THE 
Military Medical Officer 
AT THE 
Openingof the Twentieth Century 
c-Address to the graduating class of the Army Medical School 
at Washington, April 14, 1903. 
By DR. JOHN S, BILLINGS LL.D.,D.C.L. 
LIEUTENANT COLONEL IN THE UNITED STATES ARMY, RETIRED; 
DIRECTOR OF THE NEW YORK PUBLIC LIBRARY. 
Reprint from the 
Journal of the Association of Military Surgeons 
of the United States 
CARLISLE, PENNSYLVANIA 
THE ASSOCIATION OF MILITARY SURGEONS 
1003 THE MILITARY MEDICAL OFFICER AT THE OPENING 
OF THE TWENTIETH CENTURY.* 
By DR. JOHN S. BILLINGS, LL.D., D.C.L., 
LIEUTENANT COLONEL IN THE UNITED STATES ARMY, RETIRED; 
DIRECTOR OF THE NEW YORK PUBLIC LIBRARY. 
I SUPPOSE that it is entirely within the bounds of possibility 
that some forty or fifty years hence some member of this 
class will come back here to give the address to the gradu- 
ating class of that date. I am not specially curious as to which 
one of you gentlemen will perform that duty,—but I should very 
much like to know what he will say—if I did, I could probably 
make a very interesting address myself, although I might have to 
make a very careful selection for fear of being thought a crank. 
I can hardly imagine what Dr. McLaren, the President of the 
Army Medical Board which examined me, would have thought 
if I had tried to answer some of his questions as you would prob- 
ably answer them. He thought that great progress had been 
made since he entered the service at the beginning of the Florida 
War, and that we young fellows were going into the War of the Re- 
bellion with great advantages. He had seen the introduction of 
anesthesia, and was enthusiastic over the comparatively new opera- 
tions for excision of joints. He had just heard of the clinical 
thermometer, but doubted whether it would be of much use, and 
had also heard of the hj-podermic syringe; and when he found 
I had one of these instruments, he went to Surgeon General 
Finley (this was in 1861,) and had me assigned to duty at the 
hospital under his charge so that he might see how these new 
things actually worked. If, however, in answering his question 
as to the means of preventing malaria and typhoid fevers among 
troops, I had referred to bacilli, haematozoa, flies and mosquitoes, 
as you would probably do, I don’t think I should have passed, 
* Address to the graduating class of the Army Medical School at Wash- 
ington. Aoril la. iqov LIEUTENANT COLONEL JOHN S. BILLINGS. 
4 
and if I had referred to antitoxin as a means of treating malig- 
nant sore throat (his name for diphtheria), he would have advised 
me to take a six months’ rest in an asylum. I was asked to de- 
scribe laudable pus and the best means of securing healing by the 
second intention. Have any of ever seen any laudable pus? 
Certainly my knowledge of medicine in those days before you 
were born was not great as compared with yours, but when 
I went to the arm)7 of the Potomac I found a few doctors who 
knew less, as appeared from the results of a certain examining 
board of which I was a member. 
When the war was over and the armies of Grant and Sher- 
man had made their last parade, when, thirty-eight years ago to- 
day, President Lincoln was assassinated, and at last rested in the 
peace of death, and the old Ford’s Theatre was occupied by the 
Army Medical Museum and Library, the younger medical officers 
in the museum became busy with investigations, and it is inter- 
esting to remember some of the problems which occupied them. 
One was the comparison of high power microscopic objectives as 
tested on Nobert’s lines; another was the best way of making 
photo-micrographs; a third was the best method of staining and 
mounting tissues. I clearly recollect the feelings of triumph with 
which I took some slides of stained sections of kidney and intes- 
tines mounted in balsam to Dr. Woodward, who had been very 
incredulous as to the possibility of making such preparations. 
Then Dr. Edward Curtis and myself began the study of minute 
fungi and of Texas cattle fever, looked for the malarial organ- 
isms on Analostan Island, and spent much time on bacteria, fol- 
lowing Pasteur’s method. In the absence of the solid isolating 
culture methods devised by Koch, we were groping blindly, but 
I have not regretted the time spent in this groping. It is impos- 
sible for you to appreciate the feelings with which we read Koch’s 
first papers, or with which we viewed the commencement and 
progress of antiseptic surgery. 
When I graduated in medicine I had to write a thesis, and 
for divers and sundry reasons, I chose to write on the surgical 
treatment of epilepsy. I undertook to get the history of all re- 
ported cases of such treatment, and in trying to do that I discov- THE TWENTIETH CENTURY MEDICAL OFFICER. 
5 
ered that there was no library in the United States which con- 
tained all the reports. There were no complete files of medical 
journals in this country, and any man who really wanted to write 
a scholarly book on medicine had to go to London or Paris for 
his data. It seemed that that condition of things should be im- 
proved, and when I came here in the Surgeon General’s Office 
and was detailed to settling the medical accounts of the war, I 
put in some side time in trying to get this library together. 
The work which was done in the old Ford’s Theatre in the 
latter sixties and the seventies, in connection with the Museum 
and Library was in part merely incidental to the preparation of 
medical and surgical history of the war, in part for the advance- 
ment of medicine, and in part for the pleasure of the young men 
engaged in it. Its direct results on the science and art of medi- 
cine were not great, but its indirect results have been and are 
important. This Army Medical Museum and Library are well 
known to physicians all over the world, and the opportunities 
they have afforded and the aid which they have given to physi- 
cians in the United States have been such as to produce in the 
medical profession a strong interest in the Army Medical Depart- 
ment. It is desirable for all parties that this interest should be 
maintained, and to this end the younger members of the Medical 
Corps should know and feel that this Army Medical Museum and 
Library is an inheritance to be cared for and increased by them 
for their own and the general good. One of the good things 
about this Army Medical School is that it brings the Assistant 
Surgeons in touch with this institution, giving it some of the 
features of a central home club. 
Thirty years ago there were considerable difficulties in ob- 
taining funds for this Institution. I look back at my experience 
with Congressional appropriation committees with more amuse- 
ment than I felt at the time. At present I am told that the dif- 
ficulty is to obtain the funds required to provide shelving for the 
books, rather than to obtain the books. This is also amusing. 
When I asked for suggestions as to what I should talk to 
you about, I was told:—“Oh, the usual thing, congratulations 
and advice.” LIEUTENANT COLONEL JOHN S. BILLINGS. 
As for my congratulations,—you have them,—and they are 
sincere. It is really a very fine thing to be a young army medi- 
officer, although there are, occasionally, short periods of time 
when he may not think so: He may have some doubts about it 
after he has been for a year at some small, isolated, very healthy 
post, or, for a month before his examination for promotion, or 
when he has to decide without advice as to what he will do for 
his first case of strangulated hernia, or of incipient melancholia, or 
of shot-wound of the abdomen, or of locked twins. He may even 
more than doubt it when he takes a stereoscopic view of his con- 
templated marriage on the one side and his salary and prospects 
on the other. These doubts will pass, but as a rule he will not 
know clearly what a good time he is having and what a fortunate 
man he is until he looks back over his career across the gulf of 
twenty or thirty years. 
If it is true, and I think it is, that “aspice of danger and an 
element of chance add interest to work,” then your work will 
have that interest. You are not coming on the stage of action at 
the beginning of a period of peace and content, but in the midst 
of a waxing tide of national struggles for commercial supremacy 
and of discontent among great masses of people. ‘‘That this 
turmoil and unrest can be dealt with wisely and justly, so as to 
preserve that which is most desirable in civilization and in our 
system of representative government, I believe, but here and 
there in special localities, the immediate problems must probably 
be solved by blood and steel, and that you will have a part to play 
in some of these is not at all unlikely.'V 
You will have some epidemics to face, and no doubt some of 
you will have a chance to hear bullets whistle, arbitration to the 
contrary notwithstanding, but the increased interest which these 
things may give to an army surgeon’s life is too uncertain and 
temporary to be worth consideration. The things most to be 
dreaded in your future lives are boredom and waiting, and the 
preventive and remedy is to see to it that 3rou have something to 
do always,—and doing it.j It may be, generally must be, routine, 
like a woman’s knitting work; sketching or photography, Indian 
languages or calculus, infusoria or ascomycetes will any of them THE TWENTIETH CENTURY MEDICAL OFFICER. 
7 
keep you busy. But suggesting subjects for work is a little like 
the plan of the man who told James Russell Lowell that he had 
discovered the way to make a fortune. “As the fine flavor of 
the canvass-back is due to the wild celery on which it feeds, I am 
going.to feed tame ducks with it and supply the market.” Some 
weeks later Lowell met him and asked him how the duck feeding 
plan was getting on. “Well,” was the answer, “they wouldn’t 
eat it.” 
Forty years ago the microscope was mainly used by physi- 
cians as a plaything, a source of occasional amusement. It was 
the correct thing for the young graduate to buy a thirty dollar 
Oberhauser, and keep it in a conspicuous place in his office, but 
his chief use of it was to show his admiring friends the terrible 
monsters contained in a drop of selected water. 
To-day the microscope is one of our most important tools, 
and you have been taught how to use it, but it may be well to 
remind you that you can get a great deal of pleasure by using it 
in research work not directly connected with medicine. 
When you obtained your diploma as Doctor of Medicine, it is 
possible that many of you thought you knew it all, or nearly all, 
and that what you did not know could be found in the latest text 
books, monographs and journals. Probably all of you are now 
aware that there are many things in regard to the causes, pre- 
vention and treatment of disease which, at present, nobody 
knows; or if any one does know, he has not told. There is no 
end to the things we don’t know and ought to know, and prob- 
ably will know within your lifetime. 
Some of you have, perhaps, resolved that you will investi- 
gate some of these unsettled questions, and may have even se- 
lected the particular problem which you intend to solve. This is 
good, very good, but remember that in your life as an army med- 
ical officer the subject for investigation will usually be determined 
by your opportunities rather than by your wishes. I advise 
every young army surgeon to have some research work on hand 
for his own mental health and pleasure, just as I advise him to 
take a certain amount of physical exercise, and if he cannot make 
the particular research he would most like, that he try to like the 8 
LIEUTENANT COLONEL JOHN S. BILLINGS. 
research he can make. Of course his selection of a subject for 
study will be largely involuntary; if he feels a strong impulse 
towards .some special line of work, it is well for him to follow it, 
but if this work has no relation to his military duties he must 
bear in mind that these duties have precedence. The fact that 
he is an enthusiastic botanist, ornithologist, or comparative anat- 
omist, is no reason whatever for his neglecting to keep himself 
well informed as to advances in medical science, or not being inter- 
ested in his patients or in the sanitary condition of his post. It 
is also a very poor reason why he should try to obtain posts which 
are specially favorable to his particular hobby, if this hobby is 
not connected with military medicine. If he considers his re- 
search work more important than his army duties, he should re- 
sign from the latter. 
What amount of time and energy should be given to original 
research work by professional men employed in college and uni- 
versity work and in Government departments is a question which 
has been much discussed of late years. The exceptional man, 
who knows all that is known on some one subject and has the 
capacity and the desire to increase knowledge on that subject, 
and for whom many of our Universities and large manufacturing 
and engineering establishments are seeking, is not easily found, 
and when found it is not more than an even chance that he can 
be trusted to fulfill the ordinary every day duties of his profes- 
sion, including administrative work. 
If of you feel satisfied that you are that sort of man he 
had better communicate with the Carnegie Institution. 
Most of us hold our professional work as the first and most 
important object, and original research as a thing to be done as 
opportunity offers. We belong to the second class mentioned in 
Hesiod, i. e., those who can understand things when explained 
to them. 
I shall not attempt to advise you with regard to your special 
medical, sanitary or surgical work, but merely ask you to re- 
member that ever}’ army medical officer has some special oppor- 
tunities for increasing knowledge, but that to enable him to recog- 
nize these opportunities and to take advantage of them usually THE TWENTIETH CENTURY MEDICAL OFFICER. 
requires long study and training. It was because of this study 
and training that your late teacher and friend Dr. Walter Reed, 
was able to recognize his opportunity and to make the discovery 
with regard to yellow fever which has placed his name high on 
the roll of the famous physicians who have been great benefactors 
to mankind. His work on this subject was not done under direc- 
tion, rather in spite of it, yet the line of work in which he had 
been engaged for the previous ten years was what fitted him for 
the emergency. 
These special opportunities always come to the physician, 
the naturalist, the anthropologist, they are connected with phe- 
nomena which are occasional—rarely just alike and must be se- 
cured at the time or be lost. But you must be able to recognize 
them if you are to use them. Remember the motto of the Wash- 
ington City Directory “To find a name in this book you must 
know how to spell it.” 
Permit me to say a word about your social relations and du- 
ties, which are substantially those of the family practitioner, but 
with some special peculiarities. In time of war the surgeon is 
more intimately associated with line officers and their work than 
are the officers of other staff corps, and to a certain extent this is 
also true in time of peace, and as a general rule they are good 
friends. In my time there were two or three commanding offi- 
cers who always had difficulties with medical officers, unless they 
were sick, but so they did with all other officers. There were 
also two or three medical officers who always had difficulties with 
their commanding officers, although they might be on very 
friendly terms with other officers. These gentlemen were sensi- 
tive on questions of rank, and rights, not so much on their own 
account (as they explained), as because they felt it to be their 
duty to uphold the dignity of the Medical Department. ‘ Now 
the nature of either personal or Departmental dignity, and the 
desire to have all of one’s rights, is such that the more attention 
you give to them the more they seem to require, and it becomes 
hard to spare the time necessary to preserve them spotless and 
unfrayed. 
Your military rank may, on rare occasions, be an important LIEUTENANT COLONEL JOHN S. BILLINGS. 
10 
matter in dealing with the rank and file, but your medical skill 
and tact are more important in the ordinary routine of army life. 
It is your duty to contribute your quota towards the social 
life of your post, and to try to make it cheerful and interesting. 
Of course, your personal likes and dislikes, strength or weakness, 
in such matters as athletics and games, shooting and whist, read- 
ing clubs and amateur theatricals, the nieces of. the Major’s wife, 
and other sources of amusement, will have much influence on your 
actions,—but be ready to give some of your time to things you 
don’t care much about, if it is for the general good and pleasure. 
You have got to take into consideration the opinions, feelings 
and desires of some women as well as the men, but the 011I5" piece 
of advice I can give on this point is,—whenever you find your- 
self thinking that you thoroughly understand the ladies,—or a 
lady,—at your post, you had better not prophesy. , 
You have also certain social duties in connection with the 
soldiers under your charge. You should know them by sight 
and name, and you should be interested in their individual pecu- 
liarities. And this should be a real interest,—the soldier is quick 
to detect perfunctory, patronizing forms of apparent interest. 
Why does Smith sulk or mope and get off by himself as much as 
possible? Why has Brown suddenly become quarrelsome? How 
is Jones the new recruit getting on? ‘‘These matters are the bus- 
iness of the line officers,” you will say. They are, but they 
should also interest the medical officer, who, without imperti- 
nent inquisitiveness, and with tactful svmpatliy, can often make 
the rough path smooth, and help his brother officer to form a 
wise judgment. 
The medical officer may also have social and professional du- 
ties in connection with civilians in the vicinity of his post. At a 
few special places his medical services are in much demand by 
civilians and are paid for, wherefore these places are desired by 
army surgeons. If there are other physicians in the vicinity, and 
there are few places where there are not, they may think that 
the army surgeon’s work should be confined to the limits of his 
post, and professional jealousy with a little mixture of the Code of 
Ethics, has in bygone years, caused trouble to the medical officer. THE TWENTIETH CENTURY MEDICAL OFFICER. 
11 
On the other hand you will find that such jealousy is the 
exception and not the rule, and that if you sympathize with what 
interests your professional brethren, wherever you may be, you 
will receive cordial sympathy and aid from them. You are 
“members of a world-wide guild, the oldest one, and the only 
one.” The medical officer has thus a double comradeship, and 
this is one of the specially attractive features of his position. 
Your attendance at this Army Medical school will have other 
results besides increase of professional knowledge. You have 
become more or less acquainted with each other’s personality, 
more than you could otherwise have done in many years, and I 
hope you have formed some friendships which will endure. 
Probably you will never all come together again in this life, 
after you have taken your different routes over the iron lines that 
bind this country to its Capital, but your paths will cross each 
other many times and in unforeseen places. At each crossing may 
your memory of your Washington experience aid in making the 
meeting a happy one. 
As members of a great profession, as officers of the nation, 
as citizens of a great country, as men possessing special knowl- 
edge and selected from many candidates, you are coming on the 
stage of action to share the burden and responsibility of the world’s 
work, to bring fresh blood and energy7 into the organism, to 
maintain and add to the dignity and honor of your corps and of 
your country. Enter upon your heritage modestly, but confident- 
ly. Be strong and of good courage. “Nos morituri salutamus. ”