IT is with much diffidence that I offi­cially presume to deliver a few de­tach'd thoughts, chiefly respecting MEDI­CAL IMPROVEMENT; as an address in­troductory to the commencement of our literary business in this place. Your in­dulgent candour which I have so often experienced, I flatter myself, will, on this occasion, impute the faults which you will doubtless discover, not to intention, but inability or misconception.

I chearfully embrace this opportunity to express the most grateful impressions I [Page 8]entertain of the great and unsollicited honour you have been pleased to confer upon me, by twice calling me to the of­fice of PRESIDENT. Had my powers been equal to my wishes, no part of my con­duct in that elevated character, had been unworthy of you, or of this chair. Al­tho' indispensible avocation permits me no longer to hold any office among you; yet will I lose no opportunity of being present, and, as far as I may be able, of assisting in your instructive speculations; and of promoting to the utmost of my power, the general prosperity of a Society to which I ever have been so much at­tached.

In the commercial world, it is allowed by all, that the comparative rate of ex­change, is a just index of the prosperous or adverse state of trade in different countries individually, or relatively con­sidered. [Page 9]With no less truth, in my opnion, the comparative degree of cultivation to which Belles Lettres and philosophy, or the fine and useful arts, arrive in different kingdoms may be re­garded as demonstrative of their re­lative civilization.

Judging by this criterion, altho' in this respect CALEDONIA may not justly boast of being the first, she is by no means the last of the European nations: Her progress in the walk of general science and liberality is rapid, and I hope will long continue so. Justice, however, constrains me to confess, that long, too long, in a great degree, she had neglected the MEDICAL PHILOSOPHY. In an Aera not beyond the recollection of some present, the immortal honour of planting a medical school in this Metropo­lis; now indeed second in fame and erudition to none in Europe, was reserv­ed [Page 10]to a distinguished, a fortunate MON­RO. To his memory consenting nations pay that just tribute of applause, which his country in general, but this City and its University in particular, ought to perpetuate by a statue.

By a WORTHY SELECT BAND of the numerous students, who flocked from all quarters, allured by the rising fame of the Edinburgh University; this MEDICAL SOCIETY in 1737, was happily institu­ted. Of its various progress and present flourishing independent state, I presume you to be well informed; and there­fore avoid attempting any particular his­torical narration of these circumstances at present.

THE BUILDING ^* in which we are now [Page 11]assembled is a grand phenomenon of medi­cal ardor, unparallelled in any country; and may justly be regarded as a temple sacred to AESCULAPIUS, reared by the virtuous zeal of his youthful votaries, for purposes the most liberal and praise­worthy. The FRIENDS OF SCIENCE, not of your number, ^* who have generously contributed towards its structure; are entitled to our most grateful thanks.

Contemplating this FABRIC, and the many other aids which the present ad­vantageous state of our society affords to facilitate study; you must have anti­cipated me in this reflection, that, while our minds are gratefully affected to our MERITORIOUS PREDECESSORS, our [Page 12]every power ought to be exerted, if not to advance, at least, to maintain our ex­tended reputation: that, the verdant lau­rels they have transmitted may not wi­ther in our hands, overwhelming us with indelible ignominy and disgrace.

'Tis with the highest pleasure, I per­ceive, without being chargeable with adulation, I can fairly aver, that this So­ciety at no period of its existence has been more secure of progress than at present: the learning, genius and manly liberality of sentiment, which I know you possess, and which, with much satisfac­tion and instruction, I have so often ob­served animating your debates; constitute the foundation on which this assertion rests.

You are not to be informed that the com­bined powers of GENIUS and INDUSTRY must perseveringly operate thro' the course of several years, that a tolerably [Page 13]complete knowledge of even the elemen­tary parts of the science of medicine, as already ascertained and taught, may be acquired. To have proceeded so far in medical study, is indeed to have made no despicable progress: But I trust your ardent ambition is more aspiring than to remain satisfied with the acquisition of a bare acquaintance of the dogmata of this, or the other MEDICAL SECT or PROFESSOR, i. e. of the present state of the healing art. It would be offering an undeserved insult to your sagacity, were I but once to imagine, that you could entertain a be­lief, that the Medical Philosophy had al­ready attained the utmost perfection of which it is susceptible. You well know, that the unexplored regions of the terra incognita Medicinalis, so to speak, still af­ford abundant scope for your most pro­tracted labours; so just is the observa­tion, ars longa, vita brevis.

ANATOMY, as being the grand basis of the Medical Fabric, from the earliest periods of society, in every civilized coun­try, has been cultivated with the most unrelenting ardor of investigation, which many most material improvements have from time to time rewarded. Are there not still, however, many very interesting parts and circumstances of the structure of the ANIMAL AUTOMATON which we but little know? and many others of great importance, of which we are total­ly ignorant? What anatomist has hither­to been able successfully to evolve the texture of the SPLEEN; an organ of considerable size, and probably of pro­portional importance in the animal oeco­nomy? Very lately it has been supposed the sole fabricator of the globular part of the blood ^*. The same question may be put with respect to the structure of the MUSCULAR FIBRE, or LIVING SOLID; [Page 15]and that SPECIFIC CONFIGURATION of the several orders of the SECRETORY ORGANS, upon which such a wonderful variety and opposition of secreted liquors probably depends. But, above all, it may be put with respect to the BRAIN, and ITS APPENDAGES; parts essential to life, often the seat of disease, evidently variously organized, of great volume and surprizingly diversified in their external form.

I will be pardoned for expressing my fears, that few anatomical improvements are to be expected from you while resi­ding in this country; at least, while its present TONE continues, however great your ability and ardor: because an insu­perable barrier is opposed to your pro­gress; I mean the WANT OF PRIVATE DISSECTION. In the end of the eight­teenth century, when philosophical libera­lity is diffused from Pole to Pole, what a [Page 16]pity, or rather what a shame, that, even in the Metropolis of a kingdom, not un­civilized, and in its principal Universi­ty too, where the circle of education is otherwise tolerably complete; this GRAND and almost ONLY AVENUE to the AESCULAPIAN Temple, should re­main most barbarously blocked up!

A public course of anatomical demon­stration, exceeded by none, and equalled by few, is, I confess, annually made here; by a learned, discerning, accurate, inde­fatigable Professor: whom none of you can more respect than I do. I, notwith­standing, hesitate not to declare it as my positive opinion, and I will venture to say it is not solitary, that, no public anatomi­cal exhibitions, where the student is mere­ly a PASSIVE SPECTATOR, are sufficient to convey and impress those precise and multifarious ideas of this important branch of natural knowledge, absolute­ly requisite to complete the medical [Page 17]character; throwing discovery altogether out of the question.

To acquire a tolerable knowledge of even the great outlines of anatomy, it is indispensibly necessary to take the knife in hand, and, with the most unremitting attention, dissect a variety of bodies of different sizes, ages, and sexes, properly chosen, and prepared for the purpose: Much more must this plan be followed, if it be proposed to soar in the regions of discovery and improvement. I can ex­perimentally assert, that more anatomical information will be reaped from the well conducted dissection of one body, than from repeated public courses.

If this opinion be well founded, it is a self-evident consequence, that attending one or two public courses of anatomy, must be much inadequate to accomplish the medical philosopher; especially, if the practice of surgery, the most evident­ly useful part of the healing art, be his [Page 18]destination. Humanity revolts at the idea of the many unavoidable, and, I fear, too often fatal blunders that must result from this capital defect of the me­dical education to be obtained in this country. It is abundantly mortifying indeed, to observe those who wish to at­tain a proper degree of anatomical know­ledge, after spending several years at our Universities, and probably attaining their highest honours, reduced to the alterna­tive of either undertaking expensive ex­peditions into foreign countries, in this respect more civilized than ours; or of remaining dangerously uninformed.

If one should attempt to adjust the wheels and springs of a nice and delicate mechanism, he, perhaps, had never be­fore seen, or, at least, never minutely considered; with what indignant contempt would we treat the rude audacious pre­tender? Thousands, alas! are daily sub­jected [Page 19]to the unpractised knife of opera­tors of necessity aukward, I had almost said unskilled; because they never could enjoy the requisite opportunity, of either acquiring proper dexterity to perform any proposed operation with due address; or full knowledge of the parts concern­ed: from the want of access to the dead human body.

This alarming consideration is surely of sufficient force to conquer the vulgar prejudices against private dissection, whe­ther the offspring of superstition or igno­rance. The violation of the sepulchre or the clandestine robbery of the tomb, is most justly regarded as a crime of a deep dye; but certainly private dissecti­on, under proper regulations, is compa­tible with the most absolute security in this respect. Of this the practice of most of the European countries is an ir­refragable proof; viz. of these countries to which our students are compelled to [Page 20]resort, to obtain opportunities of diffec­ting which might so easily be afforded at home. Were a proportional number of dead human bodies annually furnished by authority, to the medical Students in the different towns of Scotland in gene­ral, and to those attending our Universi­ties, in particular, for private dissection: the salutary consequences would soon surpass conception. It is truly astonish­ing, that a matter of such endless impor­tance had not, long e'er now, challenged the notice, and roused the attention of the HONOURABLE SUPERINTENDANTS of our Police, or even of the LEGISLA­TURE itself.

The Criminal and Flagitious, whether they expire under the hands of the exe­cutioner, or by disease; ought always to be consigned to the anatomical knife: that thus, in some degree, when dead, they may attone to society for their de­predation [Page 21]and turbulence when alive. Public utility seems likewise to have a good title to the use of the dead bo­dies of those who by idleness and dissipa­tion, have rendered themselves objects of public charity; and consequently, per­haps for many years, have been cloathed and fed at the public expence.

Humanity, Patriotism, and even self-interest conspire, to stimulate every in­dividual to promote, at least, not to op­pose the establishment of a measure so pregnant with the most solid advantages to mankind. The advancing liberality of this country, affords the strongest rea­sons to hope that the auspicious Aera is not very distant, when medical improve­ment shall be no more retarded by the impossibility of acquiring anatomical in­formation in the only way that it can be acquired; a mischief hitherto so op­probrious, fatal, and gigantic.

If Anatomy be defective, PHISIOLOGY which teaches the functions of the va­rious organs and parts detected by ana­tomy, must necessarily be proportionally defective. Not only is this the fact, but the uses even of many parts which the anatomist has described with tolerable ac­curacy, are far, very far, from being suf­ficiently explained by the phisiologist; e. g. Of several of the GENERATIVE ORGANS, of the DIFFERENT SUB­STANCES and PROTUBERANCES of the BRAIN, of the GANGLIONS, &c.

In like manner, many of the gene­ral laws and principles of the living sys­tem are not illustrated with satisfactory precision; while one physiologist affirms that MENSTRUATION depends on TO­PICAL, another refers it to GENERAL PLETHORA. Some contend that NUTRI­TION is effected by the NERVES, others by the VESSELS: and a variety of facts [Page 23]are artfully adduced, to establish these opposite doctrines. With respect to many other physiological disquisitions the same contrariety of opinion exists.

If the question be put, "What shall be said when Doctors disagree?" I reply, recur to nature, collect useful facts, from them draw manly, liberal, chaste con­clusions; disregard ideal, cobweb, flimsy theories, the baseless fabric of a vision. GENERAL PRINCIPLES, rationally de­duced as corrollaries from established facts, only, in my opinion, can justly claim the dignified appellation of THEO­RY.

PATHOLOGY, you know, treats of the MORBID STATES of animal nature, with a view to effect their PREVENTION, AL­LEVIATION or CURE. Many anatomical and physiological speculations are more curious than useful, and may, therefore, altho' not strictly just, have the merit [Page 24]of being innocent. Pathological disqui­sitions, on the contrary, must always pro­duce the most serious consequences; be­cause they influence the medical conduct of disease. Our small knowledge, or rather our great ignorance, of this depart­ment, affords but a melancholy theme to the anxious philosophic inquirer. The va­riety and opposition, the absurdity and confusion of numberless futile conceits, wild imaginations, fanciful opinions, dig­nified forsooth with the name of DOCT­RINES, are the opprobrium of the medi­cal profession: and present to the con­templative mind, the idea of primaeval Chaos, when darkness brooded over the great abyss.

Altho' I possessed ability, neither your time nor patience permit me to attempt a particular enumeration of the striking absurdities, which have, in a great de­gree, hitherto overwhelmed pathology, [Page 25]depressing medicine far beneath the rank of her sister arts; because these arts are established in the evolved un­alterable laws of nature.

One class of pathologists have recourse to the SENSIBLE QUALITIES of the AT­MOSPHERE, as chiefly contributing to create the numerous and important tribe of febrile disorders; and endeavour to support their reasonings by meteorologi­cal registers and observations without end. With equal confidence, another tribe, disregarding in a great measure, this opinion, muster up INVISIBLE MIAS­MATA and FLOATING POISONS, to untie every gordian knot; either as principal agents, or complete efficients. In like manner, while the favourite system of one period, refers us, with much plausibility, to the FLUIDS, and MORBIFIC MATTER there existing, for the SEAT and CAUSES of many diseases; that of another, with [Page 26]at least equal probability, directs our at­tention almost solely to SPASM and other AFFECTIONS of the SOLIDS.

I cannot avoid here to remark, that were the science of medicine like fluxi­ons, infinitesimals, the quadrature of the circle, &c. i. e. purely a matter of curious uninteresting speculation; we might view the FLUCTUATING INSTA­BILITY of its DOGMATA or DOCTRINES, as they are called; with the same Tone of mind with which we contemplate the fantastic shiftings of the aurora borealis, or visions of the night. But how diame­trically opposite must be the feelings of humanity, reflecting that these successive doctrines have respectively, during their fashionable periods of domination, greatly influenced the medical management of disease; compelling the passive entramel­led, bewildered practitioner, to employ the most opposite curative means, in the [Page 27]same morbid states: the consequent ha­vock, devastation, and massacre of man­kind is more easily imagined than descri­bed.

The ancient maxim ‘ "in medio tutissi­mus ibis,"’ should perhaps never be en­tirely neglected. It seems exceedingly probable a priori, that, the fluids being made or elaborated by the solids; and these, on the other hand, supported by the fluids; their affections will not long remain distinct, but rather always be re­ciprocal: However, ‘"Non nostrum tantas componere lites."’

Moreover, how little we do know with tolerable certainty, respecting the IM­PRESSIONS made on the SENTIENT PARTS of our bodies, by what are named the potentiae nocentes; or of the DERANGE­MENT of ORGANIZATION; or of the NUMBER and NATURE of the MORBID ALTERATIONS thence consequent! yet [Page 28]it seems absolutely necessary that these particulars be marked with the utmost possible precision. For instance, we are told, that there are two species of FE­BRILE DELIRIUM, requiring the most opposite treatment; but who has hither­to pointed out, with sufficient accuracy, the symptoms ascertaining their important discrimination? If, therefore, in such a perilous predicament the GENIUS of blunder should but for a moment over­cloud the practitioner's discernment, which is a very supposable, but I hope, a rare occurence; conclamatum est.

'Till pathology, therefore, is more de­termined and complete, don't cases beset with dubiety and peril, seem justly to de­mand a suspension of hostilities (so to speak) or of our therapeutic efforts; which, permit me to say, may often with justice be termed the impertinence of art? These daring practitioners, who in [Page 29]the advanced critical febrile states, which they by no means understand, exhibit FEBRIFUGE NOSTRUMS, ^* with a teme­rity that equally shocks our feelings, and alarms our fears; may not ineptly be compared to the nonplus'd statesman; who, to smother dissention and broil, of which his mal-administration is probably the cause, risks the very existence of the state itself, by plunging it headlong into general combustion, and foreign war.

It is with much pleasure I acknow­ledge, that, in this most essential depart­ment of the medical philosophy, light and order happily begin to diffuse their genial influence over darkness and con­fusion. The GENIUS and LABOURS of some whom this Society can reckon among her honorary sons, have al­ready contributed, in no small degree, [Page 30]to this most desirable purpose. I am confident I speak your sentiments, and most assuredly my own, when I mention with the most particular gratitude, the great advantages we have so often and so happily reaped in our inquiries, from the CULLENIAN NOSOLOGY: a work per­spicuous tho' concise, elaborate yet not voluminous, in every part demonstrative of the liberal views, and extensive medi­cal erudition of its very respectable and accomplished author, who with truth may say, ‘"Exegi monumentum aere perennius."’

Supposing just indications of cure to be formed, in consequence of an advan­ced and chaste pathology, to be then provided with proper and active AGENTS or REMEDIES to fulfil these indications; becomes a matter of most important con­cern. The jarring opinions of authors [Page 31]respecting the nature, activity, dose and mode of exhibition, of almost every ar­ticle of the MATERIA MEDICA; present a most extensive field for useful experi­ment and investigation.

With respect to medical improvement, I shall only in general add, that, your ex­pectations, in my opinion, are less likely to be frustrated, if you look for it to re­sult more from anatomical physiological and pathological progress, than from the discovery of any addition to the Materia Medica. This part of the medical sci­ence is by no means to be neglected, altho' it be probable, that advancing but a single step in any of the other walks, may be productive of more real and solid im­provement and utility, than the acquisi­tion of a thousand simples; if it be true, that it is an easier business to fulfil, than institute proper curative indications.

Be assured that the PHYSICIAN towers above the Empiric, the nurse and old wo­man almost only in proportion to his su­perior information respecting the PARTS, the LAWS, and MORBID STATES of ani­mal nature; the more perfect his acquire­ments in these particulars, the higher his pre-eminence among the sons of Aescu­lapius. No mode of inauguration how­ever solemn, no academic rites or autho­rity however great or antient, can elevate to the honourable rank of Physician, a person of an opposite description. Such a one could only be regarded as an EMPTY DIGNIFIED FORM, around whose blighting temples, the VENAL, the SURREPTITIOUS, the PROSTITUTED LAURELS of APOL­LO must basely fade to the utter discredit of all concerned; a more melancholy consequence still would be, that his prac­tice could not fail to prove the bane of so­ciety, operating the destruction of such in­dividuals [Page 33]as might become the unfortu­nate subjects of his temerity.

If therefore to become a Physician, ( i. e. to be qualified to mark with preci­sion, the almost infinitely various affec­tions of animated matter, so as to direct, as far as may be, its movements to the blissful abode of longaevity and health,) be a task only terminating with life, to be exhausted by no labour, and to which the most discriminating mental powers are not superior; the folly, not to say criminality of attempts ^* to incite vulgar vanity to tamper with the most precious interests of mankind, needs no illustration.

In every species of philosophical inves­tigation, particularly those of a medical nature, where certainty is so difficultly attained; to guard against CREDULITY, is a counsel, I deem of such infinite im­portance, that, before I put an end to this [Page 34]address, I cannot help tendering it in the most earnest manner to the particular no­tice of my YOUNGER SOCII. In all cases, where there is not absolute de­monstration, or at least as high a degree of evidence, as the nature of the argu­ment admits; to suspend belief or to ex­ercise a proper degree of scepticism, till mature examination and reflection shall compel assent: I regard as a measure pru­dent, rational and philosophic. The un­supported ipse dixit of any man, however great his name in science, I always con­sider as a very weak argument: Recan­tation at best is exceedingly disagreeable.

The constitution of our Society, or its present system of laws, I am far from reckoning perfect; many meliorations, I doubt not will be made from time to time. No good reason can be assigned why our meetings should be suspend­ed during half the year: In summer in­deed [Page 35]they might probably be thin; but it does not follow, that your speculations on that account would be less instructive, or your essays more imperfect.

I conclude by congratulating you up­on your affairs being now happily in such a prosperous train, as to afford the most flattering prospects. I contemplate the rising glory, and future greatness of the Medical Society, with no small degree of pleasurable ecstasy and expectation: Methinks, I hear its TOWERING GENIUS with the most complacent exultation ex­claim ‘ "sublimi feriam sidera vertice."’