Onewhomwehavelost，verywidelyknownandhonored，wasaleadingpractitionerofthiscity。Hisimagecanhardlybedimmedinyourrecollection，ashestoodbeforeyouonlythreeyearsago，fillingthesameplacewithwhichIamnowhonored。Tospeakofhimatallworthily，wouldbetowritethehistoryofprofessionalsuccess，wonwithoutspecialaidatstarting，bytoil，patience，goodsense，purecharacter，andpleasingmanners；woninastraightuphillascent，withoutonebreathing-spaceuntilhesatdown，nottorest，buttodie。Ifprayerscouldhaveshieldedhimfromthestroke，iflovecouldhavedrawnforththeweapon，andskillcouldhavehealedthewound，thispassingtributemighthavebeenlefttootherlipsandtoanothergeneration。
Letushopethatourdeadhaveatlastfoundthatrestwhichneithersummernorwinter，nordaynornight，hadgrantedtotheirunendingearthlylabors！Andletusrememberthatourdutiestoourbrethrendonotceasewhentheybecomeunabletoshareourtoils，orleavebehindtheminwantandwoethosewhomtheirlaborhadsupported。ItishonorabletotheProfessionthatithasorganizedanAssociationaforthereliefofitssufferingmembersandtheirfamilies；itowesthistributetotheill-rewardedindustryandsacrificesofitslessfortunatebrotherswhowearouthealthandlifeintheserviceofhumanity。Ihavegreatpleasureinreferringtothisexcellentmovement，whichgivesourliberalprofessionachancetoshowitsliberality，andservestouniteusall，thesuccessfulandthosewhomfortunehascastdown，inthebondsofatruebrotherhood。
Amedicalman，ashegoesabouthisdailybusinessaftertwentyyearsofpractice，isapttosupposethathetreatshispatientsaccordingtotheteachingsofhisexperience。Nodoubtthisistruetosomeextent；towhatextentdependingmuchonthequalitiesoftheindividual。Butitiseasytoprovethattheprescriptionsofevenwisephysiciansareverycommonlyfoundedonsomethingquitedifferentfromexperience。Experiencemustbebasedonthepermanentfactsofnature。Butaglanceattheprevalentmodesoftreatmentofanytwosuccessivegenerationswillshowthatthereisachangeableaswellasapermanentelementintheartofhealing；notmerelychangeableasdiseasesvary，orasnewremediesareintroduced，butchangeablebythegoingoutoffashionofspecialremedies，bythedecadenceofapopulartheoryfromwhichtheirfitnesswasdeduced，orothercausenotmoresignificant。Thereisnoreasontosupposethatthepresenttimeisessentiallydifferentinthisrespectfromanyother。Much，therefore，whichisnowverycommonlyconsideredtobetheresultofexperience，willberecognizedinthenext，orinsomesucceedinggeneration，asnosuchresultatall，butasaforegoneconclusion，basedonsomeprevalentbelieforfashionofthetime。
Thereare，ofcourse，ineverycalling，thosewhogoabouttheworkofthedaybeforethem，doingitaccordingtotherulesoftheircraft，andaskingnoquestionsofthepastorofthefuture，oroftheaimandendtowhichtheirspeciallaboriscontributing。Theseoftenconsiderandcallthemselvespracticalmen。Theypulltheoarsofsociety，andhavenoleisuretowatchthecurrentsrunningthisorthatway；lettheoristsandphilosophersattendtothem。Inthemeantime，however，thesecurrentsarecarryingthepracticalmen，too，andalltheirworkmaybethrownaway，andworsethanthrownaway，iftheydonottakeknowledgeofthemandgetoutofthewrongonesandintotherightonesassoonastheymay。SirEdwardParryandhispartyweregoingstraighttowardsthepoleinoneoftheirarcticexpeditions，travellingattherateoftenmilesaday。Buttheiceoverwhichtheytravelledwasdriftingstraighttowardstheequator，attherateoftwelvemilesaday，andyetnomanamongthemwouldhaveknownthathewastravellingtwomilesadaybackwardunlesshehadliftedhiseyesfromthetrackinwhichhewasplodding。Itisnotonlygoingbackwardthattheplainpracticalworkmanisliableto，ifhewillnotlookupandlookaround；hemaygoforwardtoendshelittledreamsof。Itisasimplebusinessforamasontobuildupanicheinawall；butwhatif，ahundredyearsafterwardswhenthewallistorndown，theskeletonofamurderedmandropoutoftheniche？ItwasaplainpracticalpieceofcarpentryforaJewishartisantofittwopiecesoftimbertogetheraccordingtothelegalpatterninthetimeofPontiusPilate；heaskednoquestions，perhaps，butweknowwhatburdenthecrossboreonthemorrow！Andso，withsubtlertoolsthantrowelsoraxes，thestatesmanwhoworksinpolicywithoutprinciple，thetheologianwhoworksinformswithoutasoul，thephysicianwho，callinghimselfapracticalman，refusestorecognizethelargerlawswhichgovernhischangingpractice，mayallfindthattheyhavebeenbuildingtruthintothewall，andhanginghumanityuponthecross。
Thetruthis，thatmedicine，professedlyfoundedonobservation，isassensitivetooutsideinfluences，political，religious，philosophical，imaginative，asisthebarometertothechangesofatmosphericdensity。Theoreticallyitoughttogoonitsownstraightforwardinductivepath，withoutregardtochangesofgovernmentortofluctuationsofpublicopinion。ButlookamomentwhileIclashafewfactstogether，andseeifsomesparksdonotrevealbytheirlightacloserrelationbetweentheMedicalSciencesandtheconditionsofSocietyandthegeneralthoughtofthetime，thanwouldatfirstbesuspected。
Observethecoincidencesbetweencertaingreatpoliticalandintellectualperiodsandtheappearanceofillustriousmedicalreformersandteachers。ItwasintheageofPericles，ofSocrates，ofPlato，ofPhidias，thatHippocratesgavetomedicalknowledgetheformwhichitretainedfortwentycenturies。Withtheworld-
conqueringAlexander，theworld-embracingAristotle，appropriatinganatomyandphysiology，amonghismanifoldspoilsofstudy，marchedabreastofhisroyalpupiltowiderconquests。UnderthesamePtolemieswhofoundedtheAlexandrianLibraryandMuseum，andorderedtheSeptuagintversionoftheHebrewScriptures，theinfallibleHerophilus[“ContradicereHerophiloinanatomicis，estcontradicereevangelium，“wasasayingofFallopius。]madethosesixhundreddissectionsofwhichTertullianaccusedhim，andthesagaciousErasistratusintroducedhismildantiphlogistictreatmentinoppositiontothepolypharmacyandantidotalpracticeofhistime。
Itissignificantthatthelarge-mindedGalenshouldhavebeenthephysicianandfriendoftheimperialphilosopherMarcusAurelius。
TheArabsgavelawsinvariousbranchesofknowledgetothosewhomtheirarmshadinvaded，ortheterroroftheirspreadingdominionhadreached，andthepointfromwhichtheystartedwas，asHumboldtacknowledges，“thestudyofmedicine，bywhichtheylongruledtheChristianSchools，“andtowhichtheyaddedthedepartmentofchemicalpharmacy。
LookatVesalius，thecontemporaryofLuther。Whocanfailtoseeonecommonspiritintheradicalecclesiasticandthereformingcourt-physician？Bothstilltosomeextentunderthedominionoftheletter：Lutherholdingtotherealpresence；Vesaliusactuallycausingtobedrawnandengravedtwomuscleswhichheknewwerenotfoundinthehumansubject，becausetheyhadbeendescribedbyGalen，fromdissectionsoftheloweranimals。Bothbreakingthrougholdtraditionsinthesearchoftruth；one，knifeinhand，attheriskoflifeandreputation，theotherattheriskoffireandfagot，withthatmightierweaponwhichallthedevilscouldnotsilence，thoughtheyhadbeenthickerthanthetilesonthehouse-tops。HowmuchthephysicianoftheCatholicCharlesV。hadincommonwiththegreatreligiousdestructive，maybeguessedbytherelishwithwhichhetellsthestoryhowcertainPavianstudentsexhumedthebodyofan“elegansscortum，“orlovelydameofillrepute，thefavoriteofamonkoftheorderofSt。Anthony，whodoesnotseemtohaveresistedtemptationsowellasthefounderofhisorder。WehavealwaysrankedthephysicianRabelaisamongtheearlyreformers，butIdonotknowthatVesaliushaseverbeenthankedforhishitatthemoralsofthereligiousorders，orforturningtothegoodofsciencewhatwasintendedforthe“benefitofclergy。“
Ourunfortunatemedicalbrother，MichaelServetus，thespiritualpatienttowhomthetheologicalmoxawasappliedovertheentiresurfaceforthecureofhisheresy，cameverynearanticipatingHarvey。ThesamequickenedthoughtofthetimewhichledhimtodisputethedogmaoftheChurch，openedhismindtothefactswhichcontradictedthedogmasoftheFaculty。
HarveyhimselfwasbuttheposthumouschildofthegreatElizabethanperiod。Baconwasatoncehisteacherandhispatient。ThefounderofthenewinductivephilosophyhadonlybeendeadtwoyearswhenthetreatiseontheCirculation，thefirst-fruitoftheRestorationofScience，wasgiventotheworld。
Andisittobelookedatasamereaccidentalcoincidence，thatwhileNapoleonwasmodernizingthepoliticalworld，Bichatwasrevolutionizingthescienceoflifeandtheartthatisbaseduponit；thatwhiletheyounggeneralwasscalingtheAlps，theyoungsurgeonwasclimbingthesteepersummitsofunexplorednature；thatthesameyearreadtheannouncementofthoseadmirable“ResearchesonLifeandDeath，“andthebulletinsofthebattleofMarengo？
Ifwecometoourowncountry，whocanfailtorecognizethatBenjaminRush，themostconspicuousofAmericanphysicians，wastheintellectualoffspringofthemovementwhichproducedtheRevolution？
“Thesamehand，“saysoneofhisbiographers，“whichsubscribedthedeclarationofthepoliticalindependenceoftheseStates，accomplishedtheiremancipationfrommedicalsystemsformedinforeigncountries，andwhollyunsuitabletothestateofdiseasesinAmerica。“
Followingthisgeneralcourseofremark，Iproposetoindicateinafewwordsthedirectionofthemainintellectualcurrentofthetime，andtopointoutmoreparticularlysomeoftheeddieswhichtendtokeepthescienceandartofmedicinefrommovingwithit，oreventocarrythembackwards。
Thetwodominantwordsofourtimearelawandaverage，bothpointingtotheuniformityoftheorderofbeinginwhichwelive。Statisticshavetabulatedeverything，——population，growth，wealth，crime，disease。Wehaveshadedmapsshowingthegeographicaldistributionoflarcenyandsuicide。Analysisandclassificationhavebeenatworkuponalltangibleandvisibleobjects。ThePositivePhilosophyofComtehasonlygivenexpressiontotheobservingandcomputingmindofthenineteenthcentury。
Inthemeantime，thegreatstrongholdofintellectualconservatism，traditionalbelief，hasbeenassailedbyfactswhichwouldhavebeenindictedasblasphemybutafewgenerationsago。Thosenewtablesofthelaw，placedinthehandsofthegeologistbythesamelivingGodwhospokefromSinaitotheIsraelitesofold，haveremodelledthebeliefsofhalfthecivilizedworld。Thesolemnscepticismofsciencehasreplacedthesneeringdoubtsofwittyphilosophers。Themorepositiveknowledgewegain，themoreweinclinetoquestionallthathasbeenreceivedwithoutabsoluteproof。
Asamatterofcourse，thismovementhasitspartialreactions。Theprovinceoffaithisclaimedasaportfreeofentrytounsupportedindividualconvictions。Thetendencytoquestionismetbytheunanalyzinginstinctofreverence。Theoldchurchcallsbackitsfrightenedtruants。SomewhohavelosttheirhereditaryreligiousbelieffindaresourceintherevelationsofSpiritualism。Byaparallelmovement，someofthosewhohavebecomemedicalinfidelspassovertothemysticbandofbelieversinthefanciedmiraclesofHomoeopathy。
Undertheseinfluencestransmittedto，oratleastsharedby，themedicalprofession，theoldquestionbetween“Nature，“socalled，and“Art，“orprofessionaltradition，hasreappearedwithnewinterest。
Isaytheoldquestion，forHippocratesstatedthecaseonthesideof“Nature“morethantwothousandyearsago。MissFlorenceNightingale，——andifInamehernexttotheaugustFatheroftheHealingArt，itsnoblestdaughterwelldeservesthatplaceofhonor，——MissFlorenceNightingalebeginsherlatevolumewithaparaphraseofhisstatement。Butfromaveryearlytimetothistherehasalwaysbeenastrongpartyagainst“Nature。“ThemisoncalledthepracticeofHippocrates“ameditationupondeath。“Dr。Rushsays：
“ItisimpossibletocalculatethemischiefwhichHippocrates，hasdone，byfirstmarkingNaturewithhisnameandafterwardslettingherlooseuponsickpeople。Millionshaveperishedbyherhandsinallagesandcountries。“SirJohnForbes，whosedefenceof“Nature“
indiseaseyouallknow，andtothetestimonialinwhosehonorfourofyourPresidentshavecontributed，hasbeenrecentlygreeted，onretiringfromtheprofession，withawishthathisretirementhadbeentwentyyearssooner，andtheopinionthatnomanhaddonesomuchtodestroytheconfidenceofthepublicinthemedicalprofession。
InthisSocietywehavehadtheHippocraticandtheThemisonicsidefairlyrepresented。ThetreatiseofoneofyourearlyPresidentsontheMercurialTreatmentisfamiliartomyolderlisteners。Otherswhohaveheldthesameofficehavebeennotedfortheboldnessoftheirpractice，andevenforpartialitytotheuseofcomplexmedication。
Onthesideof“Nature“wehavehad，firstofall，thatremarkablediscourseonSelf-LimitedDiseases，[OnSelf-LimitedDiseases。A
DiscoursedeliveredbeforetheMassachusettsMedicalSociety，attheirAnnualMeeting，May27，1835。ByJacobBigelow，M。D。]whichhasgiventhekey-notetotheprevailingmedicaltendencyofthisneighborhood，atleast，forthequarterofacenturysinceitwasdelivered。NorhaveweforgottentheaddressdeliveredatSpringfieldtwentyyearslater，[SearchouttheSecrets，ofNature。
ByAugustusA。Gould，M。D。ReadattheAnnualMeeting，June27，1855。]fullofgoodsenseandusefulsuggestions，tooneofwhichsuggestionsweowethelearned，impartial，judicious，well-writtenPrizeEssayofDr。WorthingtonHooker。[RationalTherapeutics。A
PrizeEssay。ByWorthingtonHooker，M。D。，ofNewHaven。Boston。
1857。]Weshouldnotomitfromthelisttheimportantaddressofanotherofourcolleagues，[OntheTreatmentofCompoundandComplicatedFractures。ByWilliamJ。Walker，M。D。ReadattheAnnualMeeting，May29，1845。]showingbynumerouscasesthepowerofNatureinhealingcompoundfracturestobemuchgreaterthanisfrequentlysupposed，——affording，indeed，morestrikingillustrationsthancanbeobtainedfromthehistoryofvisceraldisease，ofthesupremewisdom，forethought，andadaptivedexterityofthatdivineArchitect，asshowninrepairingtheshatteredcolumnswhichsupportthelivingtempleofthebody。
Wewhoareonthesideof“Nature“pleaseourselveswiththeideathatweareinthegreatcurrentinwhichthetrueintelligenceofthetimeismoving。Webelievethatsomewhooppose，orfear，ordenounceourmovementarethemselvescaughtinvariouseddiesthatsetbackagainstthetruth。Andwedomostearnestlydesireandmostactivelystrive，thatMedicine，which，itispainfultoremember，hasbeenspokenofas“thewitheredbranchofscience“atameetingoftheBritishAssociation，shallbeatlengthbroughtfullytoshare，ifnottolead，thegreatwaveofknowledgewhichrollswiththetidesthatcircletheglobe。