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PREFACE.

The celebrated Heberden remarked, that the life of a physician should be like that of a vestal virgin, which was divided into three periods; in the first of which she learned her profession, in the second she practised it, and in the third she, also, taught it to others. I have certainly passed through the first and second of these periods: after several years employed in the study of my profession, I have spent thirty-five years in the practice of it, and, anxious to fulfil completely my vocation, I desire before I quit the stage to strike one blow for the good cause, to do something, however slight, to improve the sanatory condition of mankind, to alleviate pain, and oppose the influence of disease. I cannot hope, strictly speaking, "to teach my profession to others." The important task of instructing the rising generation of

students is most properly committed to a class of men, who, themselves trained to their duties, perform them in a most able and efficient manner, and any one even slightly acquainted with the medical profession thirty or forty years since, and who will compare its condition then with its present state, must bear testimony to the vast improvement which has taken place. Learning, ability, and skill, which were then the brilliant distinctions of a few individuals, are now generally diffused through all classes, and give the best evidence possible of the excellence of the present mode of education, and of the zeal and fitness of those who teach. Nor was it really the meaning of the great physician quoted, that they who had been many years in active practice should quit their useful labours to become the instructors of youth ; he meant that they should communicate to their brethren their opinions respecting diseases, ripened by long reflection, and tested by repeated experience ; for he did that, and did it well. In the days in which Heberden lived, few men thought deeply, and still fewer expressed their thoughts in writing; many who then practised medicine, had been but very slightly educated, and were sadly ignorant,

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and the advice of any man superior to those around him was received with avidity, and implicitly followed; but the case is now widely different, and thank heaven it is so. All men have been well educated, all have had ample opportunities of acquiring the principles of their profession, and almost all practise it as a glorious and ennobling pursuit, which, whilst it contributes to their worldly welfare, enables them to pass their time in alleviating pain, combating disease, and often in restoring to the sorrowing and afflicted the blessings of health and happiness: but few men now venture to offer themselves as the instructors of their equals in years and experience, for few men are so misled as to think themselves superior to others, except when more ample opportunities have afforded unequalled means of observation and experiment. Hence it is from the class of physicians and surgeons who have the care of large hospitals that we must expect such works as will alter and improve the practice of medicine. It is only in those magnificent institutions, where diseases are congregated together, that different modes of treatment can be effectually compared; that new theories, new practices, new-reme

dies, new operations, can be effectually tested by observation and experience; and it is one of the great duties of those who are honoured by having the control of such institutions intrusted to them, to examine and test every reasonable proposal that is made for the improvement of medicine and surgery, and to report thereon to the profession generally; and the press daily shows how completely and how ably this important duty is performed.

The position of the physician or surgeon, whose labours are devoted to private practice, is widely different: consulted daily by many persons, variously afflicted, and desirous of being cured as speedily as possible, it is for him to follow such line of practice, and to use such means as, fully sanctioned by the repeated experience of the profession, are acknowledged to be the best. He would ill perform his duty to his patients who should test in their persons the novel practices and remedies proposed by others, but which had not yet acquired the sanction of experience,-still less should he dare to put into practice any new ideas originating with himself. It is his duty to use as skilfully as he can all known appliances and means of

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