b    J4  j
 ..........-—&NNUAL ''ADDRESS


           BEFORE THE



    SAN FRANCISCO COUNTY




MEDICAL SOCIETY,


      DELIVERED PURSUANT TO APPOINTMENT,


         JANUAEY 27, 1857,


    By HENRY GIBBONS, M. D.
PUBLISHED BY DIRECTION OF THE SOCIETY.
         b wf-- ■
      SAN MANCISCO:
WHITTON, TOWNE & CO'S EXCELSIOR STEAM PRESSES,
    NO. 151 CLAY STREET, NEAR MONTGOMERY.
          1857. 
 
ADDRESS.
  The Constitution of our Society gives me on this occasion,
the dignified title of Orator.   If an oration implies a stately
production, replete with poetic imagery  and lofty diction,
the task has fallen into wrong hands.  I propose, in a plain
and practical manner, to pursue the current of my thoughts
and lay before you such topics as may present themselves to
my mind.
  This body is in the fourth year  of its  existence, and is
now the oldest medical association of a general character in
California.   Its plan  of operations embraces annual reports
on  all the branches of medical  science, and  essays and  dis-
cussions on all  topics  of professional interest.   But I am
sorry to say that it has fallen short of its design.   We may
not have done that which we ought not, but we  have  cer-
tainly left undone that which we  ought to have done.  Sel-
dom have the members of committees performed  the duties
allotted to them.   The meetings have been thinly attended.
To  our shame we must confess that the organization has been
almost a failure.
  The rapid and unexampled progress that has marked the 
4
career of the human mind in the present century, is the result
in great measure  of associated action.  Alone, as individ-
uals, great men may do great things, and write their names
on the history of the age in which they live and labor.  But
as individuals, men of moderate ability, composing the mass
of society, are but cyphers.  Without association the work
of advancement falls on a few: with it, the many  are  able
to make themselves eminently useful.
  In no department  of human  pursuit have the benefits of
associated action been more signally displayed than in med-
icine and the collateral sciences.   Especially is this true of
our own country.  Ten years ago, a congress of physicians
assembled in Philadelphia and organized a National Medical
Society.  From this center went forth with electric  speed, a
quickening influence, which aroused and embodied the slum-
bering and  isolated energies  of the  profession.   State  and
County societies rapidly sprang into being, and  knowledge
immediately began to pour  itself in copious  streams from
sources near and far into the common treasury.   The obscure
country doctor, for years esconced  in one corner of the vil-
lage tavern, his sanctum  adorned with a  few antiquated
books and bottles,  and redolent with anise and musk, awoke
from  the  chrysalis into  a more perfect life, swept the  cob-
webs from  his books, hunted up his ink horn, and produced
an essay at the county meeting.  So at the State  Society,
men never before  heard of in  the  profession  beyond  the
tracks of their horses'  feet, began  to cast valuable offerings
into the general stock.  And then the tables of the National
Society were well nigh broken down with contributions from
an expanse of territory reaching from the tropic nearly to 
5
the Arctic  circle, with mountain and prairie, and forest and
marsh, interminably blent, and presenting to the medical pro-
fession which occupy it under one  national government, a
field of investigation unequalled on the globe.
   And what is California doing in  this noble  work ?   Has
she taken the  proper position in the progressive march ?  Do
her medical practitioners, gathered  from the four  corners of
the earth, appreciate their duties to themselves, to their pro-
fession, and to the  world ?   Do they read, and  study, and
investigate, as becomes the votaries of science  and the guar-
dians of human life ?  Or do they slumber at  their post,
exerting their faculties only by compulsion, when a demand
is made for their services ?
   It is a common remark that the  atmosphere  of  California
is hostile to study.   The  pursuits  and excitements of this
land of gold distract and dissipate the powers of the  mind.
Our people read, it is true, but they  require the brief par-
agraph of the daily press ; and they turn from that with dis-
taste if  it is not highly seasoned with novelty, extravagance,
or abuse.   We choose our intellectual food, not for its nutri-
tious qualities, but for its taste.  Our choice is controlled by
the transient impression on the  palate.  Even a newspaper
paragraph, which cannot be disposed of as quickly as a  pinch
of snuff, is intolerable.
   Our physicians suffer from this habit quite as much as any
other class. They are  not  wanting in  education, for they
have learned at the best schools in the old and the new world.
Nor are they wanting in  intellectual power.   Perhaps no
other country can exhibit such an array of talent.  But they
lack fixedness in their calling.  They are ready for  politics 
6
or trade, or anything.  They have no patience—I mean the
moral  quality so  named, a very small stock of which  has
been hitherto imported in this land.  They are not anchored
in their business.   They are not advancing in medical knowl-
edge.  They learn little unless by accident or constraint, and
they forget faster than they learn. They are adding neither
to their own stock of knowledge, nor to the common stock.
   This prevailing habit is eminently hostile to the best inter-
ests of our profession.   Physicians should never cease to be
students.  The moment they do so, they forfeit all claims to
the confidence of the community.  It is essential that med-
icine and the collateral sciences be cultivated by our profes-
sion.  In every trade and in every art, success depends on
the vigilance and promptness with which all improvements
are embraced.  The practice of the healing art is no excep-
tion.  On the contrary, the  stake  that is  here at  issue—
human  life  itself—imposes obligations stronger an hundred
fold.  The practictioner that settles down on his reputation,
and ceases to be a student, and adds no more to his stock of
knowledge, should be driven from the profession in disgrace.
   And how shall this evil be remedied but through the power
of association ? Is it possible to place the medical profession
of California on a proper basis without this agency ?  Will
unorganized, individual effort accomplish the  great reform
which is necessary ?
   A beginning has been made in this work.  The San Fran-
cisco County Medical  Society claims the honor of  leading
the way.  The Medico-Chirurgical Society of this city, and
the Sacramento Medical Society have pressed  forward with
commendable industry.  These  were the only general organ- 
7
izations in existence a year since, and from them emanated
the call to the Physicians of the State to assemble at Sacra-
mento and form a State Medical Society—or rather to  con-
sider  the propriety of  so doing, for it  was not settled that
the time had come to carry out that design.  But when the
day of meeting arrived, one hundred  physicians assembled,
from  all parts of  the  State, animated  with one mind, all
intent on organizing the proposed  State  association.  With
entire harmony, and under auspices the most cheering, the
intention was put in force. A right spirit was diffused abroad,
and other County  societies  have  been  instituted.  We are
now on the verge of the second meeting of the State Soci-
ety.
   But it is not enough that associations  should exist.  They
must  be sustained and cherished with a vigorous life.   It is
the duty of every physician to give his aid and co-operation.
There can be no good reason  for standing aloof.   A selfish
and exclusive course is unpardonable.   You cannot fulfil
your  obligations to  the profession—to the cause of science—
to humanity  at large—without engaging in the  common
labor.  Are you a laggard ?   Have you  fallen  behind the
times ?  Have you  suffered your books  to moulder on  the
shelf?  And  are you conscious of your deficiencies and
wants ?  Then come to school and learn by intercourse with
your  fellows.  If you neglect the  golden opportunity, you
are the veriest fool  in the family of Esculapius, and deserve
to be  scourged from the temple.
   But on the other hand, if you have not slumbered in your
office—if you are posted in all the  improvements and discov-
eries—if your duties to yourself are performed, and you are 
8
qualified to discharge all the duties to your patients, then
the Commonwealth of Medicine has the strongest claims on
your service.  You are the very man for the work.   Your
selfishness is an offence against humanity—it is a crime.
   Nor should it suffice to enroll your names on the records of
a Medical Society and to acquire a nominal membership.
We want no drones in the  hive.  A certain valuable book
speaks  of several women laying  hold  of one man, saying
" we will eat our own  meat and wear our own apparel, only
let us be called by thy name to  take  away our reproach."
A compact like this appears to be proposed by many physi-
cians on joining a medical association.   They would have it
known  that their parchment is genuine—that they are M.
D. of right; and  this  is the sum of their aspirations.   They
contract no obligation—they propose  no benefit to others.
All they seek  is  the  name  and the honor,  to take away a
reproach which they really deserve.
   It is  probable that medical societies all over the world have
the same difficulties to encounter.  An exclusive disposition,
or personal antipathies and jealousies, deter some individuals
from joining.  Of the members, a large proportion are drones,
never attending a meeting, or coming only  to participate in
an election or a quarrel.  An organization composed mainly
of such members had better give up the ghost than prolong
an existence of alternate coma and convulsion.
   In no other country is association so essential to the inter-
ests of the profession as  in  California.   We  occupy  a new
field of labor—new in its climate, and new to some  extent
in the types and modifications of disease. Our former knowl-
edge and experience will not avail us fully.  We have more to 
9
learn before we can be properly qualified for the grave respon-
sibilities of our calling.  This additional knowledge, adapt-
ing us to our new field of labor, may be gathered gradually, by
individual  effort, at some expense to our patients.   But it
may be  acquired  much  more speedily through  associated
enterprise, whereby the observations and experience of each
become the property of all.  In this point of view the organ-
ization and sustentation of medical societies in every practi-
cable locality, becomes an imperious duty.
  Another inducement to association, which applies to Cali-
fornia with much greater force than to any other country on
the globe, is the heterogeneous character of the members of
the  profession.  Where on  the  face of this  earth  can be
found a body of Medical practitioners, gathered from so many
climes and nationalities, and  differing so widely in every
feature of mind ?   By familiar, social and professional inter-
course, these discordant materials will  become assimilated,
and the confusion  of tongues will be an element of strength.
  The world considers us a quarrelsome tribe.  " When do
you hear one Doctor speak well of another ?"—is a question
which occasionally grates on our ears.   I should like  to con-
tradict the charge, but I fear there is too much truth in it.
Poets may no longer  monopolise the title of " genus irrita-
ble."  There are a thousand vexations incident to our occu-
pation, calculated to fret the temper and to foment ill feelings.
Physicians are daily brought in collision with each other.
Temptations are continually presented to induce one to take
advantage  of another.  Suspicion, and  envy, and jealousy,
crowd themselves into  the heart.  Such is the general ten-
dency ;  and a great degree of forbearance and magnanimity
                2 
10
is necessary to resist the consequences.  Here the beneficial
influence of  association is powerfully  felt.  Nothing tends
so much to dispel  prejudice, to  remove  asperities and jeal-
ousies, and to prevent contention and bickerings.  " As iron
sharpeneth iron, so doth the countenance of a man his friend."
But if the  countenance be steadily averted, there can be no
bond of union.   Personal intercourse among physicians can
not be too free.  Distrust is often converted into friendship
merely by  acquaintance.   Frequent meetings  cherish senti-
ments of respect and  attachment, and preclude annoying
suspicions and cankering jealousies.
  I cannot imagine a more  comfortless  and  wretched life
than that of the Ishmaelite, who secludes himself from  asso-
ciation with his fellows, and regards their interests  adverse
to his own—in short, who treats them as rivals and enemies.
Suspicious  and sensitive and jealous, he is ever on the watch
for offences, and of course he finds them.  Every practitioner
is a rival, and the success of any one torments him.   Even
the mention of another's name calls for an invidious or sneer-
ing remark.  The whole course of his  professional  life is a
round of anxiety and vexation, and not a ray of genial sun-
shine breaks in upon his cold and dreary path.
   Surely we suffer enough of annoyance in the proper pur-
suit of our business, without adding to our troubles by cher-
ishing  such  feelings.   The  ingratitude  and ill usage of
patients, especially of those who receive our gratuitous ser-
vices, or who cheat us out of  our pay, and the officious
interference of their friends in thrusting  forward their own
favorite doctors, and a multitude of similar vexations that
beset us in our daily walks, occasion enough of  discomfort 
11
and draw sufficiently on our forbearance.  But all these trials
are wonderfully mitigated by the  cultivation  of social and
kindly  feelings towards  our brethren.  It is  a substantial
solace to escape from such unmerited suffering, to enjoy the
society of our fellows  and feel that they  are friends and
brothers, and to cast  our interests and sympathies  into a
common lot.  Depend on it, he who makes friends and com-
panions of his confederates, who seeks  their society in the
social circle and in the  Medical  association, fortifies himself
against the irritants that beset his path, and enjoys a much
larger share of happiness than the reserved, unsocial,  suspic-
ious, censorious and pragmatic physician.
   Experience has everywhere demonstrated the necessity of
establishing for  the  government of practitioners  in every
town or neighborhood,  a code of laws to regulate their rela-
tions one to another.  It is probable that in the United States
greater attention has been directed  to  this subject than in
other countries.   A  rigid  compliance  with such  a code is
essential to the harmony and prosperity of the profession.
But it is only through the means of association that it can
be enforced.   Even here, in San  Francisco, with all  the ad-
vantages of two  Medical Societies, how small a proportion
of physicians are conversant with their prescribed duties one
towards another, and how  much smaller is the number of
those who are scrupulous in observing them!  Especially is
it needful that consultations be conducted in  proper form;
and yet I apprehend but few even of our best trained  phy-
sicians observe the rules in this respect.
   Want of time is often alleged as an  excuse for standing
aloof from Medical  Societies, or for absence from  the meet- 
12
ings and omission of the attendant duties.   Perhaps there
is  no  expression in our language  so  commonly devoid of
truth as the phrase asserting want of time.  Men in all posi-
tions of life and in all circumstances, are in the habit of ex-
cusing themselves  from every duty by the  same universal
lie.  We shall discover  on looking around us, that the com-
plaint is most common in the mouths  of those  who  waste
their time in idleness or pleasure,  whilst men  of industry
have time for almost every thing.  The  most voluminous and
valuable medical works are from the pens of authors actively
engaged in the practice  of our art.  You will find that  the
Professor who lectures daily to his classes, who attends to a
large circle of patients, and who composes  elaborate text
books, always has  time  to take his place in the meetings of
the Medical Society.   Let me instance, without going beyond
the  limits of a single city, Professors Wood,  Meigs, and
Dunglison,—names familiar to the  world.  We  may say of
time what the Book says of another description of treasure :
" To him  that hath  shall be given, and from him that hath
not shall be taken away, even that which he hath."—Active,
energetic  business men have time for  every thing; idlers,
for nothing.
   To maintain the firm, and lofty, and dignified position that
our profession should occupy in the public mind, and to pro-
tect itself efficiently from the specious claims and attractions
of quackery, in its varied forms, from  the novel and poetic
systems of quasi scientific men,  to the   mendacious and  ob-
scene pretensions which defile the columns of the daily press,
we have need of all the strength that harmony, union and
co-operation can impart.  A constant and efficient esprit  de 
13
corps is greatly wanting among us.   The reputation of every
practitioner is two-fold—one portion earned by himself, the
other consisting  of his dividend  from the common stock.
While building up an individual character, it is his highest
interest to aid in elevating the character of the profession in
general.  In their  private family relations, men  carry out
this principle  with scrupulous attention.  If one member of
the household take a wrong  step, involving himself in dis-
honor, all the others  strive to conceal the offense or apolo-
gise for it, in order to avoid their share of the reproach.  So
let it be in the family of  Medicine.   Instead of exposing a
brother and holding him up to public reprobation, selfishness
itself would teach us to cover him with the mantle of charity,
and hide his shame from the world.  I need not remind you
that every honorable, generous and noble impulse would lead
to the same course of action.
   I have now mentioned  some of the advantages to be de-
rived from Medical Associations.   The subject is by no means
exhausted, but I  must leave it, with the remark that, while
there is no country on earth where physicians have so much
to gain by association, there  is none  where the interests of
science  and  the  welfare of society so imperatively  demand
their organized and united labor.
   Permit me now to suggest some topics of enquiry posses-
sing claims on the Medical Profession of California,  and the
further neglect of which would entitle us to  censure, if not
to opprobrium.
   In the diversified and exuberant growth of vegetation pecu-
liar in a great measure to this section of the Western coast
of North America, there lies hid an extensive Medical Flora, 
14
 the  investivation of which is not likely to be accomplished
 by individual effort.  I do not know of a single indigenous
 plant in common use as a medicine.  And yet our plains and
 forests are covered with species possessing active  sensible
 qualities, and doubtless imbued with  valuable therapeutic
 virtues.  And whilst our climate  perfects their growth and
 development, it offers facilities for collecting and preserving
 them, not to be found elsewhere.  With aromatic plants in
 remarkable  variety and abundance, almost at the  door of
 every  house, we depend exclusively on  the  Nepeta and
 Mentha prepared in the uncertain climate of  New Lebanon,
 and then transported by sea a distance equal to half the cir-
 cumference of the globe, and twice traversing  the  tropics.
 The same may be said of the more important medicinal herbs.
 And here let me remark that many of the drugs sold in our
 shops have  been seriously injured, if not rendered entirely
 inert, during their  transportation.   I have more  than  once
 obtained powder of Ipecacuanha which was nearly worthless,
 from  this cause.  In  fact, so uncertain was the  quality  of
 many articles found in the market some years ago, as to in-
 duce me to supply myself with such as I knew  to be active
 and to dispense them in important cases, rather then depend
 on the chances of a written prescription.  Of  latter years
there is more  care  exercised by druggists.   But room for
improvement still exists.  It is a subject which, in connection
with the heinous practice of adulterating drugs, should never
for a moment be  allowed  to escape  the notice of medical
practitioners.
  One of our common  plants is a species of Echynocystis,
sometimes called Wild  Cucumber from the resemblance  of 
15
its vine to that of the Cucumber.  The root, which grows in
the sand to the size of a man's  body, is a remarkably pun-
gent bitter, and was used  in the early settlement of this
country, by some enterprising druggists, in the manufacture
of Stoughton's Bitters.   With the exception of some exper-
iments in the treatment of Intermittent Fever, in which it
proved successful—experiments made  by  my brother, Dr.
W. P. Gibbons, in the County Hospital,—I do not know that
its medicinal qualities have  been applied to any other use.
There is a Helenium growing  in Alameda County, of most
intense bitterness, which I have no doubt would prove  val-
uable.   The same  may  be  said of other plants, especially
those of resinous  and balsamic properties, which  exist in
 great abundance.
   Our thermal and mineral springs too, should be explored.
 They are found in  every  direction—in Napa Valley  and
 northward, Sulphur waters, varying from blood heat to the
 boiling point—in the Valley of Santa Clara and  elsewhere,
 Seltzer or Carbonated springs with magnesia and saline mat-
 ters in solution—and chalybeate waters, profusely distributed
 in the Alameda hills and the  Coast  Mountains  to  the east-
 ward.  The Carbonated springs of New Almaden, located in
 a picturesque country beyond the Valley of Santa Clara, can-
 not be excelled in  any  part of the  world.   The warm Sul-
 phur springs  which abound in the  lovely valley of Napa,
 have already attracted the attention of invalids, and are the
 fashionable watering place of California.  And the Geysers,
 a short distance from the head of that valley, possess attrac-
 tions alike for the  man of science, the  lover of romance in
 nature, and  the valetudinarian, which will make them event- 
16
 ually the most popular resort in California. All these local-
 ities are within the range  of the Bay climate, and in sum-
 mer are fanned gently and voluptuously  by the sea winds,
 which rush upon us, in  San Francisco, with such  chilling
 force.
   The climate  of the Pacific  Coast, in its Etiological rela-
 tions, opens an immense field of observation and study.  In
 the winter season, if winter it can be called, from November
 to April inclusive, there is but little  difference  on the sea
 board in a range of fifteen degrees, from the mouth of the
 Columbia River on the north, to San Diego on the south.
 Nor is there much difference inland, except that the more ele-
 vated regions are liable to colder weather.  Thus whilst snow
 and ice are rarely seen on the coast, the mountains of the
 Sierra Nevada range  are covered with snow nearly all the
 year.
   In the summer season, a similar uniformity of climate pre-
 sents itself  on the sea board ;  but during this  period, from
 May to October, a wave of cold air flows daily  from the
 ocean, often loaded with falling mist.   So little difference is
 there in temperature  between winter and summer in this
 wide range of coast, that flannel garments are constantly
 worn, and no one thinks of changing the  dress from winter
 to summer.
   But beyond the mountain barrier, which skirts the ocean
and walls  out  the  sea  breeze  from the interior, the  heat of
summer is often intense, the mercury rising  frequently to
 100 degrees, or upwards.  At the same time the air is gen-
erally very dry.  Almost invariably, however, the nights are
pleasantly cool, so that sleeping is well done everywhere. 
17
   A few years ago it was supposed that the climate of Cal-
 ifornia  was almost  proof against Pulmonary disease.   In
 1850, if an individual happened to cough in church, all eyes
 were turned  on  him with  curiosity and amazement.  The
 native  population, it  was said, were entirely exempt from
 disorders of the lungs.  But time has dispelled the delusion,
 and  Pulmonary  Consumption  and the kindred  affections,
 have become  the great enemy of human life, as in  the Atlan-
 tic States.  Our  entire climate everywhere, is less injurious
 to pectoral disorders  than the corresponding latitudes on the
 Atlantic.  But the cold and searching winds of summer on
 the  sea  board, while they often  build  up  the strength by
 their bracing and tonic  power, are  in  general, unfavorable
 to patients suffering  from the class of maladies under con-
 sideration.  And the extreme heat of the interior  is equally
 noxious, from its debilitating influence.
   The relation of our climate to this class  of diseases, may
 be summed up in a few words.   Persons afflicted with bron-
 chial or pulmonary  disorders,  in the  incipient  stage, are
 almost invariably benefitted, and oft times cured by travers-
 ing a tropical climate and taking up their abode in Califor-
 nia.  On  the other hand, such diseases are developed ab initio
 in this country, about in the same degree as in  the Atlantic
 States.   As the female population increases, the bills of mor-
 tality exhibit a corresponding increase in the number of
 victims.
   Some  years ago, it was a general practice to send pulmo-
 nary cases to  the  Sandwich  Islands.   But experience has
 shown its futility.   We stand  in need of some other Sanita-
rium.  In many cases, change  of climate is the only remedy ;
                3 
18
and a genial temperature, not  liable to sudden or material
fluctuations, and exempt  from strong winds, are  requisite
conditions.  In the summer season, the region bordering on
the Bay, at its northern and southern extremities, may serve
the purpose; holding  as it does a medium  place between
the damp and chilly ocean climate  of San Francisco, and the
arid and scorching heat of the interior.  In  the winter, we
must turn our attention to the South.  Los Angeles and San
Diego, in the southern  section  of the State, are still  too far
north.   The table land of Mexico will probably supply the
desideratum.  But even in Mexico, proximity to the ocean
must bo  avoided.   Twelve months ago, in  a brief stay at
Manzanillo, which is on the  Western  Coast, in latitude 19
deg., I observed among the native population, an extraordi-
nary prevalence of  pulmonary disease; caused in all prob-
ability by their sleeping on the damp  ground, exposed more
or less to the  cool night wind.   Sixty  or  seventy miles
inland, in the vicinity of Colima, is  a  different  climate, said
to be much more salubrious.  With all the  knowledge I now
possess on the subject, this spot appears  preferable to any
other; and accordingly I  have  latterly  recommended  it to
my patients, instead of the Sandwich Islands.   This subject,
however, deserves much more  consideration than it has yet
received.
   If important  advantages  are to be gained by change of
climate in pulmonary subjects, the change must be made at
an earlier stage than is common.   In  the  majority of cases,
the patient defers until no reasonable hope of recovery exists;
and then he goes abroad to die.  I believe that in the greater
number of instances, the timely application of  this remedy, 
19
if not  adequate to a  complete cure, will add  from ten to
twenty years to the duration of life.
  Much has  recently been  written  in  favor of the direct
application of remedies to the bronchial and pulmonary sur-
faces, by inhalation.  But inasmuch as the mode of treat-
ment has been taken up as a speciality, and  by outsiders, it
is regarded  by  our profession  with distrust and  hostility.
Being a subject of rational experiment  and investigation, it
is simply absurd that we  should allow ourselves to be turned
away from it by prejudice.   The direct application of medi-
cines to diseased surfaces, when possible, is not  only of uni-
versal practice, but constitutes an essential part of  the treat-
ment.   We pry into all the orifices and cavities of the body,
and thrust in our various appliances.   The ear, the throat,
the sesophagus, the rectum, the urethra, the uterus, are  all
treated with topical applications.  We even  go  into the lar-
ynx with sponge  and  caustic.   But all beyond  that point is
forbidden ground. Why should not the diseased surface of
the bronchial tubes, and of the  air cells, be sensible  to the
direct contact of medicines in  the  form of vapor ?  What
is there irrational in the idea ?  Do we not apply the vapor
of water to the fauces  in tonsillitis and other affections ?  Do
we not apply carbonic acid gas,through the fermenting  poul-
tice, to diseased surfaces, thus excluding oxygen and substi-
tuting its opposite ?
  The most effectual means that I have ever employed to re-
lieve the distressing paroxysm of Asthma,is the  popular rem-
edy of brown paper and nitre,  which is  burnt, and the fumes
inhaled.  Why  may not  iodine and other vegetable agents
be applied in a similar manner—not only to act  on  the respi- 
20
ratory surfaces, but to pass through this  channel into  the
blood, without disturbing the stomach ?
   Many years ago, the inhalation of oxygen gas was pro-
mulgated as a cure for Pulmonary Consumption, by Dr. Bed-
does and others.  But it was soon abandoned.   The  vapor
of the Sugar House has performed some wonderful cures in
modern times.  Physicians have not disdained to use these
remedies.  Dr. Clutterbuck ventured to extend the range of
inhalation, on strictly scientific principles, but he almost lost
caste by the operation.  In a class of diseases, acknowledged
as the opprobium of the profession—more  fatal and  more
incurable  than  any  other—whose  victims  are fearfully
numerous, and mostly in the flower of life, and composed of
the fairest and brightest of our friends and kindred, let us,
rather than turn away our faces, encourage every endeavor
to devise remedies  and palliatives.   Even if such endeav-
ors prove futile, we gain a negative knowledge not destitute
of value.
   Epidemics  are  of rare  occurrence  is this  State.   At an
early period, when the comforts of life were greatly wanting,
Diarrhea  and  Dysentery  were prevalent, and extremely
fatal. In those days men dwelt in tents and slept on the
earth ; they used a diet of animal food, almost  exclusively,
undiluted with vegetables  and fruits, and composed  of beef
run down before killing; and  they employed that blessed
prophylactic, brandy.  With  improved habits of  life, and
wholesome diet, and a diminished antipathy to the internal
use of cold water, those diseases  have greatly diminished,
and death from Dysentery or Diarrhea,  is  comparatively
rare. 
21
  In the winter of 1850-51, the Malignant Cholera was epi-
demic in various localities, visiting our territory in its regu-
lar course of march on the Western Coast of North America.
In this city the  mortality was light, but Sacramento was
nearly depopulated.   Since that time, sporadic cases have
occasionally appeared, and patients laboring under the mal-
ady, and dying with it, have been frequently landed from
the steamships from  Nicaragua and Panama, and taken to
the  County Hospital, or otherwise  disposed of.  But  the
disease has, in no well authenticated instance, extended to
others.  Several cases were said  to have appeared in the
neighborhood  where the  clothing from the infected vessel
was sent to be cleansed—giving support to the theory which
attributes the spread of Malignant Cholera  to exhalations
 from the feces of its victims.  But  as the statements to that
 effect were connected with some pecuniary interests or spec-
 ulations, they are not entitled  to credit.
   In June and July, 1851, bronchial affections first made
 their appearance  in  San  Francisco, in the form of an influ-
 enza.   Since that date, catarrhal disorders  have prevailed
 nearly every summer, in a sufficient degree to be pronounced
 epidemic.
   Whooping Cough prevailed to some extent in the summer
 of 1856, in San Francisco, and a few other  localities.  It
 was unusually severe and fatal.
   Croup is a disease from which the infantile population of
 our State suffer very much.  It is apt to be violent and in-
 tractable, terminating fatally in many cases, perhaps as much
 for  want of timely medicine and proper nursing as from the
 intrinsic violence of the malady. 
22
  In the summer of 1856, simultaneously with  Whooping
Cough and Croup, measles appeared, to a limited  extent.
  Scarlatina first presented itself to the notice of the Amer-
ican inhabitants in the spring of  1851, on the heels of the
cholera.  There were few cases however, and they were of
mild grade.   Since that time it  has occurred sporadically,
and with the same tractable character.
  There is a form of disease bordering on Malignant Scar-
latina, which has  committed  sad havoc in certain localities
in the past two or three  years.  It commences  with inflam-
mation, and mostly ulceration, of the fauces and tonsils, ex-
hibiting no peculiar features, and exciting no alarm.  Some-
times a cough is present from the beginning.  Suddenly the
patient is seized with croupy symptoms, and in a brief period,
from six to  twenty-four  hours,  life  is  extinguished.  The
muscular strength and the faculties of the mind are generally
retained to a late period.  The pulse is that of  Scarlatina,
but there is no eruption.  Delirium and convulsions seldom
occur.  Children  are its ordinary victims, though adults are
not always exempt.
  A striking feature of this malady, is its fatality in certain
families.  It may visit  only a  few houses in a village or
neighborhood, but in them it is apt to carry off all the young
children, in rapid succession.   In San Francisco,  it has not
prevailed so much as in  Oakland, Sonoma, and  some other
towns.  In the only instances within my knowledge, in this
city, where all, or nearly all the  children of the household
were  swept away, the victims were trophies of Homoeopathic
practice.  I have had no fatal, and no very malignant cases,
in my own charge exclusively, but have visited a number in 
23
this city, and at a distance, in consultation, where no oppor-
tunity was afforded for autopsic examination.  In these cases
the fatal result appeared to arise from the  rapid extension
of the inflammation to the air passages and lungs, without a
full development of the proper  symptoms.   The  treatment
that has proved most salutary under my observation, consists
mainly of the free internal use of Quinia, and  the  applica-
tion of Nitrate of Silver, in solution, to  the  fauces, with a
large blister on the chest in case of pneumonia.  I am con-
strained by the narroAv limits of this address, to hasten thus
briefly  over a subject which we are required, by the interests
of humanity, as  well as by the character of our Profession,
thoroughly to investigate.
   Diseases of the urinary passages are frequent and trouble-
some, especially chronic affections of the Urethra, which often
defy all treatment, yielding only to time.  In  fact it  may
safely be said, that an unusual tendency exists on this coast
to disorders of the mucous membranes in general.
   Insanity, as might be expected, is fearfully prevalent in
California.  It grows directly out of the excited mental con-
dition of our population,  to which the  common muse of alco-
holic drinks, is a powerful adjunct.   Other cerebral disorders
do not abound—excepting meningitis in infants.  It has
been remarked that, notwithstanding the constant exposure
of a large portion of the male  population to the  extreme
heats of the interior," sun stroke " is scarcely ever heard of.
   Derangements of the Uterus  and its appendages are very
frequent.  The moral  relations  of the sex in this country
tend to produce an undue excitement of the uterine system.
 California babies are noted for their magnitude, and couplets 
24
are common.  Abortions are of frequent occurrence, and still
born children and  sudden deaths of mothers  in childbed.
Nervous disorders of all descriptions, are painfully numerous
among females.
  Erysipelas and opthalmitis are prevalent, especially  in
the mining region, where the former is often endemic.  Cuta-
neous  disorders  abound,  and are  frequently  intractable
Syphilis, primary and secondary, assumes an endless variety
of forms, not unfrequently resisting the most vigorous treat-
ment.   Old cases, supposed to have been cured, are revived
in our climate.   Rheumatism abounds, mostly in a sub-acute
or chronic form, and is eradicated with  difficulty.  Gout is
almost unknown, while  neuralgic ailments are popular.
   There has been observed in the diseases of this  coast, an
extraordinary tendency to the paroxysmal form, or to exac-
erbations, requiring the use of Quinia.   This occurs in Dys-
enteries, in Pneumonia, in Puerperal  women—in short it is
traced in almost every affection attended with febrile action.
  Fevers to which the dubious term Malarious is conveniently
applied, are scattered everywhere, in city and country, and
are often endemic in  certain districts.  In the intermittent
phase, they are often excessively annoying by their repeated
returns  after  apparent cure.  Typhoid, or rather Ataxic
fevers, are^fritf frequently met with.
   Acute inflammations, requiring  the lancet, are  not com-
mon.  It is truly singular to what extent venesection is dis-
carded in California.  I am apprehensive that we allow this
potent remedy to be too much neglected.
   But I must detain you no longer, though there are  other
topics which want of time forbids me even to mention.  My
remarks have been brief and superficial, from necessity. But
should they serve in some degree to excite inquiry and direct
into channels of investigation and study, and to promote  the
spirit of association, I shall be more than satisfied.