[NoteB。]
Letmeillustratethispropositionbeforeyoudecideuponit。Ifitwereknownthataprize-fighterweretohaveadrasticpurgativeadministeredtwoorthreedaysbeforeacontest，oralargeblisterappliedtohisback，noonewillquestionthatitwouldaffectthebettingonhissideunfavorably；wewillsaytotheamountoffivepercent。Nowthedrainupontheresourcesofthesystemproducedinsuchacasemustbeatitsminimum，forthesubjectisapowerfulman，intheprimeoflife，andinadmirablecondition。Ifthedrugortheblistertakesfivepercent。fromhisforceofresistance，itwilltakeatleastaslargeafractionfromanyinvalid。Butthisinvalidhastofightachampionwhostrikeshardbutcannotbehitinreturn，whowillpresshimsharplyforbreath，butwillneverpanthimselfwhilethewindcanwhistlethroughhisfleshlessribs。Thesufferingcombatantisliabletowantallhisstamina，andfivepercent。maylosehimthebattle。
Allnoxiousagents，allapplianceswhicharenotnaturalfoodorstimuli，allmedicinesproper，costapatient，ontheaverage，fivepercent。ofhisvitalforce，letussay。Twentytimesasmuchwasteofforceproducedbyanyofthem，thatis，wouldexactlykillhim，nothinglessthankillhim，andnothingmore。Ifthis，orsomethinglikethis，istrue，thenallthesemedicationsare，primafacie，injurious。
InthegameofLife-or-Death，RougeetNoir，asplayedbetweentheDoctorandtheSexton，thisfivepercent。，thiscertainsmallinjuryenteringintothechancesisclearlythesexton’sperquisiteforkeepingthegreentable，overwhichthegameisplayed，andwherehehoardsuphisgains。Supposeablistertodiminishaman’spain，effusionordyspnoeatothesavingoftwentypercent。invitalforce；hisprofitfromitisfifteen，inthatcase，foritalwayshurtshimfivetobeginwith，accordingtoourpreviousassumption。
Presumptionsareofvastimportanceinmedicine，asinlaw。Amanispresumedinnocentuntilheisprovedguilty。Amedicine——thatis，anoxiousagent，likeablister，aseton，anemetic，oracathartic——
shouldalwaysbepresumedtobehurtful。Italwaysisdirectlyhurtful；itmaysometimesbeindirectlybeneficial。Ifthispresumptionwereestablished，anddiseasealwaysassumedtobetheinnocentvictimofcircumstances，andnotpunishablebymedicines，thatis，noxiousagents，orpoisons，untilthecontrarywasshown，weshouldnotsofrequentlyheartheremarkcommonly，perhapserroneously，attributedtoSirAstleyCooper，butoftenrepeatedbysensiblepersons，that，onthewhole，moreharmthangoodisdonebymedication。Throwoutopium，whichtheCreatorhimselfseemstoprescribe，forweoftenseethescarletpoppygrowinginthecornfields，asifitwereforeseenthatwhereverthereishungertobefedtheremustalsobepaintobesoothed；throwoutafewspecificswhichourartdidnotdiscover，andishardlyneededtoapply[NoteC。]；throwoutwine，whichisafood，andthevaporswhichproducethemiracleofanaesthesia，andIfirmlybelievethatifthewholemateriamedica，asnowused，couldbesunktothebottomofthesea，itwouldbeallthebetterformankind，——andalltheworseforthefishes。
Buttojustifythisproposition，Imustaddthattheinjuriesinflictedbyover-medicationaretoagreatextentmaskedbydisease。
Dr。HookerbelievesthatthetyphussyncopatiaofaprecedinggenerationinNewEngland“wasofteninfactabrandyandopiumdisease。“Howisaphysiciantodistinguishtheirritationproducedbyhisblisterfromthatcausedbytheinflammationitwasmeanttocure？Howcanhetelltheexhaustionproducedbyhisevacuantsfromthecollapsebelongingtothediseasetheyweremeanttoremove？
Lastly，medicationwithoutinsuringfavorablehygienicconditionsislikeamputationwithoutligatures。Ihadachancetolearnthiswellofold，whenphysiciantotheBroadStreetdistrictoftheBostonDispensary。There，therewasnohelpfortheutterwantofwholesomeconditions，andifanybodygotwellundermycare，itmusthavebeeninvirtueoftherough-and-tumbleconstitutionwhichemergesfromthestruggleforlifeinthestreetgutters，ratherthanbytheaidofmyprescriptions。
Butifthemateriamedicawerelostoverboard，howmuchmorepainswouldbetakeninorderingallthecircumstancessurroundingthepatientascanbedoneeverywhereoutofthecrowdedpauperdistricts，thanaretakennowbytoomanywhothinktheydotheirdutyandearntheirmoneywhentheywritearecipeforapatientleftinanatmosphereofdomesticmalaria，ortothemostnegligentkindofnursing！IconfessthatIshouldthinkmychanceofrecoveryfromillnesslesswithHippocratesformyphysicianandMrs。Gampformynurse，thanifIwereinthehandsofHahnemannhimself，withFlorenceNightingaleorgoodRebeccaTaylortocareforme。
IfIamrightinmaintainingthatthepresumptionisalwaysagainsttheuseofnoxiousagentsindisease，andifanywhomImightinfluenceshouldadoptthisasaprincipleofpractice，theywilloftenfindthemselvesembarrassedbytheimperativedemandofpatientsandtheirfriendsforsuchagentswhereacaseisnotmadeoutagainstthisstandingpresumption。Imustbepermittedtosay，thatIthinktheFrench，anotwhollyuncivilizedpeople，areinadvanceoftheEnglishandourselvesintheartofprescribingforthesickwithouthurtingthem。AndIdoconfessthatIthinktheirvariedptisansandsyrupsareasmuchpreferabletothemineralregimenofbug-poisonandratsbane，solonginfavorontheothersideoftheChannel，astheirartofpreparingfoodforthetabletotherudecookeryofthosehard-feedingandmuch-dosingislanders。
Wewantareorganizedcuisineofinvalidismperhapsasmuchastheculinary，reform，forwhichourlyceumlecturers，andotherswholivemuchathotelsandtaverns，aresourgent。WillyouthinkIamdisrespectfulifIaskwhether，eveninMassachusetts，adoseofcalomelisnotsometimesgivenbyaphysicianonthesameprincipleasthatuponwhichalandlordoccasionallyprescribesbaconandeggs，——becausehecannotthinkofanythingelsequitesohandy？I
leavemysuggestionofborrowingahintfromFrenchpracticetoyourmatureconsideration。
Imay，however，callyourattention，briefly，tothesingularfact，thatEnglishandAmericanpractitionersareapttoaccuseFrenchmedicalpracticeofinertness，andFrenchsurgicalpracticeofunnecessaryactivity。Thus，Dr。BostockconsidersFrenchmedicaltreatment，withcertainexceptions，as“decidedlylesseffective“
thanthatofhisowncountry。“Mr。S。Cooper，again，defendsthesimpleBritishpracticeofprocuringunionbythefirstintentionagainsttheattacksofM。RouxandBaronLarrey。[Cooper’sSurg。
Diet。art。“Wounds。“YetMr。JohnBellgivestheFrenchsurgeonscreditforintroducingthisdoctrineofadhesion，andaccusesO’Halloranof“rudenessandignorance，“and“bold，uncivillanguage，“
indisputingtheirteaching。Princ。ofSurgery，vol。i。p。42。
Mr。Huntersucceededatlastinnaturalizingthedoctrineandpractice，butevenhehadtostruggleagainsttheperpetualjealousyofrivals，anddiedatlengthassassinatedbyaninsult。]Wehaveoftenheardsimilaropinionsmaintainedbyourowncountrymen。WhileAnglo-AmericancriticismblowshotorcoldonthetwodepartmentsofFrenchpractice，itisnot，Ihope，indecenttoquestionwhetherallthewisdomisnecessarilywithusinbothcases。
Ourarthashadtwoorthreelessonswhichhaveadeepmeaningtothosewhoarewillingtoreadthemhonestly。Theuseofwater-
dressingsinsurgerycompletedtheseriesofreformsbywhichwasabolishedthe“coarseandcruelpractice“oftheoldersurgeons，whowiththeirdressingsandacridbalsams，theirtentsandleadentubes，“absolutelydelayedthecure。“ThedoctrineofBroussais，transientaswasitsempire，reversedthepracticeofhalfofChristendomforaseason，andtaughtitshastydisciplestoshuntheiroldfavoriteremediesasmortalpoisons。Thiswasnotenoughpermanentlytoshiftthepresumptionaboutdrugswhereitbelonged，andsoatlast，justasthesympatheticpowderandtheUnguentumArmariumcameinasuperstitiousagetokillouttheabusesofexternalover-medication，thesolemnfarceofHomoeopathywasenactedinthefaceofourowntoocredulouscivilization，thatundershelterofitspretencesthe“inwardbruises“ofover-druggedvisceramightbeallowedtohealbythefirstintention。Itslessonwemustaccept，whetherwewillornot；itsfollieswearetiredoftalkingabout。Thesecurityofthemedicalprofessionagainstthisandallsimilarfanciesisintheaverageconstitutionofthehuman。mindwithregardtothelawsofevidence。
MyfriendsandbrothersinArt！Thereisnothingtobefearedfromtheutteranceofanyseemingheresytowhichyoumayhavelistened。
Icannotcompromiseyourcollectivewisdom。IfIhavestrainedthetruthonehair’sbreadthforthesakeofanepigramoranantithesis，youareaccustomedtocountthenormalpulse-beatsofsoundjudgment，andknowfullwellhowtorecognizethefever-throbsofconceitandthenervouspalpitationsofrhetoric。
Thefreedomwithwhicheachofusspeakshisthoughtinthispresence，belongsinparttotheassuredpositionoftheProfessioninourCommonwealth，totheattitudeofScience，whichisalwaysfearless，andtothegeniusofthesoilonwhichwestand，fromwhichNaturewithheldthefatalgiftofmalariaonlytofillitwithexhalationsthatbreedthefeverofinquiryinourbloodandinourbrain。Butmainlyweowethelargelicenseofspeechweenjoytothoseinfluencesandprivilegescommontousallasself-governingAmericans。
ThisRepublicisthechosenhomeofminorities，ofthelesspowerinthepresenceofthegreater。Itisacommonerrortospeakofourdistinctionasconsistingintheruleofthemajority。Majorities，thegreatermaterialpowers，havealwaysruledbefore。Thehistoryofmostcountrieshasbeenthatofmajorities，mountedmajorities，cladiniron，armedwithdeathtreadingdownthetenfoldmorenumerousminorities。Intheoldcivilizationstheyrootthemselveslikeoaksinthesoil；menmustliveintheirshadoworcutthemdown。Withusthemajorityisonlytheflowerofthepassingnoon，andtheminorityisthebudwhichmayopeninthenextmorning’ssun。
Wemustbetolerant，forthethoughtwhichstammersonasingletonguetodaymayorganizeitselfinthegrowingconsciousnessofthetime，andcomebacktouslikethevoiceofthemultitudinouswavesoftheoceanonthemorrow。
Twenty-fiveyearshavepassedsinceoneofyourhonoredPresidentsspoketothisSocietyofcertainlimitationstothepowerofourArt，nowverygenerallyconceded。Someweretroubled，somewerealmostangry，thinkingtheProfessionmightsufferfromsuchconcessions。
Ithascertainlynotsufferedhere；if，assomeaffirm，ithaslostrespectanywhere，itwasprobablyforother，andnodoubtsufficientreasons。
Sincethattimethecivilizationofthisplanethaschangedhands。
Strikeoutofexistenceatthismomenteverypersonwhowasbreathingonthatday，May27，1835，andeveryinstitutionofsociety，everyartandeverysciencewouldremainintactandcompleteinthelivingthatwouldbeleft。Everyideatheworldthenheldhasbeensincedissolvedandrecrystallized。
Wearerepeatingthesameprocess。Nottomakesilvershrinesforourolddivinities，eventhoughbythiscraftweshouldhaveourwealth，wasthisSocietyorganizedandcarriedonbythegoodmenandtruewhowentbeforeus。Notforthis，buttomeltthegoldoutofthepast，thoughitsdrossshouldflyindusttoallthewindsofheaven，tosaveallouroldtreasuresofknowledgeandminedeeplyfornew，tocultivatethatmutualrespectofwhichoutwardcourtesyisthesign，toworktogether，tofeeltogether，totakecounseltogether，andtostandtogetherforthetruth，now，always，here，everywhere；forthisourfathersinstituted，andweaccept，theofficesanddutiesofthistime-honoredSociety。
BORDERLINESOFKNOWLEDGEINSOMEPROVINCESOFMEDICALSCIENCE。
AnIntroductoryLecturedeliveredbeforetheMedicalClassofHarvardUniversity，November6，1861。
[ThisLectureappearsasitwouldhavebeendeliveredhadthetimeallowedbeenlessstrictly，limited。Passagesnecessarilyomittedhavebeenrestored，andpointsbrieflytouchedhavebeenmorefullyconsidered。Afewnoteshavebeenaddedforthebenefitofthatlimitedclassofstudentswhocaretotrackanauthorthroughthehighwaysandby-waysofhisreading。Iowemythankstoseveralofmyprofessionalbrethrenwhohavecommunicatedwithmeonsubjectswithwhichtheyarefamiliar；especiallytoDr。JohnDean，fortheopportunityofprofitingbyhisunpublishedlabors，andtoDr。HasketDerby，forinformationandreferencestorecentauthoritiesrelatingtotheanatomyandphysiologyoftheeye。]
TheentranceuponanewcourseofLecturesisalwaysaperiodofinteresttoinstructorsandpupils。Asthebirthofachildtoaparent，soistheadventofanewclasstoateacher。Asthelightoftheuntriedworldtotheinfant，soisthedawningofthelightrestingovertheunexploredrealmsofsciencetothestudent。InthenameoftheFacultyIwelcomeyou，GentlemenoftheMedicalClass，new-bornbabesofscience，orlustiernurslings，tothismorningofyourmedicallife，andtothearmsandthebosomofthisancientUniversity。FourteenyearsagoIstoodinthisplaceforthefirsttimetoaddressthosewhooccupiedthesebenches。AsIrecallthesepastseasonsofourjointlabors，Ifeelthattheyhavebeenonthewholeprosperous，andnotundeservingoftheirprosperity。
Forithasbeenmyprivilegetobeassociatedwithabodyoftrueandfaithfulworkers；Icannotpraisethemfreelytotheirfaces，orI
shouldbeproudtodiscourseoftheharmoniousdiligenceandthenoblespiritinwhichtheyhavetoiledtogether，notmerelytoteachtheirseveralbranches，buttoelevatethewholestandardofteaching。
Imayspeakwithlessrestraintofthosegentlemenwhohaveaidedmeinthemostlaboriouspartofmydailyduties，theDemonstrators，towhomthesuccessiveclasseshaveowedsomuchoftheirinstruction。