The Americans and the Tenth 
I nternational Congress 
A. JACOBI, M.D. 
BY 
NEW YORK 
Reprinted from the Medical Record, November 15, 1850 
TROW’S PRINTING AND BOOKBINDING CO. 
201-213 East Twelfth Street 
1890 
NEW YORK The Americans and the Tenth 
International Congress. 
A. JACOBI, M.D., 
NEWYORK. 
Reprinted from the Medical Record, November 15, 1890. 
On August 4, 1890, during the first, and largest, general 
meeting of the Tenth International Congress, there were 
three universal and spontaneous outbursts of applause. 
The first and most sympathetic greeted the name of James 
Paget, and never was there an ovation more deserved. 
The second rang through the immense building when it 
was announced that the government of the French Re- 
public had sent thirty-four official delegates, and that 
nearly one hundred and fifty more Frenchmen had joined 
the Congress. They had overcome political enmity and 
jealousy, disregarded a rather slighting reference to their 
“ national insanity ” of twenty years ago, and came with 
open hearts and friendly feelings, a large number of them 
men of fame and high rank. The third greeted the an- 
nouncement of the fact that on the first day of the gather- 
ing, more than six hundred Americans were inscribed on 
the rolls. This recognition afforded to our name must 
1 Being an introduction to special reports of Delegates to the Con- 
gress before the New York Academy of Medicine, November 6, 1890. 2 
have flattered the national pride of everyone of us who 
was present. 
This hearty welcome was more than I had mustered the 
courage to expect. For, indeed, Americans visiting 
Europe on such occasions as this labor under certain 
difficulties. Europeans do not quite understand our 
country, its political and social configuration or its scien- 
tific attainments. If that be so even in Great Britain, both 
race and language being identical and mutual intercourse 
more frequent, how much less can we expect it to be known 
on the Continent. Besides, it is not always the best polit- 
ical, social, and scientific class of our fellow-citizens who 
travel extensively, and though it be not the crowd of the 
“ profanum vulgus ” that ought to tell in the estimation 
of the best spirit of their country, it does so tell. Now, 
the majority of medical Americans they know in Europe, 
and particularly in Germany, belong to one of two classes: 
either they are bona fide students, whom, being mere 
foreigners, they consent to matriculate even without the 
preliminary education rigorously insisted upon in their own 
young countrymen, or they are our young doctors who 
pass a few months or a year in European laboratories and 
clinics for the sake of special studies. It is these latter 
that are also the occasional participants in their national 
associations, where, nobody else being present, they are 
naturally considered the representatives of American 
medicine. Our best men travel little and talk less. In- 
deed, some of those who were most fit to represent us in the 
Congress kept in the rear, modest and retiring. Besides, 
the great opportunity America might have had to present 
to the view of the world whatever there is great and pro- 
gressive in American medicine appears lost. For in the 
very number of the German Medical Weekly which was 
published in the week of the Congress you could, in the 
history of previous congresses, read the statement that the 
Washington Congress was unfortunately a failure, for 
which all of us, being Americans, are held responsible. 
Moreover, though English is read by a great many of 3 
the best men in Europe, the knowledge of our language 
is not so general as to insure a wide acquaintance with 
our literature through anything but the uncertain channels 
of extracts or translations. Nor are even these well se- 
lected. We are all aware that our medical journals are 
of as unequal rank as our schools, and not infrequently 
will you find a journal which is deservedly unknown among 
us quoted in Europe under the impression that it is a fair 
representative of American medical literature. Nor is 
the treatment Europeans receive at our hands always 
very courteous or considerate. The editorial remarks of 
a great New York weekly were quoted as unkind, inas- 
much as the efforts to make the Congress international 
and Berlin a neutral ground for the whole world, did not 
appear to be appreciated by us. It must be admitted, 
though, they did not deem that Western journal worthy 
of serious consideration which spoke of the Tenth Inter- 
national Congress as a congress of snobs, and advised 
everyone of the forty thousand practitioners of the Mis- 
sissippi Valley, “ everyone superior to the leaders of the 
Congress,” to stay at home. 
Public opinion is often made or unmade by trivialities; 
sometimes, indeed, by personalities of an inferior nature. 
It was a source of complaint in Berlin that an American 
who had been honored with the request to represent our 
country by delivering one of the great addresses had 
neglected to see to it that his refusal reached the Com- 
mittee of Organization in anything like due time. The 
proverbial courtesy of Americans was found wanting, and 
that at a time of feverish excitement and overwork. Such 
occasions aie the very opportunities for those formerly 
Europeans who manage to rise, in their own estimation, 
and that of their former countrymen, by detraction of us. 
For there are those who do not immediately succeed, 
when they, our guests and future fellow-citizens, arrive 
among us, in impressing us with their superiority, or in 
being appreciated by us as they are by themselves, or in 
obtaining at once a lucrative practice and professional 4 
positions and honors. It is they who pay for the hospi- 
tality proffered by our country, with shoulder-shrugging 
insinuations and pitying remarks upon our crudeness and 
inferiority, our “mob rule,” our “civilized barbarism,” 
instead of aiding in the realizations of the national and 
cosmopolitan aims of the medical profession and science. 
Nothing is so small as not to have some effect. Un- 
fortunately, there is still so much national jealousy every- 
where that faults and shortcomings in your neighbor 
beyond the boundary line are easily believed in, and slan- 
derers and libellers are always busy. When I arrived in 
Germany, a newspaper article was shown me which was 
concocted by a sectarian practitioner formerly in New 
York, who detailed the inferiority of American medicine, 
schools, and practice to the horrified sanctity of the Ger- 
man public; and in the very week preceding the Con- 
gress, hundreds, or perhaps thousands, of pamphlets were 
distributed in Berlin, for the avowed purpose of insulting 
us and making us uncomfortable. The pseudonymous 
author, who appears to have lived, or lives, in Chicago, 
says, among a great many other things, the following : 
“ In reference to the transatlantic gentlemen, nothing 
is more out of place than indulgence. American toler- 
ance, so frequently extolled, exists for Americans only. 
When about to travel they leave it at home. It 
is almost always the result of ignorance, indifference, 
and bad conscience. As the average American never 
cares for the history of a science, the majority of the 
transatlantic members of the International Congress are 
totally unacquainted with European institutions, labors, 
and scientific methods and their aims. Nevertheless, 
everyone of these gentlemen carries a paper in his pocket, 
easily compiled, wherewith to resuscitate the obsolete 
science of Europe.” 
In the same sheet the man asserts that forty-two per 
cent, of all the doctors in Chicago are professed abortion- 
ists and a great many followers of “Christian Science.” 
Some of the great Germans, with whose names every- 5 
one of us is perfectly familiar, denied being in any way 
influenced by such rubbish ; but then, again, it was through 
them that I was informed of a New York specialist, and 
a fellow of this Academy, who was reported to have 
availed himself of his personal intimacy with the officers 
of the Associated Press for the purpose of having his 
Congress paper served at the breakfast-tables of a million 
of American households on the day of its delivery. That 
was a week before the opening. 
Thus, you see, Mr. President, American medical gen- 
tlemen may meet with difficulties in the face of such oc- 
currences. Still, though they are as human on the other 
side of the Atlantic as we on this, the facilities of com- 
munication between the continents have become such as 
to enable those wishing to see and know the truth that 
the time when American medicine was merely receptive 
and imitative has long passed by, and that we have 
entered the arena as co-operating peers. They were, 
indeed, anxious to have us and secure a large American 
attendance. In order to accomplish that end the organ- 
izing committee appointed an American committee, which 
was to enlist universal sympathy in our country. No 
time was to be lost, and the first ten medical men who 
expressed their willingness to serve were appointed. The 
territorial jealousy, one of the most marked Ameri- 
can littlenesses, which found its way into print several 
times, has obliged me to explain publicly, in the May 
meeting of the Association of American Physicians, why 
that committee consisted of Stewart, Fitz, Lusk, Draper, 
Hun, Pepper, Busey, Osier, and Peyre Porcher. Will the 
Western gentlemen who found fault with the committee, 
and heaped vituperation on the mode of its composition, 
tell us that the names selected did not deserve the honor 
conferred upon them, or that there are better ones 
among us? Does American medicine begin at the 
Alleghanies or the Sierra? Or will you, gentlemen of 
Ohio, Mississippi, or Nevada, tell us which of the forty- 
four stars of the glorious flag is the one you claim as 6 
yours i \ ours are the torty-lour, so they are ours. Are 
your minds not big enough, your hearts not large enough 
to embrace the love of, and the pride in, the whole flag of 
America ? 
A further proof of the anxiety to secure the co-opera- 
tion and good-will of the Americans was given by the 
Berlin committee in this, that they insisted upon one of 
the public addresses in the general meetings being deliv- 
ered by an American. Weir Mitchell having declined in 
time and courteously, and Osier not being within reach, 
I was telegraphically directed to select an orator. The 
choice of Horatio C. Wood was heartily approved of in 
Berlin and elsewhere. Again, a few have asked why a 
New Yorker could not have been honored with that 
commission ? That question is answered by some other 
queries : Do you know of a better man ? Is America 
bounded by the East and North Rivers ? And lastly, has 
New York forgotten that she can afford to be courteous 
and generous ? 
More, a few weeks only before the meeting of the 
Congress the American orthopedists expressed the de- 
sire that there should be a separate section of orthope- 
dics. When I, then already in Europe, was notified of 
that request by the Chairman of the Orthopedic Section 
of this Academy, and expressed my fear lest it might be 
too late to make arrangements for that change, I was by 
returning mail informed by the Secretary-General that 
the request was at once granted by the Committee of 
Organization, on the ground that my countrymen must 
know best what suited them and their scientific labors. 
Again, the organization of the Congress was not com- 
pleted without the election of an American vice-presi- 
dent, John S. Billings, and an American, M. Allen Starr, 
as one of the two English-speaking secretaries, and a 
large number of American vice-presidents of sections. 
And lastly, when, on the third day of Congress and in the 
second general meeting, the hour grew late and the audi- 
ence melted under the hot sun, Dr. Wood’s address was, 7 
out of consideration for the Americans, postponed to be 
the first topic of the third meeting, though the hour and 
arrangements and printed preparations had to be changed 
accordingly. 
All this was meant, and was believed to suffice, to make 
every American feel at home. If it did not succeed, it 
ought to have accomplished that end. But I have been 
told that disappointments have been keenly felt and com- 
plaints been uttered. 
When an English paper was read, many have been re- 
ported to have left the room. Many essays were not read 
at all, some were not allowed the time required by the 
authors, some men would read beyond the legal limits. 
Such comments are natural, but also their causes. The 
unprecedented number of papers offered at a late date, 
and too courteously accepted, and some acoustic disad- 
vantages of many of the audience halls, are among the 
causes of disappointments, which are unavoidable in 
everything human. The experience of the past can fur- 
nish remedies in the future. However, when one man 
complains that he was not one among the five per cent, 
of members who could be admitted to the court reception 
in Potsdam; another, that he had to pay for his share of 
the section dinner on the evening of Wednesday, the 6th, 
proclaiming that matters were different in Washington, 
where no foreigner paid anything; it proves one of two 
things, either that there were those who went more for 
the incidental appurtenances of the Congress than the 
Congress, or that our national failing, which is a highly 
developed emotional hypersesthesia, was rather demon- 
strative. I can assure those who are finding fault with 
the scantiness of their enjoyments that I know of one at 
least who neither shared in the entertainment in the City 
Hall, for which Berlin paid 80,000 marks, nor danced at 
any of the five balls, nor imbibed the music and songs in 
eleven languages, and as many beverages, at Kroll’s, and— 
did not feel the worse for it the following mornings. If 
I have any fault to find, it is with the overflow of enter- 8 
tainments, the excess of generosity, the multiplicity of 
luncheons, dinners, and receptions, the waste of money 
in the vast number of public and private social gather- 
ings. 
If there ever were hosts spending unstintingly—aye, 
squandering—money in the service of unlimited hospital- 
ity they were the profession as a whole, and the single 
medical men of Berlin. 
In connection with this fact let me make a remark, which 
is dictated by no cavilling spirit, that I have too many rea- 
sons to appreciate the universal kindness and untiring hos- 
pitality of the great and gentlemanly members of the Berlin 
profession, who were bent on nothing so much as render- 
ing the sojourn of the foreign guests comfortable and 
pleasant. I must here mention the names of Virchow, 
Bergman, Waldeyer, Gerhardt, Henoch, Martin, and 
Leyden, and his accomplished wife, the Chairman of the 
Ladies’ Committee, and could name a host of others. 
Many of us have found it impossible to respond at the 
same time to the requirements of actual congressional 
duties and the urgent demands of hospitable courtesy. 
In this, also, there is discomfort and loss for the individ- 
ual member. But the matter has a very much more im- 
portant aspect. An excess of social entertainments on 
one hand, and the accomplishment of the end for which 
the International Congress is convened on the other, are 
incompatible at a certain point. Too many feasts inter- 
fere with legitimate work. The expectation of a good 
time may—if I must not say it does—invite the attend- 
ance of many, of hundreds, perhaps of thousands, who 
would not go for the sake of work. On the other hand, 
those who have gone for the latter are liable to feel 
sorely disconcerted. Thus it has happened—at least this 
disappointment can be held in part responsible—that the 
national associations have suffered from the persistent 
absence of those who do not wish to lose great oppor- 
tunities ; and that all over America, Great Britain, France, 
Germany, and other countries there have been formed by 9 
dissatisfied men, who place scientific work over any dis- 
tractions, be they ever so pleasant, special societies, the 
objects of all of which ought to have been accomplished 
in the sections of the general bodies. It would be a sad 
development if the same tendency were to grow up in 
international congresses. This very moment, there are 
already in existence an international ophthalmological and 
an otological congress. It would be the fault of the 
management of international medical congresses, if other 
specialities, or doctrines, should follow the example, 
for no other reason than the predominance of the social 
over the scientific element. If the latter cease to rule 
the great men of science will stay away, and the holiday- 
seekers and a few ambitious office-holders will remain. 
Experientia docet. 
It is only a wealthy city and rich professional men who 
can entertain as Berlin did. For such hospitality as was 
displayed there you require large and generous hearts, 
ample and well-filled purses. There are but few com- 
munities like her. If the habit of prodigality becomes 
persistent we shall be received in future with misgivings 
on the part of our hosts, who must fear lest their efforts 
fall short both of the results of predecessors and the ex- 
pectations of the guests. Let these two calamities occur— 
viz., the absence of the best men of all nations, and on the 
part of cities and men hesitation to request our coming 
—what will become of the International Congresses ? 
And where is the prevention of the danger alluded to ? 
Here: Let the social entertainments be reduced to a 
minimum. Then any city with ample hotel accommoda- 
tions will be able to receive us, though we be thousands. 
Then those bent upon pleasure only will seek it else- 
where. Then the numbers will no longer be unwieldy 
and shapeless. Then the men looking for work, and for 
the men who work, will be eager to come and see and be 
seen, to teach and to be taught. 
The unprecedented success of the American Congress 
of Physicians and Surgeons, the first meeting of which was held in Washington, in September, 1888, tells its own 
tale and exhibits the proof of what I say. In my mind 
there is no doubt that its second meeting, in September, 
1891, will be equally successful; its three days will be 
dedicated to work, and the official social entertainment 
limited to a plain subscription banquet. In that way 
neither the lawful work of the Congress nor private in 
tercourse and hospitality are interfered with. 
It may appear invidious to mention the co-operative 
services rendered by the members of the different na- 
tions represented in the various sections of the Congress. 
Still as we generally have a good opinion of ourselves, 
we are not afraid of looking back at our own contribu- 
tions to the scientific material that was furnished. When 
we do so we have to admit, however, that but a small per- 
centage of our seven hundred participated in the general 
work. It is true there was one who got himself delivered 
of quintuplets; fortunately, he had no equals, and he was 
not, as a medical journal reported, “taken in earnest.” 
Still, there were a number of papers, not compiled, but 
original. The Orthopedic Section was American to a 
great extent. The Neurological had a very fair represen- 
tation from our country. The Gynecological and Ped- 
iatric Sections were not without American contributions. 
The Surgical was supplied with papers which were highly 
appreciated, mostly from the West. Indeed, there were 
but few sections in which no American took part, though 
there were some in which no active work at all was fur- 
nished by us. The most redeeming feature was the meet- 
ing of the combined Laryngological and Pediatric Sec- 
tions, in which the ingenuous, painstaking, and successful 
efforts of O’Dwyer were heartily applauded. 
After all, however, the labor performed in the general 
sessions may be the principal, but is certainly not the only, 
object in view. An English journal has said that “con- 
gresses are not instruments of research;” and still, the 
transactions of all are replete with it. It is true a con- 
gress is not so much meant for new discoveries as for the broad dissemination of facts, hints, and ideas. A man— 
not being übiquitous—may not take away with him many 
things new, but what he carries home is a new stimulus 
and encouragement. 
In the Congress you saw a great many men whom you 
thought you knew, but since you listened to them and 
watched them while you listened and took their measure, 
you know better now. You saw and heard the living ob- 
jects of your admiration, the moulders of professional 
thought in all countries; discoverers, teachers, laboratory 
workers, practitioners; those who, after hard work, create 
books by spontaneous generation out of their brains, and 
those who compile them uot of their pigeon-holes; the 
eagles, the bees, and the moles—also the parrots, and 
that class of envious cuckoos who transfer other birds’ 
eggs into their own nests. You found there is room in 
our great army for many men and many classes of men. 
You gathered encouragement from learning that even 
truly great men are still men and human; and that some 
degree of greatness is within the grasp of any man, in 
town or village, who will work for it intelligently, bravely, 
and honorably. All this is what a congress will teach 
those who consent to learn. 
There is another lesson that is taught by a congress : 
The separation into twenty sections proves the endless 
and diversified branching of the grand old tree of medical 
science. Their working under the same roof, however, 
and under the same administration; their occasional combi- 
nation for a common purpose; their gathering in general 
meetings, and their listening to the same addresses, with 
the same interest and profit—all this, in spite of the fact 
that some of the twenty appear to be threatened with the 
danger of degenerating into mere handicraft, proclaim 
louder than steeple bells that medical science is “ one and 
indivisible, now and forever.” 
The Congress has conveyed to me, like its predecessors 
in Copenhagen and London, a great lesson, and furnished 
an elevating spectacle. Imagine, those of you who have 12 
not been present, thousands of medical men from all 
parts of the world, and speaking a dozen different lan- 
guages, not perhaps endowed with the same erudition or 
mental or moral power, but moved by the same instincts and 
interests, and assembling at the same call and for the same 
special purpose. The great and the lowly, the old and 
young meet as brethren on the same platform, if not 
of equality, still of fraternity and solidarity. National 
jealousy and prejudice are shelved for at least a week, and 
the lesson is taught that brethren may live together peace- 
ably under the same roof, an example to the nations both 
of the present and the future. The man and the man of 
science are appreciated and loved, though political adver- 
saries. Applause takes the place of hisses. The contest is 
no longer against each other but with each other, side by 
side, arm in arm, with the same weapons of the brain and 
soul against the common enemy of science and mankind, 
viz., physical deterioration and social misery. Thus the 
cosmopolitan spirit of coming centuries is foreshadowed 
and initiated by the co-operation of the men arrayed in 
the army of the noblest of all sciences and professions. 
Therefore, may no man who can prove an example to his 
peers in this or any other country, no man who can teach, 
none who can learn, none who can worthily represent his 
country in any capacity and do honor to America among 
foreigners—may no man, except for valid reasons, ever 
shirk his duty to attend an International Medical Con- 
gress.