Commencements: Address of Thomas Sewall, 1827

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A CHARGE DELIVERED TO THE GRADUATING CLASS OF THE COLUMBIAN COLLEGE, D.C.
AT THE MEDICAL COMMENCEMENT, MARCH 22, 1827
BY THOMAS SEWALL, M.D., PROFESSOR OF ANATOMY AND PHYSIOLOGY

Gentlemen: — In consequence of the absence of our venerable President, it has become my duty to address you upon the present occasion, on the subject of your moral deportment in future life; a duty which I cannot assume but with diffidence, as well from the delicacy of its nature, as from the responsibility which it involves.

This day, gentlemen, you cease to be the pupils of the Columbian College; but you assume a relation more important to you, and not less interesting to us, than that which you have sustained during the period of your studies. You are admitted to the high and responsible station of practitioners of medicine, welcomed to full fellowship, and invited to participate in its labors and benefits. You are about to receive from us the highest testimony of confidence which the profession can confer. We are then, gentlemen, to separate, and you are to be situated in different and perhaps in distant parts of our country.

The profession you have chosen will place you in a commanding attitude, and give you an influence in society far beyond the scene of your personal labors. The responsibility you assume is great, and the duty arduous; to sustain them you will require not only an accurate and extensive knowledge of the science of medicine, but you will need the light of moral principle to direct your steps in the various and often perplexing circumstances in which you will be placed. And permit me, my young friends, before I place in your hands the parchment roll which you are to bear away as the evidence of your attainments and of our confidence in your skill—before I place upon you the final seal of approbation, to bring to your view, and press upon your consideration, some of those moral duties which are more particularly involved in the practice of your profession.

1. Maintain, gentlemen, a sacred regard to truth.

Truth is the great moral bond of society; it is the very basis of moral character, the element of which all other virtues are only modifications.

“Early in life,” says Dr. Franklin, “I became convinced that truth, in transactions between man and man, was of the utmost importance to the happiness of life; and I resolved from that moment, and wrote the resolution in my journal, to practise it as long as I lived. I knew its value, and made a solemn engagement with myself never to depart from it.”

It is derogatory to the influence of the profession, that the want of veracity has been alleged as the too frequent vice of medical men; and it should be equally mortifying to us, that the peculiar nature of the profession-has been urged in extenuation of this despicable offence. It is said that the frequent necessity for concealing from the patient or his friends the nature and danger of his disease, furnishes an apology to the physician for the practice of prevarication; but the intelligent, the honorable, and high-minded physician, will never thank the world for such an apology. He needs not resort to falsehood to shelter him from the charge of error or the want of skill. He desires not to augment the difficulty of his cases, or to enhance the importance of his cures.

Falsehood is the offspring of a debased and grovelling mind, and is resorted to only to cover ignorance, or to conceal the workings of a dishonest heart; and in no character does it appear more odious than in that of the physician.

“Of all lying,” says Dr. Johnson, “I have the greatest abhorrence of telling a lie to a sick man, for fear of alarming him.”

Although there are many cases in which it is highly proper for the physician to encourage the hopes of his patient and dissipate his fears, there is no case in which it is justifiable to do it at the expense of truth.

To conceal from a dying man his situation, not only involves a sacrifice of truth, but is a violation of the highest principles of honor and justice.

Maintain, gentlemen, in all your intercourse with your fellow-men, a sacred regard to truth; make it your polar star, and it shall prove your grand moral beacon in every situation of life.

Remember the favorite maxim of that venerable moralist and philosopher, William Penn. “A man of veracity,” says he, “is a true man, a bold man, a steady man. He is to be trusted and relied upon. No bribes can corrupt him, no fears daunt him.” Be assured that where this principle is wanting, you will look in vain for any other virtue.

2. Be attentive to the sufferings of the poor.

This is a virtue for which our profession has generally been highly distinguished.

There have been but few physicians, in any age or country, so merciless as to withhold their professional services from the poor, or so avaricious as to exact from pittance necessary to procure the comforts of life. The great and good of our profession, in all times, have regarded their attendance on the poor as a duty and a privilege, and no one ever faithfully administered to the necessities of this portion of the community, without receiving an ample reward.

Most of our great men have laid the foundation of their eminence in the experience they have derived from an attendance on the poor, and to this class they have been principally indebted for their introduction to more lucrative business. Sydenham, Boerhaave, Fothergill, and Rush, furnish eminent examples of this truth.

Wherever your lot may be cast, gentlemen let the poor be the subjects of your peculiar care, and while you derive a high satisfaction in relieving their sufferings, their diseases will open to you a field of observation and experience, of the highest importance to you in setting out in life.

Remember, too, that you are stewards appointed to dispense the bounties of a munificent Providence, and that what you bestow on the deserving, while it is a voluntary gift of your hands, is a debt that you owe, and are bound in duty to pay.

“Cast your bread upon the waters, and you shall find it after many days.” Yes, you shall find it before many days. Be just to the poor, and their gratitude and friendship shall protect and comfort you, when the applauses of the great, and the rewards of the wealthy, shall cease to follow you.

“When the ear heard me, then it blessed me; and when the eye saw me, it gave witness to me."

“Because I delivered the poor that cried, and the fatherless and him that had none to help him."

“The blessing of him that was ready to perish came upon me, and I caused the widow's heart to sing for joy.”

Besides gratuitous attendance on the poor, there are others, on whom it will be equally your duty to attend without charge: such as the clergy of all denominations, and their families; physicians, and the widows and orphans of physicians; and, especially, indigent strangers who are taken sick from home. All persons devoted to the improvement of science, morals, and religion, or who are connected with institutions for the amelioration of the condition of man, will have peculiar claims upon your professional services when they are placed in circumstances of indigested.

3. In your professional intercourse, assiduously cultivate a pure and elevated style of conversation, urbanity and gentleness of manner, and kindness of heart.

These are virtues which adorn the medical practitioner, and it is deeply regretted that too often they compose no part of his character. The practical duties of the physician, the tender and often heart-rending scenes he is called to witness, the society with which he has to mingle, all unite to render them indispensable to the proper discharge of his duty. Indeed, so, just an estimate does the community place upon these qualifications that but few physicians who have been characterized by vulgar and profane language, rude and uncourteous manners, or an unfeeling heart, have ever possessed the confidence and affection of their patients, or the respect of the public.

Study, gentlemen, so to unite in your deportment, tenderness with firmness, condescension with dignity, sedateness of manner with cheerfulness of spirit, as to inspire the minds of your patients with confidence, gratitude, and respect.

4. Maintain a due observance of the Sabbath.

It is a stigma on the profession, that this sacred day, set apart for the most important of purposes, has been so little regarded by medical men. Instead of a day of rest and devotion, it has too often been a day of professional study, or devoted to such duties as could be performed equally well on other days of the week. Indeed, some physicians have been in the habit of reserving all their consulting visits for the Sabbath, so far as circumstances would admit, and of appropriating this day to the performing of such surgical operations as did not require immediate attention; and for no other reason than because it is a day of leisure on which the members of the profession can more conveniently be assembled. But the practice, it is believed, is subsiding in our country, and the Sabbath is more generally respected than it has been in times past.

The observance of the Sabbath, and in attendance on such devotional exercises as are within your reach, is a duty you are bound to perform, as far as is compatible with the urgency of the cases committed to your care; and it will seldom happen that your cases are so urgent, or your practice so extensive, as not to be disposed of during the interval of public worship.

Dr. Rush used to say that he never knew a time when his professional business in Philadelphia did not admit of his attendance on public worship at least half of the day, and he never failed to inculcate the importance of this duty on his pupils.

Another custom, recommended and practised by this distinguished philanthropist and physician, will be equally worthy of your imitation, as soon as your circumstances will admit; that of bestowing all Sabbath fees on objects of charity.

5. Be guarded against Infidel sentiments.

When we consider the peculiar character of our profession, as displayed in the wonderful structure and organization of Man, in the various functions of his body, their necessary connexion and mutual dependance, the whole animated by an invisible agent, enabling every part to act in harmony with the rest, and subject to the control of an intelligent principle, all of which bear the visible impress of a Divine hand: and when, too, we contemplate the profession as exhibited in the Scenery of the death-bed, in the deep repentance of the profligate, and in the dying confessions of the Infidel, and these appalling circumstances placed in contrast with the animating hopes of the Christian, the serenity of his last moments, the unshaken confidence that nerves his spirit in its passage through the dark vale, all of which come under the view of the physician, there would seem to be no necessity for admonishing you on this subject.

Yet, under all these circumstances, some of the members of our profession have imbibed infidel principles, insomuch that it has been seriously questioned whether there was not something inherent in the science itself, calculated to originate and to cherish a disbelief in a Divine agency. But the sentiment is as unfounded as it is unphilosophical. Both the study, and the practice of medicine are alike calculated to impress the candid mind with a conviction of the existence of the Supreme Being, and to excite the highest admiration of his power, wisdom, and beneficence.

Whatever may have been the moral and religious state of the profession in other times, and in other countries, its present condition, and particularly in the United States, shows us that there is no necessary connexion between the science of medicine and scepticism; and it must be gratifying to the profession to recognise the fact, that all the most eminent physicians of our country openly espouse the Christian religion, defend its doctrines, and give the whole weight of their influence in support of moral and religious institutions.

Remember, that the way of Infidelity is downward, and that when you once enter it, every succeeding step will urge you onward with increasing celerity. Few have trod this dark and fearful path, and returned to warn others of its fatal termination.

Flee, gentlemen, that chilling system of philosophy, which sees in the universe no design, in adversity no tendency to good, in futurity no gleams of hope, and in heaven no Creator, Benefactor, Father, or Judge.

Study daily the oracles of divine truth; and, while you examine the pages of the sacred volume, open your minds to the conviction of its evidences, and be guided by its precepts.

6. Observe strict temperance in the use of ardent spirit.

There is no subject, gentlemen, on which I would entreat you with more earnestness than upon this. It is a rock on which many of our profession have foundered; a whirlpool into which many of them have been drawn.

The habits and the occupation of the physician expose him peculiarly to the vice of intemperance. The arduousness and the irregularity of his business, his exposure to the vicissitudes and inclemencies of the season, the interruption to his hours of repose, all seem to call for refreshment, and furnish his friends with an apology for constantly urging upon him the use of ardent spirit.

But, gentlemen, beware how you yield to such solicitations. Though there may seem to be no danger at first—when it is known that you can join your friends in a social glass, you will be surrounded by merry companions, and solicited to drink at every house and upon every occasion. Recollect that no person ever became a drunkard at once. In almost every case the progress is slow and imperceptible, and probably no one ever felt the least apprehension of danger when he began to fall. But he advances by degrees, and at every step his path becomes more steep, and every day adds a new and a stronger link to the chain that binds him beyond the hope of deliverance.

How many an unwary traveller in our profession has thus fallen; and how affecting to see a cultivated mind lose its polish and its dignity, brilliant talents clouded, and strong powers enervated; to see the noblest work of the Deity shattered and laid in ruins, by the terrible agency of ardent spirit!

Universal temperance is incumbent on you, not merely as essentially requisite to preserve your minds in that unclouded state, which may render you equally able at all times to pronounce on the cases you may be called to investigate, but because it is a virtue which you will often find it your duty to inculcate on your patients, and which you will enforce with but little effect, if it is not regularly exemplified in your own conduct.

Shun, gentlemen, the first temptation which may assail you, and when it shall be once known that you are inexorable, your acquaintance will cease their importunities, and no longer offer you those well meant but dangerous civilities.

7. Intimately connected with intemperance, is the practice of gambling; a vice, which, though less common, is not less destructive to the peace of society, and to domestic happiness and virtue.

Let me exhort you, gentlemen, to abstain from all games of chance, as a practice alike degrading to you as men, and inconsistent with the dignity, and the high and important duties of your profession.

8. Discountenance and abstain from the practice of duelling.

It is highly creditable to our profession, that so few of its members have exposed themselves in single combat. A few have exposed themselves, and some have fallen, and many more have been accessory to the crime, by attending the combatants to the field, and extending to them surgical aid.

How absurd, how inconsistent it is, for that man whose peculiar province, and let me say privilege, it is to preserve life, voluntarily to mingle his blood with that of his fellow!

Never forget, gentlemen, that you have been this day received as members of the medical profession; have taken upon you its vows, and assumed its responsibilities. You are no longer at your own disposal; you are the property of the profession, of the public, and more particularly of that community who shall give you a residence, and confide to your hands their lives and health. To tear yourself from them by an act of self-destruction, would involve a violation of the highest principles of honor, of gratitude, of justice, and of truth.

In all this I say nothing of the obligations which bind you to your family and friends, nothing of your obligations to your country and to your God. Here let conscience decide.

And when you have made the decision, gentlemen, let your country see that you have too high a sense of moral rectitude, to imbrue your hands in human blood. Let the world see that you have too much elevation of soul, too much independence of spirit, to be awed by the clamor of unprincipled men, and induced to yield to this unhallowed practice.

Finally, gentlemen, keep constantly in view the moral obligations you are under to your patients and to the community.

Your profession, while it will give you, if properly sustained, an extensive influence in society, will present you with frequent opportunities of exerting a controlling power in private, and in circumstances the most important.

The moral and religious influence of sickness is, no doubt, highly beneficial to the best interests of man, and of society. At this time the stoutest heart is softened, old animosities are forgotten—the mind looks back with regret upon the errors of past times, and extends itself forward with new and better resolutions to the future. Old vices are broken off, and the mind then, if ever, is open to the convictions of truth.

The frequent opportunities you will enjoy of promoting and strengthening the good resolutions of your patients, and especially if suffering under the consequences of vicious conduct, ought never to be neglected. Your counsel and reproof will be listened to with respect, and, received as tokens of friendship, whenever they are imparted at proper seasons, and evince a sincere interest in the welfare of the individual to whom they are addressed.

You will sometimes be made the depository of secrets; and such, too as deeply concern the happiness of families and the welfare of society. Whatever you thus receive, preserve inviolable. You will often have it in your power to prevent family-discord, and heal family feuds.

You will hold the reputation of many in your hands. In such cases it will be your duty to throw the mantle of charity over the frailties of human nature, and “to do to others as you would that they should do to you.”

Thus armed with the panoply of virtue, we fear not to bid you go. Go, gentlemen; enter the abodes of wretchedness and distress, and while you dispense the powers of the healing art, forget not to comfort the aching heart, to calm the heaving breast, and to wipe away the tear of sorrow. Let the widow and the orphan find in you a guide and protector; the youth, a bright example of moral virtue; and the aged, a staff to sustain him in his decrepitude.

And when each of you, after a long life of eminent services, shall have sunk to the grave, may the traveller who passes by, point to your tomb and say, “There lies the dust of an honest man; who loved truth, was just to the poor, was pure, kind, and courteous, revered the Sabbath, discountenanced infidelity, reproved drunkenness, gambling, and duelling, and practised and enforced all the moral virtues.”

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Agreeably to a statute of the Board of Trustees, it is made the duty of the President of the College, at each Medical Commencement, to deliver a charge to the graduating class, upon the subject of their moral deportment, while the Dean of the Media requited, to deliver an address upon the subject of their professional conduct. It was in conformity with these regulations that the following address was given.

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Photographic Credit: University Historian's collection
Author or Source: University Bulletin/RG0127
Document Location: University Archives
Date Added to Encyclopedia: January 30, 2007
Prepared by: Lyle Slovick, Assistant University Archivist

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