JOHNS HOPKINS HOSPITAL 
ADDRESSES ■ 
AT THE 
OPENING OF THE HOSPITAL 
MAY 7, 1889 JOHNS HOPKINS HOSPITAL 
ADDRESSES 
AT THE 
OPENING OF THE HOSPITAL 
MAY 7, 1889 
BALTIMORE 
1889 JOHN MURPHY A CO., PRINTERS, 
BALTIMORE. INTRODUCTION. 
The Johns Hopkins Hospital of Baltimore was formally 
opened May 7, 1889. 
At eleven o'clock in the morning, the Governor of the 
State, the Mayor and City Council, the Judiciary, and other 
Federal, State, and Municipal Officers, the Maryland dele- 
gation in Congress, the foreign Consuls, the Trustees of the 
Hospital, together with the officers of the Johns Hopkins 
University, a large number of physicians and surgeons from 
Baltimore, Washington, Philadelphia, and more distant places, 
including the Surgeons General of the Army, Navy, and 
Marine Hospital Service, and a company of ladies and gentle- 
men representing the hospitals and other philanthropic institu- 
tions of the country, assembled beneath the dome of the 
central or administration building. 
A marble bust of Johns Hopkins was placed upon the plat- 
form and his portrait hung upon the wall. In the assembly his 
only surviving sister, his sister-in-law, and others of his near 
kindred were seated. Flowers and flags decorated the stage. 
The company was received by a Committee consisting of 
the following gentlemen: Clayton C. Hall, Chairman, and 
Henry J. Bowdoin, Frederick J. Brown, Robert A. Dobbin, 
John M. Glenn, Dr. William F. Lockwood, Dr. Robert W. 
Johnson, Allan McLane, Jr., Joseph Packard, Jr., John C. 
Rose, Lawrason Riggs, Dr. N. Ryno Smith, Dr. Henry M. 
Thomas, Dr. William H. Welch, and Miles White, Jr. 4 
Instrumental music was performed by an orchestra of which 
Mr. A. Itzel, Jr., was the leader. 
The President of the Board of Trustees, Francis T. King, 
called the assembly to order and said :- 
" Johns Hopkins, in his letter to his Trustees, said, ' It is 
my special request that the influence of religion should be felt 
in and impressed upon the whole management of the Hos- 
pital; but I desire nevertheless that the administration of the 
charity shall be undisturbed by sectarian influence, discipline, or 
control.' It is therefore most appropriate that we should begin 
the opening exercises of the Hospital by reverently waiting upon 
God, and asking his blessing upon this work and his abiding 
presence within these walls, which are to be devoted to the 
care of the sick and suffering." 
Prayer was then offered by Rev. Joseph T. Smith, D. D., 
of Baltimore. 
Addresses were then delivered by Mr. Francis T. King, 
Dr. John S. Billings, and President Daniel C. Gilman. 
At their conclusion, several letters and telegrams were pre- 
sented from the officers of other institutions at home and abroad. 
The wards of the hospital were then visited. Luncheon was 
provided for persons from out of town. PRAYER 
BY 
REV. JOSEPH T. SMITH, D. D. 
Most merciful and gracious God, our heavenly 
Father! We worship Thee, we praise Thee, we 
magnify Thy name as the God in whom we live and 
move and have our being, and from whose kind hand 
cometh down every good gift and every perfect gift 
which we enjoy. In all our ways we would acknow- 
ledge Thee, for Thou art God alone. Upon all the 
works of our hands we would seek Thy benediction, 
for Thy blessing alone can prosper. " Establish 
Thou the work of our hands upon us; yea, the 
work of our hands establish Thou it." 
We adore Thee, 0 Lord, as the " Father of our 
spirits and the former of our bodies." These bodies, 
so fearfully and wonderfully made-the crown and 
glory of the whole material creation-Thy hands 
have fashioned; these living souls which inform 
them, bearing Thine own image, partners of Thine 
own immortality, whose earthly fellowship was to 
be with the higher world of spirits and their eter- 
nal home, the home of God and of angels,-are 
Thine own inbreathing. "Thou has made us a little 
lower than the angels, and hast crowned us with 6 
glory and honor. Thou madest us to have domin- 
ion over the works of Thy hands. 0 Lord, our 
Lord, how excellent is Thy name in all the earth!" 
We bless Thee as the God of life, and health, 
and happiness. Thou dost have " a desire to the 
work of Thy hand" and preservest amidst ten thou- 
sand perils the life Thou hast given. The mystic 
mechanism of life Thou hast so constructed that its 
healthful and harmonious movements are a perpet- 
ual joy, so that health is happiness. 
Since death, the penalty of sin, must come, we 
bless Thee that Thou dost send so many heralds 
before to warn us of his coming, that we may set 
our hearts and houses in order. We bless Thee 
for all the alleviations Thou hast provided for pain 
and for all the remedies Thou hast provided to 
mitigate, where they cannot remove disease; for 
these healing waters compounded in Thine own 
hidden laboratory; for these healing plants which 
Thou has caused to grow in garden, and field, and 
forest; for these healing minerals which Thou hast 
stored away, with the silver and the gold in the 
mines, furnishing the hospital earth so abundantly 
with all needful supplies for its sick and impotent 
folk. We thank Thee for the pity Thou hast im- 
planted in human hearts, and the skill Thou hast 
given to physicians to discover and administer the 
remedies Thou hast provided, so and ever increas- 
ingly lessening the sum of human sufferings. 7 
And now that this great company is gathered 
here from their wide dispersion on this day of glad- 
ness, which crowns the cares and labors of so many 
years, our hearts rise up to Thee in thanksgiving 
and praise. As we look around on this Bethesda, 
this house of mercy, with its many apartments so 
admirably constructed, so abundantly furnished 
with all needful appliances, we thank Thee that 
Thou didst put into the heart of Thy servant, who 
so long went in and out among us, to provide so 
munificently for the building of this hospital. We 
thank Thee for the grace given to these, Thy ser- 
vants, to whom, as he was about to go into the far 
country, he left his goods, to fulfil with such wis- 
dom and fidelity their high trust. 
And now, as we are about to throw wide open 
the doors of this house of mercy, 0, Thou Great 
Physician, who, whilst a denizen of earth, didst go 
about opening the eyes of the blind, unstopping the 
ears of the deaf, loosing the tongues of the dumb, 
healing the lunatic and the leper, and " healing all 
manner of sickness and all manner of disease;" 
who didst enter the Jerusalem Bethesda, and walk 
through its porches and minister to the sufferer, to 
whom there was none other to minister, we beseech 
Thee, enter into this house of mercy. Is it not Thy 
spirit of charity which has reared it ? Is it not for 
an asylum and a home for those who are the objects 
of Thy tenderest care? Come in, Thou Divine Pres- 8 
ence, and ever abide here, walking through these 
wards, standing by these bedsides, healing the 
deadly maladies of the soul, that so when the body 
must perish the spirit may ascend to that better 
land where the inhabitants never say, I am sick. 
Bless and reward abundantly, for their labor of 
love, Thy servants who have given so many years 
of care and toil to the erection of these buildings. 
Bless the physicians and nurses who shall from 
time to time be employed here with wisdom and 
skill and tenderness. Bless all who shall in any 
way be employed in the service of this hospital, and 
let Thy choicest benedictions rest upon the suffer- 
ers who shall be gathered here from generation to 
generation. 
And now that we have brought in this topmost 
stone, and the temple is complete, may the Divine 
Presence descend, and fill and glorify the house of 
His habitation. 
Our Father who art in Heaven, hallowed be Thy 
name. Thy kingdom come, Thy will be done on 
earth as it is done in Heaven. Give us this day 
our daily bread, and forgive us our debts, as we 
forgive our debtors, and lead us not into tempta- 
tion, but deliver us from evil; for thine is the king- 
dom and the power and the glory forever. Amen. OPENING ADDRESS 
by the President, 
FRANCIS T. KING. 
It is my pleasant duty, in behalf of the Trustees 
of the Johns Hopkins Hospital, to offer you a cor- 
dial welcome, and to express our high appreciation 
of the interest in our work which is manifested by 
your presence here to-day. 
It cannot be a matter of small or temporary im- 
portance that brings to this opening the chief exec- 
utives of our State, and our City, so many of our 
distinguished men in all branches of the public ser- 
vice, so many well-known professional men from 
distant cities and countries, and so many of our own 
most prominent and public spirited citizens; and it 
gives us a renewed sense of our responsibilities and 
duties to find that we are to give an account of what 
we have done in the past and what we hope to do 
in the future to such an audience as we see before 
and around us. 
It encourages us to hope and believe that the 
trust which has been confided to us is one not only 
of local but of national and even of international 
importance, and we have abundant evidence in the 10 
many letters which have come to us from beyond 
the sea, that the opening of this hospital and the 
commencement of its philanthropic, educational and 
scientific work, is a matter which interests many 
men and women in Europe as well as in all parts 
of this country. 
Johns Hopkins did not leave a hospital; what 
he did leave was a complicated piece of machinery 
in the form of various investments capable of evol- 
ving the power required to construct and maintain 
a hospital, for in this sense, money is power. This 
machinery requires constant adjustment and look- 
ing after, and for this part of the work the Trustees 
are solely responsible. 
When I tell you that these seventeen buildings 
have been constructed and furnished, and these 
fourteen and a half acres enclosed and beautified 
as you see them to-day, not only without taking a 
dollar from the principal placed in the hands of the 
Trustees, but with an actual increase of the en- 
dowment by judicious investments by the sum of 
$113,000, I think it may be justly claimed that the 
Trustees have not failed in this part of their duty. 
The speakers who are to follow me will tell you 
of the plans of the hospital, of the objects which 
have been kept in view in the preparation of the 
methods adopted to secure the best possible condi- 
tions for the treatment of the sick and wounded 
who come to it, of its relations to medical educa- 11 
tion, to improvement of the science and art of med- 
icine, and to the other great trust of Johns Hopkins 
with which it is so intimately connected, namely 
the university. 
I will therefore devote my closing remarks to one 
or two personal reminiscences of the man to whom 
we owe the magnificent possibilities of his two great 
gifts. 
I need not speak of the birth, education and bus- 
iness career of Johns Hopkins, with which most of 
you are familiar, as he was a native of this State. 
What were the motives which led him to found 
his two great trusts, each with an endowment of 
nearly three millions and a half of dollars? Was 
it the act of a man of great wealth without children, 
who near the close of life wished to build a monu- 
ment to his memory? No, not at all; it was done 
conscientiously, with all the deliberation, judgment 
and grasp of subjects which characterized him 
through life, first as a successful merchant, then as 
a banker. 
I remember, many years ago, while spending an 
evening at Clifton, I heard Johns Hopkins say, in 
reply to a question put to him by an intimate friend 
of his own age, why he had never made a will, that 
he looked upon his wealth as a gift, for which he 
was accountable; that it grew and piled up from a 
small beginning, he hardly knew how; but he was 
sure it was given to him for a purpose, and he did 12 
not believe he would die before he was given to see 
how he should dispose of his estate. " This wealth," 
he repeated, "is my stewardship." 
Again, when his Trustees arranged to visit the 
hospitals of Philadelphia, New York, and Boston 
he was asked to accompany them; his reply was, 
"You surely do not want to parade me around the 
country. I would not for a moment think of going; 
it would be in very bad taste, to say the least of it. 
I have carefully chosen my Trustees and have com- 
mitted every thing to them. I will furnish the 
means and they must build the Hospital." 
Johns Hopkins purchased this site himself, which 
then consisted of the grounds of the Maryland In- 
sane Asylum, two large lots and seventeen dwell- 
ings, in all fourteen and a half acres of ground in 
an improved portion of the city, closing two public 
streets, thus at once determining the magnitude 
and character of his Hospital. 
Let Johns Hopkins again speak for himself in 
the words of his letter to his trustees, which show 
the wide scope of his interest in all conditions of 
mankind: 
"You shall receive into the Hospital the indigent 
sick of this city and its environs without regard to 
sex, age or color, who may require surgical or med- 
ical treatment, and the poor of this City and State, 
of all races, who are stricken down by any casualty. 
"You will also provide for patients who are able 13 
to make compensation for the room and attention 
they may require, and thus be enabled to afford 
to strangers and to those of our own people who 
have no friends or relatives to care for them in 
sickness, and who are not objects of charity, the 
advantages of careful and skilful treatment. 
"It will be your duty hereafter to provide for the 
erection upon other ground of suitable buildings 
for the reception, maintenance and education of 
orphan colored children, for which purpose I desire 
that you shall apply the yearly sum of twenty thou- 
sand dollars, or so much thereof as may be neces- 
sary." 
I wish to say on behalf of the Trustees a few 
words of recognition to all who have labored to 
bring these plans to their conclusion ; to the medi- 
cal adviser whose invaluable services have covered 
more than ten years; to the President of the Uni- 
versity, who has so ably aided in organizing; to 
the architects and builders, and to those who have 
had but occasional opportunities to serve us, but 
who have freely contributed their wisdom and ex- 
perience whenever called upon, and especially to 
the physicians and surgeons, the managers of other 
hospitals, the superintendents of training schools 
for nurses, and to many others, at home and abroad, 
whose kind co-operation has been most serviceable. 
Many of these friends are within the sound of 
my voice, others far away; none are forgotten; not 14 
a few sent us letters which show their lively inter- 
est in this occasion. 
As Johns Hopkins was brought up by godly 
parents-members of the Society of Friends-I 
should have been glad if we might have heard the 
voice of Whittier, the Quaker poet, but in the letter 
which I hold in my hand he pleads his age and ill- 
ness as an excuse for his silence. He expresses his 
pleasure in seeing that the wise and benevolent 
design of the founder has been so well carried out, 
and his hope that the example of Johns Hopkins 
will not be lost upon his country. 
To the words of his letter I will venture to add 
this verse which he wrote for another occasion, but 
which is equally appropriate to this. 
" Not vainly the gift of its founder was made ; 
Not prayerless the stones of its corner were laid; 
To Him be the glory forever!-we bear 
To the Lord of the harvest our wheat with the tare; 
What we lack in our work, may He find in our will, 
And winnow in mercy our good from the ill! " THE PLANS AND PURPOSES OF 
THE JOHNS HOPKINS HOSPITAL, 
BY 
JOHN S. BILLINGS, M. D., 
SURGEON, U. S. ARMY. 
The third paragraph of the letter of instructions 
communicated by Johns Hopkins to the trustees 
whom he had chosen to carry out his plans for a 
hospital in the city of Baltimore, states that " it 
is my wish that the plan . . . shall provide for a 
hospital which shall, in structure and arrangement, 
compare favorably with any other institution of 
like character in this country or in Europe." What 
do you suppose the writer was thinking of when he 
penned that sentence? Had he in view any defi- 
nite ideal, any mental picture of the institution 
which he proposed to establish, or was it merely 
an expression of a desire to give to his city the 
best thing that could be devised? I have read 
that letter many times, have heard much of the 
ideas, hopes, and wishes which were expressed in 
the numerous conversations which preceded its 
preparation, and it seems to me that the writer 
had an ideal, and not a mere vague desire-an 16 
ideal which was no doubt somewhat misty, but 
which did not correspond to any existing hospi- 
tal, and one which he did not attempt to define 
except in a few prominent points to which I shall 
presently refer. In most respects Johns Hopkins 
took the same course with his hospital which he 
did with his university, and deliberately refused to 
trammel with specific directions those whom he 
had chosen to carry out his plans; but this letter 
of instructions indicates, nevertheless, a conception 
of much more definite character, and one which 
had been the subject of more discussion and reflec- 
tion than his scheme for a university. Whether 
this be so or not, I am at all events sure that his 
trustees have endeavored to comply with this letter 
of instructions, and to do so in the broadest and 
best sense of the words. 
The beginning of the results we have before us 
to-day-results which even now are not confined 
to these particular aggregations of bricks and mor- 
tar, as will be presently explained, and the end of 
which will be, as we hope and believe, to make life 
happier for millions now living and yet unborn. 
Only those who took part in the early deliberations 
of those charged with this trust can fully realize 
the anxieties, the doubts, the manifold perplexi- 
ties which at first attended their decisions and 
movements. Only one or two of them had any 
knowledge of hospital matters ; most of them were 17 
business men, bankers, lawyers, judges, railway 
managers, men who knew something of the man- 
agement of men and money, but who were now 
brought face to face with a new problem-viz., 
how to build, organize, and manage a hospital 
so that it should compare favorably with any other 
hospital in this country or in Europe. 
To " compare favorably with," what does that 
mean? It is a peculiar phrase, which, coming 
from a shrewd business man and a member of 
the Society of Friends, signifies, I think, to excel, 
if possible; at all events, that is the safest inter- 
pretation. And it was not this or that hospital 
which was to be surpassed or equaled, but all 
other hospitals in this country or in Europe; 
Africa, Asia, and Australasia being put out of 
the question. It was a large contract. 
The location was fixed-that had been done by 
Johns Hopkins; but they had to decide whether 
the structures to be erected should be temporary 
or permanent, of wood, brick, or marble, in one 
large building or in many, and many other like 
points, before even the preparation of plans could 
be commenced. They followed the instructions 
of the donor and got advice, of which a great 
abundance was available. They visited the large 
hospitals of our eastern cities, employed five men, 
supposed to be skilled in hospitals, each to write 
an essay giving his plans and suggestions, pub- 
2 18 
lished these essays in a book which had a wide 
circulation, and studied the criticisms and reviews 
to which this book gave rise. 
Having duly considered the multifarious and 
widely divergent suggestions thus obtained, they 
finally selected one of the essay writers and asked 
him if he was satisfied with his own plans now 
that he had seen the others and the published 
criticisms upon them. He promptly said that he 
was not, whereupon they asked him to try again 
and do better. He set to work, aided by the 
architect of the board, and the result was a set 
of sketch plans which he took abroad and obtained 
much counsel and criticism on, examining at the 
same time the model hospitals of Europe. He 
was much less satisfied with the sketch plans when 
he came back than he was when he started, and 
again the building committee, the architect, and 
himself reviewed the whole matter, and finally 
settled on the general arrangement which you 
will see to-day. Many details remained to be 
worked out; even the facades had not yet been 
designed; but the general scheme was settled, and 
the rest was comparatively easy for the time being. 
Let us now for a few moments consider the 
broad general principles which governed the trus- 
tees in the adoption of this plan. The first hos- 
pitals were established to give shelter and food to 
the sick poor, especially those who gathered in 19 
cities. Gradually physicians found that they could 
learn much in these aggregations of suffering and 
that they afforded the means of teaching others; 
but this last use of them is only about two hun- 
dred years old. Gradually, also, it came to be 
known that the knowledge thus obtained in the 
care of the sick poor was of use in treating the 
diseases of the well-to-do; and finally, within 
the last twenty-five years or so, people are be- 
ginning to find out that when they are afflicted 
with certain forms of disease or injury they can 
be better treated in a properly appointed hospital 
than they can be in their own homes, no matter 
how costly or luxurious these may be. In the 
hospital they can have not only all the comforts 
of home, but more; not only skilled medical 
attendance and skilled nursing, but the use of 
many appliances and arrangements specially de- 
vised for the comfort and welfare of the sick which 
can hardly be found in any private house, and 
also freedom from noise and many petty annoy- 
ances, including in some cases too much sympathy 
and in others too little. This hospital, then, is to 
provide for the rich as well as for the poor; for those 
who can, and ought to, pay for the help given, as 
well as for those who can not. 
A second cardinal principle to be observed in 
such a hospital as this is, that it shall do as little 
harm as possible. A hospital may do harm by its 20 
foul air, by spreading contagious disease among its 
inmates, by neglect or carelessness of its nurses or 
attendants ; and in years gone by hospitals have, no 
doubt, caused nearly as much sickness as they have 
relieved. This is now rarely the case, and in this 
hospital the arrangements for ventilation, isolation, 
and nursing are such as to entirely do away with 
this danger. There is another danger connected 
with free hospitals and dispensaries which is of 
quite a different kind and to which I can here only 
allude, namely, the danger of promoting negligence, 
shiftlessness, laziness, and vice by offering free 
relief from their consequences-the danger of pau- 
perizing people. This is a danger connected with 
organization and management rather than with con- 
struction, and I can only say here that it has been 
foreseen and will be as far as possible guarded 
against. 
The third principle to be kept in view in such a 
hospital as this is, that it should provide the means 
of giving medical instruction, for the sake of the 
sick in the institution as well as of those out of it. It 
is well known to those familiar with the subject 
that the sick in a hospital where medical instruc- 
tion is given receive more constant, careful and 
thoughtful attention than do those in a hospital 
where no such instruction is given. The clinical 
teacher must do his best; keen eyes will note every 
error in diagnosis, every failure in results of treat- 21 
ment. Moreover, the very act of teaching clarifies 
and crystallizes his own knowledge; in attempting 
to explain, the dark places become prominent and 
demand investigation, and hence it is that those 
cases which are lectured on receive the best treat- 
ment. I need say nothing here on the other side 
of the question, the value of properly trained phy- 
sicians to the community and the necessity for 
hospital instruction in such training; Johns Hop- 
kins understood all this and specially directed that 
"in all your arrangements in relation to this hos- 
pital you will bear constantly in mind that it is 
my wish and purpose that the institution shall ulti- 
mately form a part of the Medical School of the 
University." 
Now there are medical schools and medical 
schools, and in obeying this direction of the donor 
the trustees had to consider what sort of a medical 
school this school of the university was likely to be. 
As the majority of the trustees were also trustees of 
the university, they knew well the principles which 
underlie the organization of that institution, and 
that the same principles would govern the organiza- 
tion of the medical department when that came to 
be taken in hand. One of these principles is the 
thorough teaching of that which is known, another 
is to increase that which is known, and to fur- 
nish the men and means for doing this. So also 
the hospital should not only teach the best methods 22 
of caring for the sick now known, but aim to 
increase knowledge, and thus benefit the whole 
world by its diffusion. Another point which had 
to be kept in view was the direction of Mr. Hop- 
kins that there should be established, " in connec- 
tion with the hospital, a training school for female 
nurses, not only to care for the sick in the hospital, 
but to benefit the whole community by supplying it 
with a class of trained and experienced nurses." 
It is also highly desirable that a hospital of this 
kind should have connected with it a well-appointed 
dispensary for the treatment of those who need 
medical aid, but not a bed, in the hospital. Through 
such a dispensary much good can be done at small 
cost, the selection of proper patients for the hos- 
pital is facilitated, the means of medical investi- 
gation and teaching are greatly extended, and the 
scope of the nursing system can be made to reach 
the poor and ignorant in their own homes. 
The last point to which I shall refer, which was 
kept in view by the trustees in deciding upon the 
plans, was the general appearance of the buildings 
and grounds. 
Mr. Hopkins gave no specific directions as to the 
buildings, but he directed that the grounds should 
be properly enclosed by iron railings, and so laid 
out and planted as to be a solace to the sick and an 
ornament to the city, and it was evident that the 
buildings should be of the same character so far 23 
as their purpose would admit. It was therefore 
decided that, while no utility should be sacrificed 
for the sake of architectural ornament, and the 
main purpose which I have referred to should be 
fully worked out in the plans before any attention 
was paid to external appearance, it was fit and 
proper that the buildings should form an ornament 
to the city, and a suitable monument to the memory 
of the donor. 
Bearing in mind, then, these main principles, to 
provide for the proper care of the sick, both rich 
and poor, to provide for the highest class of medical 
education, to increase and diffuse knowledge, to 
provide trained nurses for both hospital and city, 
to provide a dispensary, and to make the buildings 
and grounds ornamental and attractive, let us see 
how the problem has been thus far worked out. 
I will begin with the arrangements for securing 
that article of prime necessity in a hospital, viz., 
pure air. Air supply and ventilation in this climate 
are inseparably connected with heating for a con- 
siderable portion of the year, for comfortable 
warmth must be secured, and on the means of doing 
this must largely depend the methods of ventilation 
and their success. The temperature of Baltimore 
may vary from 103° in the shade to 17° below zero 
F., hence its perfect hospital must be one which 
would answer for the tropics or for northern Russia. 
To secure this, double walls, with air spaces, were 24 
given to the buildings, and a system of heating by 
the circulation of hot water was adopted for the 
wards. This system consists of central boilers, from 
which flow and return pipes extending beneath every 
building, connected with heating coils, of which 
there is one for every two beds in the ward above. 
The temperature in these coils can be exactly regu- 
lated to any temperature between 150° F. and the 
temperature of the external air by simply regulating 
the velocity of the flow of water by the valves 
attached to each coil, and thus it is quite possible 
to give one pair of beds a temperature of 70° and 
another pair in the same room, at a little distance, 
a temperature of 60° F., to suit the needs of different 
cases. The 80,000 gallons of water contained in 
this heating apparatus go round and round, carry- 
ing heat from the furnaces to the wards ; but every 
building has its own independent means of ventila- 
tion, and it is not possible to go from one ward into 
another without going into the open air on the way, 
so that foul air, if any forms, cannot spread from 
one building to another. Nevertheless, the build- 
ings are so connected by corridors and underground 
tunnels that in passing from one to another there is 
no exposure to rain or snow, and the least possible 
to cold air, while the food is not exposed at all. 
This is not the place to describe the ventilation. I 
will only call your attention to the fact that the 
temperature of the incoming air by any bed is easily 25 
changed by turning a valve, while the quantity of 
air is not changed; to the arrangement for taking 
foul air from either the bottom or top of the ward, 
or from both, and to the fact that all this has been 
thoroughly tested during two winters and found to 
give the results hoped for. 
One of the peculiarities of the wards is that all 
the service rooms are collected at the north end, 
leaving the south end free of obstruction and fully 
exposed to the sun, the end of the ward being a 
large bay window looking out on the central garden, 
and with a floor which can be warmed so that the 
patients, able to sit there, can be thoroughly com- 
fortable. Another peculiarity of the sick wards 
is fhe arrangements for easy cleansing, and to 
prevent possible accumulations of dust in corners 
and crevices. Corners are to a great extent done 
away with, and easy curves given in their place; 
even at the junction of the floor and walls there 
is a curve instead of the usual right angle, and I 
advise you to look at it and see how it has been 
produced, for it ought to become fashionable, and 
take the place of the old mop-board in all well- 
constructed houses. So, also, the doors have not 
the usual moulding about the panels, giving re- 
cesses which it is almost impossible to clean. 
One of the wards is especially arranged for cases 
which may be either contagious or offensive. In 
this building each patient is in a room by himself, 26 
and all these rooms open into a corridor through 
which the wind is always blowing. There are 
many details about this isolating ward which are 
worth looking at, but which I have not time now 
to refer to, and I must omit details about the pay 
ward, the octagon ward, and the peculiar fittings 
and conveniences of the kitchen, laundry, apothe- 
caries' building, etc., for the same reason. 
Let us pass now to the second object of the 
hospital, the giving means for higher medical edu- 
cation, and see what has been done for that. In 
the first place, there is a large amphitheatre with 
appended rooms for the reception of accidents and 
emergencies of all kinds. In the second place, 
provision is made for at least thirty students to 
reside constantly in the hospital and devote them- 
selves under proper guidance to the study of dis- 
ease and the practical care of the sick. It is 
intended that these places shall be open only to 
those who have had a thorough previous training, 
and who have shown themselves to be fitted to 
undertake this important part of their studies. 
As a rule, not more than five per cent, of medical 
graduates have had any opportunities worth speak- 
ing of to study and treat diseases in the living 
man when they receive their diplomas. They 
have to get this experience on their first patients, 
and sometimes the experience is rather hard-for 
both doctor and patient. This hospital has pro- 27 
vided for the class of the medical school in the 
last year of their studies good rooms with bath- 
rooms, a dining-room, and other conveniences, and 
here they can be taught the actual daily work of 
a physician, for which all their previous studies 
are only preparatory. Many of the arrangements 
of the hospital have been constructed with refer- 
ence to this instruction; it is a great laboratory 
for teaching the practical applications of the laws 
of hygiene to heating, ventilation, house-drainage, 
and other sanitary matters. All pipes and traps 
are either exposed to view or can be seen by merely 
opening a door, and in the tunnel beneath the 
corridor you can study at your leisure the com- 
plicated and yet simple arrangement of pipes for 
gas, steam, water, sewage, etc., which are usually 
buried and remain a profound mystery to every 
one except the plumber, and often puzzle even him. 
Closely connected with this subject of teaching is 
that of increasing our knowledge of the causes, 
symptoms, results, and treatment of disease; in 
fact one cannot be thoroughly and well done with- 
out the other, and hence many of the provisions for 
the one are also useful for the other. For example, 
to go back to our system of heating and ventila- 
tion, there are many points connected with it which 
are destined for experimental work, to compare 
steam with hot-water heating, to determine the 
velocity of water at different temperatures, to com- 28 
pare ventilation by aspiration with that by pro- 
pulsion, or by upward currents with those drawn 
downward. 
One structure is very largely devoted to and 
fitted for experimental research, and that is the 
pathological laboratory, where the causes, processes, 
and results of disease are to be studied. Upon the 
results obtained in that laboratory may yet depend 
the saving of many lives, the relief of unspeakable 
agony, the warding off of pestilence from the city, 
and, to put it in a strictly business light, the value 
of real estate and the rate of taxation of this com- 
munity. We are on the verge of great advances 
in our knowledge of the causes and methods of 
disease, and I feel sure that these will be only pre- 
liminary steps to far greater and better knowledge 
of how to prevent or to treat them than we now 
have. The probable length of life of the new-born 
infant to-day is not much more than half what 
it ought to be; the practical productive period of 
the life of our men and women is shortened and 
interrupted by unnecessary disease and suffering; 
but remember, if these things are to be amended, it 
is not merely by teaching old doctrines; we must 
open fresh windows and let in more light, so that 
we can see what these obstacles really are. It is in 
this work of discovery that it is hoped that this 
hospital will join hands with the university, and it 
is in this hope that some of the structures around 
you have been planned and provided. 29 
A word now on the fourth object kept in view in 
this hospital, viz., the training school for nurses. 
Some of you probably have had some personal 
experience of the difference between an educated, 
properly trained female nurse, and one of the old- 
fashioned sort, but if you have not, it would take 
much more time than I now have to describe it. 
I can only say that in many cases a competent 
trained nurse is as important to the success of 
treatment as a competent doctor, and that one 
of the greatest difficulties in treating well-to-do 
patients in their own homes in this city is the 
want of proper nurses. Affection and zeal may 
do much, but they cannot take the place of knowl- 
edge, and this kind of knowledge is not to be 
acquired in a day or in a month. It is a work 
best carried out by women, though not one woman 
in ten is fit for it, or should undertake it. But 
the woman who is fit for it, who has physical 
health and strength, sound sense, loving kindness, 
patience and tact, and who has been thoroughly 
taught the art of nursing the sick, with all its 
thousand details, has the power of doing good and 
increasing happiness to a degree which few others 
possess. In a properly conducted hospital ward 
she is a necessity, but her field of usefulness and 
helpfulness is by no means limited to that. She 
is needed outside the hospital, in the home of the 
rich to nurse and care for the sick; in the home 30 
of the poor, to teach prevention as well as nursing. 
To gather here such women, to have them thor- 
oughly instructed, to furnish them with the attrac- 
tive and comfortable home which they deserve, 
and to send them where they are most needed, 
with provision for their return when the work is 
done, is the object of the training school of this 
hospital. 
For this purpose the trustees have provided a 
large and handsome building, separated from the 
others, and exclusively appropriated to the female 
nurses, where each can have her own comfortable 
room, and where a common parlor, library, dining- 
room, bath-rooms, and, in short, the arrangements 
of a first-class hotel are provided for their use. 
Here also is a training-kitchen and a lecture-room 
to aid in the work of instruction. The intention 
is that when the nurse has finished her six or eight 
hours' tour of duty with the sick, she shall come 
quite away from the ward and all that pertains 
to it, and take her rest and recreation in a totally 
different atmosphere, and special effort has been 
made to have this home attractive and pleasant. 
The fifth object which I mentioned as having 
been kept in view in the plan and construction 
of these buildings is the dispensary. This is a 
large building on the north front, consisting of a 
large central waiting-room, surrounded by a num- 
ber of smaller rooms for the use of the physicians 31 
and surgeons who are to examine and prescribe 
for the patients, and having bath-rooms, and a 
small apothecaries' establishment for the issue of 
the medicines ordered. This building is connected 
with the amphitheatre by a short covered corridor, 
and is specially arranged with reference to teach- 
ing. It, as well as the amphitheatre, is heated by 
steam instead of hot water, partly because they are 
not in constant use, and a rapid means of warming 
is desired, partly for the purpose already referred 
to of giving the means of experimental comparison 
of the two systems. The means of supply of fresh 
warm air in these two buildings, and of removing 
the air made impure by exhalations, are somewhat 
peculiar, and merit examination. 
With regard to the architectural design and 
external appearance of the buildings, and the laying 
out and ornamentation of the grounds, I can only 
say that you must see and judge for yourselves 
whether Mr. Hopkins's wish that they should be an 
ornament to the city has been successfully complied 
with. So far as external ornamentation is con- 
cerned, it is confined almost entirely to the large 
buildings on the west, or Broadway, front, which it 
was felt should harmonize in style of decoration. 
These central buildings, consisting of the adminis- 
tration, with the one pay ward on either side, are 
constructed of pressed brick with ornamentation of 
a dark blue, fine-grained, hard, and durable stone, 32 
known as Cheat River stone, and of molded terra- 
cotta of the color of the brick. The external designs 
for these, as for all the other buildings, were fur- 
nished by Messrs. Cabot and Chandler, of Boston, 
and I think we have good reason to be well satisfied 
with the results they have produced. The grounds 
are laid out and planted in accordance with designs 
furnished by Mr. E. W. Bowditch, of Boston. 
As regards construction, I do not hesitate to 
affirm that these are the best built buildings of 
their kind in the world. The material is the best, 
the most skilled and careful workmen were em- 
ployed, and, above all, the work received the most 
careful, conscientious, and intelligent supervision 
as it progressed. For this supervision we are 
indebted to Mr. John Marshall in the beginning 
and to Mr. William H. Leeke for the remainder 
and conclusion of the work; and we are also 
indebted to the latter for many valuable sugges- 
tions as to modes and details of finish which are so 
important in a hospital. The details of the compli- 
cated and extended system of heating, ventilation, 
and plumbing were designed and the work executed 
by Messrs. Bartlett, Hayward & Co., of this city. 
I should like to go on and mention the names of a 
number of other persons who have done good work 
here, but want of time forbids. I will only say that 
these buildings embody the counsels and sugges- 
tions of many men and women in this country and Corridor J(oof. 
LINEN CLOSET. 
WATER 
CLOSET' 
fAYATORY LOBBY 
PRIVATE WARD 
PRIVATE ward 
PATIENT S 
CLOTHING 
SERVICE HALL 
CENTRAL 
HALL 
'TEA 
KITCHEN 
NURSES / / 
G'LQ'SET 
DINING and DAY ROOM 
Corridor ftoof. 33 
abroad, but among them all there is no one who, 
from the very beginning of the conception of the 
idea of this magnificent gift in the mind of 
Johns Hopkins down to this present moment, has 
had more to do with shaping the results, who has 
furnished more valuable suggestions, who is more 
thoroughly acquainted with all that has been done 
and why it has been done, who has worked so 
unselfishly, and who more deserves honor in this 
connection than the president of the board and 
chairman of the building committee through the 
whole progress of the work, Mr. Francis T. King. 
Briefly and incompletely as I have sketched 
these salient points of the plans and purposes of 
this hospital, I hope I have, nevertheless, shown 
you that it is intended for other purposes besides 
providing shelter, food, and drugs for the sick. In 
saying this I have not the least wish to undervalue 
or disparage those institutions which do make this 
their main or only object. There is abundant need 
of their existence and work also; but this institu- 
tion should not be judged by the rules which apply 
to them ; it cannot be managed after their fashion ; 
if it does not produce results different from theirs 
it is a failure and the expenditure upon it a mis- 
take. 
Thus far I have been speaking of the buildings 
only, and trying to give you some idea of the 
motives which led to their being as they are, and 
3 34 
what they are, and not otherwise. From the be- 
ginning, however, it has been recognized that the 
buildings and machinery are only means to an 
end, tools which must be handled by skilled work- 
men to produce the desired result; and through- 
out all these years of planning and building the 
question of organization and of the sort of men 
and women who were to use and work with these 
things has not been lost sight of. It is true that 
no attempts were made to select and engage indi- 
vidual members of the hospital staff until quite 
recently; but there was, nevertheless, a tolerably 
definite conception as to the ideas, mode of work, 
character, and wants of those who are to constitute 
this staff, and when the time came for selecting, 
it was made by this standard. 
On the philanthropic, social, and religious aspects 
of this great trust I do not propose to touch, but I 
wish to say a very few words of the hopes and 
wishes of scientific men and physicians with regard 
to it. From the time of the first announcement 
of the Hopkins bequests to the present, these men, 
all over the world, have been keenly interested in 
the plans and methods adopted in carrying them 
out. Whenever and wherever the problems of 
higher medical education have been discussed 
within the last ten years, there has been specula- 
tion as to the probable course of the Johns Hop- 
kins medical department, and the influence it 35 
would have upon the standard. I may even say 
that some of this influence has been exerted in 
advance, has been discounted, as it were, for the 
plans of this hospital have stimulated changes in 
some of our best medical schools, and have been 
copied with more or less modification in some of 
our latest hospitals. 
What is it, then, that the physicians want ? Is 
it more physicians, more family practitioners, more 
surgeons, more specialists? Not at all. They 
know very well that there is no danger that the 
supply will not be equal to the demand; when 
they become overburdened with practice they do 
not at present find it difficult to obtain assistants; 
they have no fear lest the seventy or eighty medi- 
cal schools of this country should fail to produce a 
sufficient number of medical practitioners to meet 
the wants of our increasing population; and they 
know also that the medical schools of Great Britain 
and Germany are sending to us quite as much of 
their product as we can conveniently dispose of. 
They hope that the Hopkins medical school and 
hospital will do two things. The first is, that it 
will demand of those who propose to become its 
students evidence that they have a sound basis of 
preliminary education before they commence, and 
that its standard in this respect shall be little 
below that of the requirements for granting the 
degree of bachelor of arts in the university. It 36 
is hoped that the men thus selected will go through 
a carefully graded course of study, including actual 
work in properly fitted laboratories, and that after 
this they will he brought into contact with the 
sick, and thus obtain practical experience of the 
duties and responsibilities of the practitioner of 
medicine before they offer their services as such 
to the public. 
So much our physicians desire of every medical 
school, for the sake of the honor and dignity of 
the profession, and for the good of the public, and 
they desire especially that this school shall form 
an example to which they can point as showing 
how medical education should be conducted, and 
what should be required of the candidate for the 
degree of doctor of medicine. 
The very general interest in the combined Hop- 
kins trusts felt by physicians and scientific men 
not only of this country but of the whole civilized 
world, is largely due to the belief that the relations 
which will here exist and be maintained between 
the university as a whole and its medical depart- 
ment, of which this hospital is to be an important 
part, will be close and intimate, so that the true 
university spirit will pervade, stimulate, and 
encourage the hospital work. In this country 
medical schools have either had no connection 
with universities properly so-called, or the con- 
nection has been slight and nominal, such as 37 
depends upon the formal conferring of medical de- 
grees by the university. Here, however, through 
the influence of the biological department, there 
are secured common interests and mutual influence, 
and it is hoped therefore, that the necessary details 
of technological instruction will be arranged in 
accordance with and subordinate to the broad prin- 
ciples of scientific culture upon which this univer- 
sity is organized. 
It is because it is believed that this will be the 
case that there is a widespread hope and expecta- 
tion that these combined institutions will endeavor 
to produce investigators as well as practitioners, to 
give to the world men who can not only sail by the 
old charts, but who can make new and better ones 
for the use of others. This can only be done where 
the professors and teachers are themselves seeking 
to increase knowledge, and doing this for the sake of 
the knowledge itself;-and hence it is supposed that 
from this hospital will issue papers and reports 
giving accounts of advances in, and of new methods 
of acquiring knowledge, obtained in its wards and 
laboratories, and that thus all scientific men and all 
physicians shall share in the benefits of the work 
actually done within these walls. But, however 
interesting and valuable this work may be in itself, 
it is of secondary importance to the future of science 
and medicine, and to the world at large, in com- 
parison with the production of trained investigators, 38 
full of enthusiasm, and imbued with the spirit of 
scientific research, who will spread the influence of 
such training far and wide. It is to young men 
thus fitted for the work that we look for the solution 
of some of the myriad problems which now con- 
front the biologist and the physician. 
Do I seem to ask too much ? to be too sanguine 
as to what human thought, and study, and skill 
may accomplish ? to forget that there is one event 
unto all; that the shadow of pain and death comes 
on the wise man as on the fool ? I have two answers. 
As surely as our improved methods of prevention 
and treatment, based on the advances in knowledge 
of the last fifty years, have already extended the 
average duration of life in civilized countries nearly 
five years, have prolonged thousands of useful and 
productive lives, and have done away with the in- 
describable agonies of the pre-anaesthetic period, 
so surely we are on the verge of still greater ad- 
vances, especially in the prevention of infectious 
and contagious disease, in the resources of surgery 
against deformities and morbid growths, and in the 
mitigation of suffering due to causes which cannot 
be wholly removed. But the second answer is more 
important, and it is this: It is our duty to try to 
increase and diffuse knowledge according to the 
means and opportunities which we have, and not to 
rest idle because we cannot certainly foresee that 
we shall reap where we have strewn. "It is not 39 
incumbent on thee to finish the work, but thou 
must not therefore depart from it," says the Talmud, 
and " Of him to whom much is given much shall 
be required," says the Scripture. 
To you, the officers of this institution, and to you, 
men and women of Baltimore, there is now given 
the opportunity of giving powerful aid in this in- 
crease and diffusion of knowledge of the laws of 
human life, disease, and death. Surely, those who 
are working in the wards and laboratories of the 
hospital and university will do their best; surely, 
also, the citizens of this great city, of a great nation, 
which at no distant day will take the lead in scien- 
tific work, will encourage, sustain and sympathize 
with these workers. I would have this hospital 
become famous, not for fame's sake, but because 
this will be evidence of the good work which has 
been done in it; but we must not be impatient. 
There are difficulties to be overcome, delays which 
must be submitted to. We cannot at once have 
the medical school which is essential to the plan 
which I have sketched; but there is plenty to do 
for the present, and I am certain that in time all 
these present obstacles to full development will be 
happily overcome. 
Success in this, as in all other enterprises in this 
world, is to be obtained by unselfish work for the 
good of others, by wise counsel, by cooperation, and 
by persistent effort. 40 
A hospital is a living organism, made up of many 
different parts, having different functions, but all 
these must be in due proportion and relation to 
each other, and to the environment, to produce the 
desired general results. The stream of life which 
runs through it is incessantly changing; patients 
and nurses and doctors come and go; to-day it has 
to deal with the results of an epidemic, to-morrow 
with those of an explosion or a fire; the reputation 
of its physicians or surgeons attracts those suffer- 
ing from a particular form of disease, and as the 
one changes so do the others. Its work is never 
done; its equipment is never complete ; it is always 
in need of new means of diagnosis, of new instru- 
ments and medicines; it is to try all things and 
hold fast to that which is good. 
"Et quoniam variant morbi, variabimus artes." 
It has been said that " hospitals are in some sort 
the measure of the civilization of a people, but a 
hospital of this kind should be more than an index. 
It should be an active force in the community in 
which it is placed. When the mediaeval priest es- 
tablished in each great city in France a Hotel Dieu, 
a place for God's hospitality, it was in the interests 
of charity as he understood it, including both the 
helping of the sick poor and the affording to those 
who were neither sick nor poor an opportunity and 
a stimulus to help their fellow-men; and doubtless 
the cause of humanity and religion was advanced 41 
more by the effect on the givers than on the receiv- 
ers. It is the old lesson so often expounded, appar- 
ently so simple and yet so hard to learn, that true 
happiness lies in helping others; that it is more 
blessed to give than to receive. 
In some respects we to-day have a much wider 
outlook than the men of a thousand years ago. 
This hospital is designed, as I have told you, to 
advance medical science as well as to give relief to 
the sick poor, but the fundamental motive is the 
same-to help others. 
We have here the beginning of an institution 
which shall endure long after the speakers and the 
audience of to-day shall have finished their life- 
work and have passed away. Founded in the in- 
terest of suffering humanity, intimately connected 
with a great university, amply provided with what 
is at present known to be essential to its work, we 
have every reason to predict for it a long and pros- 
perous career, with steadily progressing improve- 
ment in its organization and methods, and enlarge- 
ment of its activity and influence. 
Let us hope that before the last sands have run 
out from beneath the feet of the years of the nine- 
teenth century it will have become a model of its 
kind, and that upon the centennial of its anniver- 
sary it will be a hospital which shall still compare 
favorably, not only in structure and arrangement, 
but also in results achieved, with any other institu- 
tion of like character in existence. CHARITY AND KNOWLEDGE, 
BY 
DANIEL C. GILMAN. 
Thirteen years ago during the centennial cele- 
brations of Independence Day, the University 
founded by Johns Hopkins began its work, and 
now, as we commemorate a completed century 
of constitutional life, the Hospital, gift of the 
same donor, throws open its doors. These build- 
ings-on which thought, time and wealth have 
been freely spent-are now consecrated to the 
ministry of mercy and the prolongation of life. 
Science and charity, knowledge and pity, skill 
and sympathy are here installed in the service of 
mankind. 
That large-minded citizen of Maryland, "who 
by noble gifts for the advancement of learning 
and the relief of suffering, has won the gratitude 
of his city and his country," found two words 
adequate to his great ideas. " University " and 
"Hospital" were his chosen terms, and he linked 
them together by this significant phrase: " Bear 
constantly in mind that it is my wish and purpose 
that the hospital shall ultimately form a part of 
43 44 
the medical school of that university for which 
I have made ample provision by my will." How 
brief the phrase, how large the purpose! "Apples 
of gold in pictures of silver." 
Like James Henry Roosevelt of New York, " a 
man upright in his aims, simple in his life and 
sublime in his benefaction,"* whose hospital and 
dispensary give clinical instruction • to the College 
of Physicians and Surgeons; like James Lenox 
of New York, whose munificence established a 
public library and gave birth to a hospital, Johns 
Hopkins, already honored as a patron of learning, 
will be henceforward remembered in the annals 
of charity and medicine. May we not almost say 
of him as Pindar said of Theron, 
-and I will swear 
That city none,-tho' she unroll, 
A century past, her radiant scroll,- 
Hath brought a mortal man to light 
Whose hand with larger bounty flows. 
The blessings to that man we owe 
Say who shall hope to count.f 
We may form an idea of what this hospital 
may become by the study of a like institution in 
London. About a century and a half before Johns 
Hopkins died, the days of Thomas Guy were 
*This phrase, (like that above, referring to Johns Hopkins,) is taken 
from a memorial tablet. 
f Olympic II, Cary's version. 45 
ended. Like our benefactor, he had lived unmar- 
ried to the age of eighty years, and from humble 
beginnings had acquired a fortune, with which 
he provided for the establishment of a hospital. 
The amount of his gift was more than a million 
of dollars (£238,292). The beneficent influences 
of Guy's hospital are now known in every part of 
the globe. It is doubtless safe to say that every 
one of us has shared, indirectly, in its benefits. 
The name of the great surgeon, Sir Astley Cooper, 
would alone give renown to the hospital to which 
he was attached,-Sir Astley Cooper, of whom it 
was said that from the period of his appointment 
to Guy's, until the moment of his latest breath, 
he was everything and all to the suffering and 
afflicted; his name was a host; but his presence 
brought confidence and comfort.* Addison and 
Hodgkins, whose names are familiar to the his- 
torians of medicine, were physicians in that hos- 
pital. So was Richard Bright whose discoveries 
have been pronounced the most important contri- 
bution to medical science, made in the first half 
of the nineteenth century. The observations and 
studies made in Guy's Hospital since 1836 fill 
fifty volumes. Thousands of medical students 
have been trained within its walls; "their pres- 
ence," says a competent observer, "has made the 
* Letter of Dr. Roots in the Memoir of Sir A. Cooper. 46 
hospital." Hundreds of thousands of patients 
have received relief from the treatment there 
afforded. In a single year, five thousand in-door 
patients have been cared for and more than thirty 
thousand out-door patients have sought advice. 
But we are planning for a future much longer 
than a century and a half; for a history as long 
as that of St. Bartholomew's or St. Thomas's, 
which now, after many centuries, are more useful 
than ever. 
By a curious coincidence, as I had reached this 
point in the preparation of my address, I received 
a volume from Dr. Norman Moore, the Warden of 
St. Bartholomew's Hospital in London - bearing 
an inscription so welcome and so apposite that I 
will read it. " To the library of the newest of 
Hospitals this account of the progress of medicine 
in one of the most ancient is given by Norman 
Moore, with the earnest hope that the Johns Hop- 
kins Hospital may flourish at least as long as the 
Royal Hospital of St. Bartholomew, in Smithfield, 
and prove no less useful to mankind,-on the open- 
ing day of the Johns Hopkins Hospital, 1889." 
This little book is full of suggestions for us. 
First, as to the longevity of a hospital. " For 
more than seven hundred and fifty years the 
hospital has flourished upon its present site, and 
its Smithfield gateway, through which passed men 
of the generation whose fathers saw William the 47 
Conqueror enter London, has ever since been open 
to the sick poor." 
Then as to the progress of medical science. Here 
you may see " how the physician grew from a 
schoolman into a scientific observer, and how the 
surgeon, who appeared on the scene in livery and 
without learning, grew from a handicraftsman to 
be a man of science." 
Next as to the training of illustrious men. Here 
you will find a record of the names and services of 
Caius, Bernard, Pott, Abernethy, Lawrence and 
Paget; you may learn that Dr. Thomas Young, 
the originator of the undulatory theory of light, 
was here a student, and you will come upon the 
story of one more famous than any person I have 
named, the discoverer of the circulation of the 
blood, the illustrious Harvey* 
Time may efface the personality of our founder, 
as it has effaced the personality of Rahere, the 
founder of St. Bartholomew's, but the beneficence 
of Johns Hopkins will last for centuries; and grati- 
tude will cherish the memory of his broad views, 
his great liberality, his wise and beneficent purposes. 
The previous speakers have told us of the cir- 
cumstances which led to the construction of these 
* Dr. Moore calls attention to the fact that it was a fund given by Dr. 
Caius to encourage the study of anatomy, which was the immediate means of 
leading Harvey to his discovery, and also to a remark in one of Harvey's lec- 
tures that it was a passage of Aristotle which first suggested to him the idea. 48 
buildings and have described their purposes. Let 
me from a different point of view point out some 
of the benefits which are likely to proceed from 
this foundation. As I enter upon this theme, I am 
reminded that in 1789, John Howard, facile prin- 
ceps among modern philanthropists, published in 
a quarto volume, just before his death, the obser- 
vations he had made upon the Lazarettos of Europe. 
That was the beginning of reforms in prisons, 
asylums, refuges, and hospitals. To this work he 
prefixed these words of Cicero, a motto so appro- 
priate that I might take it for a text: Quid tam porro 
regium, tam liberate, tam munificum, guam opem ferre 
supplicibus, excitare adflictos, dare salutem, liber are 
periculis* 
First, last and always, this hospital is to furnish 
relief to the sick and wounded. Make the best of 
it, introduce fresh air and sunshine, and provide 
the utmost comfort, secure wise physicians, engage 
the best trained nurses, decorate the walls with 
pictures, bring fruit and flowers and books and 
friends,-and even the comforting influences of 
Religion, yet you cannot conceal the direful consci- 
ousness, that this is the home of suffering. 
From any other ill, 
(Except it be remorse) can men escape 
By work,-the healing of divinest balm 
* Cicero, De Oratore, I. 8. 49 
To whomso hath the courage to begin:- 
But sickness holds the sick man in a chain 
No will can break or bend to earthly use.* 
The names that have been given to these abodes 
of the sick are suggestive. Hospitality and hospital 
alike suggest the bestowal of kindness to guests. 
The word Lazaretto, ultimately degraded, pointed 
at first to the restoration of life. Misericordia, la 
Charite, la Pitie, the Home of the Good Samaritan, 
the House of Mercy, bring to mind the kindly in- 
fluences of love and care. St. John, St. Thomas, 
St. Bartholomew and St. Luke, above all other 
apostles, are favorite patronymics. Paracelsus 
died in the Hospital of St. Sebastian. Bethlehem, 
Bethany, Bethesda and Jerusalem recall the scenes 
where the Great Physician was present. The name 
of Christ has been given to many a foundation. In 
other places the hospital shares with the temple 
the name of Hotel-Dieu or House of God. 
By whatever name it may be called this is a con- 
vent where sickness is the abbess. The rule of 
sympathy for the suffering must govern every body 
with a strictness of discipline as rigid as the rule 
of the Benedictines or the Carthusians. Those who 
daily walk these cloisters will be the warders of life 
and health, however high their station or however 
humble their service; and casual visitors will not 
*Ugo Bassi's "Sermon in the Hospital," p. 13. 
4 50 
cross the threshold of the wards without pity for 
those who are disabled or without admiration and 
gratitude for those whose lives are spent in alleviat- 
ing distress. 
This hospital will not only meet the daily calls 
of humanity, it will stand ready to render extraor- 
dinary services in those emergencies which not even 
the progress of municipal reform and preventive 
medicine can entirely ward off. A fire, an explo- 
sion, an accident on the rails or on the sea-shore, 
the fall of a platform or of a building poorly con- 
structed, may at any moment tax the utmost 
resources of a great establishment. True, we have 
no fear of leprosy and the plague ; we have almost 
ceased to dread the coming of the cholera; yellow 
fever, we are hoping to thwart in its approaches 
to our northern seaports ;-vaccination, which was 
spoken of by Sir James Simpson, " as the greatest 
thought ever broached in practical medicine" is 
a great prophylactic; but we are not certain 
that diphtheria and infectious fevers will not con- 
tinue to be epidemic; nor can we always be sure 
that the boards of health in the city and State will 
succeed in protecting us, as well as they can, from 
the inroads of pestilence. Indeed it is well to 
inquire whether Baltimore is now fortified as it 
should be against the hostile incursions of epidemic 
disease. In addition to its other functions, this 
hospital will stand as a reserved force, a sort of 51 
storehouse of energy, ready to serve the city if 
apprehension and disease spread their pall upon it. 
Here let me say, in anticipation of the future, 
and in memory of the past, that in all the records 
of bravery on land and sea none are more noble 
than those of the medical profession. Free from 
all excitement, free from the hope of reward, free 
from any commands but those which are divine, 
they have in times of pestilenee gone from bed to 
bed firm, fearless, faithful, carrying the offerings of 
cheer, comfort and relief, and often of restoration to 
health and vigor. For them, there is no repose in 
time of danger. The black wings of death hovering- 
over a city do not deter them from duty; and often 
it may be said of them as Milton said of Abdiel, 
" faithful found among the faithless," faithful only 
they. Read the annals of modern pestilence, of 
cholera in New York, of fever and famine in Ire- 
land, of yellow fever in the South. Every where 
it is the same story. The more direful the record, 
the more unflinching, the more self-forgetful, the 
more humane are the efforts of physicians. 
While the offices of a hospital are bestowed 
without money and without price on those who are 
destitute,-those who are able to pay for suitable 
attendance, and for the domestic comforts to which 
they are accustomed, may discover that they can 
here be better treated than in many private houses. 
The conditions of quiet are more easily secured; 52 
suitable diet at unusual hours can be commanded; 
medical attendance is within call at every moment 
of the day and night; manifold appliances for 
relief are more readily obtained. More and more 
frequently, travellers, students, all whose homes 
are in hotels and boarding houses, and even many 
who have good private homes, turn toward good 
hospitals when they see the need approaching for 
prolonged and special care. For the wants of such 
persons provision has been made in the wards here 
set apart for paying patients,-male and female. 
This hospital would be a very narrow insti- 
tution if it kept to itself its experience. It is the 
essence of quackery to deal in mysteries and nos- 
trums ; it is the glory of medicine that it owns no 
patents and conceals no discoveries. On the con- 
trary, the best hospitals of the world consider it 
one of their first duties-second only to the care 
of their patients-to record the cases they have 
treated, the methods they have pursued, the re- 
sults whether favorable or unfavorable which have 
followed. Scientific studies in pathology and prac- 
tical medicine must be printed. Special papers, 
often requiring costly illustrations, must be pub- 
lished upon extraordinary cases, and upon new 
operations and modes of relief. It is thus that the 
science of Medicine is advanced. Where secrecy 
reigns, carelessness and ignorance delight to hide ; 
skill loves the light. 53 
It is impossible to have a hospital without 
its becoming a place for medical education. It 
is interesting to note that in the physician's oath, 
attributed to Hippocrates, the duty of imparting 
knowledge is explicitly enforced. Even the coun- 
try doctor as he rides from village to village, takes 
in his gig an observing pupil, like the squire to a 
knight-errant. Every great surgeon is watched 
with the closest attention by the younger physi- 
cians who assist him. Every mother is the pupil 
of the physician whom she calls upon to attend 
her suffering child. So, of course, a hospital, hav- 
ing upon its staff men of rare qualifications who 
are in daily consultation with their most skilful 
brethren, is, from the necessities of the case, a 
place for instruction. How systematic that in- 
struction will be depends on circumstances that at 
the moment need not be presented. All that need 
now be said is that hospitals the wide world over 
are the schools of medicine and surgery. 
The training of nurses is another form of hos- 
pital activity, recently developed, never hence to 
be abandoned. To the sisterhoods of the Roman 
Catholic Church, to the Protestant Deaconesses of 
Kaiserswerth and the Bethanien at Berlin, and to 
many guilds in many lands, much credit is due for 
lessons they have taught the world, as to the 
importance of training nurses. Elizabeth Fry was 
one of the first Englishwomen to propose such in- 54 
struction. Florence Nightingale, by her services 
in the Crimean war, and by her subsequent writings, 
has borne a noble part in this work. So, too, have 
our own country-women. The civil war, full of sad 
recollections, has some bright stories, and among 
them none more inspiring than the labors of brave, 
self-sacrificing and intelligent women in the Hospi- 
tals. Who that has read "What we did at Gettys- 
burg," or "Hospital Days," has forgotten their 
lessons? As a direct result of the war, Nurses' 
Schools have grown up in every part of this land. 
Our Hospital has such a department soon to be 
opened, where nurses will be trained, not only for 
their merciful offices within these walls but for 
household engagements and for visiting among the 
poor. 
A good hospital may readily become the rally- 
ing place of the medical profession who are resident 
in the City. 
"Through mutual intercourse and mutual aid 
Great deeds are done and great discoveries made; 
The wise new wisdom on the wise bestow 
Whilst the lone thinker's thoughts come slight and slow." 
One purpose of this central building is to afford 
opportunities for professional intercourse. Here 
are rooms set apart for the library that will 
presently be collected; here the medical journals 
will be taken in; here are the best appliances and 55 
instruments for the treatment of patients; here are 
rooms for private consultations and for public con- 
ferences ; here are laboratories for physiological 
and pathological determinations; and it will not 
surprise me to hear that within a very short time 
medical associations are here brought together " for 
mutual intercourse and mutual aid" at the invita- 
tion of Dr. Osler, the physician in chief, who this 
day assumes his great responsibility with the 
hearty welcome of Baltimoreans, and with the well- 
earned confidence of the profession throughout the 
entire land. 
Reference must also be made to the lessons 
that this hospital has already given to the world, 
before a single patient has been received. The 
vast amount of thought bestowed upon these 
buildings, not only in their general arrange- 
ments,-but in thousands of details which pro- 
mote their efficiency, has not failed to attract the 
attention of observers from every part of the 
globe. The letters which have been received dur- 
ing the last few days from the most distinguished 
surgeons and physicians abroad, and the presence 
of this large body of medical men from the distant 
cities of the United States are indications of this 
interest. 
Finally, if this hospital becomes the seat of 
knowledge in all that pertains to the nature of 
disease, its treatment, its prevention and its cure, 56 
it will of necessity be a constant guide to the 
people of the city and the State in which it is 
placed; it will promote the general health of the 
inhabitants. There is an altar in one of the 
churches of Messina, which bears an inscription 
to Aesculapius and Hygeia, the God of Medicine 
and the Goddess of Health; and their statues are 
found together on the fagade of Guy's Hospital. 
May they always be associated in Baltimore. 
Is all this outlay wise? I might answer an 
inquirer in the words which Wordsworth em- 
ployed in speaking of King's Chapel, one of the 
most costly structures in the University of Cam- 
bridge. 
11 High heaven rejects the lore 
Of nicely calculated less or more, 
Tax not the royal saint with vain expense; 
With ill-matched aims, the architect who planned 
This glorious work of fine intelligence." 
For in this hospital, as in that church, are 
" Thoughts whose very sweetness yieldeth proof 
That they were born for immortality." 
But I prefer to give a more specific and ap- 
propriate reply to those (if any such there be) 
who say, "I believe in everything that is prac- 
tical, in whatever leads to the relief of suffering; 
but I am afraid of this talk about science. I 
would rather see a thousand beds for patients 57 
than any provision for medical education." Such 
reflections are to be heard with respect, for they 
are natural to minds unacquainted with the inti- 
mate relations which subsist between the progress 
of medical knowledge and the progress of medi- 
cal art. Nevertheless it is true that those who 
have most carefully studied the conditions by 
which human life is perpetuated, human suffer- 
ings lessened and human vigor increased, are well 
aware that every step forward in science leads to 
many forward steps in practice. May I endeavor 
to be a mediator between these two divergent 
views and bring a few illustrations from the 
Doctor's shop to the attention of those who are 
practically interested in hospitals, but who have 
paid no attention to the steps, so slow, so diffi- 
cult, so uncertain at first but so sure at last, by 
which the Healing Art makes progress. 
The late Dr. Austin Flint of New York in an 
address prepared near the close of his life, has 
pointed out with the wisdom of experience the 
probable " Future of Medicine." It would be pre- 
sumptuous for me to attempt to do again what he 
has done so recently and so well. But on this day 
of promise, in view of all this expenditure, it is 
fitting that we should bring to mind some inspiring 
thoughts. 
Let us first consider the benefits which have 
come to mankind from the opportunities which 58 
hospitals have afforded for the observation of dis- 
ease. There is no one among us more competent 
to speak upon this subject than the pathologist 
of this hospital, Dr. William H. Welch, who, years 
in advance of its opening, has been engaged as a 
professor of the university in the study of the 
nature and origin of disease. He has called my 
attention to these noteworthy points: 
" Those who have contributed the most to the 
advancement of practical medicine and surgery 
have accumulated their experience largely in hos- 
pital service. By the constant attendance of skil- 
ful physicians and of well-trained nurses in hospi- 
tals, precise observations can be made and the phe- 
nomena of disease and the influence of treatment 
determined under the most favorable conditions. 
" Our present knowledge of the natural history 
of disease, of its diagnosis, prognosis and treat- 
ment are based to a very large extent upon 
experience derived from hospitals. Text books, 
monographs and medical journals incorporate this 
experience and bring it to the knowledge of the 
medical profession. This is why intelligent physi- 
cians are always eager to secure the advantages of 
a hospital service." 
The benefits which medicine has received from 
purely scientific investigations may be shown by so 
many examples that it is difficult to make a selec- 
tion among them. Dr. Welch mentions these: 59 
" Upon the foundation laid by Helmholtz's re- 
searches in physiological optics, and his discovery 
of the ophthalmoscope, the art and science of 
ophthalmology have developed into the most ac- 
curate department of clinical medicine. 
" The investigations which received their im- 
pulse from Du-Bois Reymond in the difficult 
subject of animal electricity have rendered elec- 
tricity available for diagnosis and treatment, and 
have advanced thereby our knowledge of nervous 
diseases. 
" Of the many ways in which the work of the 
chemist has aided medicine may be cited, as one 
of its most recent contributions, the introduction 
into modern therapeutics of many useful remedies 
which are the products of synthetic chemistry. 
Doubtless this is a field which will be cultivated 
still further, and it would be rash to attempt to 
foretell what agents for the cure of disease and 
relief of suffering are still hidden in the chemist's 
laboratory. 
" By the discovery of the specific germs causing 
various infectious diseases, surgical practice has 
been revolutionized. It has become possible to 
prevent the infection of wounds from the exterior, 
and thus to guard against a host of traumatic 
infections which rendered dangerous and futile so 
many surgical operations. Preventive medicine 
has taken its place among the exact sciences. 60 
" Accurate knowledge of the causes of dis- 
ease now forms a sure basis for intelligent thera- 
peutics and there is every reason to expect that the 
future will bring to light means to overcome the 
injurious agents which are now, for the first time, 
known." 
But there is another illustration so marvelous 
that it may almost be called miraculous. The 
relations of advancing knowledge to advancing- 
charity are brilliantly displayed by the history 
of methods for the relief of pain. 
To put a stop to suffering is an instinct of 
human nature, distinguishing man from animals. 
The most scientific men, and the most practical 
are agreed upon this, and have been so agreed 
for centuries. But Anaesthesia, most welcome 
of all the angels of mercy, came down from 
heaven. When the older surgeons in this assem- 
bly were students, opium and alcohol were the 
imperfect anaesthetics most usually employed. 
Their use was restricted and unsatisfactory if not 
dangerous. No one can tell what was suffered in 
places where gentle sleep now quiets apprehension 
and makes the patient unconscious of his state. 
To this alleviation, we are so wonted that we 
accept it as the air we breathe. But if you would 
learn how man secured this boon, how many 
efforts of scientific and of practical men were 
combined before the results were reached, recur to 61 
the history of four modern agencies, nitrous oxide, 
ether, chloroform, and cocaine, which are like "the 
gentle dew from heaven, which blesseth him that 
gives and him that takes." It is a chapter more 
wonderful than any romance of the Arabian Nights. 
Let any one present who is skeptical in respect 
to the usefulness of science to the healing art, keep 
this record in his mind. Let him reflect on the 
apprehensions that have been removed not only 
from the patient but from his attendant friends; 
let him see how much easier and therefore how 
much more certain the task of the surgeon has been 
made; and above all let him think of the hours of 
pain that have been absolutely annulled, and then 
let him divide the honors if he can, which belong to 
Science from those which belong to Philanthropy; 
let him balance half a century of scientific relief 
with the previous practice of many thousand years ; 
then let him tell us which is better. 
From the past let us turn to the future. All the 
signs of the times point to a new era in the history 
of mankind. All the sciences are leading up to a 
better understanding of the laws of life, to a true 
Anthropology, and the consequent improvement of 
the physical, mental and moral powers of man. 
There are four or five directions toward which 
we may turn an expectant gaze, as in days gone by 
the merchants watched upon the house tops for the 
return of the ships they had sent out to distant ports. 62 
Preventive medicine promises to do more and 
more for mankind. As the germs of many specific 
disorders have been discovered, so the means of 
their destruction have been found out. If legisla- 
tion and civil administration keep up with science, 
if knowledge is controlled by virtue and followed 
by temperance, the community will be freed from 
many of the foes which in former generations have 
slain their tens of thousands. 
From the chemical laboratory new remedies, as 
well as simpler forms of old remedies, are to be 
constantly looked for. The synthetical processes 
which now receive so much attention have lately 
made important contributions to the pharmacopeia. 
It would surprise any one whose attention has not 
been directed to this point to know how many 
claimants are awaiting judgment. Scores of sub- 
stances, till lately unknown, as I have heard my 
colleague* say, are awaiting the study of com- 
petent therapeutists. Nobody can foretell what 
will come from their new contributions to materia 
medica, but one who watches the processes of 
discovery must feel certain that secrets hid from 
the beginning are ere long to be revealed, and 
that many of the substances already discovered 
have properties of the most serviceable char- 
acter. 
* Professor Remsen. 63 
No one can say what will result from the atten- 
tion that has been recently given to the study of 
psychical phenomena by the exact methods of 
science,-but the outlook is hopeful. If we are 
as far as ever from elucidating the mysterious 
inter-relationship of the mind and the body, pro- 
gress has certainly been made in a knowledge of 
the laws by which they act upon each other. The 
knowledge that has been acquired in respect to 
the functions of the brain and nervous system has 
already led to the treatment of many disorders and 
the relief of many diseases which a short time ago 
were beyond the reach of remedy. We are not 
without hope that in the physiological and psycho- 
physical laboratories already established here, im- 
portant contributions will be made to science which 
will ultimately prove to be of value to medicine 
and to the conduct of the body in health and dis- 
ease. 
Medical appliances and surgical instruments are 
greatly to be improved. A surgeon who has just 
returned from Europe, after visiting in the interest 
of this hospital the most celebrated instrument 
makers, has informed me that the processes of 
manufacture even now are behind the devices and 
requirements of surgical science. The hands of the 
artisan have not kept up with the brains of the 
chirurgeon. It is not possible to buy ready made 
the instruments required by this hospital. 64 
In the near future we are to look for progress in 
the applications of electricity and magnetism to 
the treatment of disease as well as to its diagnosis. 
Chemistry by its synthetic methods is produc- 
ing new remedies, which experimental thera- 
peutics proceeds to test, and pharmacy then 
appropriates. The laws of light, heat, elec- 
tricity and magnetism are found in close rela- 
tionship to the problems of relief and cure. The 
laws of temperature and climate have their ser- 
vices to render. Even the influence of barome- 
trical pressure upon surgical operations begins to 
be noticed. The study of the nervous system is 
sure at no distant day, to make important con- 
tributions to the welfare of man. Psychology is 
waiting for the results. Experimental physiology 
is doing its part. Pathology, a term as old as 
Hippocrates, has become a new science within the 
last few years. The laws of descent have but 
just begun to assume a scientific form. Preven- 
tive medicine is almost a new conception. The 
morality of personal hygiene is a new depart- 
ment of ethics. Biology, after having met with the 
same critical reception with which anatomy, astro- 
nomy, geology and chronology were greeted, may 
yet be honored as leading to the highest and noblest 
conceptions of humanity; anthropology, and the 
knowledge of man in his relations to the universe 
in which he is placed, may sum up finite knowledge. 65 
So all aloiig the line, in the laboratories of the 
university and in the wards of the hospital, 
knowledge is contributing to the welfare of man. 
The days of the coming man may not always 
reach the full allotment to which Chevreul has 
just attained, but perhaps to die at seventy will 
be to die in youth, and to reach the age of eighty 
or ninety in health and vigor, will be the rule 
and not the exception. Nor is length of days 
our only hope. The disappearance of epidemics, 
fewer days of confinement in sickness, fewer "minor 
ailments," a decrease of infantile mortality, greater 
powers of resistance to the evils of certain occu- 
pations, and comparative immunity from many 
infirmities which are now common, artificial rein- 
forcements and replacements of bodily defects, 
simpler and surer means of diagnosis, the detec- 
tion of the nature, origin and history of specific 
affections,-and finally the assurance of eutha- 
nasia. These, as it seems to a layman, are reason- 
able expectations which the nineteenth century 
holds out to the twentieth. Can any outlay be too 
great if humanity is thus benefited ? 
To the attainment of these noble aims, "the 
relief of suffering and the advancement of knowl- 
edge," the foundations of Johns Hopkins are 
forever set apart. On the one hand stands the 
university, where education in the liberal arts and 
sciences is provided, and where research is liber- 66 
ally encouraged; on the other hand stands the 
hospital where all that art and science can 
contribute to the relief of sickness and pain is 
bountifully provided. Is there anything wanting? 
Yes,-there is still a great want to be supplied, 
an arch to rest upon these pillars. An institute 
of Medicine and Surgery, a College of Physicians 
and Surgeons, a Medical School,-the office of 
which shall be to promote the training of young 
physicians, and the encouragement of medical 
science is imperatively needed. Is it too much to 
say that there is not such an opportunity on the 
face of the globe, for another Peabody or another 
Hopkins to benefit his fellow men ? 
The university needs all it has, and more, to 
carry on the non-professional courses to which its 
funds are appropriated. The hospital, with all its 
readiness to co-operate in the advancement of 
knowledge will, after all, remain as I have said 
before, and cannot say with too much emphasis,- 
the home of the sick, the feeble, the injured and 
the dying. It is the house of mercy, not the hall 
of philosophy. But in close alliance with both 
these foundations there is a place for a school of 
medicine, which may bear its founder's name, and 
may render services as significant and memorable 
as those of Salerno and Bologna, at the beginning 
of the modern era; as those of Leyden and Edin- 
burgh where the earliest American physicians re- 67 
ceived their education; or as those of Berlin and 
Vienna to which so many students of this decade 
resort. 
This grateful city should no longer delay 
placing upon one of the squares near the 
monument of Washington, the figure of Johns 
Hopkins, with such designs as an artist, and 
an artist only, could devise, to typify the great 
ideas which underlie his gifts,-"the advancement 
of knowledge and the relief of suffering." Then 
might some friend of this hospital place beneath 
this dome a copy of Thorwaldsen's Christus 
Consolator, with the outstretched hands of mercy, 
to remind each passer-by-the physician and the 
nurse as they pursue their ministry of relief; 
the student as he begins his daily task; and the 
sufferer from injury or disease, that over all this 
institution rests the perpetual benediction of Chris- 
tian charity, the constant spirit of "good will to 
man." Upon one hill of Baltimore rises a temple, 
" whose guardian crest, the silent cross " is an em- 
blem of the Christian faith; upon another, a lofty 
column reminds us of the patriots' hope; upon a 
third, the Hotel-Dieu is placed,-the house of char- 
ity. Significant triad! " Here abideth Faith, Hope 
and Charity, but the greatest of these is Charity."