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must develop other and at present equally unsuspected sources of knowledge. You will introduce new instruments of precision, new means of investigation, and will thus be able to defeat and, still better, to prevent disease. The men who will make the most progress in the next generation will be the physiological physicians and surgeons, those who are best acquainted with chemistry and physics, and who will investigate the blood, the secretions, and the tissues in present ways more perfectly developed, and in new ways of which now we cannot even guess the method or the object. Leukocytosis, iodophilia, cytodiagnosis, cryoscopy, blood-pressure-all these you will use and improve upon far more than I dare picture. Comparative pathology will enrich and broaden your views. Possibly the original suggestion of Sir Christopher Wren, of intravenous medication, which we practice to but a small degree to-day by infusions of salt solution and of adrenalin, may become one of the recognized avenues for the administration of remedies. The ultramicroscopical vision which has just been conferred upon us, by which minute particles far beyond observation with our ordinary microscopes have been made visible, has opened up a new world for investigation which may develop truths as yet unsuspected.
Ten years ago who would have believed that it would be possible to look through skin and flesh, bandages and splints as though they were not, and to see our bones and determine their state of health or disease, of fracture, or integrity; and yet to-day this is known to every layman. Radio-activity, and possibly new means for the employment of light, may open new avenues for treatment. Certain it is that your studies in immunity, in toxines, and antitoxines will give you new weapons by which to prevent or vanquish disease and confer health. We need a new and safe anæsthetic. We need new drugs, new instruments of precision, by which new properties of matter, and novel methods of physical diag
nosis shall be discovered, and the beneficence of medicine illustrated by unexpected and, to-day, impossible methods of cure. In these researches, alas, I shall take no part, but I can at least goad you on to their accomplishment.
But I must not forget that I am speaking to American graduates in medicine. When I was a young man, every young graduate who could afford the time and expense went to Europe to put the finishing touches to his medical education. But the current is turning westward, and will enable us ere long to repay the great debt we owe to our European brethren by freely sharing with them our future wealth of scientific and practical knowledge and experience. We have awakened to a new life of research in the laboratories founded by liberal citizens, and no institution has more reason to be proud of a generous patron than has Cornell,—we have felt a new intellectual impulse in our colleges-our physicians and surgeons are alert and progressive as never before.
Coincident with a great political expansion that has carried us half-way around the globe, with a commercial expansion which has made the world stand amazed at what we have accomplished-if the experience of England under Elizabeth, of Italy under Victor Emmanuel, of Germany under two Kaisers is any guide—there will surely be in America an equal intellectual and scientific expansion. The future belongs to America-it belongs to you-if you but show yourselves worthy of the great inheritance to which you are heirs, and of the splendid possibilities which medicine offers you with lavish hand. You will be unworthy children of worthy sires if you do not rise to the level of these opportunities. Shall it be said that our statesmen, our merchants, and our manufacturers are abler, more enterprising, more conquering than our scientists, our surgeons, and our physicians? Nay, verily. You, new members of our own profession, will assuredly prove yourselves equal to the mighty task set before you, and conquer the world by being its noblest, wisest, and most unselfish benefactors.
SURGICAL REMINISCENCES OF THE
HAD the honor of being sworn into the service of the United States as an Assistant Surgeon in the shadow of the Capitol on July 4, 1861, though I had only begun the study of medicine in September, 1860, and did not graduate until March, 1862. It came about in this wise. My preceptor, Dr. John H. Brinton, had received a telegram from a former student (let us call him Smith), who had graduated in March, 1861, and was Assistant Surgeon of the Fifth Massachusetts, saying that he was going to leave the regiment and asking that Dr. Brinton should immediately send some one in his place if possible. Dr. Brinton very kindly offered the place to me. I said to him with very becoming modesty that I hardly felt I knew enough, to which he replied with combined frankness and flattery by saying: "It is perfectly true that you know very little, but, on the other hand, you know a good deal more than Smith." Accordingly I entered the army and immediately went into camp in Alexandria.
From the 4th until the Battle of Bull Run, Sunday, July 21, 1861, fortunately, I had very little to do. The surgeon of the regiment attended to sick call, while I tried to make myself somewhat familiar with military surgery. I remember only too well, however, the trepidation with which I went to attend one member of my regiment who accidentally had shot himself through the chest. If the soldier had known how slender was my own fund of information, his breast would have harbored not only a serious gunshot
* Read before the College of Physicians of Philadelphia, April 5, 1905. Dr. S. Weir Mitchell and Dr. John Billings contributed papers on their reminiscences at the same time.
wound, but many disturbing doubts as to the probability of his recovery in the hands of Assistant Surgeon Verdant Green.
My first initiation into real warfare was at the First Bull Run. We had marched the day before until after midnight and were awakened after a brief sleep to the activities of a memorable day in the history of the war. It was an exceedingly hot day, and we marched and halted and marched and halted in the thick dust under a broiling sun until about noon, when my regiment became engaged. Up to that time, and, in fact, during the entire engagement, I never received a single order from either Colonel or other officer, Medical Inspector, the surgeon of my regiment, or any one else. It was like the days when there was no King in Israel, and every man did that which was right in his own eyes. I did not see the surgeon from the middle of the forenoon.
As we approached the battlefield, I saw beside a little stream a few surgeons, among whom I knew one, and I asked him what I ought to do, for I was as green as the grass around me as to my duties on the field.* My friend Carr, of Rhode Island, suggested that I should turn in there and help, advice which I followed all the more readily because just at that time some of the advance of my own regiment appeared among the wounded. After a time, I saw everybody around me packing up and leaving, and upon asking what was the reason, was told that we were ordered back to Sedley Springs Church, a mile or more in the rear. Accordingly I went with them, and there in a grove alongside of the road, with no fence to enclose it, stood the little church perhaps one hundred feet distant from the road.
* Surgeon W. S. King, of the regulars ("Medical and Surgical History of the Rebellion," Part I, Medical Volume, Appendix, p. 2), calls attention to the fact that he and Assistant Surgeon Magruder were, with few exceptions, the only medical officers at the first battle of Bull Run who had ever served with troops in the field.
Both inside and outside the church much was going on. An operating table was improvised from two boards laid on two boxes in front of the pulpit; the slightly injured looked down from the gallery upon the industrious surgeons, and a number of kind women from the neighborhood helped to soothe the wounded.
I always have remembered one little illustration of the ignorance even of brigade surgeons who had been hastily appointed at the outbreak of the war. One of the wounded required an amputation at the shoulder-joint, and the operator asked the brigade surgeon to compress the subclavian artery. This he proceeded to do by vigorous pressure applied below the clavicle. With a good deal of hesitation, I at last timidly suggested to him that possibly compression above the clavicle would be more efficacious, when, with withering scorn, he informed me that he was pressing in the right place as was proved by the name of the artery, which was subclavian. I do not remember whether the operator took a hand in this little linguistic discussion or even overheard it. I had my rather grim revenge, happily, not to the serious disadvantage of the patient. When the operator made the internal flap the axillary artery gave one enormous jet of blood, for the subclavian persisted in running where it could be compressed above the clavicle, in spite of its name. I caught the artery in the flap, as I had been taught to do by Dr. Brinton, and instantly controlled the hæmorrhage.
Later, I was outside the church dressing a man who had a fracture of the humerus from a Minié ball. I was applying a splint and an eight-yard bandage. We were in the wood surrounding the church, perhaps twenty feet back from the road, when suddenly one hundred or more of the soldiers rushed pell-mell down the road from the battlefield crying "the rebs are after us!" It did not take more than one positive assertion of this kind to convince the man