvy； betrayed the want of proper nourishment and protection from the elements。 In December six of their number died； in January eight； in February； seventeen； in March thirteen。 With the advance of spring the mortality diminis
