Medicine – The Leaven of Science Part 1

IN the continual remembrance of a glorious past individuals and nations find their noblest inspiration, and if today this inspiration, so valuable for its own sake, so important in its associations, is weakened, is it not because in the strong dominance of the individual, so characteristic of a democracy, we have lost the sense of continuity? As we read in Roman history of the ceremonies commemorative of the departed, and of the scrupulous care with which, even at such private festivals as the Ambarvalia, the dead were invoked and remembered, we appreciate, though feebly, the part which this sense of continuity played in the lives of their successors—an ennobling, influence, through which the cold routine of the present received a glow of energy from “the touch divine of noble natures gone.” In our modern lives no equivalent to this feeling exists, and the sweet and gracious sense of an ever-present immortality, recognized so keenly and so closely in the religion of Numa, has lost all value to us. We are even impatient of those who would recall the past, and who would insist upon the importance of its recognition as a factor in our lives, impatient as we are of everything save the present with its prospects, the future with its possibilities. Year by year the memory of the men who made this institution fades from out the circle of the hills, and the shadow of oblivion falls deeper and deeper over their forms, until a portrait, or perhaps a name alone, remains to link the dead with the quick. To be forgotten seems inevitable, but not without a sense of melancholy do we recognize that the daily life of three thousand students and teachers is passed heedless of the fame, careless of the renown of these men; and in the second state sublime it must sadden the “circle of the wise,” as they cast their eyes below, to look down on festivals in which they play no part, on gatherings in which their names are neither invoked nor blessed. But ours the loss, since to us, distant in humanity, the need is ever present to cherish the memories of the men who in days of trial and hardship laid on broad lines the foundations of the old colonial colleges.

Today, through the liberality of General Wistar, we dedicate a fitting monument to one of the mighty dead of the University—Caspar Wistar. The tribute of deeds has already been paid to him in this splendid structure, to all in the stately group of academic buildings which you now see adorning the campus—the tribute of words remains, to be able to offer which I regard a very special honour.

But as this is an Institute of Anatomy, our tribute today may be justly restricted, in its details at least, to a eulogy upon the men who have taught the subject in this University. About the professorship of anatomy cluster memories which give it precedence of all others, and in the septemviri of the old school the chairs were arranged, with that of anatomy in the centre, with those of physiology, chemistry, and materia medica on the left, and with those of practice, surgery, and obstetrics on the right. With the revival of learning anatomy brought life and liberty to the healing art, and throughout the sixteenth, seventeenth, and eighteenth centuries the great names of the profession, with but one or two exceptions, are those of the great anatomists. The University of Pennsylvania has had an extraordinary experience in the occupancy of this important chair. In the century and a quarter which ended with the death of Leidy, six names appear on the faculty roll as professors of this branch. Dorsey, however, only delivered the introductory lecture to the course, and was seized the same evening with his fatal illness; and in the next year Physick was transferred from the chair of surgery, with Horner as his adjunct. In reality, therefore, only four men have taught anatomy in this school since its foundation. Physick’s name must ever be associated with the chair of surgery. We do not know the faculty exigencies which led to the transfer, but we can readily surmise that the youthfulness of Horner, who was only twenty-six, and the opportunity of filching for surgery so strong a man as Gibson from the Faculty of the University of Maryland, then a stout rival, must have been among the most weighty considerations.

If in the average length of the period of each incumbency the chair of anatomy in the University is remarkable, much more so is it for the quality of the men who followed each other at such long intervals. It is easy to praise the Athenians among the Athenians, but where is the school in this country which can show such a succession of names in this branch: Shippen, the first teacher of anatomy; Wistar, the author of the first text-book of anatomy; Horner, the first contributor to human anatomy in this country; and Leidy, one of the greatest comparative anatomists of his generation? Of European schools, Edinburgh alone presents a parallel picture, as during the same period only four men have held the chair. The longevity and tenacity of the three Monros have become proverbial; in succession they held the chair of anatomy for 126 years.

Shortly before the foundation of this school Monro secundus had succeeded his father, and taught uninterruptedly for fifty years. His son, Monro tertius, held the chair for nearly the same length of time, and the remainder of the period has been covered by the occupancy of John Goodsir, and his successor, Sir William Turner, the present incumbent.

To one feature in the history of anatomy in this school I must refer in passing. Shippen was a warm personal friend and house-pupil of John Hunter. Physick not only had the same advantages, but became in addition his house-surgeon at St. George’s Hospital. Both had enjoyed the intimate companionship of the most remarkable observer of nature since Aristotle, of a man with wider and more scientific conceptions and sympathies than had ever before been united in a member of our profession, and whose fundamental notions of disease are only now becoming prevalent. Can we doubt that from this source was derived the powerful inspiration which sustained these young men. One of them, on his return from England, at once began the first anatomical classes which were held in the colonies; the other entered upon that career so notable and so honourable, which led to the just title of the Father of American Surgery. It is pleasant to think that direct from John Hunter came the influence which made anatomy so strong in this school, and that zeal in the acquisition of specimens which ultimately led to the splendid collections of the Wistar-Horner Museum.

William Shippen the younger shares with John Morgan the honour of establishing medical instruction in this city. When students in England they had discussed plans, but it was Morgan who seems to have had the ear of the trustees, and who broached a definite scheme in his celebrated “Discourse,”delivered in May, 1765. It was not until the autumn of the year that Shippen signified to the board his willingness to accept a professorship of anatomy and surgery. He had enjoyed, as I have mentioned, the friend-ship of John Hunter, and had studied also with his celebrated brother, William. Associated with him as fellow-pupil was William Hewson, who subsequently became so famous as an anatomist and physiologist, and as the discoverer of the leucocytes of the blood, and whose descendants have been so prominent in the profession of this city. No wonder, then, with such an education, that Shippen, on his return in 1762, in his twenty-sixth year, should have begun a course of lectures in anatomy, the introductory to which was delivered in the State House on November 16. To him belongs the great merit of having made a beginning, and of having brought from the Hunters methods and traditions which long held sway in this school. Wistar in his eulogium pays a warm tribute to his skill as a lecturer and as a demonstrator, and to the faithfulness with which he taught the subject for more than forty years. Apart from his connection with this institution he served as Director-General of the Military Hospitals from 1777 to 1781, and was the second president of the College of Physicians.

In the history of the profession of this country Caspar Wistar holds an unique position. He is its Avicenna, its Mead, its Fothergill, the very embodiment of the physician who, to paraphrase the words of Armstrong, used by Wistar in his Edinburgh Graduation Thesis, “Sought the cheerful haunts of men, and mingled with the bustling crowd.” He taught anatomy in this school as adjunct and professor for twenty-six years. From the records of his contemporaries we learn that he was a brilliant teacher, “the idol of his class,” as one of his eulogists says. As an anatomist he will be remembered as the author of the first American Text-Book on Anatomy, a work which was exceedingly popular, and ran through several editions. His interest in the subject was not, however, of the “knife and fork” kind, for he was an early student of mammalian palaeontology, in the development of which one of his successors was to be a chief promotor. But Wistar’s claim to remembrance rests less upon his writings than upon the impress which remains to this day of his methods of teaching anatomy. Speaking of these, Horner, who was his adjunct and intimate associate, in a letter dated February 1, 1818, says, “In reviewing the several particulars of his course of instruction, it is difficult to say in what part his chief merit consisted; he undertook everything with so much zeal, and such a conscientious desire to benefit those who came to be instructed by him, that he seldom failed of giving the most complete satisfaction. There were, however, some parts of his course peculiar to himself. These were the addition of models on a very large scale to illustrate small parts of the human structure; and the division of the general class into a number of sub-classes, each of which he supplied with a box of bones, in order that they might become thoroughly acquainted with the human skeleton, a subject which is acknowledged by all to be at the very foundation of anatomical knowledge. The idea of the former mode of instruction was acted on for the first time about fifteen years ago.” We have no knowledge of a collection of specimens by Shippen, though it is hard to believe that he could have dwelt in John Hunter’s house and remained free from the insatiable hunger for specimens which characterized his master. But the establishment of a museum as an important adjunct to the medical school was due to Wistar, whose collections formed the nucleus of the splendid array which you will inspect today. The trustees, in accepting the gift on the death of Dr. Wistar, agreed that it should be styled the Wistar Museum, and now, after the lapse of seventy-six years, the collection has found an appropriate home in an Institute of Anatomy which bears his honoured name.

But Wistar has established a wider claim to remembrance. Genial and hospitable, he reigned supreme in society by virtue of exceptional qualities of heart and head, and became, in the language of Charles Caldwell, “the sensorium commune of a large circle of friends.” About no other name in our ranks cluster such memories of good fellowship and good cheer, and it stands today in this city a synonym for esprit and social intercourse. Year by year his face, printed on the invitations to the “Wistar Parties” (still an important function of winter life in Philadelphia) perpetuates the message of his life, “Go seek the cheerful haunts of men.”

How different was the young prosector and adjunct who next taught the subject! Horner was naturally reserved and diffident, and throughout his life those obstinate questionings which in doubt and suffering have so often wrung the heart of man were ever present. Fightings within and fears without harassed his gentle and sensitive soul, on which mortality weighed heavily, and to which the four last things were more real than the materials in which he worked. He has left us a journal intime, in which he found, as did Amiel of whom he was a sort of medical prototype, “a safe shelter wherein his questionings of fate and the future, the voice of grief, of self-examination and confession, the soul’s cry for inward peace, might make themselves freely heard.” Listen to him: “I have risen early in the morning, ere yet the watchman had cried the last hour of his vigil, and in undisturbed solitude giving my whole heart and understanding to my Maker, prayed fervently that I might be enlightened on this momentous subject, that I might be freed from the errors of an excited imagination, from the allurements of personal friendship, from the prejudices of education, and that I might, under the influence of Divine grace, be permitted to settle this question in its true merits.” How familiar is the cry, the great and exceeding bitter cry of the strong soul in the toils and doubtful of the victory! Horner however, was one of those on whom both blessings rested. Facing the spectres of the mind, he laid them, and reached the desired haven. In spite of feeble bodily health and fits of depression, he carried on his anatomical studies with zeal, and as an original worker and author brought much reputation to the University. Particularly he enriched the museum with many valuable preparations, and his name will ever be associated with that of Wistar in the anatomical collection which bears their names.

But what shall I say of Leidy, the man in whom the leaven of science wrought with labour and travail for so many years? The written record survives, scarcely equalled in variety and extent by any naturalist, but how meagre is the picture of the man as known to his friends. The traits which made his life of such value—the patient spirit, the kindly disposition, the sustained zeal—we shall not see again incarnate. The memory of them alone remains. As the echoes of the eulogies upon his life have scarcely died away, I need not recount to this audience his ways and work, but upon one aspect of his character I may dwell for a moment, as illustrating an influence of science which has attracted much attention and aroused discussion. So far as the facts of sense were concerned, there was not a trace of Pyrrhonism in his composition, but in all that relates to the ultra-rational no more consistent disciple of the great sceptic ever lived. There was in him, too, that delightful “ataraxia,” that imperturbability which is the distinguishing feature of the Pyrrhonist, in the truest sense of the word. A striking parallel exists between Leidy and Darwin in this respect, and it is an interesting fact that the two men of this century who have lived in closest inter-course with nature should have found full satisfaction in their studies and in their domestic affections. In the autobiographical section of the life of Charles Darwin, edited by his son Francis, in which are laid bare with such charming frankness the inner thoughts of the great naturalist, we find that he, too, had reached in suprasensuous affairs that state of mental imperturbability in which, to borrow the quaint expression of Sir Thomas Browne, they stretched not his pia mater. But while acknowledging that in science scepticism is advisable, Darwin says that he was not himself very sceptical. Of these two men, alike in this point, and with minds distinctly of the Aristotelian type, Darwin yet retained amid an overwhelming accumulation of facts—and here was his great superiority—an extraordinary power of generalizing principles from them. Deficient as was this quality in Leidy, he did not, on the other hand, experience “the curious and lamentable loss of the higher esthetic taste” which Darwin mourned, and which may have been due in part to protracted ill health, and to an absolute necessity of devoting all his powers to collecting facts in support of his great theory.

When I think of Leidy’s simple life, of his devotion to the study of nature, of the closeness of his communion with her for so many years, there recur to my mind time and again the lines,

He is made one with nature: there is heard His voice in all her music, from the moan Of thunder, to the song of night’s sweet bird; He is a presence to be felt and known In darkness and in light, from herb and stone, Spreading itself where’er that Power may move which has withdrawn his being to its own.