ANNIVERSARY DISCOURSE, BEFORE THE NEW YORK ACADEMY OF MEDICINE, 
DELIVERED IN THE CHAPEL OF THE UNIVERSITY OF NEW YORK, NOVEMBER 3rd, 1852. 
BY F. CAMPBELL STEWAKT, M.D. 
[published by order of the ACADEMY.J 
NEW YORK: PRINTED FOR THE ACADEMY BY R. CRAIGHEAD, 53 Vesey Street. 1 8 5 3. 




ANNIVERSARY DISCOURSE. 
Mr. President, and Associates of the Academy of Medicine : 
We are assembled this evening to celebrate the Sixth Anniversary of the organization of our Society. You have honoured me with the pleasant duty of addressing you on the occasion. For so distinguished an evidence of your confidence and esteem, accept my sincere thanks, and permit me to bespeak your kind indulgence, should the ability to meet your expectations not equal my earnest desire to interest you. 
Accustomed as you have heretofore been at these times, to the eloquent and instructive addresses of the venerable and learned " Fathers in Medicine" who are numbered among your Fellows, it would be presumption on my part to deem myself capable of presenting to you such a discourse as their erudite learning and established ability have enabled them to entertain you with. My endeavour shall be to emulate their example, without even a remote expectation of doing 


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more than showing my sincere wish to repay your kindness, and evince the deep and abiding interest with which I regard all that may pertain, directly or remotely, to the advancement of your views, the promotion of the general well-being and success of our common and beloved profession; and more especially, the furtherance of the aims of this, our favourite Academy. 
Allow me, before entering upon the subject which it is intended to discuss, to make a few remarks in regard to the designs of our Institution, which have been intentionally misrepresented to the public by interested parties, for the purpose of exciting sympathy in their favour by making it appear as though the motives which actuate us were selfish, and that our individual advancement and pecuniary profit, to the detriment of others not connected with us, was the mainspring of our action. By encouraging and fostering this erroneous impression, the cry of persecution against a portion of the profession not recognised as belonging to the regular and established school, may be made to prove highly beneficial to them, and unjustly detrimental to our interests, and those of the public at large, which are so closely allied as to be mutually dependent upon one another. 
The present appears to me to be a proper and fitting occasion to disabuse the public mind on this point, and to demonstrate that there is nothing exclusive in our organization—that the Association is open to all who are properly qualified as practi- 


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tioners, and deserving of the confidence of the profession and of the community. 
You are aware that up to the year 1844 legal enactments were in force in this State in regard to the practice of physic, and the power of licensing to engage in the active pursuits of our calling was conferred upon the State Medical Society, through county Censors, and upon chartered Medical Colleges. At the period indicated, the Legislature, whether wisely or not I do not now pretend to assert, abolished all legal restrictions, and virtually declared that any person might engage in the practice of medicine, and recover compensation for services rendered in the capacity of physician. 
Under these circumstances it became requisite for us to know who among us were in reality entitled, by education and knowledge, to be recognised as co-labourers and professional associates. 
The only apparent means for accomplishing this end was the organization of a voluntary Association, which, while it should possess the power to exclude those who were found professionally or morally disqualified, should throw no impediment in the way of the educated and the deserving. As was justly remarked by your eloquent first orator, the organization of this Academy was a "necessity arising from the condition of things in the profession." It, or some similar institution was absolutely requisite for our own protection and that of the public. 
There was nothing clandestine in our proceedings, 


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and there exists no evidence of a desire to interfere with or molest any party or sect. The call for the preliminary meetings which resulted in the establishment of the Academy, was published in all the city papers ; it was signed by the President of the County Medical Society, and by the eminent heads of the two Medical Colleges which were then in existence ; and it was addressed to all the regular members of the medical profession of the city and county of New York. You may remember what a general response was made to this call, and how numerously attended were these first meetings. The necessity of the case demanded prompt and united action. Old animosities were forgotten; and the most modest and retiring, with the humble and the eminent, assembled together, and resolved, with entire unanimity, that it was expedient and necessary to organize an Association. An impartial and numerous Committee was appointed to draft a Constitution, which was duly reported and deliberately adopted. What are the requirements of this Constitution ? Do its provisions contain anything that can be construed into an intention to form an exclusive or monopolizing Society ? Not one sentence or word. It declares, in the Second Article, that the objects of the Academy shall be, 
First —The cultivation and advancement of the Science of Medicine. 
Second —The promotion of the character and honour of the profession. And, 
Third —The elevation of the standard of medical education. 


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In the Charter granted you by the Legislature of the State, it is also expressly declared that the New York Academy of Medicine is incorporated for the purpose of promoting Medical Science by such means as shall (to its Members) appear expedient and proper. 
Such, then, being the explicitly defined objects of our Association, what are the conditions and requirements for Fellowship ? 
In Article Third of your Constitution it is provided that " Resident Fellows shall be regular practitioners of Medicine and Surgery in the city of New York and its vicinity, of at least two years' standing in the profession." They are, upon application, elected by a majority vote, by ballot, upon the recommendation of a committee, whose duty it is to examine their credentials and ascertain the fact of their being duly qualified for connexion with you. The sole pecuniary cost of admission is one dollar, as an initiation fee. Is there anything exclusive or oppressive in these provisions ? Are not some guarantees of proficiency requisite in the total absence of legal protection ? Or could any more mild or just course be pursued? During the six years of your existence as a Society, no single instance has occurred of an individual being refused admission to your ranks who had been duly recommended. 
That many have been deterred from applying to be received by you may doubtless be true; but it has been, except in a very few instances, because 


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they were aware that they could not be admitted among you, either on account of their not being qualified to comply with your conditions, or because they were unwilling to submit to the wholesome, just, and necessary restraints imposed by your By-Laws. 
The present opportunity seems to me, then, favourable for making the express declaration that we invite all our brethren, who are morally and medically qualified, to join our Association. We reject none who can comply with these requisites, and we say naught against those who are not connected with us. They can seek and obtain patronage without molestation from us. We do not think it allowable, however, for any honest physician to pursue a course of routine or exclusive method of prescribing. His treatment of disease must be regulated by circumstances, and be adapted to suit the peculiarities of each individual case. In the words of our Code of Ethics, which we have adopted in accordance with the recommendation of the National Medical Association, and which is now the guide of the entire profession throughout our country, we believe that " no one can be considered as a regular practitioner, or a fit associate in consultation, whose practice is based upon any exclusive dogma, to the rejection of the accumulated experience of the profession, and of the aids actually furnished by anatomy, physiology, pathology, and organic chemistry." We therefore prescribe no rules for regulating the practice of our members. 


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Their judgment and their conscience must decide their course in this respect. But while admitting and permitting the full and free exercise of their discretion in this particular, we will not tolerate in their conduct or course of action anything that may savour of fraud, imposture, or deception. Ours is a free and open science; the profession is liberal in every sense; the discoveries of its members are public property, and we avail ourselves immediately of every improvement that may be made, and which will aid us towards the accomplishment of the great object of our exertions—the amelioration and restoration of health, and the alleviation of suffering. We desire that our Members should be physicians in the broadest and fullest acceptation of the term; familiar with all that transpires in regard to the healing art, and availing themselves of every means to serve the public and their patients ; but scorning, for the sake of pecuniary profit or personal aggrandizement, to dishonour their calling and abuse the holy trust, the faithful discharge of the duties of which they have voluntarily assumed. 
Let it be distinctly understood, then, that at present the laws of this State afford to the public no guarantee as to the character and capability of practising physicians, and no protection from fraud— the field being open to all who may choose to assume the title. This Academy has been organized for the purposes already enumerated, and can embrace among its members none but such as are regularly educated and qualified to practise medicine 


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in all its several departments. We believe those who are admitted to the Association, after due investigation of their claims, to be entitled to public confidence and professional regard; when they shall prove themselves unworthy of either, their names will no longer be found enrolled among the Fellows of this Academy. 
The subject which I now propose to present for your consideration is the general relation of the Medical profession to the community at large. 
I will endeavour to examine, first, whether physicians as a body continue to be entitled to the public confidence and regard which have in all ages been bestowed upon them; and, secondly, whether such public confidence and regard are still manifested towards them. 
The claims of the regular Medical profession to the continued consideration and esteem of the community are so numerous and varied, that it will be impossible to present and illustrate more than a very few of them in the brief space of time which I am expected now to occupy. I shall therefore be able to dwell but little on any of them ; and to avoid wearying you with minute details, with which, as members of the fraternity, you are mostly familiar, I shall endeavour to render my remarks as concise as the proper elucidation of the subject will permit; avoiding also, as far as may be practicable, the use of technicalities and terms which cannot be supposed to be intelligible to the non-professional portion of 


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the audience, which has, at your invitation, assembled with you to commemorate your annual festival. 
One of the most striking proofs of the fact that the regular Medical profession continues to be justly entitled to confidence and encouragement, will be found in its constantly progressive advancement in improvement and discovery, the results of which are daily experienced by the public, which, however, owing to the nature of the case, cannot always afford them a proper estimate, or. be made immediately to comprehend their importance. 
Since the commencement of the second era in Medicine—that which succeeds to the dark age which followed the loss of most of the precepts and experience of the great Hippocrates and his followers, of the renowned School of Cos—there have been constant improvements and discoveries in Medical science. This remark is applicable, not to one alone, but to every department contingently or remotely connected with the healing art. 
In General and Comparative Anatomy our knowledge has been so extended, and rendered so clear and comprehensive, as to leave them at present but little short of a perfect science. The skill of our dissectors and naturalists, aided by the mighty reasoning powers and physiological knowledge of some among them, have developed and explained the most hidden and obscure secrets of anatomy, and taught us clearly the nature and uses of the several organs and tissues which combine to form the finished work of a created being. Very many of the 


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most important advances in the progress of anatomical and physiological discovery have been made by modern investigators ; and while the older labourers in the field have performed their work faithfully and well, it is to the zealous and successful exertions of the men of the last, and especially of the present century, that we are indebted for the positive knowledge which has been obtained, and which is at the present moment being widely extended, through the experiments and investigations which are simultaneously progressing in both hemispheres, more especially those of an anatomico-physiological character, relating to Neurology or study of the nerves, which promise results of the most surprising character, and of incalculable importance and value. 
The science of Materia Medica and the art of Pharmacy have been, and are still cultivated with untiring zeal and success. The almost daily discovery of new remedies, and the constant improvements in the method of preserving and preparing them, render these departments of increased value and importance, and entitle those through whose agency such satisfactory results have been accomplished, to be regarded as well worthy of distinction and praise. 
The modern discoveries and recent advances in Chemistry constitute one of the most remarkable evidences of progress and improvement that could be adduced. To it we are indebted for a minute understanding of the ingredients of many of the medicinal agents which we daily employ. Our knowledge of 


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poisons, their antidotes, and the means of detecting them, has been so extended by its agency, as to leave but little more to be desired in regard to them. It has not only aided us in procuring new agents, but has so separated and changed others as to have greatly increased our resources. To it we are also indebted for the use which is now so advantageously made of electricity, galvanism, and electro-magnetism. 
Its most brilliant triumphs for our profession, however, have been the detection and isolation of the active principles of medicines. It has thus enabled us to obtain the most powerful results through almost imperceptible agents ; and the infinitesimal system of practice has probably been a consequence of its discoveries : for while there is nothing out of the way or remarkable to the general mind in the effects produced by a grain of opium or a dose of laudanum, the imagination is lost in wonder at finding similar results obtained from apparently magical pellets scarce large enough to be seen, but which in reality contain the most potent anodyne and poisonous products which we possess. It not being generally known that the fractional part of a grain of some of the more active medicines—of morphine the eighth, and of some of the alkaloids as low as the fiftieth part — constitutes a full dose, to exceed which requires the greatest circumspection and caution j the effects sometimes obtained by those who use drugs only in their most concentrated form, appear to be marvellous, and engender unbounded faith in the skill and power of the prescriber; a faith founded, however, 


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as is almost invariably the case, upon the general ignorance of those who recklessly submit to imposture in the name of progress, and who could scarcely be expected to know the necessity for discrimination in the use of drugs, or to understand that the active essence of a medicine cannot, either with safety or benefit, be always substituted for the same article in some other and perhaps grosser form. Although quinine has superseded, to a great extent, the use of bark in substance, we all know that it not unfrequently happens that some of our most satisfactory cures are obtained through the agency of the latter, when the former has failed to produce the desired and expected result. 
Chemistry, then, advances pari passu with other branches of Medical science ; its votaries are still indefatigable in their exertions, and their discoveries and improvements follow one another in rapid succession. 
In the department of Obstetrics the results of vast experience and the accumulation of an immense amount of statistics, have enabled us to direct our course with the greatest possible degree of precision and safety. Progress in this branch of our science, has demonstrated the fact that the use of instruments and the performance of painful and critical operations, are in reality but rarely necessary; and that, with the lights afforded us through the investigations of modern obstetricians, we are enabled to surmount, by simple and harmless means, most of the inconveniences and dangers attending the accomplishment of 


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a natural process which, however, the excess of refinement —a consequence, perhaps, of the advancement of civilization and of luxury—too often renders complicated and hazardous. Figures on a large scale fully establish the fact that very great progress has been made in the practice as well as in the theory of Obstetrics, and in confirmation of the assertions now made, I will state, that I have collected the particulars of more than ninety thousand cases, embracing two periods. The first series comprises 47,116, occurring between the years 1800 and 1825, in which instruments were used 430 times, or about once in one hundred. The second series is composed of 43,256, occurring subsequently to 1825, and in these instruments were resorted to only 252 times, or about once in two hundred. * 
The art of Diagnosis has been brought by modern discoveries to a rare degree of perfection. The invention of the Stethoscope and Speculum has enabled us to detect with positive certainty, thoracic and other diseases, the exact seat and character of which had, to say the least, been previously only imperfectly understood. 
The indications, too, furnished by extensive post mortem investigations, under the influence of an enlightened pathology, with close and extensive observation, and seconded by the application of the microscope to assist minute researches—contribute largely to aid us in the important task of discriminating between diseases ; so that many of those which were but a few years since obscure find ill defined, 


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are now as easily and certainly recognised, as though they were manifested directly to the eye. Surely, these facts justify the assertion, that great advance has been made in the study and knowledge of the means whereby to detect their seat, and establish the nature of diseases. 
In the Practice of Medicine and the success of medical treatment, the manifestations of progress are most numerous and encouraging. In many instances, positive rules have been laid down and established, which generally produce a uniform and happy result. 
Intermittent Fevers, which were during so long a period the bane and a reproach to medicine, are now made to yield to judicious treatment, as readily as the most ordinary and simple maladies. Not one alone, but numerous remedies for this formidable and common complaint, have been discovered and placed at the disposition of the practitioner ; and yet, a new one is at this moment being experimented with, and gives satisfactory promises of usefulness. 
Owing to extensive researches as to its causes and mode of prevention, Scurvy, which was formerly so fatal, and so seriously dreaded by mariners in particular, and about which so much anxiety was manifested, and such great interest excited, as to lead to the publication of dozens of volumes by non-professional as well as professional writers; Scurvy, which was only so lately as the last quarter of a century, so fatal as to more than decimate those whom it attacked, is now so rarely met with as scarcely to have been seen by many, even experienced, among 


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junior physicians. Scorbutic diseases have been almost wholly annihilated, and when met with, they are readily resisted and soon vanquished by the means with which we are now prepared to overcome them. 
One of the greatest blessings ever conferred upon mankind, is the modern treatment of Insanity, including all the varieties of mental alienation. 
The substitution of the moral and rational treatment of mania, for the harsh and brutal system which was in vogue even so lately as the first quarter of the present century, has not only divested this awful affliction of the horrors which formerly accompanied and appeared to be inseparable from it, but has produced curative results to an extent heretofore deemed unattainable. It is not in vain that splendid palaces in Europe and in this country, with their elegant surroundings and the necessary accompaniments for the modern treatment of insanity, have been erected to supply the places of dark jails and dungeons, with their accompaniments of gloom, filth, starvation, and the scourge. No outlays or extravagance can be considered superfluous, when they facilitate the accomplishment of such results as the statistics, and percentage of cure in modern lunatic asylums will present. 
The philanthropist will—while contemplating these fruits of improvement and wandering among the insane of our day, who without apparent restraint accompany him in his visit to their temporary home, and converse freely and gaily on general topics, with 
2 


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happy countenances and cheerful hearts—devoutly and in wonder, return thanks to the great Giver of all good, and exclaim with heartfelt joy, that his mission, here at least, is accomplished. While he thus congratulates himself and invokes the blessing of God on mankind, for the accomplishment of such mighty and beneficent results, we think of the agency through which the Almighty has thus manifested his benevolence, and silently, but with pride, point to the tableau suspended by order of the French government over the President's chair in our sister Academy of Paris. It represents Pinel in the act of striking their fetters from the insane at Bicetre; a modest but fitting testimonial to the great originator of the modern moral treatment of madness, and to the profession and institution of which he was so honoured a member. 
But this advance in the treatment of positive insanity is not all that has been done by our profession for mental difficulties. Even the results of defective innervation and mental development as manifested in idiotcy, are claiming the deep study and close observation of many eminent men. Their efforts have been seconded abroad by philanthropic governments, and in this country, our own State and that of Massachusetts are foremost in contributing legislative aid. Encouraging progress has been already made, which affords fair prospect of eventual success. Let the efforts of our colleagues who are engaged in this good work, be encouraged by our fervent aspirations for their final triumph. 


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DISCOURSE. 
Another striking manifestation of progress in the department of practical medicine, will be found in the results of treatment in Small-pox. 
This disease, which was formerly a scourge to our race more dreaded probably than any other, not even excepting Cholera, and whose direful effects were experienced to the extent of almost depopulating whole communities, has, through the influence of the discovery of vaccination and improvements in the method of treatment, been deprived of most of its terrors, and rendered as facile of management as are most other complaints. 
The introduction of Vaccination is a subject of such general interest, and its beneficial effects are so universally known and appreciated, that it is useless to dwell further upon it at this time than to ask you to bear in mind the source whence this improvement was obtained, and the agency through which it was promulgated. 
Passing by then, this, the greatest discovery in medicine during the last century, permit me to indicate some of the results obtained by the present improved method of treating the original complaint, which vaccination, it was hoped, would exterminate ; but which, owing to the neglect of this precaution, and of re-vaccination, with other causes, unfortunately still exists, and is very frequently met with in its most loathsome and complicated varieties. 
Prior to the year 1798 —the period at which the discovery of Vaccine inoculation was announced by the immortal Jenner, and for many years subse- 


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quently, the mortality from genuine Small-pox was rarely less than fifty, and often exceeded seventy-five per cent. Even long after the advantages of the new prophylactic had been indicated and fully established, and general resort been had to its protection, the proportion of deaths in cases of the original disease remained frightfully great. Hence the utmost alarm and confusion prevailed wherever it manifested itself, and recourse was had to the most painfully strict quarantine and sanitary regulations for the protection of the community; while the poor sufferers from the disease were forced to encounter such hardships and privations, owing to the personal fear of those who ministered to their small comforts, and an erroneous system of treatment, that it is truly surprising that any recoveries should be recorded among them. As contrasted with such a state of things, what is the condition of those afflicted with Variola at the present day ? Surrounded by every comfort and suitable luxury, both in private and in our public institutions, they are humanely and kindly tended, and subjected to such a course of medical treatment as produces the result of a mortality scarcely greater than in many mild and non-contagious diseases. The percentage of deaths from Small-pox, at this time, is reduced, in public hospitals even, where it must almost necessarily be greater than in private practice, to an average of less than fifteen per cent.! Such, at least, is shown to be the case by the experience of the last ten years at the London Small-pox Hospital, where more than five thousand cases were admitted 


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during the time specified; and at some of our own establishments devoted to the accommodation of variolous patients, the returns furnish even a more favourable exhibit; nine, ten, and twelve per cent., being the proportion of deaths in many hundreds of cases treated. 
Besides those alluded to, very many other diseases have been so closely studied and observed of late years, that the management of them is now comparatively easy, and the mortality from them most obviously diminished. The dread Yellow Fever, even, is now considered by our most eminent southern colleagues who are periodically brought into contact with it, as capable of being subdued with comparative ease when timely recourse is had to recognised and appropriate means. Progress is likewise constantly made in the study of the all-important subject of public health, and the measures requisite for the prevention of disease. The pathology and treatment of many still obnoxious maladies, including Typhus Fever, Scarlatina, Asiatic Cholera, Cholera Infantum, and Croup, are being closely scrutinized and examined into. Some of those named, have, you are aware, recently been the subject of anxious, and, let us hope, profitable discussion in this Academy. 
Our knowledge of the laws of Contagion and Infection is widely extended, and while it does not justify the placing of patients labouring under Small-pox side by side with those suffering from mild diseases, as is now habitually done in some Foreign hospitals, 


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it has shown that the dangers of indirect and even of immediate contact, have been greatly exaggerated. 
If advance has been made in the knowledge and treatment of Medical diseases, the progress of Surgery has been equally great, and the votaries of this branch of our science have earned the lasting gratitude of mankind for the immense blessings which they have conferred upon the race. 
Among the more directly manifest of surgical improvements are the present mechanical and operative processes for remedying deformities, many of which were, until a very recent period, considered as beyond the reach of our art. 
The whole science of Orthopedy is comparatively new ; and yet within the brief space of a few years it has performed the most wonderful achievements, and attained to a degree of surprising accuracy and certainty. Club-foot, spinal deviations, strabismus, torticollis, and numerous other deformities resulting from muscular and tendinous contractions, as well congenital as those arising from burns and other accidental causes, are now partially or wholly remedied, and with comparative ease, by the numerous means which are placed at the disposal of the enterprising surgeon. Improvements in instruments and in the method of operating have enabled us to overcome difficulties and simplify processes to so great an extent as to have caused the unfounded assertion, by those unacquainted with the subject, that surgery is now only a mechanical art. 
The process of Lithotripsy, or crushing of calculi, 


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for the invention and establishment of which we are indebted to the experiments and researches of three eminent French surgeons —all of whom, fortunately, still live to adorn their profession—is a mighty triumph in the department of operative surgery, and is justly entitled to be regarded as the surgical discovery of the age. To enable us to realize its value, we must recollect the painful and dangerous operations which had previously been in exclusive use, and the mortality attending which was, in olden times, most disastrous. By the improved method there is but little pain, and so small a proportion of deaths—as manifested by the vast experience of one alone of the gentlemen alluded to, which embraces more than nine hundred cases —as not to exceed from six to eight per cent. 
Let me trust that you will not construe what is here said in regard to this, my favourite operation, as evincing a disposition to disparage other means for accomplishing the same end, or deem me backward in admitting the great progress which has also been made in that which it was intended and expected to supersede. I am well aware of the great advantages of Lithotomy in certain cases, and of the improvements which have been made in the several methods of operating with the knife, which afford most satisfactory, and in the case of one of our Western surgeons, certainly unparalleled and truly astonishing results. This is neither the time nor the occasion for discussing the relative advantages and value of the two operations, and, for the present, I merely 


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allude to Lithotripsy as furnishing one of the most prominent and conclusive evidences of the advance which is being made in surgery. 
The application of the operation of Laryngotomy to certain conditions in croup; the improved and simplified methods of treating fractures ; the several operations of Autoplasty, and the skill of the modern surgeon in forming entirely new organs or remedying defects in those which have been disfigured or impaired by disease or accident; together with the bold and elegant operations of ligature of the arteries for aneurism and in other cases—for which we are greatly indebted to American and New York surgeons—constitute some of the innovations and improvements in surgery, upon which I should take great pleasure in dwelling did time permit and the occasion warrant. Enough has been said, however, to illustrate the fact that surgery is by no means backward in its advances towards perfection. 
v The introduction of the use of Anaesthesia is too important an improvement—particularly as it is purely an American discovery—for me to omit its mention in this connexion. The effects of these agents, however, are now so generally known, and their value so universally acknowledged, that it would be useless and unnecessary for me to detain you with remarks on the subject, which would only be superfluous. 
Let it be known, however, that in bestowing this boon alone, America has repaid a heavy instalment of the debt which she owes the world for benefits 


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conferred through the discoveries of science in other countries. 
I have now indicated a few of the most striking and important discoveries and improvements which have been made at recent periods in the several departments of medicine to which I have alluded; and although the task has been briefly and very imperfectly performed, enough has been shown, it is hoped, to refute the assertions that are sometimes made, to the effect that the regular Faculty of the present day is behind the age; wedded to old doctrines ; slow in its advances ; and disposed arbitrarily to reject the lights furnished by modern experiment and investigation. How manifestly unjust and unfair are these and similar declarations, when it is borne in mind that very many, if not most, general scientific discoveries are the result of the labors of those who have been educated in medicine. Every one of those to which I have directed your attention this evening has been accomplished and perfected by regular physicians. Irregulars, or those who view the profession as a money-making trade, and practise the art of deception rather than that of physic, have yet to manifest their claims to consideration by one single discovery or improvement that has withstood the test of experience and truth. 
The question might be asked, however, that, supposing the exertions of the profession and the accomplishment of the discoveries alluded to, to be admitted, where is the evidence of their not being innova- 


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tions merely ? and what proof can be adduced to show that positive results have been obtained by them illustrating their beneficial influence in prolonging life, and thus benefiting humanity ? Should such a query be propounded, we may triumphantly exhibit the certain evidences furnished by statistics, and other proofs also. 
Besides the figures already referred to in speaking of obstetrics, small-pox, and lithotripsy, we have the testimony of several learned men at home and abroad, and particularly that of a celebrated divine of Geneva, in Switzerland, who has devoted much time and attention to the subject of general statistics as connected with longevity in different parts of the civilized world; and this gentleman shows most conclusively that the duration of human life has been materially prolonged during the last fifty years. He also attributes the result mainly to the improvements and discoveries in medical science. 
An eminent professor of our own country has also, on the occasion of a recent lecture before the Mechanics' Institute of Cincinnati, made the following remarks in regard to the increased average duration of life, which he admits to be owing, in part at least, to the progress of medical science. He says, " that in the latter part of the sixteenth century, one half of all that were born, died under five years of age, and the average longevity of the whole population was but eighteen years. In the seventeenth century, one half of the population died under twelve. But in the first sixty years of the eighteenth century 


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one half of the population lived over twenty-seven years. In the latter forty years, one half exceeded thirty-two years of age. At the beginning of the present century, one half exceeded forty years; and from 1838 to 1845 one half exceeded forty-three. The average longevity of these successive periods has been increased from 18 years in the sixteenth century up to 43.7 by our last reports." 
" Applied to this country, such an improvement as is here exhibited would, from the year 1600 to 1845, make a variation in our bills of mortality of more that half a million, or 1,500 deaths daily !" 
In addition to this important testimony, allow me to present the following table, which has been prepared with great care. It illustrates the progressive decrease in the per centage of mortality during a period of twenty-four years, in one of the largest and best conducted general hospitals of the world— the Hotel Dieu of Paris. Antecedent to the great French Revolution, the records of this institution, which then was, as it still is, the great receptacle for the sick poor of Paris, show that the number of deaths fo cases treated was as one in three-anda-half, or nearly thirty per cent. In the year 1816, the period when the above table commences, they were reduced to one in four-and-a-half; and the diminution of mortality is progressive to 1840, up to which time the tabular returns are completed ; and in that and the six years immediately preceding, it had not exceeded one in nine. Or, in other words, it had been brought down from twentyfive and thirty to about eleven per cent. 


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TABLE SHOWING THE NUMBER OP PATIENTS, DURATION OP TREATMENT, AND MORTALITY, AT THE HOTEL-DIEU OF PARIS, FROM THE YEAR 1816 TO 1840, INCLUSIVE. 
Number of Mean time of Proportion of Deaths Years. Admissions. Treatment in to Admissions. Remarks, days. 1816 7,090 40. 1 in 4.47 1817 7,276 40. 1 " 4.42 1818 7,117 36.25 1 " 5.35 1819 8,796 29.25 1 " 6.07 1820 10,248 26.54 1 " 6.50 1821 11,163 26.06 1 " 7.10 1822 10,689 25.23 1 " 6.82 1823 11,383 26.96 1 " 6.54 1824 11,170 28.50 1 « 7.11 1825 12,583 23.73 1 « 6.95 1826 11,530 26.01 1 « 6.81 1827 11,485 23.56 1 " 6.88 1828 17,861 21.29 1 " 6.89 1829 13,649 24.16 1 « 6.33 1830 14,320 23.36 1 " 6.87 1831 14,559 24.01 1 " 8.53 1832 15,357 18.37 1 « 5.12 Cholera. 1833 16,992 19.60 1 " 9.96 1834 17,753 19.20 1 " 11.03 1835 17,429 19.20 1 " 10.14 1836 17,289 17.43 1 " 9.35 1837 17,980 17.55 1 " 8.93 Influenza. 1838 17,467 19.64 1 " 9.12 1839 17,583 18.06 1 " 9.08 1840 11,130 17.61 1 " 9.13 Being rebuilt. 
This same table shows likewise that while the proportion of deaths has been thus diminished nearly two thirds, the duration of treatment, or the time required for effecting a cure, has been abridged just one half; forty days being the average time in 1816, and less than twenty days in 1838. I regret that I have been unable to obtain such 


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positive information in detail from the records of our own hospitals as will permit the verification by figures, of the fact of like results having been obtained in this country; enough has been gleaned, however, from their registers to justify the assertion that in none of them has the extent of mortality equalled that of the early periods of the French hospital, and that there has been everywhere, in our institutions, a most satisfactory and progressive diminution in the ratio both of time and of deaths. 
One more evidence that the duration of human life has been much prolonged in latter years, and its value greatly enhanced, and I have done with this subject. The fact may be demonstrated from the course of action of financiers and the money-making men of the day, whose proverbial sagacity and thorough acquaintance with all that relates to pecuniary interest, are generally admitted, and is fully illustrated in their connexion with the subject of life insurance. 
When those useful and profitable institutions—life insurance companies—were first established, the then average duration of human life was such as to require a heavy percentage in the shape of premium and initiation fee to render them at all productive as investments for money. 
The first organized was the "Amicable," which commenced business in 1706. The charge for admission into this Society was seven per cent., with an annual premium of five per cent, on the amount for which the life might be insured—and it failed ! 


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As compared with these terms, what are tho?e now required ? There is no entrance-money demanded by any of the institutions of the present day, —as far at least as my knowledge extends—and the annual premium varies from one to five per cent., according to the age or other circumstances connected with the insured. Or, in other words, in the year 1706, to procure the payment of one thousand dollars on the death of a party, it was necessary to contribute seventy dollars for initiation, and fifty dollars thereafter annually; while now, an individual at the age of twenty-five years secures to his family at his death the benefit of one thousand dollars, by contributing yearly the small sum of eighteen dollars and fifty cents, or less than two per cent. 
Even at these present moderate rates, the profits of the business of life insurance, the calculations of which have been reduced almost to a science, are so satisfactory as to have induced the establishment of as many as forty-two companies in the United States alone; and thirty-six of these have been organized within the last ten years. 
Are not the evidences already adduced, sufficient to justify the position which I take, viz. that the regular Medical profession of the present day is entitled to the confidence and regard of the general public? But ample as they are deemed to be, they by no means constitute our only claims to such high consideration. The benevolence, high sense of honour, charity, and general morality of medical men, evince 


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yet more strongly that they are entitled to public regard. 
Most of our charitable institutions are attended by them gratuitously, and their skill is at all times cheerfully and freely bestowed upon the suffering poor. They are foremost in promoting literature and the interests of society, and make larger pecuniary contributions for public and charitable purposes in proportion to their means, than any other class of the community, a striking instance of which has just occurred in the donation, by one of our colleagues, of ten thousand dollars from a moderate fortune, to aid in establishing a new hospital in this city, while the directors and originators of the institution, the reputed means of each one of whom greatly exceed his own, have scarcely contributed as many hundreds! 
Regular physicians voluntarily organize and attend personally, at great pecuniary sacrifice and inconvenience, the meetings of numerous scientific associations, the benefits to be derived from which do not accrue to them alone, but to society at large. They are the depositaries of confidence, and have intrusted to their keeping secrets, such as are never told even at the confessional, and which not unfrequently involve the happiness and honour of individuals and families. They are steadfast and honourable to an extent, as never to be known to betray the secrets of those whose trust is reposed in them; at least, if such instances have occurred, we have yet to learn them; and I am confident in the prediction, that there 


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is not one in this Association who would not willingly and unhesitatingly encounter the humiliation and indignity of imprisonment, to which one of our colleagues in France has been subjected for refusing to disclose information obtained in a professional capacity. And you would be justified in your course by the same enlightened public opinion which encouraged him with its approval, and finally secured his triumphant vindication and release by the highest legal tribunal known in his country. 
The morality of the profession, and the observance by its members, of law and the obligations imposed by society, are established facts—never to be boasted of—but which it may be allowable to allude to, as an evidence of their claims upon public confidence; especially, when it is manifested to the extent stated on a recent occasion by an eloquent professor, who produced a criminal calendar, which showed that in a period of eighteen years, only two physicians had been found implicated in crime; while by the same records, it appeared that there were in the same community four priests and lawyers annually found guilty of grave offences ! 
Let us not vaunt this circumstance, however; for it should be a cause of deep mortification, that even a single member of our regular corps should be ever forgetful of honour and duty. 
I now conclude this branch of my subject. You will have perceived that, in the course of my remarks, I have generally abstained from mentioning the names of those to whom we are indebted for the dis- 


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coveries and improvements, which have been so inadequately portrayed. The list would be too long if it included the moiety of those entitled to notice, and when full justice cannot be done to all, it has been deemed better to avoid what might be considered as invidious, and trust to a general acknowledgment of our obligations. 
Let it not be supposed, however, that when the list of modern benefactors to our science shall be completed, the titles of members of this Academy will be omitted ; the names of many of them will be entitled to the first mention in any catalogue that may be furnished of those to whose exertions our profession and mankind are indebted for the increased benefits of knowledge and health which they enjoy. 
Let us now briefly consider whether the public confidence and regard to which we deem our profession entitled, are in reality manifested towards it. 
One of the strongest proofs that the regular Medical profession does at the present time possess the esteem and confidence of the community, is that derived from the fact of its members being almost invariably selected to occupy places of trust and responsibility of a medical character. This is done to the almost entire exclusion of irregular pretenders. The public mind is healthy in this respect; and although individuals may, and doubtless do, often give countenance to and employ charlatans temporarily in their own cases, or those of their immediate family, these same persons almost invariably, when 
3 


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acting in a public or corporate capacity, select from the ranks of the regular profession only, those who are to receive appointments at their hands. 
In a medical population of more than twenty-two thousand in France, there are estimated to be six thousand employed in the very numerous hospitals, alms-houses, asylums, dispensaries, and other charitable institutions, and there is not one among them, as far as is known, who does not belong to the regular and orthodox school—that school whose precepts are founded on the results of " observation, experiment, and accumulated experience." None others than such as are in all respects competent and regular, are permitted to give instruction in any of the French medical schools; and none others are ever admitted into the professional and scientific corps of their army and navy! 
The same statement may be made in regard to Great Britain and Ireland, except that it is rumoured that in London an hospital has been recent y organized, the non-medical managers of which have assumed the heavy and unenviable responsibility of directing what course of medical treatment shall be pursued by their officers; an innovation, the result of which, if persisted in, will be soon manifested in the abandonment of their wards by those who may be induced to enter them; for it is a well established fact, known to each of us, that of all classes of persons, those for whose ostensible benefit such an institution as the one alluded to, is founded, viz. the poor sick, they are most exacting in their demand 


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for skilful and regular medical treatment. Poverty seems to render their powers of perception and discrimination more acute, in this particular at least; and hence they rarely, if ever, voluntarily submit to treatment from any but such as are known to be of established reputation and skill. Our daily experience teaches us that the poor are not the patrons of quackery. It must be admitted, however, as a reason for this, in addition to their own disinclination to employ them, that the exertions of charlatans to secure poor patients are by no means as great as are their endeavours to propitiate the rich. 
I have been at some pains to ascertain if the confidence of the community, in this country, is as extensively manifested towards the regular profession in this respect as abroad ; and the result of my inquiries has been the establishment of the fact, that in a number exceeding six hundred physicians, employed in ministering to the sick in public and charitable institutions of a respectable character, in the cities of New York, Philadelphia, Boston, Baltimore, Richmond, Charleston, and New Orleans, scarcely one single individual has been elected who is not an honourable member of the regular faculty. Let this fact speak for itself; and let it also be borne in mind, that in all our army and navy medical staff, constituting a body of physicians whose high sense of honour, bravery, and acknowledged scientific attainments are proverbial, there is not one who may not be regarded as an ornament to his calling, and not only regular in his practice, but scrupulously punctilious in his observ- 


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ance of the rules of ethics. In our public service at least, there is no foothold for empiricism; the tests of attainment are so rigid and so rigidly enforced, that they afford a sure and certain guarantee of proficiency and capability. 
Another evidence that the regular members of our profession enjoy the confidence of the public, is derived from the fact of their being invariably looked up to and consulted in times of threatened danger from pestilence. The medical advisers of the authorities are, in such cases, uniformly selected from among those who belong to the recognised faculty; and, heretofore at least, care has been taken to choose, even from them, only such as enjoyed in an eminent degree the respect and confidence of their colleagues. Even political predilections and prejudices, the strongest known in our country, are in such cases made to yield to the public good ; and the voice of public opinion has, in this respect at least, forced party ties and party connexions to be laid aside by those by whom, in most other instances, they are habitually disregarded. In times of danger all other considerations are made to yield to the general welfare : and as, in war or invasion, the public will demands that only those acknowledged to be brave and skilful shall be selected as leaders and commanders; so in times of danger from epidemics and the approach of pestilence, the public confidence centres only in those known to be able, and capable to encounter the difficulty. 
The homage generally and voluntarily rendered to 


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our science and its regular votaries by the great and the good, is yet another proof of public confidence. Tributes to our calling and to those who honestly and honourably pursue it are being daily proffered. 
In secular journals of a respectable character, and even in some of those the directors of which would seem at times to take pleasure in ridiculing and attempting to defame the profession, we often find just and complimentary notices of us, both collectively and individually. One of these, no later than a few days since, in giving an account of a most valuable and useful institution, concludes its notice thus:— 
" I cannot close without expressing my respect and esteem for the physicians whom I have had the pleasure of meeting in the Prison- Hospital ; earnest, Christian men, who deal kindly with the outcasts thrown under their care, and who acknowledge and act under the duty of ministering to the minds as well as the bodies of these miserable women. Of all persons, the one most capable of influencing the heart of an abandoned man or woman is the physician. With him religious words are not professional. The sick one generally confides in him, depends on him ; and he can adapt his influence to the state of the body, as no other can." 
To this notice may also be appended the following appropriate extract from an editorial of one of the most extensively circulated general newspapers j 
" It has been complained of us, that in common with other journals, we are in the habit of ridiculing the Medical profession, and endeavouring to bring it into disrepute. We disavow any such intention, and think that the playful remarks occasionally made by the press, are misconstrued or too harshly judged. The fact is, that 


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our medical friends are too sensitive, and forget that the same com plaints might be made against us by lawyers, and even clergymen, the former of whom we never spare ; the difference is that they seem to enjoy abuse, and thrive upon the notoriety which we give them. Seriously speaking, we are the warm friends of the regular medical profession; we employ none others ; and we despise quackery as heartily as they can do. "We would further their views by all legitimate means, but then we must have our joke even if the subject be their foibles." 
Of the favourable opinion entertained of medical men by the more discerning and eminent of our brethren of the law, who constitute so distinguished and influential a portion of the community, we have repeated proofs:— 
" I have," says one of the most learned among them, " always observed that the evidence furnished in our courts of justice by well educated members of the regular medical profession, is of the most valuable kind, and always entirely reliable. It is not only with questions pertaining to their own science that they appear to be familiar, but they are apparently well versed in all subjects of general interest, and with few exceptions, give their testimony in so clear, comprehensive, and concise a style, that I experience a real pleasure in listening to their replies. I can in a moment detect the real from the pretended physician; and never examine or cross-question one of the true stamp without deriving both gratification and instruction." 
As an instance of the flattering estimation in which medical men and their science are held by the highest authorities of our country, I would refer you to the beautiful and complimentary tribute paid them by the last able and accomplished Governor of this State, in his annual Message to the Legislature of 1850. 


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39 
Some of the sweetest and most Christian poets have eulogized us and our profession in a manner to afford the sure guarantee that they believed and felt what they wrote, and that we are honoured with their sympathy and esteem :— 
" Next, to a graver tribe we turn our view, And yield the praise to worth and science due; But this with serious words and sober style, For these are friends with whom we seldom smile; Helpers of men, they're called, and we confess Theirs the deep study, theirs the lucky guess. We own that numbers join with care and skill, A temperate judgment, a devoted will; 
Men who suppress their feelings, but who feel The painful sj'mptoms they delight to heal; Patient in all their trials, the) 7 sustain j The starts of passion, the reproach of pain ; With hearts affected, but with looks serene, Intent they wait through all the solemn scene ; Glad if a hope should rise from nature's strife, To aid their skill and save the lingering life ; But this must virtue's generous effort be, And spring from nobler motives than a fee ; To the physicians of the soul, and these, Turn the distressed for safety, hope, and ease." 
Those, however, from whom we receive the most valued testimonials of affectionate countenance and brotherly esteem are orthodox clergymen. Not the illiberal and ignorant sectarian preachers who unfortunately abound in our land, and who by example, if not by precept, frequently occasion greater injury to the cause of true religion than can be well esti- 


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mated. Such as these are, if not the avowed, certainly the open supporters of many varieties of imposture, and very frequently the willing—perhaps paid—agents of those who secure their secret services and published certificates in favour of nostrums and " cure-alls," of every variety and species. Such men as use the influence of a holy position to aid in the propagation of fraud, are known to be the enemies of our profession, and the abettors of quackery in all its Protean forms. 
It is not to such as these that I allude; but to the truly religious ministers of all denominations, of established sanctity and unwavering faith in the doctrines which they practise as well as preach. The approval and continued regard of these latter are constantly manifested towards us, and we may well feel proud of it. 
The close affinity in the nature and objects of our callings, and the constantly repeated opportunities that are afforded them for observation in the sick chamber, and in intimate private relations, render them fit and capable judges as to what extent we are entitled to the good will of the community; themselves educated and accomplished in various learning, they understand and can appreciate the claims of physicians; and I repeat, that we almost invariably find able coadjutors and Christian brothers in refined and educated preachers of established orthodoxy. The commendation of such is indeed a rich reward for our exertions; as a manifestation of public confidence, it is invaluable. 


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If other evidences of public regard and esteem towards the regular Medical profession be necessary, I might perhaps be permitted to cite in illustration, the attendance of the present audience, whose assembling here is a proof of the interest, at least, which is taken in your proceedings; and as a yet more striking manifestation of the same sentiment, I would recall to your minds the circumstances attending your first Anniversary Meeting, when the then most capacious building in our city was inadequate for the accommodation of the thousands who convened, at your invitation, to listen to the eloquent discourse of the finished scholar and popular physician, whom your wise discernment had selected to be the exponent of your views. The events of that occasion form an epoch in our local annals, and refute conclusively the oft repeated assertion that our citizens are indifferent in matters regarding your profession. 
As a final proof in support of the position which has been assumed, I may be allowed to allude to the social standing of physicians in the several localities in which they are domiciled. 
Everywhere throughout our wide-spread country, and particularly in small communities, they are accorded the highest place in society, and hold rank in the estimation of their fellow-citizens as those whom they delight to reverence and honour. Their society is eagerly sought, and their presence is always welcome. They are consulted upon all matters of general local interest; and their counsel, with 


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that of the clergyman, regulates, very generally, the action of the poorer classes, who are accustomed to appeal to them for aid and advice in all their difficulties and trials. Contrast this high social position, so willingly yielded to the conscientious and educated regular physician as his right, with the low estimation in which irregular pretenders are held, even by those who do occasionally seek relief from their specious promises. In their case no social equality is admitted; they are never met with or countenanced in the society of the refined and educated; and even the menials who attend upon them consider that they are temporarily engaged in the service of those whose social position is in reality inferior to their own. 
I assert most emphatically, and without fear of contradiction, that with us, irregular practitioners of medicine are wholly excluded from general and refined society; and I cite the fact as a convincing proof of the discernment of the public, and of the inferior estimation in which they are held. 
Let us then give no credence to the assertion that is so frequently made, with the vain hope of establishing faith for the declaration, that the confidence of the public has been withdrawn from the regular faculty and bestowed elsewhere. I am firmly convinced, that at no period in the history of our science have its votaries been more deserving of public regard; and I am equally sincere in the belief that they stand, collectively and individually, as high, if not higher, in the estimation of the community, than they ever have done. 


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We must not put a harsh construction upon the action of the comparatively few individuals who encourage and promote, without being able to estimate, what they are pleased te call new and improved systems of medical treatment. There is not one person in a hundred of our population who does not, in all serious cases of illness, have recourse to you or your colleagues of the regular faculty. It is true that your counsel is often sought at too late a period, and after injudicious treatment has so impaired the constitution as to render your success uncertain, and your exertions often unavailing to save life ; but the fact of your being summoned, even at the eleventh hour, and when too late, is a triumphant vindication of the confidence that is reposed in you. 
We must recollect that quackery has prevailed in all ages, often much more extensively than it now does; and that the number of those who at present countenance it, even in our city, which has generally been considered its stronghold, is very small and daily diminishing. Charity, too, should induce us to make great allowances for those who are led astray. The infirmity of human nature is great, and even the educated cannot always resist such appeals and promises as are made to them; they too, not we, must pay the penalty of the errors into which they are led. The knowledge which we derive from the study and practice of our profession, gives us an insight into the workings of the human mind, and should teach us that, — 


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" From powerful causes spring th' empiric's gains; Man's love of life, his weakness and his pains; That love of life, which in our nature rules, To vile impostures makes us dupes and tools. Suffering compels th' impatient soul to seize On promised hopes of instantaneous ease. To pain, to fear, to terror their appeal,— To those, who weakly reasoning, strongly feel." 
In conclusion, let me congratulate you, fellowmembers, on the recurrence of this your Anniversary, and upon the continued prosperity of the Academy. Your numbers are daily increasing, and most of the few who at first held aloof, are, I am happy to say, now anxious to unite with you. Your career of usefulness is fairly commenced ; and your exertions for the general weal, and for the promotion of science and the public health, are duly appreciated. Your counsel is sought by our Municipal authorities; and your proceedings, when published, attract the anxious attention, not of the profession alone, but of the whole thinking community. You have already achieved great good, but much yet remains for you to accomplish. The scientific discussions which now constitute the most interesting feature of your ordinary meetings, evince the fact that you have among you ample material wherewith to contribute your quota towards the advancement of knowledge and the perfection of our science. 
The first published volume of your " Transactions " has been extensively and favourably noticed at home and abroad ; and the wish is anxiously expressed 


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that a successor of equal merit may soon be produced. All then that is necessary to insure lasting success and abiding prosperity, is that we shall continue zealous in our exertions and indissolubly united. That cordial union which is so indispensable to our national existence, is equally essential to the success and welfare of the regular medical profession. Without it we are powerless and insignificant; but when united, what power and influence may we not exert, when our efforts are directed, as I trust they always will be, to the accomplishment of a general good ? 
Let us continue the wise policy of keeping our Academy, as an institution, sacred from the invasion of politics. In our individual capacities, we are bound, in common with all other good citizens, to aid in promoting such political principles and measures as our judgments may lead us to approve ; and instances may and do occur, when it is not only a right, but a duty, for our whole profession to speak and be heard in its collective capacity; but in this Society, let us, as we hope for prosperity, banish from our hall, always and for ever, so prolific a cause of dissension, the introduction of which I should regard as the signal of our downfall and dissolution. Our main object is the promotion of science. The hopes of the profession here are centred in this Academy ; as it prospers so will our science flourish; let this bulwark be shattered, and the present harmonious elements are again scattered and divided, with but small prospect of their ever being reunited. I 


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have said that the hopes of the profession in this locality are centred in this Academy. In like manner, the hopes of us all dwell in the progress and prosperity of our great National Association. This noble institution holds its next annual meeting in our metropolis. Subjects of grave importance, and of deep and probably exciting interest, will be discussed. Upon us will devolve the responsibility of whatever action may be then had ; for, under the present system of representation in the Association, we of this and the immediately neighbouring States will possess a large preponderating influence. Let us therefore consider calmly and seriously the course that we shall pursue ; and, above all things, let us remember that in what we do, we act for the good of the whole profession throughout our country—neither for the benefit of any particular portion, nor to the unnecessary detriment of any class. Where the general interests of the whole body are at stake, let us look to it that they be not sacrificed or impaired through any agency of ours. 
It is unnecessary to bespeak your hospitable attention to those of our colleagues from a distance, who will on that occasion be your guests. Whatever difference of opinion may exist in regard to such measures as will be proposed in association, the regular faculty of this city will unite to a man in extending the hand of friendship and according a brotherly welcome to all who may be delegated to assemble with us. 
In closing the celebration of this our Anniversary, 


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let us pause for a moment and look around for those who were wont to assemble here with us, but who are no longer in their places. 
While sympathizing, as we sincerely do, with our fellow-citizens in the recent great national losses, which are common to us all, let our recollection dwell for a moment with those of our own body who have been taken from among us; and while the emblems of our country are clothed with appropriate symbols of national grief, as testimonials of veneration and love for the mighty in intellect, the noble in patriotism, and the powerful in virtue, who have been so recently withdrawn from the wide sphere of their usefulness, let us profit by the occasion to recall to memory, those, whose humble pretensions, retiring worth, and generous self-devotion, combined with exalted merit, deserve, at our hands at least, the passing tribute of unfeigned sorrow for their loss, and gratitude for the examples which they have furnished to illustrate and enlarge the catalogue of those who in life embellished and adorned the profession, the usefulness of which they extended; and who, when dead, deserve to be regarded as examples for the living. 
Death has been so busy in this body during the short lapse of time which has intervened since it was first instituted, that much space would be required to enumerate, with even the shortest possible particulars, those who have been removed. Some of our brightest lights, however, have been extinguished; and it must be long indeed ere the remembrance of 


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their virtues can be obliterated, and pride in their achievements cease to be felt. 
To some we are indebted for precepts of extensive usefulness. To others we owe gratitude for the accomplishment of original, novel, and successful operations, which had baffled and defied the skill of the most learned and enterprising of European surgeons. And to others again, whose career had been signalized by no bold innovation, we owe the well earned tribute due to sterling worth, and that unostentatious merit which satisfied its ambition in the hourly exercise of an honourable and moral life, and in the daily performance of acts of charity and benevolence, the aggregate importance of which to humanity, and the profession which they loved, is far greater than are the results of more brilliant exploits. 
Very many of our brothers have departed from us, but the recollection of their virtues remains enshrined in our hearts. While living, they, at least, merited and received both public confidence and private regard. Let us strive in our turn to earn like praise ; and let us so live and act, that we, too, at the parting hour, may be blessed with the consciousness of having contributed our share towards the accomplishment of our professional ministry—the promotion of health, the unveiling of error, and the development of truth.