“FrereJacques，“whotaughtthelithotomistsofParis，oweshisecclesiasticaltitletocourtesy，ashedidnotbelongtoareligiousorder。
Medicalscience，andespeciallythestudyofmentaldisease，isdestined，Ibelieve，toreacttomuchgreateradvantageonthetheologyofthefuturethantheologyhasactedonmedicineinthepast。Theliberalspiritverygenerallyprevailinginbothprofessions，andthegoodunderstandingbetweentheirmostenlightenedmembers，promisewellforthefutureofbothinacommunitywhichholdseverypointofhumanbelief，everyinstitutioninhumanhands，andeverywordwritteninahumandialect，opentofreediscussiontoday，to-morrow，andtotheendoftime。Whethertheworldatlargewilleverbecuredoftrustingtospecificsasasubstituteforobservingthelawsofhealth，andtomechanicalorintellectualformulaasasubstituteforcharacter，mayadmitofquestion。Quackeryandidolatryareallbutimmortal。
Wecanfindmostoftheoldbeliefsaliveamongstusto-day，onlyhavingchangedtheirdressesandthesocialspheresinwhichtheythrive。WethinkthequarrelsofGalenistsandchemistsbelongtothepast，forgettingthatThomsonismhasitsnumerousapostlesinourcommunity；thatitiscommontoseeremediesvauntedaspurelyvegetable，andthattheprejudiceagainst“mineralpoisons，“
especiallymercury，isasstronginmanyquartersnowasitwasatthebeginningoftheseventeenthcentury。Namesareonlyair，andblowawaywithachangeofwind；butbeliefsarerootedinhumanwantsandweakness，anddiehard。TheoaksofDodonaareprostrate，andtheshrineofDelphiisdesolate；butthePythonessandtheSibylmaybeconsultedinLowellStreetforaverymoderatecompensation。
NostradamusandLillyseemimpossibleinourtime；butwehaveseentheadvertisementsofanastrologerinourBostonpapersyearafteryear，whichseemstoimplythathefoundbelieversandpatrons。YousmiledwhenIrelatedSirKenelmDigby’sprescriptionwiththeliveeelinit；butifeachofyouweretoemptyhisorherpockets，wouldtherenotrollout，frommorethanoneofthem，ahorse-chestnut，carriedaboutasacureforrheumatism？ThebrazenheadofRogerBaconismute；butisnot“Planchette“utteringherresponsesinahundredhousesofthiscity？WethinkofpalmistryorchiromancyasbelongingtothedaysofAlbertusMagnus，or，ifexistinginourtime，asgivenovertothegypsies；butaverydistinguishedpersonhasrecentlyshownmethelineoflife，andthelineoffortune，onthepalmofhishand，withaseemingconfidenceinthesanguinepredictionsofhiscareerwhichhadbeendrawnfromthem。Whatshallwesayoftheplausibleandwell-dressedcharlatansofourowntime，whotradeinfalsepretences，likeNicholasKnappofold，butwithoutanyfearofbeingfinedorwhipped；orofthemanyfolliesandinanities，imposingonthecredulouspartofthecommunity，eachofthemgapingwitheager，openmouthforagratuitousadvertisementbythementionofitsfoolishnameinanyrespectableconnection？
Iturnfromthislesspleasingaspectofthecommonintelligencewhichrenderssuchfolliespossible，toclosethehonorablerecordofthemedicalprofessioninthis，ourancientCommonwealth。
Wehaveseenitinthefirstcenturydividedamongclergymen，magistrates，andregularpractitioners；yet，onthewhole，forthetime，andunderthecircumstances，respectable，exceptwhereitinvokedsupernaturalagenciestoaccountfornaturalphenomena。
Inthesecondcenturyitsimplifieditspractice，educatedmanyintelligentpractitioners，andbegantheworkoforganizingforconcertedaction，andformedicalteaching。
Inthis，ourowncentury，ithasbuilthospitals，perfectedandmultiplieditsassociationsandeducationalinstitutions，enlargedandcreatedmuseums，andchallengedaplaceintheworldofsciencebyitsliterature。
Inreviewingthewholecourseofitshistorywereadalonglistofhonorednames，andapreciousrecordwritteninprivatememories，inpubliccharities，inpermanentcontributionstomedicalscience，ingeneroussacrificesforthecountry。WecanpointtoourcapitalastheportofentryfortheNewWorldofthegreatmedicaldiscoveriesoftwosuccessivecenturies，andwecanclaimforitthetriumphoverthemostdreadedfoethatassailsthehumanbody，——atriumphwhichtheannalsoftheracecanhardlymatchinthreethousandyearsofmedicalhistory。
THEYOUNGPRACTITIONER
[AValedictoryAddressdeliveredtotheGraduatingClassoftheBellevueHospitalCollege，March2，1871。]
Theoccasionwhichcallsustogetherremindsusnotalittleofthatotherceremonywhichunitesamanandwomanforlife。Thebannshavealreadybeenpronouncedwhichhaveweddedouryoungfriendstotheprofessionoftheirchoice。Itremainsonlytoaddresstothemsomefriendlywordsofcheeringcounsel，andtobestowuponthemthepartingbenediction。
Thisisnotthetimeforrhetoricaldisplayorambitiouseloquence。
Wemustforgetourselves，andthinkonlyofthem。Tousitisanoccasion；tothemitisanepoch。Thespectatorsattheweddinglookcuriouslyatthebrideandbridegroom；atthebridalveil，theorange-flowergarland，thegivingandreceivingofthering；theylistenforthetremulous“Iwill，“andwonderwhatarethemysterioussyllablestheclergymanwhispersintheearofthemarriedmaiden。
Buttothenewly-weddedpairwhatmeaninginthosewords，“forbetter，forworse，““insicknessandinhealth，““tilldeathusdopart！“Tothefather，tothemother，whoknowtoowellhowoftenthedeadlynightshadeisinterwovenwiththewreathoforange-blossoms，howemptythepageant，howmomentousthereality！
YouwillnotwonderthatIaddressmyselfchieflytothosewhoarejustleavingacademiclifeforthesternerstruggleandthelargertasksofmaturedandinstructedmanhood。Thehourbelongstothem；
ifothersfindpatiencetolisten，theywillkindlyrememberthat，afterall，theyarebutasthespectatorsatthewedding，andthatthepriestisthinkinglessofthemthanoftheirfriendswhoarekneelingatthealtar。
Ispeakmoredirectlytoyou，then，gentlemenofthegraduatingclass。Thedaysofyoureducation，aspupilsoftrainedinstructors，areover。Yourfirstharvestisallgarnered。Henceforthyouaretobesowersaswellasreapers，andyourfieldistheworld。Howdoesyourknowledgestandto-day？Whathaveyougainedasapermanentpossession？Whatmustyouexpecttoforget？Whatremainsforyouyettolearn？Thesearequestionswhichitmayinterestyoutoconsider。
Thereisanotherquestionwhichmustforceitselfonthethoughtsofmanyamongyou：“HowamItoobtainpatientsandtokeeptheirconfidence？“Youhavechosenalaboriouscalling，andmademanysacrificestofityourselvesforitssuccessfulpursuit。Youwishtobeemployedthatyoumaybeuseful，andthatyoumayreceivetherewardofyourindustry。Iwouldtakeadvantageofthesemostreceptivemomentstogiveyousomehintswhichmayhelpyoutorealizeyourhopesandexpectations。SuchistheoutlineofthefamiliartalkIshallofferyou。
Youracquaintancewithsomeoftheaccessorybranchesisprobablygreaternowthanitwillbeinayearfromnow，——muchgreaterthanitwillbytenyearsfromnow。Theprogressofknowledge，itmaybefeared，orhoped，willhaveoutrunthetext-booksinwhichyoustudiedthesebranches。Chemistry，forinstance，isveryapttospoilonone’shands。“Nousavonschangetoutcela“mightserveasthestandingmottoofmanyofourmanuals。Scienceisagreattraveller，andwearshershoesoutprettyfast，asmightbeexpected。
Youarenowfreshfromthelecture-roomandthelaboratory。Youcanpassanexaminationinanatomy，physiology，chemistry，materiamedica，whichthemeninlargepracticeallaroundyouwouldfindamorepotentsudorificthananyinthePharmacopceia。Thesemastersoftheartofhealingwereonceasreadywiththeiranswersasyouarenow，buttheyhavegotridofagreatdealofthelessimmediatelypracticalpartoftheiracquisitions，andyoumustundergothesamedepletingprocess。Hardworkwilltrainitoff，assharpexercisetrainsoffthefatofaprize-fighter。
Yet，pauseamomentbeforeyouinferthatyourteachersmusthavebeeninfaultwhentheyfurnishedyouwithmentalstoresnotdirectlyconvertibletopracticalpurposes，andlikelyinafewyearstolosetheirplaceinyourmemory。Allsystematicknowledgeinvolvesmuchthatisnotpractical，yetitistheonlykindofknowledgewhichsatisfiesthemind，andsystematicstudyproves，inthelong-run，theeasiestwayofacquiringandretainingfactswhicharepractical。
Therearemanythingswhichwecanaffordtoforget，whichyetitwaswelltolearn。Yourmentalconditionisnotthesameasifyouhadneverknownwhatyounowtryinvaintorecall。Thereisaperpetualmetempsychosisofthought，andtheknowledgeofto-dayfindsasoilintheforgottenfactsofyesterday。Youcannotseeanythinginthenewseasonoftheguanoyouplacedlastyearabouttherootsofyourclimbingplants，butitisblushingandbreathingfragranceinyourtrellisedroses；ithasscaledyourporchinthebee-hauntedhoney-
suckle；ithasfounditswaywheretheivyisgreen；itisgonewherethewoodbineexpandsitsluxuriantfoliage。
Yourdiplomaseemsverybroadto-daywithyourlistofaccomplishments，butitbeginstoshrinkfromthishourlikethePeaudeChagrinofBalzac’sstory。Donotworryaboutit，forallthewhiletherewillbemakingoutforyouanamplerandfairerparchment，signedbyoldFatherTimehimselfasPresidentofthatgreatUniversityinwhichexperienceistheoneperpetualandall-
sufficientprofessor。
Yourpresentplethoraofacquirementswillsooncureitself。
KnowledgethatisnotwanteddiesoutliketheeyesofthefishesoftheMammothCave。Whenyoucometohandlelifeanddeathasyourdailybusiness，yourmemorywillofitselfbidgood-bytosuchinmatesasthewell-knownforaminaofthesphenoidboneandthefamiliaroxidesofmethyl-ethylamyl-phenyl-ammonium。Bethankfulthatyouhaveonceknownthem，andrememberthateventhelearnedignoranceofanomenclatureissomethingtohavemastered，andmayfurnishpegstohangfactsuponwhichwouldotherwisehavestrewedthefloorofmemoryinloosedisorder。
Butyoureducationhas，afterall，beenverylargelypractical。Youhavestudiedmedicineandsurgery，notchieflyinbooks，butatthebedsideandintheoperatingamphitheatre。Itisthespecialadvantageoflargecitiesthattheyaffordtheopportunityofseeingagreatdealofdiseaseinashortspaceoftime，andofseeingmanycasesofthesamekindofdiseasebroughttogether。Letusnotbeunjusttotheclaimsoftheschoolsremotefromthelargercentresofpopulation。WhoamongushastaughtbetterthanNathanSmith，betterthanElishaBartlett？whoteachesbetterthansomeofourlivingcontemporarieswhodividetheirtimebetweencityandcountryschools？Iamafraidwedonotalwaysdojusticetoourcountrybrethren，whosemeritsarelessconspicuouslyexhibitedthanthoseofthegreatcityphysiciansandsurgeons，suchespeciallyashavechargeoflargehospitals。Therearemodestpractitionerslivinginremoteruraldistrictswhoaregiftedbynaturewithsuchsagacityandwisdom，trainedsowellinwhatismostessentialtothepracticeoftheirart，taughtsothoroughlybyvariedexperience，forcedtosuchmanlyself-reliancebytheircomparativeisolation，that，fromconversewiththemalone，fromridingwiththemontheirlongroundsastheypassfromvillagetovillage，fromtalkingovercaseswiththem，puttinguptheirprescriptions，watchingtheirexpedients，listeningtotheircautions，markingtheeventoftheirpredictions，hearingthemtelloftheirmistakes，andnowandthengloryalittleinthedetectionofanother’sblunder，ayoungmanwouldfindhimselfbetterfittedforhisrealworkthanmanywhohavefollowedlongcoursesoflecturesandpassedashowyexamination。Buttheyoungmanisexceptionallyfortunatewhoenjoystheintimacyofsuchateacher。Anditmustbeconfessedthatthegreathospitals，infirmaries，anddispensariesoflargecities，wheremenofwell-
siftedreputationsareinconstantattendance，arethetruecentresofmedicaleducation。Nostudents，Ibelieve，aremorethoroughlyawareofthisthanthosewhohavegraduatedatthisinstitution。
Here，asinallourlargercityschools，thegreatestpainsaretakentoteachthingsaswellasnames。Youhaveenteredintotheinheritanceofavastamountoftransmittedskillandwisdom，whichyouhavetaken，warm，asitwere，withthelifeofyourwell-schooledinstructors。Youhavenotlearnedallthatarthastoteachyou，butyouaresaferpractitionersto-daythanweremanyofthosewhosenameswehardlymentionwithoutagenuflection。Ihadratherbecaredforinafeverbythebest-taughtamongyouthanbytherenownedFerneliusortheillustriousBoerhaave，couldtheycomebacktousfromthatbetterworldwheretherearenophysiciansneeded，and，iftheoldadagecanbetrusted，notmanywithincall。IhadratherhaveoneofyouexercisehissurgicalskilluponmethanfindmyselfinthehandsofaresuscitatedFabriciusHildanus，orevenofawiseAmbroisePare，revisitingearthinthelightofthenineteenthcentury。
Youwillnotaccusemeofunderratingyouraccomplishments。Youknowwhattodoforachildinafit，foranaldermaninanapoplexy，foragirlthathasfainted，forawomaninhysterics，foralegthatisbroken，foranarmthatisoutofjoint，forfeversofeverycolor，forthesailor’srheumatism，andthetailor’scachexy。Infactyoudoreallyknowsomuchatthisveryhour，thatnothingbutthesearchingtestoftimecanfullyteachyouthelimitationsofyourknowledge。
Ofsomeoftheseyouwillpermitmetoremindyou。Youwillneverhaveoutgrownthepossibilityofnewacquisitions，forNatureisendlessinhervariety。Buteventheknowledgewhichyoumaybesaidtopossesswillbeadifferentthingafterlonghabithasmadeitapartofyourexistence。Thetactuseruditusextendstothemindaswellastothefinger-ends。Experiencemeanstheknowledgegainedbyhabitualtrial，andanexpertisonewhohasbeeninthehabitoftrying。ThisisthekindofknowledgethatmadeUlysseswiseinthewaysofmen。Manycitieshadheseen，andknownthemindsofthosewhodweltinthem。ThisknowledgeitwasthatChaucer’sShipmanbroughthomewithhimfromtheseaa“Inmanyatempesthadhisberdbeshake。“
Thisistheknowledgeweplacemostconfidencein，inthepracticalaffairsoflife。
Ourtraininghastwostages。Thefirststagedealswithourintelligence，whichtakestheideaofwhatistobedonewiththemostcharmingeaseandreadiness。Letitbeagameofbilliards，forinstance，whichthemarkerisgoingtoteachus。Wehavenothingtodobuttomakethisballglancefromthatballandhitthatotherball，andtoknockthatballwiththisballintoacertaincaecalsacculusordiverticulumwhichourprofessionalfriendcallsapocket。Nothingcanbeclearer；itisaseasyas“playinguponthispipe，“forwhichHamletgivesGuildensternsuchluciddirections。
ButthisintelligentMe，whostepsforwardastheseniorpartnerinourdualpersonality，turnsouttobeaterriblebungler。Hemissesthoseglancinghitswhichthehard-featuredyoungprofessionalpersoncalls“carroms，“andinsistsonpocketinghisownballinsteadoftheotherone。