“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。