are seldom worth catching. I would much rather create a favorable impression with those sober, thoughtful men who are repelled rather than attracted by self-sufficient parade. To such, then, I now address myself, and request their attention to the true nature of the transaction just witnessed.

Ladies and gentlemen, we are here to recommend to your favorable acceptance the young gentlemen whose names you have just heard, and whom you are now called upon to receive and greet as Doctors of Medicine. We challenge on their behalf your confidence, not in consideration of any boastful assertions they make of themselves, not in virtue of testimonials cajoled from those ignorant of them and of the true value of medical procedure, but upon the strength of our having subjected them to a rigorous scrutiny in regard to their attainments. And I assure you here, and now, that, in spite of vulgar misconceptions upon the subject, our scrutiny has been no child's play. I for one have never known any thing so seriously discussed or transacted as the proceedings of the last few days; and consider it as affectation if you will, I will nevertheless say it if you had witnessed the last consultation of yesterday, in regard to who should be found worthy of our diplomas, you would yourselves have been deeply impressed with the solemnity, and profound-I might say painful sense of responsibility with which it was done.

No, my friends, let popular derision make what it will of it, it is no light matter with us to invest our students with the title and position they have now assumed: they have earned it, or they could never have received it.

Ladies, I cannot refrain from the assertion that you, more than all others, are concerned in this transaction. When sickness has spread the bed of suffering in a household, and the terrors of anticipated bereavement have possessed its trembling inmates, thither the fine and beautiful instincts of your sex always call you, so that it is an unfailing rule that where sorrow is, there, also, is woman, its consoling angel; and in that darkened chamber, the physician alone, of all men, is privileged to be your companion, the trusted partner and aider of your charitable toils, your holy vigils, your angelic ministrations. Is it not, then, of the last importance to you that he who is associated with you, when all the finest sensibilities are strung up to the highest pitch, where any thing discordant with them would be agony, he who must then be either a valued friend or an intolerable intruder, should be not only prudent and able, but refined and delicate, not only an accomplished physician, but a finished gentleman?

Such, ladies, are the physicians whom it is our aim to produce. The

enterprise in which, as the Faculty of Shelby Medical College, we are for life engaged, is that of annually sending forth a body of young physicians who shall be carefully trained, not only scientifically, but morally, for the great responsibilities, the delicate and self-sacrificing duties which await them. Give them, ladies, the cheering encouragement of your smiles and favors at their starting: let them go forth with the inspiring conviction of your approbation, your good wishes, your fervent prayers in their behalf.

Finally, gentlemen, I must say briefly, because I know not how to say it eloquently to say it as I feel it-Farewell. You have made friends in us, your instructors, who have that interest in you that no one else can have. With you it rests whether the labors we are undergoing for the moral and intellectual elevation of the profession shall prosper or not. We can never cease, therefore, to be interested about you. We can only say, then, in the simple language of friends who shake hands at parting, "Come and see us often;" if you can't, let us hear from you; never be afraid to ask us for advice or instruction or assistance. In one word, God bless you; go and prosper; your success is our success, your honor is our honor.

II. AN ESSAY ON CHOREA SANCTI VITI.

AN ESSAY ON CHOREA SANCTI VITI: Submitted, as an Inaugural Thesis, to the Examination of the Reverend John Andrews, D.D., Provost, (pro tempore,) the Trustees and Medical Faculty of the University of Pennsylvania, on the fifth day of June, 1805, for the Degree of Doctor of Medicine. By FELIX ROBERTSON, of Tennessee, Member of the Philadelphia Medical Society.

The subject of the following pages is an inquiry into the affection denominated Chorea St. Viti, or the Dance of St. Vitus; and although my principal design is to give a history of the epidemic chorea at present prevailing in the States of Kentucky, Tennessee, and Virginia, I shall also transcribe the substance of what has heretofore been written on the subject, generally using the language of each author.

The first account we have of this disease is by Horstius, who says that "certain virgins yearly visited the chapel of St. Vitus near Ulm, who on

those occasions exercised themselves day and night in dancing, being disordered in their minds; at length falling down in ecstacy, and were thus relieved until the next spring, when they were again affected in the same manner; which always returned at that season of the year afterward." And hence the very appropriate name of Chorea St. Viti. Dr. Mead considers it a paralytic disease, and speaks of it as follows: "I look on chorea as a paralytic affection, arising from a relaxation of the muscles, which, being unable to perform their functions in moving the limbs, shake them irregularly by jerks. Is for the most part a slight evil, and commonly attacks weak habits of body; girls more frequently than boys, and seldom adults. Wherefore, I never found it difficult to be cured by cold bath and chalybeates."

Dr. Sydenham says: "It is a kind of convulsion, manifesting itself by a halting or unsteadiness of one of the legs, and at the same time the arm of that side being affected by convulsive contractions." He treated it by bleeding, purging, etc., and this practice he repeated for several springs, at the season it first appeared, with the view to prevent its

return.

He seems to have thought it very nearly allied to epilepsy, differing principally from it in attacking only children, whereas epilepsy commonly affects adults; and concludes that it is probable the same treatment would be successful in that disease.

Dr. Cullen denominates it a convulsive disease, and adds, "With very few exceptions it attacks boys and girls from the age of ten to fourteen years;" that "it comes on always before the age of puberty, and rarely continues beyond that period." After describing it nearly in Dr. Sydenham's words, he continues: "It appears to me that the will often yields to the convulsive motions, as to a propensity, and thereby they are often increased, while the patient seemed to be pleased with increasing the surprise and amusement which his motions occasion in the bystanders. In this disease the mind is often affected with some degree of fatuity, and often shows the same varied, desultory, and causeless emotions which occur in hysteria." He adds, "And there have been instances of this disease consisting of such convulsive motions, appearing as an epidemic in a certain corner of the country. In such instances persons of different ages are affected, and may seem to make (he might have said do actually make) an exception to the general rule above laid down; but still the persons are for the most part the young of both sexes, and of the more manifestly movable constitutions." In some plethoric habits he found small bleedings and mild purgings of service; but in general extensive evacuations, especially by bleeding, were very injurious. It sometimes

resisted every remedy for many months, but often readily yielded to tonics, as the Peruvian bark and chalybeates. One case, which had long resisted many remedies, he cured by repeated electrical shocks. Dr. De Hean also cured several persons by this remedy.

Dr. Darwin says, "In Chorea St. Viti the patient can, at any time, lie still in bed, which shows the motions not to be convulsive; and he can at different times voluntarily exert every muscle of the body, which evinces that they are not paralytic. This disease is frequently left after the itch has been too hastily cured. A girl about eighteen, after wearing a mercurial girdle to cure the itch, acquired the Chorea St. Viti in so general a manner that her speech became affected as well as her limbs, and there was evidently a disunion of the common train of ideas. As the itch was still among the children of the family, she was advised to take her sister as a bedfellow, and thus received the itch again, and the dance of St. Vitus gradually ceased." He advises the use of calomel for some time, steel, bark, warm bath, cold bath, opium, venesection, (once at the beginning of the disease,) and electricity; perpetual, slow, and repeated efforts to move the limbs in the designed direction.

The chorea, which is more particularly the subject of this dissertation, made its appearance during the summer of 1803, in the neighborhood of Maryville, Tennessee, in the form of an epidemic. Previously to entering on its history, I think it necessary to premise a few cursory remarks on the mode of life of those amongst whom it originated, for some time before the appearance of the disease.

I suppose there are but few individuals in the United States who have not at least heard of the unparalleled blaze of enthusiastic religion which burst forth in the western country about the year 1800'; but it is perhaps impossible to have a competent idea of its effects, without personal observation. This religious enthusiasm travelled, like electricity, with astonishing velocity, and was felt almost instantaneously, in every part of the States of Tennessee and Kentucky. It often proved so powerful a stimulus that every other entirely lost its effect, or was but feebly felt. Hence that general neglect of earthly things which was observed, and the almost perpetual attendance at places of public worship. Their churches are in general small, and every way uncomfortable; the concourse of people on days of worship, particularly of extraordinary meetings, was very numerous; and hundreds who lived at too great a distance to return home every evening, came supplied with provisions, tents, etc., for their sustenance and accommodation during the continuance of the meeting, which commonly lasted from three to five days. They, as well as many others, remained on the spot day and night, the whole or greater part of

this time worshipping their Maker almost incessantly. The outward expressions of their worship consisted chiefly in alternate crying, laughing, singing and shouting, and at the same time performing that great variety of gesticulation which the muscular system is capable of producing. It was under these circumstances that some found themselves unable by voluntary efforts to suppress the contraction of their muscles; and to their own astonishment, and the diversion of many of the spectators, they continued to act from necessity the curious character which they had commenced from choice.

The disease no sooner appeared than it spread with rapidity through the medium of the principle of imitation; thus it was not uncommon for an affected person to communicate it to the greater part of a crowd, who, from curiosity or other motives, had collected around him. It is at this time in almost every part of Tennessee and Kentucky, and in various parts of Virginia, but it is said not to be so contagious (or readily communicated) as at its commencement. It attacks both sexes, and every constitution, but evidently more readily those who are enthusiasts in religion, such as those above described, and females, children of six years of age, and adults of sixty have been known to have it, but a great majority of those affected are from fifteen to twenty-five. The muscles generally affected are those of the trunk, particularly those of the neck, sometimes those of the superior extremities, but very rarely, if ever, those of the inferior. The contractions are sudden and violent, such as are denominated convulsive, being sometimes so powerful, when in the muscles of the back, that the patient is thrown to the ground, where for some time his motions more resemble those of a live fish when thrown on land, than any thing else to which I can compare them.

This, however, does not often occur, and never, I believe, except at the commencement of the disease. The patients in general are capable of standing and walking, and many, after it has continued a short time, can attend to their business, provided it is not of a nature requiring much steadiness of body. They are incapable of conversing with any degree of satisfaction to themselves, or company, being continually interrupted by those irregular contractions of their muscles, each causing a grunt, or forcible expiration; but the organs of speech do not appear to be affected, nor has it the least influence on the mind. They have no command over their actions by any effort of volition, nor does lying in bed prevent them, but they always cease during sleep. The disease

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I have lately been informed that some have been known to have them during sleep, but have not been able to learn whether or not, previous to having the dis