MEMOIR OF ISAAC HAYS, M. D. [Extracted from the Transactions of the College of Physicians of Philadelphia, 3d Series, Volume V.] MEMOIR OF ISAAC HAYS, M.D., FORMERLY ONE OF THE CENSORS OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA, PRESIDENT OF THE ACADEMY OF NATURAL SCIENCES, SURGEON TO WILLS HOSPITAL, ETC. Read before the College, February 4, 1880, BY ALFRED STILLS, M.D., LL.D., VICE-PRESIDENT OF THE COLLEGE. [Extracted from the Transactions, 3d Series, Yol. V.] PHILADELPHIA: 1880. COLLINS, PRINTER. M EMOI R. Every thoughtful man seeks to order his life so that it shall afford him the greatest amount of happiness. But men’s ideas of happiness are as diverse as their features. To some sensual sloth is attractive, to others a feverish pursuit of pleasure, to others a lust for wealth, popularity, fame, or power. Even if they secure these objects, they are apt to find them as unsubstantial as shadows; and, when life draws near its close, they mourn with unavailing regret over blighted joys and disappointed hopes. If society were composed of men like these alone, it would be destined to a rapid dissolution ; indeed, out of such mate- rials it could never have been developed. Historically, we know that it emerged from the dark waste of barbarism, only by looking beyond the present into a future which might grow out of the elements of the past. While men have pro- bably lived in every age who moulded their conduct more or less successfully on this ideal, only very recent genera- tions have witnessed its general recognition and illustration. 4 Even now the examples are not numerous of men from whose characters the grosser elements have been eliminated, and who seek happiness, first of all, in the culture of the intellect, the moral sense, and the affections. But whenever they do arise, their action is not confined to the development of their own intellectual and moral natures; its beneficent influence is apt to be felt over a wide sphere. Virtue has its contagion no less than vice; it vivifies and beautifies society as much as vice deforms and corrupts it, and its influence is none the less powerful because it is silent and unobtrusive. The world does not always nor readily recognize its greatest benefactors. They are not apt to be those whose names are most conspic- uously associated with public acts, or with the great changes that stir the political, social, scientific, or literary spheres. They are oftener modest and silent thinkers who, in the seclusion of their closets, lay plans or evolve ideas that become the inspiration and the law of more enterprising men who apply them to their purpose and render them practically efficient. Teaching by example rather than by precept, they illustrate the beauty and the power of a life steadily devoted to beneficent ends. A man of such qualities and of such exceptional virtues was our late Fellow, Dr. Isaac Hays. While yet only a student of medicine I learned to know him, and from that time until his death, I never had occasion to reverse my judgment of his character, or abate anything of my esteem and respect for his person. Isaac Hays, born July 5, 1796, was the son of Samuel and Richea Gratz Hays, of Philadelphia. His father was a wealthy merchant, and brought up his family with all the culture and luxury which his means enabled him to com- mand ; nor was it until mature manhood that the subject of 5 this memoir was obliged by stern necessity to win his bread by acquisitions which had seemed intended only for the delectation of his life. The refinements of his early home and social circle doubtless impressed upon him that courteous and affable manner which always distinguished him. His school education was acquired while the traditions of English scholarship were still living influences, and when it was a cardinal doctrine that education was designed, not so much to fill the memory with facts as to cultivate all the natural powers and fit them for use in any field whatever. He was for many years a pupil of the Rev. Hr. Samuel B. Wylie, so famous in this city for his classical learning, and as a school- master, and who was afterwards elevated to the chair of an- cient languages in the University of Pennsylvania. At that institution Hr. Hays graduated A.B. in 1816. In those days the amenities of scholarship were habitually associated with the courtesies of life, as the frequent use of the phrase “a scholar and a gentleman” sufficiently attests, as well as the term “literae humaniores” which described a literature that was supposed to refine the mind and manners, and of which the classical languages were the indispensable foundation. It cannot be doubted, I think,that the delicate and refined literary taste of Hr. Hays was developed by his liberal education, although he was by nature fitted to bear more perfect fruit in such a soil than in one which, according to modern ideas of excellence, is filled with the hard facts of physical science. The influence of his severer and mathe- matical training was exhibited in his acute and very critical judgment which experience sharpened into a sagacious in- stinct. After leaving college the predilections of young Hays were for a professional career, but, at the urgent instance of his 6 father, who desired to initiate him into commercial affairs that he might succeed himself in business, he entered the counting-house where he remained for about a year. This experience did but confirm him in his original preference, and, abandoning commerce, he began the study of medicine with Dr. Nathaniel Chapman, who, throughout his life, retained a lively friendship for his pupil, and more than once influenced the direction of his career. It would be dif- ficult to determine what motives inclined him towards the study of medicine. They may have been quite fortuitous; but the zeal with which he soon afterwards began to culti- vate the natural sciences, appears to prove that it was not chance, but a genuine predilection and fitness for the study of nature that made him a physician. In like manner it would seem as if his fondness for mathematical processes de- termined him to the culture of ophthalmology,the department of medicine in which, above all others, physical methods of observation and mathematical forms of reasoning prevail. He graduated in medicine in 1820, at the University of Penn- sylvania, and the subject of his inaugural thesis was “Sym- pathy” The earlier years of his professional life were actively de- voted to laying a firm foundation for his future position, and so determining its form and proportions that it might thence- forth be developed without his active intervention. It was only at the mature age of thirty-eight years that he was mar- ried to Miss Sarah Minis, of Savannah, Ga., who, with four children, survives him. We may venture to believe that this happy union was not without its influence in creating his fondness for domestic life, and perfecting the tranquillity of manner and of mind for which he was so remarkable. No doubt, also, the peacefulness and contentment of his home 7 had much to do with the diligent and steady performance of the literary work which constantly occupied him. Even in the summer when recreation is generally felt to be essential to health and efficient labor, he was rarely out of town. I well remember that while accompanying him to New York in 1846, as a delegate to the Convention that originated the American Medical Association, he informed me that for twenty years he had never, but once, spent a night outside of Philadelphia for pleasure, and even in subsequent years he was rarely absent from home. Before offering a sketch of his medical career it may be mentioned that his strong bias towards Natural History was shown by his editing, in 1828, Wilson’s American Ornithology. There now lies before me a letter to Hr. Hays from his friend Prince Charles Lucien Bonaparte, himself one of the most eminent of ornithologists. It is dated “Off Leghorn, April 9, 1828,” and in it the writer thus refers to the new edition of Wilson: “So great is the interest I take in that under- taking that I authorize you (if agreeable to and thought proper by your editorship) to offer in my name to the pub- lishers to conclude this edition with a volume of mine, bring- ing American ornithology, or rather Wilson’s Ornithology, to the order of the day.” In 1831, Dr. Hays read a paper to the American Philoso- phical Society, in which he described various jaws of the Mastodon Giganteus and the teeth contained in them. “He seems to have been the first writer who clearly pointed out the probability that the number of these teeth was six on each side of each jaw. He says: ‘The whole number of teeth possessed by the animal described by Dr. Godman (Tetracaulodon) is, then, at least twenty; and we think that it is at least probable that the animal possessed an interme- 8 diate tooth between the second tooth with three denticules, and that with four denticules.’ ‘Should we be correct in our views, this animal possessed three teeth with three den- ticules in each side of each jaw, making the whole number of teeth twenty-four; but to render this certain would require specimens of intermediate ages to those hitherto described.’ These have since been obtained, and have fully confirmed the opinion suggested by the sagacity of Dr. Hays.” (The Mas- todon Gigamteus of North America. By John C. Warren, M.D., Boston, 1852.) The first published medical paper of Dr. Hays appeared as a leading article in the Philadelphia Journal of the Medical and Physical Sciences, in 1826. It is stated to be a “Lecture delivered to the Academy of Natural Sciences, 1823,” and its subject was “ The forces by which the blood is circulated.” It gives a summary of the successive steps in a knowledge of the subject, including the statement of Galen that the arte- ries conveyed blood; the demonstration of the pulmonary circulation by Servetus and his immediate successors; and the final description of the route of the greater as well as the lesser circulation by Harvey. But neither the illustrious Englishman nor his successors fully solved the problem by what forces the circulation is effected. Even Bichat’s decla- ration is quoted by Dr. Hays, “that when the blood has arrived in the general capillary system it is absolutely beyond the influence of the heart, and still less has the heart any influence on the motion of the blood through the venous system.” Moreover, this famous anatomist and physiologist was of the opinion that “the heart is the only power that puts in motion the blood in the arteries, and that these ves- sels are entirely passive.” Dr. Hays expresses regret at being obliged to differ in opinion from so eminent an authority, 9 but he goes on to argue that “the blood is not circulated by the impulse received from the heart alone, but that its pro- gress is assisted and maintained by a contractile power in tbe arteries.” Among his arguments is the unanswerable one, drawn from his acquaintance with comparative ana- tomy, “that in fishes where there is no heart but for a pul- monary circulation, the blood must be moved through the body by the impulse of the arterial system alone.” In regard to the movement of the blood in the veins he is less clear; but he dwells upon the suction power exerted upon the blood in these vessels by the diastolic action of the right side of the heart and the expansion of the chest in respiration. Like his cotemporaries he overlooked the simple but sufficient fact that the circulatory system is always full, and that a movement of any portion of its contents must urge their whole mass. It may appear strange that only fifty-four years ago so great obscurity should have involved a subject which is now re- garded as hardly calling for a special demonstration. But while we may congratulate ourselves on living in the more perfect day of physiological science we should not be un- mindful of our debt to those who, even in a humble degree, like the subject of this notice, contributed to establish and disseminate a fundamental truth. In the same journal, in 1826, and while he was a surgeon to the Pennsylvania Infirmary for Diseases of the Eye and Ear, Dr. Hays published “ Observations on Inflammation of the Con- junctiva,” a paper on “ Inflammation of the Sclerotica,” and one on “ The Pathology and Treatment of Iritis.” These papers, which we have no claim to judge, appear to have laid the foundation of the high repute which Dr. Hays afterwards attained as an ophthalmic surgeon, and probably determined his selection as one of the first surgeons of Wills Hospital in 10 1834. This appointment secured to him a larger field for observation and experience, and led to the distinguished position which he afterwards occupied among the ophthal- mologists of this country. Indeed, no one in Philadelphia enjoyed a higher reputation for skill in this branch of sur- gery, and from all parts of the United States patients sought the benefit of his counsel and operative skill. In those days neither ophthalmology, nor indeed any branch of surgery, rested upon a well-defined scientific basis; and in this country, as in Europe, surgeons were regarded by physicians as some- thing less than equals. Perhaps no other department of surgery has more rapidly or more securely advanced since then than that to which diseases of the eye belong; and if we must, in the light of existing knowledge, regard the writings of that period as crude and unscientific, and the operative methods as defective, we cannot refuse to those who used them with the judgment and dexterity of Dr. Hays, the admiration with which their cotemporaries also regarded them. The knowledge acquired by Dr. Hays through study and practice he embodied in several publications, the first of which was the Practice of Medicine, of Dr. Dewees, for which he prepared the chapter on Diseases of the Eye. This work was published in 1830, and in its preface the author alludes to the contribution of “his friend, Dr. Hays, whose long and attentive study of the subject, together with his experience in this branch of practical medicine, has amply fitted him for the work.” The chapter, in about seventy 8vo pages, con- tains a succinct account of the anatomy, physiology, and pathology of the organ of vision, and of the treatment of its diseases, which is certainly not the least meritorious in the work, although, like other cotemporary essays on similar 11 subjects, it cannot be judged by the standards of the present day. In 1843, Dr. Hays edited an American edition of Lawrence’s treatise on Diseases of the Eye. In a letter of the author to the editor acknowledging a copy of the volume the following passage occurs: “I return you my best thanks for the book, and at the same time beg to express to you how highly I am gratified at finding that you not only think my work worthy of republication in America, but that you should have conde- scended to act as editor, and to enrich my treatise with those valuable additions which might well have constituted a sepa- rate publication. I feel that I could not have received a higher compliment, and I shall always hold the circumstance in gratifying remembrance.” In 1854, on receiving a copy of the third edition, Sir William wrote again to the editor a letter of thanks from which the following is an extract: “I feel it a particularly fortunate circumstance that one so thoroughly conversant with the whole subject, and so used to literary composition, should have undertaken the trouble- some task of making these additions to my treatise, published in 1840, which are necessary to bring it up to the present state of knowledge, and should have conferred upon it the new and interesting feature of so many beautifully executed pictorial illustrations.” The preparation of the successive editions of this work was to Dr. Hays a labor of love, for by it he not only associated his own name with that of perhaps the most eminent ophthalmic surgeon in England, with his consent and also high approbation, but it gave him the oppor- tunity, as he himself says in the preface to the second edition, of presenting the results of his own experience “derived from more than a quarter of a century’s devotion to the subject, during which period he had been attached to some public 12 institution for the treatment of diseases of the eye.” In the third edition of the work, issued in 1854, Dr. Hays recorded the first case of astigmatism published in America. Donders, in his treatise on “Anomalies of Refraction and Accommoda- tion,” cites in historical order the earliest published cases of astigmatism. They are five in number, and of these three occurred in the persons of their reporters, the fourth is due to Dr. Hamilton, and the fifth to Dr. Hays. He was also the first, it is believed, to observe color-blindness as a pathological condition; it being generally a congenital defect. (See case of Mary Bishop, Amer. Journ. of Med. Sci., Aug. 1840, p. 277.) This case ended in recovery. It is cited by Dr. B. Joy Jeffries in his recent work on Color-Blindness. The bent of Dr. Hays’ mind towards the physical depart- ments of medicine is illustrated not only by his special devo- tion to ophthalmology but by the total absence from all his writings of theoretical discussions. Doubtless the same inclination determined him to edit Arnott’s Elements of Physics, in order that students and practitioners of medicine might become better acquainted with the physical phe- nomena of life. This work, which was first published in 1829, exerted a marked influence upon medical instruction while it was passing through three successive editions. Two years later, along with his life-long friend, Dr. Robert Eglesfeld Griffith, he translated the famous Chronic Phregmasice of Broussais, and, after a like interval, The Principles of Phy- siological Medicine of the same author. He was, perhaps, moved thereto by the semblance of simplicity and precision which distinguished the writings of this celebrated theorist, whose influence was distinctly marked on the opinions and practice of many American ph}rsicians, among whom the Professor of the Institutes of Medicine in the University of 13 Pennsylvania, Dr. Samuel Jackson, was the most eminent and influential. If they attracted Dr. Hays by their seem- ingly logical character, they captivated the versatile imagi- nation of Dr. Jackson by the fervor of their eloquence and their all-embracing generalizations. They are now utterly forgotten, although at one time they formed the law and the gospel of the medical profession on both sides of the Atlantic; and their fate remains as a monument of warning to all who would attempt to construct science out of materials furnished by the imagination. The American Cyclopaedia of Practical Medicine and Surgery, of which only two volumes were completed, comprised titles from “A” to “Azygos,” and was produced under the editor- ship of Dr. Iiays between 1834 and 1836. It everywhere exhibits signs of his painstaking supervision, and contains, of his own, besides innumerable brief articles, a great many bibliographical additions to the essays of his collaborators. He contributed to it a large proportion of the article Ab- domen, including its symptomatology and pathology, its abscesses, fistulse, adhesions, tumors, pulsations, etc.; the whole of the article Abstinence, covering ten pages in double columns; Amaurosis, occupying fifteen pages; Aphlexia, or Revery, three pages, etc. The list of collaborators he secured included many of the foremost medical men of the time, in- cluding Bache, Chapman, Reynell Coates, Condie, Dewees, Dunglison, Emerson, Griffith, Thomas Harris, Hodge, Horner, Jackson, Mitchell, Robert Patterson, and Wood, of Philadel- phia, Geddings, of Baltimore, and Warren, of Boston, every one of whom, except Dr. Coates, he survived. Dr. Hays was admirably fitted for editing such a work. His knowledge of the medical profession enabled him to select the most com- petent collaborators; his courtesy combined with firmness 14 Secured their cordial co-operation; his critical judgment assured the desirable harmony of opinions and unity of method among them ; and it can scarcely be doubted that the Cyclopaedia would have been carried to its completion by the editor and publishers, and have become a lasting monument to the attainments of the profession at that day, if it had not been smothered in its infancy by the country that should have fostered it. To-day, as nearly half a century ago, the class of our citizens which is least protected or encouraged is that which provides the intellectual, that is the highest, elements of civilization. From time to time encyclopaedic works have been issued in this country, but, with one or two exceptions, they have been reprints or translations of foreign books for which legal, if not legitimate, protection has been secured through the pious fraud of a putative American father who had little to do with the generation of the affili- ated work. No doubt the failure of his great literary pro- ject continued to rankle in Dr. Hays’ mind, and to animate his feelings against the irrational policy which our national government has pursued towards nearly all the higher forms of intellectual culture when not prosecuted directly by its own officers. The history of Dr. Hays’ connection with the American Journal of the Medical Sciences, which proved to be the most important event in his professional life, was not an accidental occurrence, nor was his selection by the editors and pub- lishers of that periodical an experiment. Mr. Isaac Lea was a member of the historic publishing house of Carey, Lea, & Carey, and still survives at a patriarchal age with senses and intellect unimpaired, and with that fresh and lively temperament which always distinguished him. He was also an active member of the Academy of the Natural Sciences 15 to which Dr. Robert E. Griffith likewise belonged. The latter was a very intimate friend of Dr. Hays, and intro- duced him, in 1818, into the Academy, where he was soon made a member and chairman of its Publishing Committee. In this office he was earnest and indefatigable, and by his great industry and tact he procured the publication of no less than fifty-six numbers of the Society’s Journal. The active management of the Society then passed into other hands, and its Journal was suspended for many years. In 1827 Mr. Lea became a member of the American Philosophical Society, and was soon afterwards made chairman of its Com- mittee of Publication, to which Dr. Hays, who entered the Society in 1880, was subsequently added. During all this period, as ever afterwards, Mr. Lea and Dr. Hays were united in a close friendship by harmony of character and a commu- nity of scientific pursuits. It was therefore natural, when the medical journal issuing from the publishing house of the former was in need of additional editorial ability, that he should gladly sanction the selection, as editor, of Dr. Hays, whose special qualifications he so well knew. The Journal at that time bore the title of the “ Philadelphia Journal of the Medical and Physical Sciences.” It was commenced in 1820, with Dr. Chapman as editor, and in 1825 Drs. Dewees and Godman were associated with him in that office. But, in the following year, Dr. Godman having accepted the professorship of anatomy in Rutgers Medical College, Hew York, and the senior editors, owing to increasing business, being unable to devote their time to its interests, it became necessary that another editor should be selected. The long intimacy of Dr. Hays with Chapman and Dewees, and the community of tastes between him and Godman, seemed naturally to designate him as their associate. From Hew 16 York Godman continued, as long as his engrossing duties and failing health would permit, to contribute to the Jour- nal ; but at last, finding that he could no longer do so, he withdrew from any active share in its conduct, which then devolved upon Dr. Hays alone. But he did not retire until he had prepared an announcement which, although it was not published in full, should here be cited in proof of the high estimate which Godman had formed of the subject of this memoir. It was as follows:— “ The Publishers, with the entire approbation of the Editors, announce with pleasure that they have secured the valuable assist- ance of Isaac Hays, M.D., who w;ill henceforth co-operate in con- ducting the Journal. Independent of this gentleman’s practical experience and zealous devotion to the interest and honor of the profession, we consider him as a great acquisition, on account of his long experience and well-earned reputation in the management of such a publication. The Journal of the Academy of Natural Sciences owes a very large portion of its success to his exertions and attention to the business of its publication. In adding him to the editors we give an ample pledge of our determination to make every effort to merit a continuance of the liberal support it has uniformly received.” On the cover, then, of the second number of the thirteenth volume of the “Philadelphia Journal,” published in Febru- ary, 1826, the name of Dr. Hays appears as one of the editors. By the close of the year, all his associates having retired, the responsibility of conducting it devolved upon him alone. Immediately he laid aside its local for a national name, and in its management, as the American Journal of the Medical Sciences, in November, 1827, gave it that cosmo- politan character which has constantly become more per- fect, and which was never tarnished by his negligence or in- 17 discretion during the fifty-three years that elapsed between its birth and his own death. Looking back over this long period of time, every one acquainted with the Journal must admit that it honestly and thoroughly fulfilled its object, which was declared to be “ to establish a National work devoted exclusively to the improvement of medical science, and to the elevation of the dignity and character of the pro- fession, to the entire rejection of all local and individual interests and party views.” We cannot refrain from quoting in this place the accurate and striking terms which were used to describe the Journal by Dr. Billings, in his Centen- nial History of American Medical Literature. “ The ninety- seven volumes of this Journal need no eulogy. They contain many original papers of the highest value ; nearly all the real criticisms and reviews that we possess; and such care- fully prepared summaries of the progress of medical science, and abstracts and notices of foreign works, that from this file alone, were all other productions of the press for the last fifty years destroyed, it would be possible to reproduce the great majority of the real contributions of the world to medical science during that period.” Although from 1869 Dr. Hays was aided by his son, Dn I. Minis Hays, whom he thus trained to the responsible duties which he now discharges alone, he never abandoned his supervision of the Journal, nor abated his interest in it, and it survives not only as a monument to his steadfast industry, but is, we believe, without a parallel in the length of time for which one man has conducted a periodical publication.’ The career of Dr. Hays, as thus far sketched, is a striking illustration of the truth that each one’s place in life is gene- rally determined by himself. It is often remarked that a man’s first steps towards eminence are directed by some acci- 18 dent without whose occurrence lives that have been eminent and brilliant might have been passed in obscurity. History is full of instances which are accepted as illustrations of this superstition, and are too often invoked by the indolent as a sufficient reason, or even as an apology, for their own inac- tion. They seem to say, “ If Fate will have me king, why, Fate must crown me without my stir.” But no such wait- ers upon Providence ever achieved the honorable distinction, which, on the contrary, has generally been reached by those who deliberately and faithfully prepared themselves for their high office, and who added to their fitness for its duties their conspicuous presence in the world and the support of influ- ential friends. The precise position one shall take may be uncertain, it may even seem to be determined by accident, but “ There’s a divinity that shapes our ends, rough-hew them how we will.” Beyond a doubt men fall into their fit- ting place as certainly as the particles adapted to form a crys- tal come together to produce their destined form. And thus it was that all the peculiar elements of Dr. Ilays character, and his social, professional, scientific, and literary relations, combined to fit him for the duties of his life’s office and to raise him to it in the fulness of time. The gravity and dignity of the quarterly journal unfitted it for the discussion of subjects which concerned tlie medical profession as distinguished from the science and art of medi- cine. For this purpose the Medical News was established in 1843 as a monthly journal which kept physicians informed of all that transpired of general interest in the various medi- cal societies and colleges of the country, and especially of everything that tended to advance or retard the paramount cause of medical education. A portion of its columns was also devoted to exposing the evils and iniquities of quackery 19 both at home and abroad. In pursuit of the latter object, once, and only once, did Dr. Hays find himself called upon to answer for the maintenance of the truth. In 1846 a suit was brought against him, by the author of a quack remedy for having declared in the Medical News that the pamphlet describing this medicine, “ displays quackery in its most un- blushing and undisguised form.” The case was tried in the Nisi Prius branch of the Supreme Court of this State, before Judge Burnside. It is memorable for the professional interest it excited, for the wit and humor of the Judge, for the display of adroitness and eloquence by the plaintiffs advocate, the late David Paul Brown, and for the verdict of the jury which sus- tained the criticism of Dr. Hays by awarding merely nominal damages to his assailant. The Bulletin of Medical Science, edited by the late Dr. John Bell, commented on the case in the fol- lowing language: “We must not let the present opportunity pass without recording the obligations under which the pro- fession lies to Dr. Hays for his continued exposure of quackery and medical delusions.” In this exposure he persisted to the end of his life; not by denunciation or the use of bitter epi- thets, which the subject certainly prompted and warranted, but by simple narratives of facts. Within the medical pro- fession the faithful were encouraged by these publications, and it may be believed that the weaker brethren, who from imperfect education or the temptations of gain were in danger of being seduced into error or crime, were sometimes held to their moorings by the reiterated exposures of fraud, and the records of its punishment. It is even possible that this influence was radiated and reflected in some degree upon the general public ; for, however small and incapable of accurate measurement that influence may be, its existence and its power cannot be doubted. 20 Dr. Hays was never a lecturer upon any branch of medi- cine. That he was not resulted only from an accidental occurrence. There lies before me a printed circular of the “Philadelphia Anatomical Rooms,” which were in College Avenue, now called Chant Street, announcing a course of lectures during the winter months by Dr. Godman, on Ana- tomy and Operative Surgery; by Dr. Griffith, on Materia Medica and Medical Jurisprudence; by Mr. Keating, on Chemistry; and by Dr. Hays, on Practice of Medicine and Diseases of the Eye and Ear. The lecture rooms in which this course was to be delivered had already acquired a local celebrity through the lectures of Lawrance and of Godman, which was destined to be maintained by a long line of teachers who were there trained to become professors in the medical schools. It is said that Dr. Hays was appointed to deliver the introductory lecture of the course, which, how- ever, was never given, in consequence probably of the removal of Dr. Godman to Hew York. Thus Dr. Hays not only lost an opportunity of overcoming the natural diffidence which restrained him from taking the part in public discussions which his merit entitled him to, but also of becoming what he was eminently fitted to be, one of the most accurate and thorough teachers of his day. It is probable that he with- drew from this career lest it might interfere with a proper discharge of the duties of the editorial office he soon after- wards accepted. The participation of Dr. Hays in the organization of the American Medical Association was doubtless prompted by the same spirit which led him on every fitting occasion to aid the efforts of individuals or societies to improve the culture of his profession. It has already been stated that the Medical News was constant in this purpose, and contained, in 21 almost every issue at times, whatever could be gathered at home or abroad which denoted either the striving of indi- viduals after a better system of education or the action of societies in favor of greater strictness in teaching and licens- ing. Addresses upon education (and they never failed, for the subject was practically inexhaustible) were sure to con- tribute their most telling paragraphs to these columns when they clamored for reform; and not a few who advocated the least possible education as the best possible preparation for a medical career, found their base and treasonable platitudes pilloried with a quiet scorn that we may believe cut more deeply than any invective however crushing, or the sting of any wit however keen. In 1846 this subject was more than ever the order of the day, and Dr. Hays was sent by the Philadelphia Medical Society as a delegate to the Convention, which was held in Hew York City, at the call of the Medical Society of the State of Hew York. He took an active part in its proceed- ings, and was a member of the committee appointed to “ bring the subject of medical education before the Convention.” In that capacity it was he who presented the resolutions which proposed to create “a Hational Medical Association;” to adopt “a uniform and elevated standard of requirements for the degree of M. D.;” that “young men before being received as students of medicine should have acquired a suit- able preliminary education ;” and that “it is expedient that the medical profession in the United States should be governed by the same code of medical ethics.”1 1 The following account of the origin of these resolutions is contained in a manuscript of Dr. Hays : “ The idea of taking advantage of that occasion to form a National Medical Association is due, I have reason to believe, to Dr. A. Still6, of Philadelphia. He consulted one of his colleagues [Dr. 22 These subjects were assigned to several committees, Dr. Hays being a member of that appointed to prepare a Code of Medical Ethics. At the meeting held in the following year at Philadelphia he presented the Code, which has ever since been recognized as the ethical guide of the medical pro- fession in this country. When the Plan of Organization of the American Medical Association was under consideration by that Convention, Dr. Hays, in common with some others, feared that a merely representative and therefore transient body would be unfitted to inspire respect for its dignity and authority, or to make any steady progress in scientific or practical knowledge. He, therefore, proposed that the Association or Society should be composed solely of members elected directly by it or through its council, and that this council should be a permanent body, but renewable in part every year, and charged with the “general superintendence of the concerns and publications of the Association.” The suggestions of Dr. Hays did not, however, suit the views of the greater number of the dele- gates. The Convention, as is well known, adopted the popu- lar system, according to which representation and member- ship in the Association became dependent much more upon personal popularity than upon professional merit or distinc- Hays] in regard to a series of resolutions which he had prepared to offer for the consideration of the Convention; but as no opportunity for his offering them had presented itself, so great was the disorder on the first day of the meeting, a colleague [Dr. Hays], who had been appointed one of a committee to prepare business for the next day, asked to be allowed to bring them before that committee and try to obtain the recommendation of the passage of those resolutions. With some difficulty this was obtained, and the reso- lutions adopted by the Convention were substantially the same as those prepared by Prof. Stille.” 23 tion; and the custom was maintained of discussing subjects of every kind at the general meetings, until at last the latter evil became intolerable, and a Judicial Council was created to which “all questions of an ethical or judicial character” were referred. By adopting this law the Association tardily, and still imperfectly, accomplished the object aimed at by Dr. Hays in the beginning ; and its failure to accept the other and more radical principle would seem in part to explain the want of interest in it shown for many years past by the more cultivated members of the profession, and especially by the medical colleges, ever since they were ostracized by the Asso- ciation. We have often heard Dr. Hays deplore these original defects and these later tendencies of our National Medical Congress, which he considered as having lowered its original dignity and lessened the amount of scientific work it was at one time expected to accomplish. It may not be generally known that the original and con- tinued publication of the Transactions of the Association in Philadelphia was due entirely to Dr. Hays, whose editorial experience and intimate relations with the chief medical publishers of the country gave him peculiar advantages in printing and distributing the volumes. He continued to be the Chairman of the Committee of Publication for five years. As a Fellow of this College, Dr. Hays always displayed a lively interest in its welfare. He was chairman of the com- mittee to which the erection of the present Hall of the College was entrusted, and was constant and unwearied in superin- tending its progress. He felt a special interest in the library, which he regarded as the most permanent and influential agency at the command of the College for developing a love of knowledge among its Fellows, and, through them, in the profession at large. His gifts of books from time to time 24 entitled him to the thanks of the College, and to the inscrip- tion of his name upon the honorable roll of its benefactors. Among the contingent bequests in his last will, that to the College for the use of its library takes precedence of the others. It marks the interest felt in the institution by our deceased Fellow, and adds another to the many motives which we have to cherish and respect his memory. It will be proper in this place, and before adverting to the more personal relations of Dr. Hays, to enumerate the various public offices that he filled, and the honorary distinctions he received. In 1818 he became a member of the Academy of Natural Sciences of Philadelphia; in 1865 was elected its President, and re-elected until 1869, when advancing years obliged him to decline a re-election. He had been also a Curator and mem- ber of the Library and Publication Committees. In 1830 he was chosen a member of the American Philo- sophical Society, of whose publication committee he was also a member, as well as a Councillor and one of the Trustees of its Building Fund at the time of his death. He was for many years an active member of the Franklin Institute of this city, in which he was successively Manager, Corresponding Secretary, Chairman of the Library Commit- tee, and Chairman of the Committee of Publication. He was also a director of the Musical Fund Society; mem- ber of the American Academy of Arts and Sciences; honorary member of the Historical Society of Georgia; corresponding member of the National Institution for the Promotion of Science, established at Washington, D. C.; of the Montreal Mechanics’ Institution; and of the Royal Society of Northern Antiquarians, Copenhagen. He was also a manager of the 25 Society of the Alumni of the University of Pennsylvania, Department of Arts and Science. The medical institutions with which Dr. Hays was con- nected were the following::— From 1822 to 1827 he was a surgeon to the Infirmary for Diseases of the Eye and Ear; and from 1834 to 1854 surgeon to Wills (Ophthalmic) Hospital; he was also physician to the Philadelphia Orphans’ Asylum; Philadelphia Dispensary ; Southern Dispensary; and Pennsylvania Institution for the Instruction of the Blind. In 1832 he was chairman of a Medical Committee created by the Board of Health of this city to examine into the facts relating to the epidemic cholera. In 1835 Dr. Hays became a Fellow of the College of Phy- sicians of Philadelphia, and served it as chairman of its building committee, as Censor, and as one of its delegates to the American Medical Association from 1849 to 1853. In 1847 he was elected treasurer of the Convention out of which grew the American Medical Association, and was annually made treasurer of the latter from 1848 to 1852, when he declined being again a candidate for the office. He was chairman of the Committee of Publication from 1847 to 1853. In 1852 he acted as chairman of a special committee on amendments to the constitution; and, in 1853, of a committee on plans for organizing State and County Medical Societies. In 1854 he was chairman of the committee on prize essays, and, in 1855, chairman of the committee of arrangements for the meeting held in Philadelphia. In 1848 Dr. Hays was a delegate from the College of Phy- sicians of Philadelphia to the Convention held in April of that year for organizing the Medical Society of the State of 26 Pennsylvania. He was chairman of the committee which drafted the constitution of the latter society, of which, in 1849, he was elected the corresponding secretary; and from 1850 to 1854 he was a delegate from the Philadelphia County Society to the State Medical Society. Dr. Hays was also a member, and in 1825 was elected secretary, of the Ka7t7ta Aafifiba Society of Philadelphia; a Vice-President of the Society of the Alumni of the Medical Department of the University of Pennsylvania; the first President of the Ophthalmological Society of Philadelphia; a corresponding member of the Gynaecological Society of Boston ; an honorary member of the American Ophthalmo- logical Society; of the State Medical Societies of New York and Rhode Island ; of the Academy of Medicine of Abington, Va.; and of the Medical Society of Baltimore; and a corre- sponding member of the Medical Society of Hamburgh; of the Society Universelle d’Ophthalmologie ; and of the Con- gr&s Internationale de Paris. Having sketched the career of Dr. Hays in its more public and professional aspects, it remains for me to present some of the traits that distinguished his social relations. It has already been stated that he was the private pupil of Dr. Nathaniel Chapman, and it may be added that to the end of his life the interest of the teacher in his pupil was unabated. Dr. Hays was frequently employed by him to attend his patients, and, during the last illness of his old preceptor, was his medical attendant. He held similar responsible and con- fidential relations with Dewees, between whom and himself there existed a warm sympathy to which their fondness for music and painting probably conduced; and, at one time, if Dr. Hays had desired to cultivate obstetrics, the door of a 27 lucrative practice would have been opened to him by Dewees. Very similar were the ties that bound him to Dr. Jackson during a long period. It is well known that this eminent physician and eloquent teacher was, for many years before his death, confined to his chamber, which almost until the end was brightened by his cheerful manner and tbe lively interest he showed in every subject of public and professional concern. At least once a week Dr. Hays was his welcome guest, and no doubt his visitor’s gentle and subdued tone and deliberate judgment exerted a calming influence upon the friend whose impetuous enthusiasm and animated manner often needed a soothing rather than a stimulating influence. At Dr. Jack- son’s death it was found that he had bequeathed to Dr. Hays one thousand dollars as a token of his esteem. Throughout his life Dr. Hays seems to have enjoyed the intimate friend- ship of an unusually large number of distinguished men, and to have preserved it with singular constancy, a fact as honor- able to him as to them, and tending to illustrate the sterling quality of his character. It is the more remarkable because such intimacies are rare among men of the same profession, and especially so among physicians. P>ut his fondness for natural science also brought him into close contact with some of the most eminent cultivators of that branch of knowledge. His relations with Mr. Isaac Lea and Prince Charles Lucien Bonaparte have been elsewhere mentioned, and it may now be added that among his most intimate and cordial friends were Thomas Say and George Ord, whose fame is indissolubly associated with the natural history of the United States. His social position and his active membership of the Phi- losophical Society made him a frequent guest at the Wistar Parties while he was still comparatively young, and subse- 28 quently, in 1844, led to his being enrolled in that association, which was composed exclusively of members of the Philo- sophical Society. At its social meetings, which were held every Saturday evening during the winter, were assembled most of the gentlemen of the city who were distinguished in science, literature, art, or general culture, as well as emi- nent strangers sojourning in Philadelphia. Here Dr. Hays was always a pleased and welcome guest, for he delighted to converse upon intellectual topics with men whose profes- sional or social rank gave interest or weight to their opin- ions, while his own abundant information, his affable yet modest tone, as free from dogmatism or from pedantry as from flippancy, and his perfect exemption from any suspicion of selfish objects, made him a desirable companion for men of all parties and shades of opinion. When the civil war broke out, which absorbed the interest and activity of every citizen, and was destined to break asunder so many social ties, and alienate so many lifedong friends, the Wistar Party no longer interested its members as in the days of prosperity and peace, and several among them being out of sympathy with the greater number, its meetings gradually declined and were at last suspended. They have never been resumed. For several years, however, before this catastrophe, Dr. Hays conceived that such social meetings were too useful as well as agreeable to be confined to the winter months, and, accordingly, in concert with several friends, he organized the “ Saturday Evening Club” which met, except in midsum- mer, between spring and autumn. Its entertainments were simple, the number of the guests limited, and the members, not being all physicians, the subjects of conversation were of more general interest than they would have been among 29 persons of one profession only.1 But this association, like the Wistar Party, gradually declined, and died through the operation of causes like those which terminated the career of the latter. Its founder, we may believe, recognized, with many others, that the medical profession in this city had completed its longest and one of its most notable cycles, and that henceforth the antique sense of honor and dignity which had so long distinguished it must give way to more tangible and perhaps coarser motives of action. Dr. Hays, as well as many others who had lived in both epochs of our history, could not doubt that the civil war, which had crushed so many of the amenities of life, had infused a more robust vigor into every branch of society, and that henceforth all the departments of our civilization had entered upon a new era. Of this no clearer demonstration can be found than the recent history of medical literature in the United States, and no more certain indication of it than in the rapid and vigorous development of the quarterly medical journal: which he founded. Ho doubt he was too wise to believe that any social institutions possess the secret of immor- tality; and therefore he could rejoice in events that set. the final seal on the independence of American thought and deed, however rudely they may have shaken the accu- mulated habits and prejudices of several generations, and impaired those gentle and almost family ties which the edu- cated physicians of this city had been accustomed to regard as inseparable from their professional life. 1 The list of members included Mr. Isaac Lea, Prof. H. Copp6e, Mr. Samuel Powel, Drs. G. B. Wood, G. W. Norris, J. Carson, F. Bache, R. LaRoche, R. E. Rogers, T. Stewardson, S. H. Dickson, I. Hays, and A. StillA 30 In attempting to form an estimate of Dr. Hays’ character we must allude to a very striking, if not the greatest, pecu- liarity it presented. It was well balanced. In nothing did he err by excess or by impulse. As his walk was measured and his conversation grave, although he was the opposite of indolent or dull, so the structure of his mind was remarkable for a due proportion and equilibrium of the reflective faculties which passion never overthrew and but seldom disturbed. In public assemblies as in private conversation he was always calm and as self-possessed as his modesty and aversion to disputation would permit. He neither achieved nor was ambitious of oratorical success, but whatever he was called upon to say went directly to the point, was tersely and cor- rectly expressed, and impressed his hearers with a conviction not only of the sincerity, but also of the weight, of his opinions. With a taste naturally delicate, and refined by culture and a long study of modes of thought and expression, he became very fastidious in regard to style. A verbose and declamatory manner in speaking or writing was supremely distasteful to him, and sometimes, perhaps, led him to under- value men of substantial merit whose defective training or exuberant imagination tempted them to step beyond the boundaries of moderation and good taste. This rigor of judgment, however, was not the result of his refinement and culture alone ; it was due, in part, to a certain peculiarity of character which may perhaps be described as a deficiency of imagination and enthusiasm, as compared with the deliber- ative faculties. A careful examination of his writings, so far as I have been able to make it, seems to reveal this char- acteristic; for while his narratives or criticisms are remark- able for the lucid arrangement of appropriate thoughts, they 31 are never colored vividly, and are rather deficient even in contrasts of light and shade. The Ciceronian rule, “ Est oratoris proprium, apte, distincte, ornate dicere,” he, indeed, obeyed so far as to write and speak appropriately and clearly, but his genius was not to write eloquently. He lacked the perfervidum ingeniam which inspires “thoughts that breathe and words that burn.” And well, no doubt, that it was so. The duties of an editor, which he fulfilled with such remark- able distinction, demand far different qualities; an enlight- ened, unbiassed, and deliberate judgment, a suavity of man- ner that invites confidence, and a firmness that is proof equally against the cajoleries of designing flattery and the exactions of overweening self-esteem, the dictation of ill-advised coun- sellors, and the injustice of hostile criticism. Such influences neither disturbed the serenity of his feelings, nor warped the rectitude of his judgment, nor turned him from the straight path of duty. What he felt obliged to do, that he did ; not rashly nor even impulsively, nor with the zeal that is blind to the right of judgment in others, and to the truth so often proved by example that errors may be propagated fanatically by men who are honest in their convictions and aims. It is perhaps almost without example that a leading medical periodical for more than half a century should never have been known as the organ of a party, and never contained an edi- torial line that betrayed personal animosity. Even the Medi- cal News, which afforded a ready field for the display of such feelings, never exhibited them during the thirty years that he conducted it—not even at times when there was sufficient ground in the notorious misconduct of others to justify severe criticism or even moral reprobation. This peculiarity, so rare in the history of journalism, was determined neither by laxity of principles nor indifference: for no man ever lived 32 who had a higher standard of moral right, or who felt more keenly the attacks of others upon himself or upon the cause that he was serving, or was more decided in his judgment of measures and of men. It was the result of his instinct of justice which always separated the individual from his act, and which led him while he condemned the latter to keep the former out of sight. He carried this principle even into his personal relations with men. It is remarkable that although he long held an office which is generally supposed to he more prolific of enmities than any other, he had very few personal enemies, and there were fewer still whom he held to be such without sufficient cause. For them his aversion was deep, but not loud. He indulged in no invec- tives against them, even wffien he spoke of them most severely; he would admit the good even while denouncing the evil that was in them, yet he seldom mitigated, still less reversed, a judgment he had once deliberately formed. A mean, a dishonest, a disloyal action stamped its author in his mind with perpetual reprobation; but his dignity of char- acter did not allow him to become a public prosecutor or a private executioner. In all allusions to men guilty of such deeds, or even to those whose general course or character he did not approve, he usually limited himself to the bare fact which he had to announce, unqualified by any opinion favor- able or unfavorable. He would not condescend to the un- manly act of “damning with faint praise,” nor would he covertly attempt to damage those whom he did not care to attack openly. He was a man of peace; and not regarding the triumphant issue of any personal conflict as important as a quiet life, he was neither apt to take offence nor prompt to resent it, except by a dignified and expressive silence. It would even be easy to prove that he was capable of taking 33 the noblest revenge, by doing a substantial good in return for what he regarded as a malevolent injury. Although the weight of fourscore years rested upon him, and occasional indispositions confined him to the house, Dr. Hays continued to show a lively interest in public and pro- fessional affairs even to the very verge of his life. Of this the following incident offers a striking illustration. About two months before his death, while reading the Boston Medi- cal and Surgical Journal for Feb. 6, 1879, his attention was arrested by a statement attributed to the late eminent and venerable Dr. Jacob Bigelow of that city, who graduated in 1810 at the University of Pennsylvania. After some allu- sion to several other professors, he is represented to have said : “ Physick was a savage, and would have no intercourse with us. We never were allowed to enter his house.” Pain- fully impressed by so erroneous a description, Dr. Hays felt bound to correct it, and he began to write a letter to the gentleman from whom it proceeded, which is interesting, not only as a vindication of the “ Father of American Sur- gery,” but also as a proof that age had not dimmed its author’s memory nor chilled his sense of justice. It is also of interest as being the last writing that Dr. Hays ever penned, sickness having overtaken him before he had finished it, and it deserves to be preserved, if only to show that the end of his life was in perfect harmony with his whole career. My Dear Dr. Bowditch : I have read with deep interest your account published in a recent No. of the Boston Medical and Sur- gical Journal of an interview with the late Dr. Bigelow when ninety years of age. I yield to no man in my esteem, respect, and high estimate of the judgment and extensive attainments and noble moral qualities of Dr. B., to whom I am indebted for many kindnesses; but justice to Dr. Physick, with whom I was 34 well acquainted, compels me to say that Dr. B.’s estimate of Dr. Physick was a hasty one and altogether erroneous. He was not “ a savage”—on the contrary he was one of the kindest hearted men. He had a skeleton in his closet which depressed his spirits and rendered him shy of company and reserved with strangers, but it was said of him that he never performed a painful ope- ration, but that he had to go to bed on reaching home, sick, so sensitive was he to the infliction of pain. He had observed that persons fatally scalded seemed to suffer no pain, and he gave orders that every oyster should be dropped in boiling water, before being cooked for him, and he would not eat them unless so pre- pared. The last operation I witnessed with him was performed by his son-in-law, Dr. Randolph, for excision of the entire lower jaw. When the jaw was removed and the bloody flap laid on the neck, the sight was appalling. I held the ligatures to hand to Dr. Physick who was to tie them ; after applying one or two he was so overcome that he beckoned to me to apply them, turned his back to the patient and walked about the room in great agitation Even in the closing period of his long life the thoughts and affections of Dr. Hays turned most of all to the journal with which his name and fame were inseparably associated. While the silver cord was loosening that bound him to this almost life long companion, he doubtless felt a natural pride that his name would survive with it in the person of his son, and Ave cannot hut think that this reflection cheered the twilight of his life. For to the very last his mind \\ras un- clouded and his feelings were not blunted. In the month of February, 1879, he suffered an attack of influenza folloAved by exhaustion from which he did not rally, and, unable to take food, for Avhich he felt no desire, he gradually fell asleep on the 12th of April, 1879. His work was completed, and, full of years, he passed away, almost the last representa- 35 tive in the medical profession of the generation to which he belonged. Nearly fifty years ago I began to know him as the pre- ceptor of one of my most intimate friends. He then lived at the N. E. corner of Eighth and Sansorn Streets, and I well remember the impression his gentle and courteous manner made upon me, and the wonder mixed with envy with which the well-filled shelves of his library inspired me. In the street he walked with deliberate steps, often with his hands behind his back and his eyes bent upon the ground, and this gravity of carriage, which, however, had nothing chilling or austere in it, never deserted him. It perhaps did not invite inti- macy; for the vulgar familiarity of recent generations was repugnant to him. Yet it formed no absolute barrier against any whose character or station deserved respect. His nearer friends were a distinguished circle composed chiefly of men who were something more than physicians by their general culture or their addiction to natural science. With some of these his relations were intimate, and continued as long as life lasted. They were all men of mark and character whose friendship conferred honor. That he retained it so long, and in so many instances, may be ascribed to the singular equa- nimity which prevented him from either giving or taking affront gratuitously. For although neither insensible nor cold he had great power of self-control, and seldom exhibited active emotion or vehemence of manner. Such indeed was the character a physiognomist would have read in his face, where the calm, honest look of the eyes harmonized perfectly with the habitual repose of all the features. But what he practised and loved he also exacted from others. Whatever might be the ties that bound him to a man,a corrupt or dis- honest action severed them at once and forever. By birth a Hebrew, he through life adhered to the ancient faith; but while fixed in his own views he was entirely liberal to those of others, often quoting Pope’s lines:— “ For modes of faith let graceless zealots fight; His can’t be wrong whose life is in the right.” To such a man, so industrious, zealous, steadfast, wise, and pure, whose long life had been devoted to promoting the noblest of sciences and most beneficent of arts, and cleansing them from the blight of ignorance and the stain of falsehood, its decline is the peaceful coming of the night’s repose, its natu- ral and necessary ending, as free from terror as from regret; and we cannot doubt that, apart from the sadness of quitting those who had been the joy and consolation of his home, he clung most fondly at the last to that work which he had reared as the fittest monument to perpetuate his memory.