ADDRESS OF THE PRESIDENT. 
BY J. EWING MEARS, M.D., 
OF PHILADELPHIA. 
Honored by your choice as the presiding officer on the 
occasion of the present meeting, it has been a subject of some 
consideration in what manner that part of my duty which per- 
tains to the opening of the session could be most acceptably 
discharged. A review of the addresses of the presiding officers 
since the foundation of the Association makes it evident that, 
on this subject, different views have been entertained by the 
occupants of the chair. As the character of the address is not 
prescribed by the By-laws, it would seem proper to have the 
occasion used as the judgment of the officer may decide. Under 
such conditions a variety in the character of the addresses 
will obtain. While it has been suggested that the President's 
Address shall be scientific in character, devoted to the discus- 
sion of some special subject or shall present a resume of the 
progress of surgery, it is important that at certain intervals of 
time the affairs of the Association should receive attention at 
the hands of the presiding officer. The scientific work of the 
Association cannot be successfully accomplished unless the 
machinery of the organization is well perfected. Each Fellow 
should have some knowledge of the affairs of the Association, 
and he should fully appreciate the responsibility which rests 
upon him in maintaining its character and promoting its wel- 
fare. With your permission, and, I trust, with your approval 
as well, I shall occupy a few moments in the discussion of cer- 
tain matters relative to the affairs of the Association which I 
deem of sufficient importance to be submitted to your consider- 
ation. 2 
MEA RS, 
The Association has reached, it may be truly said, a period 
in its history when we can study with instruction what it has 
accomplished, and on the results base our expectations of the 
future. The history of its work is told in its volumes of 
Transactions. As a matter of record, some detailed statements 
may be made with regard to ten of these volumes of which 
I was editor, which will perhaps prove of interest. 
The form, shape, and style of a book are, as is well known, not 
the least of its merits. In some instances these alone receive 
commendation at the hands of the critic. Whatever may be the 
judgment as to the habiliment adopted for our volume of Trans- 
actions, it received the commendation of the Founder of the 
Association, who at the time of the issue of the first volume 
expressed satisfaction with the binding, and placed an injunc- 
tion, in a note to the editor, on the cutting of the leaves. Not- 
withstanding the resolution adopted at the meeting of the 
Association in 1882, directing the publication of a volume of 
Transactions only if the material on hand would form a volume 
of 450 octavo pages, it has been deemed expedient to publish 
a volume each year containing the material of the annual meet- 
ing. In only two instances has the number of pages of the 
volume equalled that set forth in the resolution-volumes one 
and nine. One volume, number seven, contained exactly one- 
half the prescribed number of pages. The number of papers 
in each volume has varied from eleven to thirty-two, the total 
number in the ten volumes being one hundred and ninety-one, 
contributed by eighty-three Fellows. 
While it is difficult to classify accurately the subjects of the 
papers, it may be stated that operative and therapeutic surgery 
claimed the larger number. Nine papers were devoted to 
experimental inquiries. 
Fifty subjects were discussed in the one hundred and ninety- 
one papers. Of these subjects, the surgery of the brain, kidney, 
bladder, and intestine claimed the larger number of papers. 
Operations on the arteries, hernia, and fractures come next 
in point of number. Antiseptic surgery was treated in six 
papers. To the appendix vermiformis, a part of the economy ADDRESS OF THE PRESIDENT. 
3 
now receiving so much attention at the surgeon's hands, three 
papers were devoted. The bacteriology of surgical diseases 
received treatment in four papers. Without further particulari- 
zation, it may be stated that the remaining papers were devoted 
to the discussion of surgical subjects of importance, involving 
the different parts and organs of the body. Considering the 
geographical distribution of the work done among those who, 
in the period of time embraced by the issue of the ten volumes, 
constituted the Fellowship of the Association, it is ascertained 
that Fellows from the East contributed forty-eight of the papers, 
from the West twenty-two, and from the South thirteen. This 
is in proper proportion to the membership from the different 
portions of the country, and indicates the general interest taken 
in the scientific work of the Association. 
In reviewing some of the papers it is interesting to note the 
progress made in surgical methods in the time covered by the 
volumes. This is notably true with regard to the subject of anti- 
septic surgery. When this subject was presented at the meeting 
the proceedings of which were recorded in the first volume, the 
discussion which followed was of a character to indicate that 
the system of antiseptic surgery at that time had but few advo- 
cates in our body. Many of the participants in the discussion 
felt called upon to disclaim that they or the surgeons in this and 
in that city, and in this or in that part of the country, employed 
the system or in any manner approved of it. The author of 
one of the papers in closing the discussion said the great objec- 
tions came not from those who have tried Listerism, but from 
those who are willing to raise their hands and thank God that 
they have never witnessed its application nor used it. By one, 
prophetic words were uttered to the effect that antiseptic 
methods in surgery were not dead, but that we were yet to 
hear more of them. 
I think it may be stated as true that the character of the scien- 
tific work which has thus far existed in the Association has 
been due to the system early adopted of the assignment of sub- 
jects of leading importance to a limited number of Fellows for 
the preparation of papers and the formulation of propositions 4 
MEARS, 
for discussion. This duty, at first belonging to the President, 
has been wisely delegated to a Business Committee. In reliev- 
ing the President of the duty of providing business for the 
meeting over which he was to preside it removed from him an 
onerous duty and a task not altogether congenial. The duty 
was therefore properly given to a committee,- with the belief 
that in its hands the business would receive the attention de- 
manded by its importance. This committee, as constituted, 
includes the President, Secretary, Recorder (ex-officio), and 
two Fellows. My experience as a member, for some time, of 
this committee, leads me to make certain suggestions with re- 
gard to the manner in which its duties should be performed. 
The committee should have its organization, and its duties 
should be defined by the By-laws. It should be required to 
hold stated meetings during the year and present a report of 
its work at each annual meeting. The entire scientific business 
of each meeting, as well as the publication of the volumes 
of Transactions, should be confided to its care. The scope of 
the work of the committee might with advantage be extended, 
including not only the assignment of the limited special sub- 
jects for presentation and discussion at each meeting, but 
authority might be given it to appoint, after approval by the 
Association, special committees to prepare from time to time 
exhaustive reports upon subjects of interest. It might fur- 
ther assist in obtaining scientific work of good character if the 
committee should have prepared a list of at least one dozen 
subjects for presentation at each meeting of the Association, 
from which the six special subjects for the next meeting may 
be chosen by vote of the Association. It would also be well to 
request the Fellows of the Association to send to the commit- 
tee a list of subjects which they think desirable for discussion, 
and at any meeting it would be of service if any Fellow should 
by motion request the Business Committee to receive for con- 
sideration and action any topic he may desire to be brought 
before it for discussion. If the limited special subjects are 
chosen on report of the committee at the meeting preceding 
the one at which they are to be discussed, it will afford ample ADDRESS OF THE PRESIDENT. 
5 
time for the Fellows of the Association to consider the topics 
and to prepare papers having a relation to them. 
The question as to the assignment of the subjects presents 
some difficulties. Shall the subject be assigned to the Fellow 
chosen to present it, or shall the Fellow be requested to make 
choice out of the number in the hands of the committee? It 
can be readily understood that in some instances the Fellow 
would find a congenial task in the subject assigned-a topic in 
which he happens to be especially interested; in other instances 
it might not be so. Therefore it would be well to assign the 
subject after consultation with the Fellow, as is now provided 
for. In order to insure prompt publication of the volume of 
Transactions, Fellows presenting papers should prepare at least 
two copies, one of which should be delivered at the time of 
reading to the Business Committee. 
The list of Honorary Fellows includes many of the most 
distinguished surgeons of Europe-authors, teachers, and prac- 
titioners of surgery. Each year a certain number of these 
should be invited to contribute papers on subjects of their own 
choice, or to take part by written contributions in the discus- 
sion of chosen subjects. By such a plan the interest of our 
meetings will be greatly increased and our volumesof Transac- 
tions enriched. 
The work of the Business Committee is of the gravest impor- 
tance. The success of the meeting depends upon the manner 
in which its duty is performed; the character of the work of the 
Association rests in its hands, and the Fellow accepting service 
as one of its members should be willing to give all of the time 
and attention which a proper performance of its duties demands. 
As well there rests upon the Fellow accepting duty as a con- 
tributor to the programme of a meeting, an important duty with 
the performance of which nothing, so far as may be possible, 
should be permitted to interfere. 
The question of Fellowship in the Association has been the 
subject of consideration from time to time, presented through 
the introduction of amendments to the Constitution, having for 
their object the extension of the limit fixed and the change in the 6 
MEARS, 
number of votes necessary to exclude the candidate from Fellow- 
ship. In considering these propositions it is desirable to bear in 
mind the intention of the Founder of this Association. The object 
was distinctly stated to be "to found a national surgical society 
to consist exclusively of distinguished surgical practitioners, 
writers, and teachers;" it was to bring representative surgeons 
from the centres of surgical thought, teaching, and practice in 
this country into council ; its organization was to be on a plan 
different from any existing surgical society ; its work was in- 
tended to be of a higher order than that of any existing body. 
It was to be the Senate of the surgical profession of this coun- 
try, into which the great questions in surgery were to be brought 
for discussion and decision. In order that it should accomplish 
the purpose of its creation, it was necessary that its Fellowship 
should be limited ; that it should be representative in character; 
that its conditions of admission should be exacting, not to be 
used for the purpose of excluding meritorious candidates, but 
to prove their qualifications. 
The experience of the past has demonstrated that the limit 
fixed is sufficient for the work of the Association. At no time 
since its foundation has the limit been filled, and there now exist 
eighteen vacancies. If in the past a duly qualified candidate, 
qualified in all respects, has been excluded on personal grounds; 
if action has been inspired by motives other than those which 
are intended to conserve the best interests of the Association, 
then we have been unfaithful to the trust transmitted to our 
keeping. In the selection of Fellows we should keep con- 
stantly in mind the standard of excellence fixed by our organic 
law, and we shall do our duty only by a strict and impartial 
adherence to it. Furthermore, it is to be borne in mind that 
the Association was designed to be national in character. All 
parts of this great country were to be represented in the Asso- 
ciation. Our large centres in the East naturally present a 
larger number in proportion, but in making choice of candidates 
consideration should be given to the representation from other 
parts. At the time of the organization of the Association the 
original Fellows numbered forty-seven. Of these a geographi- ADDRESS OF THE PRESIDENT. 
7 
cal distribution gave twenty-three (49 per cent.) from the East, 
thirteen (29 per cent.) from the West, and ten (22 per cent.) 
from the South. In the past thirteen years-which mark the 
active life of the Association-ninety-one Fellows have been 
elected, of which number sixty (66 per cent.) represent the 
East, nineteen (20 percent.) the West, and twelve (14 per cent.) 
the South. Of the total Fellowship, 137, since the foundation, 
the percentage is: 60 per cent., 21 per cent., 19 per cent. At 
this time the list of eighty-three Fellows includes fifty-four (65 
per cent.) from the East, nineteen (23 per cent.) from the West, 
and ten (12 per cent.) from the South. This proportion in the 
Fellowship marks a decided increase in the percentage in favor 
of the East over that in the number of original Fellows and 
of the total Fellowship. In the election of Fellows in the future 
regard should be paid to the geographical distribution, if it is 
possible, in order that the national character of our Association 
shall be maintained. 
The selection of candidates for Fellowship is a matter of so 
much importance that it seems desirable some method different 
from that which now obtains could, with advantage, be adopted. 
This might be accomplished with due regard to the interests of 
both the Association and the candidates by the formation of a 
Committee on Membership, whose duty it should be to request 
from the Fellows the names of those deemed to be eligible 
for Fellowship or Honorary Fellowship, or to adopt any plan 
regarded proper to bring before it the names of those who 
come within the qualifications demanded by the Constitution. 
This committee should have charge of all matters relating to 
the nomination of candidates for Fellowship. All papers now 
required to be deposited with the Council relating to the nomi- 
nation of candidates should be placed in the hands of this com- 
mittee for its action. It should be organized by the election of 
proper officers, and hold stated meetings during the year, and 
should send to the Fellows, at least three months before a 
meeting, the list of candidates eligible for election, with such 
information as may be proper to communicate. 
The question of the number of votes required to exclude a 8 
M EARS, 
candidate from Fellowship is one of grave import. As fixed 
by the Constitution it is stated as not more than three-a limit 
deemed essential to the protection of the interests of the Asso- 
ciation created with its purposes. To have a Fellowship with- 
out limit as to number, and to open widely the door of admis- 
sion, would defeat at once the intentions of the Founder of 
the Association. Such an Association would have no distinc- 
tive character; it would in nowise be anything more than 
others already in existence. 
Another question to which I beg to call the attention of 
Fellows is that of the place and time of meeting of the Asso- 
ciation. With the exception of five meetings of the thirteen 
which have been held the Association has met at Washington 
and in the spring of the year, except at the time of the meeting 
of the Congress. The reasons in favor of having Washington 
alone as the place of meeting are: i. Its accessibility from all 
parts of the country. 2. The conditions which surround it as 
the capital of the country. 3. The opportunity presented of 
having in that city meetings independent of any local condi- 
tions, and in which there can be no interference with the 
prompt execution of the business of the meetings. 4, The 
identification of the Association as a national body with the 
nation's capital. 
The principal reason assigned for the change in the place of 
meeting is the opportunity afforded of studying in the different 
places college and hospital construction, arrangements of oper- 
ative amphitheatres, clinical methods, sanitary systems of cities, 
and other matters of general and local interest. In arriving 
at a decision with regard to the subject, it is important to con- 
sider whether these compensate for the interference with the 
proper transaction of the business of the Association which 
almost certainly follows. In addition there is always, it may 
be said, a liberal accompaniment of social festivities, which is 
apt to disturb the execution of the business programme. 
The time of meeting is also coming to be a matter for 
consideration. The change in the collegiate year of the 
medical institutions makes both the early spring and late fall ADDRESS OF THE PRESIDENT. 
9 
in some respects unfavorable times for meeting; midsummer 
cannot be chosen as favorable except for meetings at seaside or 
mountain resorts. The midwinter season-between Christmas 
and the New Year-might for some reasons be considered as 
favorable, but would undoubtedly receive objection on account 
of interference with the professional business of the prac- 
titioner. 
I have thus ventured to call your attention to certain matters 
relating to the affairs of the Association, believing that there 
is need of some action to be taken with regard to them. The 
Constitution and By-laws have required amendment to meet 
the conditions arising as a result of the growth and development 
of the Association. I suggest that a committee on its revision 
shall be appointed at this meeting to incorporate the amend- 
ments adopted from time to time, and to present for considera- 
tion and action such additional amendments as in its judgment 
may be deemed necessary. 
Fellows of the Association: To-day we meet as one of the 
constituent societies of the Congress of American Physicians 
and Surgeons-a body which had its birth within our fold ; a 
body which brings into union the active workers of our noble 
profession; the delvers in the mines of medical science; the 
exponents of medical progress in our country. Does not the 
experience of the past and our knowledge of the day justify 
us in the opinion that the creation of this body was an act of 
wisdom, and are we not, as members of the American medical 
profession, proud of its achievements ? Let us place our con- 
tributions upon the altar of Science, worthy of the time and 
occasion, and let us go forward with the work of our Associa- 
tion, imbued with the spirit of its Founder and mindful ever of 
its high mission. CLOSING REMARKS OF THE PRESIDENT. 
Fellows : It remains for me, as your President, to announce the 
final adjournment of the meeting of the Association. In doing so I 
feel it proper to speak briefly of what we have done, of some of the 
conditions which have surrounded us, and of some of the subjects 
presented to us on this occasion. 
If I mistake not, the number in attendance is quite as large as at 
any previous meeting of the Association. The programme has been 
ample for the occasion. In its preparation an effort was made to 
bring forward for discussion some of the new and important subjects 
in surgery claiming attention at this time This, I think, has been 
accomplished to a certain extent, and as a result the character of the 
work has been of a high order and such as belongs to our Association. 
I mention this not to take to ourselves any special credit or to claim 
any special commendation, but simply that it may be noted, and that 
we may be encouraged to continue to maintain the high standard of 
work for the accomplishment of which this Association was organized. 
In accepting the position of the presiding officer of the Association 
I did so with a full knowledge of the responsibilities of the office 
and with a full knowledge of its dignity and its importance. 
I felt I could not discharge my duty without receiving, what has 
been so generously bestowed, the indulgence of the Fellows during 
the sessions just held, and the assistance which they have rendered me 
during the year of preparation. For these I desire to return my sin- 
cere and heartfelt thanks. 
I now announce the adjournment of the Association. PRESENTATION OF GAVEL. 
The Secretary, Dr. Weist, asked permission to delay the regular 
order of business for a moment. This being granted, he said : 
"Fellows of the Association, I have an agreeable duty to perform. 
The President, Dr. Mears, who has labored so long and faithfully in 
our interests, places us to-day under new obligations. I hold in my 
hand a beautiful gavel which he has had made and now desires to have 
presented to the Association for the use of its future Presidents. 
" The instrument is made of oak ornamented with gold. Its beauty 
and usefulness make it a valuable gift. When, however, I read the 
inscription, engraved in gold upon the handle, you will discover 
that for the Association it has a value far beyond that attaching to it 
as a creation of art. The inscription informs us that the wood of 
which it is made was formerly a part of the office-chair of the dis- 
tinguished and loved Founder of the American Surgical Association, 
Samuel D. Gross. At the mention of this name you are overwhelmed 
with emotion, remembering as you do how pre-eminently it is con- 
nected with xA.merican surgery, and the personal association had with him 
who bore it while he was organizing and carrying into successful exe- 
cution a plan for an Association designed to make American surgery 
known and respected throughout the world. While at our meetings 
our Founder is ever present in our memories, when we see this gavel 
in the hands of the President we shall feel that through it something 
of him is present in a tangible form, and surely in the future those 
into whose hands we place it as an emblem of authority will ever 
remember to emulate the master of our art in labor for the honor and 
usefulness of our Association. 
" Gentlemen, I move that the gavel be accepted and the thanks of 
the Association be tendered to Dr. Mears for his priceless gift." 
The motion was put and carried unanimously.