From our 125th anniversary feature, “Flesh Is Heir,” published in fall of 2011.

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What follows are excerpts from the first lecture given to students of the Western Pennsylvania Medical College in September 1886. Chair of obstetrics, John Milton Duff, an MD, did the honors. Duff, who raised $15,000 to be put toward a hospital for the South Side, taught humility and respect for science and nature; he was also a product of his paternalistic times.

GENTLEMEN:

You enter a profession of which you may well feel proud. Great has been medicine’s work in the past! What may we expect of it in the future! In your labor the delight of acquiring knowledge and intellectual power will be compensation. There will be a gratification in searching for the intricate beauties of God’s most holy work, while satisfaction will abound everywhere in contemplating the gracious supply of means for removing and preventing the ills to which flesh is heir.

Entertaining in its study, often very difficult in its practice, we are sorry to say obstetrics does not always receive the consideration its importance demands. A large proportion of the laity deem the duties and responsibilities so slight that they regard any ignorant pretender ... as a person thoroughly competent to preside over the lying-in chamber. ... It is obligatory upon the practical obstetrician to acquaint himself intimately with every pathological change of physiological process which may or should take place from the moment of conception until the mother, after a return to a normal condition, walks forth from the lying-in chamber with the child of her womb pressed to her bosom. After delivery, dangers surround her on every hand. Not only the state of the solids and fluids demands attention, but the organic changes which must take place in every lying-in woman need the closest and most intelligent watchfulness.

In the study of obstetrics one of the subjects which demands your special attention is the peculiarities of sex. It is in domestic life that woman shows to greatest advantage. … In this home relation you will have the greatest opportunity to study her peculiarities. The family hearthstone is her throne, and there she wields the scepter of power. ...

What can be more inviting than to watch the development of the human ovum as it passes through its many transitions, from the time it is grasped by the fimbriated extremities of the Fallopian tube until—after months of an interesting developmental existence in the uterus—it at last through the powers of nature is expelled and comes forth to the world a perfectly formed human being breathing the breath of life.

Beautiful as is the uninterrupted display of nature under these circumstances, … it will be necessary for you who expect to become practitioners to interest yourselves in the abnormalities and pathological conditions which often occur. They should be of peculiar interest to you. There is an importance attached to them which calls for the most careful study; an importance which you will not and cannot appreciate until, perhaps far away from instructor and associates, you will be called upon to face with fear and trembling.

Picture to yourselves a scene: A happy household, joyfully anticipating the advent of a bright and tender baby to add new charms and new joys. … Suddenly the sunshine of their happiness is darkened. … Listen to the wail that goes up from those motherless children—while the ignorant pretender standing by is dumb to all entreaties, forced to inactivity by his incompetence … call upon the rocks and the mountains to fall upon him and hide him from the presence of his God!

Gentlemen, I would that I could let fall upon you words of fire to impress upon you the sacredness of the obligations you take upon yourselves when you announce to the world your readiness to practice medicine.

Do not allow yourselves to think a mere cursory knowledge of your subject is sufficient … nor that your own ingenuity will supply all deficiencies and add perfection to every excellence. Such a course will consign you most certainly, and soon, to well-merited oblivion, where you may ponder sadly over the melancholy memorial of time misspent or of industry exercised unavailingly. You will find nature a wonderful obstetrician. If let alone, many times she will surmount difficulties in a manner which would put the blush of shame on your best-directed efforts.