ItistheunintelligentMe，stupidasanidiot，thathastotryathingathousandtimesbeforehecandoit，andthenneverknowshowhedoesit，thatatlastdoesitwell。Wehavetoeducateourselvesthroughthepretentiousclaimsofintellect，intothehumbleaccuracyofinstinct，andweendatlastbyacquiringthedexterity，theperfection，thecertainty，whichthosemastersofarts，thebeeandthespider，inheritfromNature。
　　Book-knowledge，lecture-knowledge，examination-knowledge，areallinthebrain。Butwork-knowledgeisnotonlyinthebrain，itisinthesenses，inthemuscles，inthegangliaofthesympatheticnerves，——
　　allovertheman，asonemaysay，asinstinctseemsdiffusedthrougheverypartofthoseloweranimalsthathavenosuchdistinctorganasabrain。Seeaskilfulsurgeonhandleabrokenlimb；seeawiseoldphysiciansmileawayacasethatlookstoanoviceasifthesextonwouldsoonbesentfor；markwhatalargeexperiencehasdoneforthosewhowerefittedtoprofitbyit，andyouwillfeelconvincedthat，muchasyouknow，somethingisstillleftforyoutolearn。
　　MayIventuretocontrastyouthandexperienceinmedicalpractice，somethinginthewaythemanpaintedthelion，thatis，thelionunder？
　　Theyoungmanknowstherules，buttheoldmanknows-theexceptions。
　　Theyoungmanknowshispatient，buttheoldmanknowsalsohispatient’sfamily，deadandalive，upanddownforgenerations。Hecantellbeforehandwhatdiseasestheirunbornchildrenwillbesubjectto，whattheywilldieofiftheylivelongenough，andwhethertheyhadbetterliveatall，orremainunrealizedpossibilities，asbelongingtoastocknotworthbeingperpetuated。
　　Theyoungmanfeelsuneasyifheisnotcontinuallydoingsomethingtostiruphispatient’sinternalarrangements。Theoldmantakesthingsmorequietly，andismuchmorewillingtoletwellenoughalone：Allthesesuperiorities，ifsuchtheyare，’youmustwaitfortimetobringyou。Inthemeanwhileifwewillletthelionbeuppermostforamoment，theyoungman’ssensesarequickerthanthoseofhisolderrival。Hiseducationinalltheaccessorybranchesismorerecent，andthereforenearertheexistingconditionofknowledge。Hefindsiteasierthanhisseniorstoaccepttheimprovementswhicheveryyearisbringingforward。Newideasbuildtheirnestsinyoungmen’sbrains。“Revolutionsarenotmadebymeninspectacles，“asIoncehearditremarked，andthefirstwhispersofanewtrutharenotcaughtbythosewhobegintofeeltheneedofanear-trumpet。Grantingalltheseadvantagestotheyoungman，heought，nevertheless，togoonimproving，onthewhole，asamedicalpractitioner，witheveryyear，untilhehasripenedintoawell-
　　mellowedmaturity。But，toimprove，hemustbegoodforsomethingatthestart。IfyoushipapoorcaskofwinetoIndiaandback，ifyoukeepitahalfacentury，itonlygrowsthinnerandsharper。
　　Youaresoontoenterintorelationswiththepublic，toexpendyourskillandknowledgeforitsbenefit，andfindyoursupportintherewardsofyourlabor。Whatkindofaconstituencyisthiswhichistolooktoyouasitsauthorizedchampionsinthestruggleoflifeagainstitsnumerousenemies？
　　Inthefirstplace，thepersonswhoseektheaidofthephysicianareveryhonestandsincereintheirwishtogetridoftheircomplaints，and，generallyspeaking，toliveaslongastheycan。Howeverattractivelythefutureispaintedtothem，theyareattachedtotheplanetwithwhichtheyarealreadyacquainted。Theyareaddictedtothedailyuseofthisempiricalandunchemicalmixturewhichwecallair；andwouldholdontoitasatipplerdoestohisalcoholicdrinks。Thereisnothingmenwillnotdo，thereisnothingtheyhavenotdone，torecovertheirhealthandsavetheirlives。Theyhavesubmittedtobehalf-drownedinwater，andhalf-chokedwithgases，tobeburieduptotheirchinsinearth，tobesearedwithhotironslikegalley-slaves，tobecrimpedwithknives，likecod-fish，tohaveneedlesthrustintotheirflesh，andbonfireskindledontheirskin，toswallowallsortsofabominations，andtopayforallthis，asiftobesingedandscaldedwereacostlyprivilege，asifblisterswereablessing，andleecheswerealuxury。Whatmorecanbeaskedtoprovetheirhonestyandsincerity？
　　Thissamecommunityisveryintelligentwithrespecttoagreatmanysubjects-commerce，mechanics，manufactures，politics。Butwithregardtomedicineitishopelesslyignorantandneverfindsitout。
　　IdonotknowthatitisanyworseinthiscountrythaninGreatBritain，whereMr。Huxleyspeaksveryfreelyof“theutterignoranceofthesimplestlawsoftheirownanimallife，whichprevailsamongeventhemosthighlyeducatedpersons。“AndCullensaidbeforehim“Neithertheacutestgeniusnorthesoundestjudgmentwillavailinjudgingofaparticularscience，inregardtowhichtheyhavenotbeenexercised。Ihavebeenobligedtopleasemypatientssometimeswithreasons，andIhavefoundthatanywillpass，evenwithabledivinesandacutelawyers；thesamewillpasswiththehusbandsaswiththewives。“Ifthecommunitycouldonlybemadeawareofitsownutterignorance，andincompetencetoformopinionsonmedicalsubjects，difficultenoughtothosewhogivetheirlivestothestudyofthem，thepractitionerwouldhaveaneasiertask。Butitwillformopinionsofitsown，itcannothelpit，andwecannotblameit，eventhoughweknowhowslightanddeceptivearetheirfoundations。
　　Thisisthewayithappens：Everygrown-uppersonhaseitherbeenillhimselforhadafriendsufferfromillness，fromwhichhehasrecovered。Everysickpersonhasdonesomethingorotherbysomebody’sadvice，orofhisownaccord，alittlebeforegettingbetter。Thereisanirresistibletendencytoassociatethethingdone，andtheimprovementwhichfollowedit，ascauseandeffect。
　　Thisisthegreatsourceoffallacyinmedicalpractice。Butthephysicianhassomechanceofcorrectinghishastyinference。Hethinkshisprescriptioncuredasinglecaseofaparticularcomplaint；hetriesitintwentysimilarcaseswithouteffect，andsetsdownthefirstasprobablynothingmorethanacoincidence。Theunprofessionalexperimenterorobserverhasnolargeexperiencetocorrecthishastygeneralization。Hewantstobelievethatthemeansheemployedeffectedhiscure。Hefeelsgratefultothepersonwhoadvisedit，helovestopraisethepillorpotionwhichhelpedhim，andhehasakindofmonumentalprideinhimselfasalivingtestimonytoitsefficacy。Soitisthatyouwillfindthecommunityinwhichyoulive，beitintownorcountry，fullofbrandspluckedfromtheburning，astheybelieve，bysomeagencywhich，withyourbettertraining，youfeelreasonablyconfidenthadnothingtodowithit。Theirdiseasewentoutofitself，andthestreamfromthemedicalfire-annihilatorhadnevereventouchedit。
　　Youcannotandneednotexpecttodisturbthepublicinthepossessionofitsmedicalsuperstitions。Aman’signoranceisasmuchhisprivateproperty，andaspreciousinhisowneyes，ashisfamilyBible。YouhaveonlytoopenyourownBibleattheninthchapterofSt。John’sGospel，andyouwillfindthatthelogicofarestoredpatientwasverysimplethen，asitisnow，andveryhardtodealwith。Myclericalfriendswillforgivemeforpoachingontheirsacredterritory，inreturnforanoccasionalraiduponthemedicaldomainofwhichtheyhavenowandthenbeenaccused。
　　AblindmanwassaidtohavebeenrestoredtosightbyayoungpersonwhomthelearneddoctorsoftheJewishlawconsideredasinner，and，assuch，veryunlikelytohavebeenendowedwithadivinegiftofhealing。Theyvisitedthepatientrepeatedly，andevidentlyteasedhimwiththeirquestionsaboutthetreatment，andtheirinsinuationsabouttheyoungman，untilhelosthistemper。Atlastheturnedsharplyuponthem：“Whetherhebeasinnerorno，Iknownot：onethingIknow，that，whereasIwasblind，nowIsee。“
　　Thisistheanswerthatalwayshasbeenandalwayswillbegivenbymostpersonswhentheyfindthemselvesgettingwellafterdoinganything，nomatterwhat，——recommendedbyanybody，nomatterwhom。
　　LordBacon，RobertBoyle，BishopBerkeley，allputtheirfaithinpanaceaswhichweshouldlaughtoscorn。Theyhadseenpeoplegetwellafterusingthem。Areweanywiserthanthosegreatmen？Twoyearsago，inalecturebeforetheMassachusettsHistoricalSociety，ImentionedthisrecipeofSirKenelmDigbyforfeverandague：Parethepatient’snails；puttheparingsinalittlebag，andhangthebagroundtheneckofaliveeel，andplacehiminatubofwater。
　　Theeelwilldie，andthepatientwillrecover。
　　Referringtothisprescriptioninthecourseofthesamelecture，I
　　said：“YousmiledwhenIrelatedSirKenehnDigby’sprescription，withtheliveeelinit；butifeachofyouweretoemptyhisorherpockets，wouldtherenotrollout，frommorethanoneofthem，ahorse-chestnut，carriedaboutasacureforrheumatism？Nobodysawfittoemptyhisorherpockets，andmyquestionbroughtnoresponse。
　　ButtwomonthsagoIwasinacompanyofeducatedpersons，collegegraduateseveryoneofthem，whenagentleman，wellknowninourcommunity，amanofsuperiorabilityandstrongcommon-sense，ontheoccasionofsometalkarisingaboutrheumatism，tookacoupleofveryshinyhorse-chestnutsfromhisbreeches-pocket，andlaidthemonthetable，tellingushow，havingsufferedfromthecomplaintinquestion，hehad，bytheadviceofafriend，procuredthesetwohorse-chestnutsonacertaintimeayearormoreago，andcarriedthemabouthimeversince；fromwhichverydayhehadbeenentirelyfreefromrheumatism。
　　Thisargument，fromwhatlookslikecauseandeffect，whetheritbesoornot，iswhatyouwillhavetomeetwhereveryougo，andyouneednotthinkyoucananswerit。Inthenaturalcourseofthingssomethousandsofpersonsmustbegettingwellorbetterofslightattacksofcolds，ofrheumaticpains，everyweek，inthiscityalone。
　　Hundredsofthemdosomethingorotherinthewayofremedy，bymedicalorotheradvice，oroftheirownmotion，andthelastthingtheydogetsthecreditoftherecovery。Thinkwhatacropofremediesthismustfurnish，ifitwereallharvested！
　　Experiencehastaught，orwillteachyou，thatmostofthewonderfulstoriespatientsandotherstellofsuddenandsignalcuresarelikeOwenGlendower’sstoryoftheportentsthatannouncedhisbirth。Theearthshookatyournativity，didit？Verylikely，and“Soitwouldhavedone，Atthesameseason，ifyourmother’scatHadkittened，thoughyourselfhadne’erbeenborn。“
　　YoumustlistenmoremeeklythanHotspurdidtothebabblingWelshman，forignoranceisasolemnandsacredfact，and，likeinfancy，whichitresembles，shouldberespected。Onceinawhileyouwillhaveapatientofsense，bornwiththegiftofobservation，fromwhomyoumaylearnsomething。Whenyoufindyourselfinthepresenceofonewhoisfertileofmedicalopinions，andaffluentinstoriesofmarvellouscures，——ofamemberofCongresswhosenamefiguresincertificatestothevalueofpatentmedicines，ofavolubledamewhodiscoursesonthemiraclesshehaswroughtorseenwroughtwiththelittlejokersofthesugar-of-milkglobule-box，takeoutyourwatchandcountthepulse；alsonotethetimeofday，andchargethepriceofavisitforeveryextrafifteen，or，ifyouarenotverybusy，everytwentyminutes。Inthiswayyouwillturnwhatseemsaseriousdispensationintoadoubleblessing，forthisclassofpatientslovesdearlytotalk，anditdoesthemadealofgood，andyoufeelasifyouhadearnedyourmoneybythedoseyouhavetaken，quiteashonestlyasbyanydoseyoumayhaveordered。
　　Youmusttakethecommunityjustasitis，andmakethebestofit。
　　Youwishtoobtainitsconfidence；thereisashortrulefordoingthiswhichyouwillfinduseful，——deserveit。But，todeserveitinfullmeasure，youmustunitemanyexcellences，naturalandacquired。
　　Asthebasisofalltherest，youmusthaveallthosetraitsofcharacterwhichfityoutoenterintothemostintimateandconfidentialrelationswiththefamiliesofwhichyouaretheprivilegedfriendandcounsellor。MedicalChristianity，ifImayusesuchaterm，isofveryearlydate。BytheoathofHippocrates，thepractitionerofancienttimesboundhimselftoenterhispatient’shousewiththesolepurposeofdoinghimgood，andsotoconducthimselfastoavoidtheveryappearanceofevil。Letthephysicianofto-daybeginbycominguptothisstandard，andaddtoitallthemorerecentlydiscoveredvirtuesandgraces。
　　Acertainamountofnaturalabilityisrequisitetomakeyouagoodphysician，butbynomeansthatdisproportionatedevelopmentofsomespecialfacultywhichgoesbythenameofgenius。Ajustbalanceofthementalpowersisagreatdealmorelikelytobeusefulthananysingletalent，evenwereitthepowerofobservation；inexcess。Foramereobserverisliabletobetoofondoffactsfortheirownsake，sothat，ifhetoldtherealtruth，hewouldconfessthathetakesmorepleasureinapost-mortemexaminationwhichshowshimwhatwasthematterwithapatient，thaninacasewhichinsistsongettingwellandleavinghiminthedarkastoitsnature。Farmorelikelytointerferewiththesoundpracticalbalanceofthemindisthatspeculative，theoreticaltendencywhichhasmadesomanymennotedintheirday，whosefamehaspassedawaywiththeirdissolvingtheories。
　　ReadDr。Bartlett’scomparisonofthefamousBenjaminRushwithhismodestfellow-townsmanDr。WilliamCurrie，andseethedangersintowhichapassionforgrandiosegeneralizationsbetrayedamanofmanyadmirablequalities。
　　Iwarnyouagainstallambitiousaspirationsoutsideofyourprofession。Medicineisthemostdifficultofsciencesandthemostlaboriousofarts。Itwilltaskallyourpowersofbodyandmindifyouarefaithfultoit。Donotdabbleinthemuddysewerofpolitics，norlingerbytheenchantedstreamsofliterature，nordiginfar-offfieldsforthehiddenwatersofaliensciences。Thegreatpractitionersaregenerallythosewhoconcentratealltheirpowersontheirbusiness。Iftherearehereandtherebrilliantexceptions，itisonlyinvirtueofextraordinarygifts，andindustrytowhichveryfewareequal。
　　Togetbusinessamanmastreallywantit；anddoyousupposethatwhenyouareinthemiddleofaheatedcaucus，orhalf-waythroughadelicateanalysis，orinthespasmofanunfinishedode，youreyesrollinginthefinefrenzyofpoeticalcomposition，youwanttobecalledtoateethinginfant，oranancientpersongroaningunderthegriefsofalumbago？IthinkIhaveknownmorethanoneyoungmanwhosedoctor’ssignproclaimedhisreadinesstoservemankindinthatcapacity，butwhohatedthesoundofapatient’sknock，andashesatwithhisbookorhismicroscope，feltexactlyastheoldpartyexpressedhimselfinmyfriendMr。Brownell’spoem“AllIaxesis，letmealone：’
　　Thecommunitysoonfindsoutwhetheryouareinearnest，andreallymeanbusiness，orwhetheryouareoneofthosediplomaeddilettantiwholiketheamusementofquasimedicalstudies，buthavenoideaofwastingtheirprecioustimeinputtingtheirknowledgeinpracticeforthebenefitoftheirsufferingfellow-creatures。
　　Thepublicisaveryincompetentjudgeofyourskillandknowledge，butitgivesitsconfidencemostreadilytothosewhostandwellwiththeirprofessionalbrethren，whomtheycalluponwhentheythemselvesortheirfamiliesaresick，whomtheychoosetohonorableoffices，whosewritingsandteachingstheyholdinesteem。Amanmaybemuchvaluedbytheprofessionandyethavedefectswhichpreventhisbecomingafavoritepractitioner，butnopopularitycanbedependeduponaspermanentwhichisnotsanctionedbythejudgmentofprofessionalexperts，andwiththeseyouwillalwaysstandonyoursubstantialmerits。