An 
ANNIVERSARY DISCOURSE, 
DELIVERED BEFORE THE 
NEW YORK ACADEMY OF MEDICINE, 
NO VEMBER 16, 1876. 
BY 
WILLIAM T. WHITE, M. D. 
PHYSICIAN TO CHABITY HOSPITAL; ATTENDING SURGEON TO THE PRESBYTERIAN 
HOSPITAL : SURGEON TO THE DEMILT DISPENSARY, NEW YORK. 
NEW YORK: 
D. APPLETON & COMPANY, 
549 & 551 BROADWAY. 
1876, AN 
ANNIVERSARY DISCOURSE, 
DELIVERED BEFORE THE 
NEW YORK ACADEMY OF MEDICINE, 
NOVEMBER 16, 1876. 
by i / 
WILLIAM T. WHITE, M. D. 
PHYSICIAN TO CHARITY HOSPITAL; ATTENDING SURGEON TO THE PRESBYTERIAN 
HOSPITAL ; SURGEON TO THE DEMILT DISPENSARY, NEW YORK. 
HEW YORK: 
D. APPLETON & COMPANY, 
549 & 551 BROADWAY. 
1876. NEW YORK ACADEMY OF MEDICINE. 
OFFICERS FOR 1876. 
President. 
SAMUEL S. PURPLE, M. D. 
Vice-Presidents. 
JOHN C. DALTON, M.D., 
GOUVERNEUR M. SMITH, M. D., 
EORDYCE BARKER, M. D. 
Recording Secretary. 
WILLIAM T. WHITE, M. D. 
Corresponding Secretary. 
JOHN G. ADAMS, M. D. 
Treasurer. 
JAMES O. POND, M. D. 
Trustees. 
ISAAC E. TAYLOR, M. D., 
EDMUND R. PEASLEE, M. D., 
JAMES L. BANKS, M. D., 
AUSTIN FLINT, M.D., 
SAMUEL T. HUBBARD, M. D. 
Librarian. 
JOHN H. HINTON, M. D. 
Assistant Secretary. 
HORACE T. HANKS, M. D. 
Statistical Secretary. 
ALLAN McL. HAMILTON, M. D. COMMITTEES FOR 1 8 7 6 . 
Committee on Admissions. 
JOSEPH E. JANVRIN, M. D., 
ELLSWORTH ELIOT, M. D., 
EDWARD II. JANES, M. D., 
MARK BLUMENTIIAL, M. D., 
TIMOTHY M. CIIEESMAN, M. D. 
Committee on Medical Ethics. 
JOHN C. PETERS, M. D., 
OLIVER WHITE, M. D., 
THOMAS 0. FINNELL, M. D., 
TIMOTHY M. CIIEESMAN, M. D. 
MOREAU MORRIS, M. D. 
Committee on Medical Education. 
FREDERICK A. BURRALL, M.D., 
ALFRED C. POST, M. D., 
I JAMES R. LEAMING, M. D., 
I EDMUND R. PEASLEE, M. D., 
CHARLES C. LEE, M. D. 
Committee on Library. 
CHARLES M. ALLIN, M. D., 
JAMES R. LEAMING, M. D., 
JOHN H. HINTON, M. D., 
E. DARWIN HUDSON, Jb., M. D.r 
GEORGE BAYLES, M. D. 
Committee on Ways and Means. 
JAMES ANDERSON, M. D., 
WILLARD PARKER, M. D., 
SAMUEL T. HUBBARD, M. D., 
JARED LINSLY, M. D., 
JOHN G. ADAMS, M. D., 
STEPHEN SMITH, M. D., 
SAMUEL S. PURPLE, M. D., 
GOUVERNEUR M. SMITH, M. D, 
EDMUND R. PEASLEE, M. D., 
Committee on Building. 
SAMUEL T. HUBBARD, M. D. ANNIVERSARY ADDRESS. 
Mr. President and Fellows of the Academy of Medicine: 
Thirty years ago an invitation was issued to the medical 
profession of this city, to meet and organize a new society, 
whose object should be to promote the progress of the science 
and art of medicine; the result was, the formation of this 
Academy, and w'e are here rto-night to commemorate that 
event. It would obviously be a tit method of observation to 
recount the names, and to do honor to the labors, of those 
who have been conspicuous in the annals of this Society; but 
as we are now arrived at the hundredth anniversary of our 
national existence, a broader sphere of investigation is sug- 
gested, and we are invited to examine the progress which our 
profession has made, not simply during the brief lifetime of 
a scientific body like ours, but during the whole century. 
We propose, therefore, to review, in a brief suggestive man- 
ner, the advance which has been made during the past hun- 
dred years, and to show the main force of those improvements 
which have been achieved by the profession, and especially in 
our own country. 
In contemplating a beneficent profession like ours, organ- 
ized in every civilized country, carrying on its researches and 
its services wherever human sickness requires relief, there 
are two questions which offer themselves to the mind. First, 
there is the question how far the great body of facts and 
principles which make up our science is growing more clear, 
more effective, and more definite, for the beneficent purposes 6 
Anniversary Discourse. 
for which it is designed. Secondly, there is the question as 
to the instruments and methods by which the growth of 
medical knowledge is promoted and its more general, diffu- 
sion secured. These are the two questions which will en- 
gage our attention to-night. We shall inquire how far prog- 
ress can be reported in the domain of medicine, of surgery, 
of physiology, of chemistry, of pathology, and of hygiene; 
and we shall also inquire by what helps, expedients, and 
agencies, the science is taught to the great body of medical 
practitioners, so that the whole profession may become per- 
meated and improved by the progress which is made in the 
theory and practice of the healing art. 
Taking up first of all the latter question, we shall find 
that there are two or three chief means by which medical sci- 
ence is taught and its advance promoted. There is, first, the 
influence of the press ; secondly, that of our medical schools; 
and, thirdly, that of our medical societies. 
At the outbreak of the Revolutionary War in 1776, the 
original thirteen States contained a population of less than 
three millions, with about two thousand physicians. At pres- 
ent the population of this country is more than forty millions, 
with about forty-seven thousand physicians. A century ago, 
most of the physicians practising in this country were de- 
prived of the advantages of regular academical study ; still a 
number of them had received more or less of their education in 
the medical schools of Europe. The cost of a trip across the 
Atlantic was then, however, so great as to place European 
study beyond the reach of most of our young practitioners. For 
these and other reasons it is computed that fully two-thirds of 
our medical men in 1776 had received a very imperfect profes- 
sional education, if we measure their knowledge by the stand- 
ard of our own times. Previous to the Revolutionary War 
only two medical schools had been established in this country, 
the University of Pennsylvania, at Philadelphia, in 1765, and 
the Medical Department of King’s College, at New York, in 
1768. From the records we find that, up to the year 1776, 
King’s College had graduated fourteen students, while none Anniversary Discourse. 
7 
are mentioned as having been graduated by the University of 
Pennsylvania. The first diploma for doctor in medicine from 
an American medical institution was conferred in New York 
on Robert Tucker, M. B., in May, 1770. We thus see that the 
ardor, of which so much has been said in the newspapers and 
journals, for multiplying medical graduates, had not at that 
early day sprung up in this country. Roth the institutions 
we have mentioned began by conferring two degrees in medi- 
cine ; the lower degree was that of bachelor, and the few 
students who received the higher degree of doctor were re- 
quired probably to pass a second and more severe examina- 
tion. (Of this, however, we have no precise record.) During 
the war both our medical colleges were closed, and, although 
the requirements for surgeons both in military and civil life 
were so great, it is probable that the numbers of the medical 
profession were rather diminished than increased during that 
struggle. After the close of the war a new impulse was 
given to medical studies, and at the end of the eighteenth 
century two hundred and twenty students had already gradu- 
ated from American schools. 
Among the more conspicuous impediments to the study 
of surgery and anatomy we may mention the scarcity of ma- 
terial for dissection. The facilities for studying anatomy a 
century ago were very poor compared with those of the pres- 
ent day. Subjects for dissection were scarce, costly, and very 
difficult to be obtained. The laws of the States held each 
surgeon responsible for an ordinary amount of surgical skill, 
and menaced him with severe penalties if he failed to possess 
it. In order to acquire the knowledge demanded of him 
under the law, he was obliged to violate another law which 
prohibited dissections, for otherwise he could not gain the 
skill which was exacted from him ; thus it happened that the 
students of those old times were tempted to become resurrec- 
tionists, and much demoralization was the inevitable result. 
In our more advanced times dissections are legalized in most 
if not in all the States, and the student who has such a work 
as Gray’s “Anatomy,” or any similar French, English, or 8 
Anniversary Discourse. 
American standard treatise, can gain a fair knowledge of anat- 
omy with half the toil and study required under the clumsy 
methods of a century ago. 
A better characteristic of the educational methods of that 
early period was, that each student was required to enter the 
office, or place himself under the instruction, of some promi- 
nent physician or surgeon. After two or three years of study 
and a limited amount of clinical instruction gained by visiting 
patients with his tutor, he was often deemed competent to 
begin practice without ever having attended a lecture at a 
medical college, and without the slightest opportunity of gain- 
ing experience by serving in a hospital. The thoroughness 
and accuracy of the instruction which was given under these 
discouraging circumstances were, of course, very diverse in dif- 
ferent cases, and its value for the training and discipline of prac- 
tical physicians is illustrated by the fact that many of those 
young men were very successful in cultivating both the theory 
and the practice of their profession. Perhaps the wonderful 
progress which the nation has made since that period in its 
facilities for medical study could scarcely receive a more strik- 
ing illustration than by the fact that since the close of the war, 
in 1783, our two medical colleges have increased to eighty- 
four, of which about sixty are in operation at present. Last 
winter these sixty colleges had about six thousand six hundred 
and twenty students, of whom one-third, or twenty-two hun- 
dred, graduated. In consequence of this rapid extension of 
the means of obtaining medical education, many changes have 
taken place in the habits of our young practitioners. As re- 
cently as thirty or forty years ago, our medical students/ound 
the means of education so inadequate here, that they were 
tempted to follow the custom,of their fathers and go abroad 
to get a foreign degree, and to complete their education in 
London or Paris. 
The prestige which attended this course gradually passed 
away, and, at the present time, few of our students go abroad 
except for the purpose of studying some specialty; and our 
facilities, even in that respect, are so great that but little ne- Anniversary Discourse. 
9 
cessity exists to supplement them by foreign studies. As a 
proof of the efficiency of our medical colleges, we may men- 
tion that the aggregate number of students who have received 
the degree of Doctor of Medicine in this country is seventy- 
three thousand five hundred and eighty-eight. No reports with 
which we are acquainted give a comparative view of the num- 
ber of students who have graduated in medicine in England, 
France, or Germany, during the last hundred years. It would 
be extremely interesting if some of our members who are given 
to statistical research would make an effort to obtain the 
information which has been suggested in regard to other coun- 
tries. 
As to our standard of medical education, it is not so high 
as it ought to be, and every reasonable effort should be made 
to raise it. This object, however, can scarcely be attained 
unless our colleges will unite to demand of their students a 
more extensive and thorough course of preparatory study. To 
raise the standard of graduation we must also raise the stand- 
ard of matriculation. The whole of the power to enforce this 
reform rests with the schools, but there is so much compe 
tition between these institutions, that each is interested in 
graduating every year as large a class as possible. To meet 
the difficulty, it has been suggested that a Board of Examiners 
should be created like that of the University of London, em- 
powered to confer degrees, but having no connection with any 
of the schools. Another reform which has been spoken of is 
to lengthen the term of study by one or two years. If these 
and other suggestions could be adopted, and if the standard 
of matriculation were so raised as to secure an adequate pre- 
liminary training to every student of medicine, we should be 
able to make a good beginning, the evils of the present system 
would gradually pass away, and the results could not fail to 
be better, both for the profession and for the public. 
Among the pioneers in medical education in this country, 
perhaps one of the most remarkable was Dr. Nathan Smith, 
of New Haven. At the great revival of medical education, 
after the Revolutionary War, he began to teach systematically 10 
Anniversary Discourse. 
the various branches of medical science, and lie lectured from 
1798 to 1810 at Dartmouth, where he was for twelve years 
the wThole faculty of the school. This distinguished professor 
lectured afterward at Bowdoin and at Yale Colleges. 
But it is time to pass to another branch of our subject. 
Besides medical colleges, there is the medical press, whose 
efficiency in spreading the scientific knowledge of our pro- 
fession has been growing in activity and usefulness throughout 
the century. There are now in course of publication about 
two hundred and eighty regular medical journals; of these, 
forty-six are published in the United States, fifty-seven in 
Germany and Austria, fifty-two in France, twenty-nine in 
Great Britain, thirty-one in Italy, eight in Belgium, and eight 
in Mexico. One hundred years ago, we might almost count 
upon our fingers the number of medical periodicals published 
in the whole world, excepting the reports of hospitals, the 
transactions of medical societies, and the annals of other 
learned and scientific bodies. The first medical journal pub- 
lished in France was Les Nouvelles Decouvertes en toutes les 
Parties de la Medecine ‘ this journal was established in 
1679, and, up to 1776, only six others had been published in 
that country. The Gazette Medicate de Paris was started in 
1773 as the Gazette de Sante, and the name was changed in 
1829; it is now said to be the oldest medical journal pub- 
lished. 
In Great Britain, the first regular medical periodical ever 
published, except the transactions of a few societies, was Dun- 
can's Medical Annals. This journal was founded in 1796, 
one year before the first medical journal was issued in New 
York. It was discontinued in 1801. 
The second medical journal in the English language was 
the one just referred to as the first published in this country. 
This was the New York Medical Depository; it was estab- 
lished in 1797, by Drs, S. L. Mitchill, E. Miller, and E. H. 
Smith. This pioneer of the medical press was followed by a 
number of other journals, of longer or shorter life; and, up to 
1S27, twenty-one different medical periodicals had been Anniversary Discourse. 
11 
started. During the century, two hundred and fourteen 
regular medical journals have been commenced in this coun- 
try ; the number now published is about fifty. Besides these, 
a large number of irregular journals have been started in the 
interest of the several sects, but only a few of these serials 
are now issued. 
The remark is often made that there are too many medical 
journals in this country; it is no part of our present task to 
discuss this opinion. We may, however, suggest that medical 
journalism has accomplished an important work in the United 
States, and that its mission for the future promises to be still 
more important. One of the more obvious arguments in favor 
of active journalism is, that it induces busy practitioners, 
whose habits are retiring and modest, to report their cases and 
to write out the results of their observations on topics which 
they may be familiar with. All over the country, a number 
of well-qualified and industrious observers are thus stimulated 
to direct their attention to specific inquiries; information in 
aid of these combined investigations is gathered from a multi- 
tude of independent observers, and a habit of noting down and 
placing upon record medical cases is stimulated, to the great 
advantage both of the individuals and of the general body of 
the profession. 
With regard to medical literature generally, the statistics 
which have been published show that the United States oc- 
cupy a position below that which has sometimes been claimed. 
In England, there are published three times as many medical 
works as in this country; in Italy, twice as many; in France, 
eight and a half times as many ; and in Germany, eight times 
as many. 
Among the works on anatomy may be mentioned those of 
Wistar, Ilorner, Morton, Leidy, and Smith ; on physiology, 
those of Dunglison, Draper, Dalton, and Flint; on surgery, 
those of Dorsey, Gross, Pancoast, and Hamilton; on materia 
medica, those of Eberle, Beck, and Wood ; on the theory and 
practice of medicine, those of G. B. Wood, and Flint, Sr. 
The first and only American work on histology was pub- 12 
Anniversary Discourse. 
lished by Dr. E. R. Peaslee, in 1855. Since that time, several 
reprints of foreign works have been published. 
Probably, the most prolific medical writer in the country 
was Dr. Dunglison, the author of our “ Medical Dictionary.” 
The reprints and translations of medical books published 
abroad are very numerous. To enumerate all these foreign 
and home publications would be an almost infinite task. The 
medical and surgical history of the war is a work of great 
value, on many accounts, and especially because it settles dis- 
puted points in regard to numerous operations in surgery. 
We now come to consider the influence on the progress of 
medical science which is due to the organization of efficient 
medical societies. Previous to 1776, there was only one State 
medical society in America, that of New Jersey, which was 
organized in 1766. At present, every State, and nearly every 
Territory, has its own medical society, and most of our large 
cities have several such organizations. The American Medi- 
cal Association was founded in 1847, with a view to reconcile 
the interests of the profession in different parts of the country, 
and to elevate the standard of medical education, by the influ- 
ence it might exert upon the medical schools. It has fur- 
nished us with a code of medical ethics for our guidance in the 
relations we sustain to one another and to the public. This 
code is, perhaps, not altogether perfect, but it offers a sufficient 
guide to those who are disposed to follow any written one. 
Its transactions, like those of all or nearly all scientific socie- 
ties, contain many valuable papers, as well as some of less 
merit. 
It would be interesting to learn to what extent medical 
societies have been organized in Europe. In all probability, 
our national tendencies to union and organization may have 
caused more activity in the formation of medical societies in 
this country than has prevailed abroad. The literature of 
this department of medical progress is, however, so scanty that 
we are left too much to conjecture. What is certain is, that, 
wherever medical societies have been established in this coun- 
try, they have been productive, when well managed, of nu- Anniversary Discourse. 
13 
merous good results. They not only tend to bring out new 
facts, and to promote the habit of observation and the careful 
reporting of cases, but they also establish such relations be- 
tween their members as to foster a better social and profes- 
sional feeling. Moreover, it may be mentioned as one of their 
advantages that, by united action, these associations are bet- 
ter able to roll aside the mischievous current of empiricism, 
whose baleful effects upon the community are thus mitigated, 
and may hereafter be wholly destroyed. 
Having thus surveyed the various agencies of schools, 
literature, and medical societies, by which the growth of 
medical knowledge has been promoted during the last cen- 
tury, let us now glance at the great body of science on 
which the healing art is based. Of course, it would be 
folly to attempt to enumerate all the improvements which 
have been made in the various branches of medical knowl- 
edge ; such a task would be both difficult and tedious, and 
it would require more time than is at the disposal of this 
meeting. I will, however, try to bring under review some of 
the more prominent discoveries, singling out especially those 
which have been the most beneficial to the public, and par- 
ticularly those which have originated in this country. It is 
not always an easy task to decide to whom belongs the credit 
of any particular discovery, for in many cases there are several 
claimants to that honor. Indeed, it has often happened in 
the domain of medical science, as elsewhere, that two or three 
individuals have, at about the same time, without any mutual 
knowledge, discovered the same remedy, made the same opera- 
tion, or devised the same method of treatment. Hence it 
often becomes a delicate question, and causes no small conflict 
of feeling and opinion, to allot to the real owner the merit of 
originality to wdiicli he has a just claim. Not a few opera- 
tions, first made in this country by American practitioners, 
have been claimed by others across the Atlantic, and these 
claims have been withdrawn with difficulty, and only on the 
strongest evidence. In the early days of medical progress in 
this country, the means of making known the new discoveries 14 
Anniversary Discourse. 
of our physicians were very limited, as there were so few 
medical journals which were widely read, and the means of 
communication by mail between distant parts of the continent 
were slow and costly. With the progress of events, all these 
difficulties have passed away, and every man possesses ample 
facilities, in the numerous medical periodicals and societies, 
to bring to the notice of the profession, without delay, any- 
thing new he may have discovered. We might mention, did 
time permit, a number of references in the earlier journals 
published in this country, in which are recorded many origi- 
nal discoveries in the different branches of medical science. 
We must, however, omit these details, and pass to some of 
those specific points in the history of the last century which 
further illustrate the growth and progress of medical knowl- 
edge. Perhaps the greatest improvement which has ever 
been realized in modern times was the discovery of vaccina- 
tion. Just one hundred years ago, Jenner’s attention was 
called to the protective power exerted by the vaccine virus. 
Put he did not publish his first paper upon that subject until 
1798. Like all new discoverers, he at first encountered con- 
siderable opposition, but he had the satisfaction enjoyed by 
so few innovators, of converting his enemies, and of obtaining 
a substantial reward from the government of his country. 
From the earliest beginnings of the healing art, efforts 
have been made to lessen the mortality, and to prevent the 
disfigurement, of that great scourge of former times, the small- 
pox. At a very remote period, the Chinese practised inocu- 
lation with a view to reduce the death-rate from this malady. 
In 1721, by the efforts of Lady Mary Wortley Montagu, in- 
oculation was introduced from the East into England, and the 
enthusiastic patroness of the new prophylactic had her own 
daughter inoculated. The success was so complete, that pub- 
lic opinion was turned in favor of the Oriental innovation, and 
the mortality from small-pox was considerably reduced. As 
late as fifty years ago, inoculation was practised occasionally 
in England, but it gradually fell into disuse, and was finally 
prohibited by act of Parliament. Anniversary Discourse. 
15 
Before the introduction of the preventive whose beneficent 
success we have just described, the deaths from small-pox 
were estimated at fifty to seventy-five per cent.; the average 
now is estimated as one in seventy-five, and a more illustrious 
example of one of the tendencies of medical progress, that of 
preventing disease, could scarcely be given. Besides the great 
gain in the death-rate from the small-pox, there has been also 
a similar gain in regard to the prevention of disfigurement. 
Formerly, it was quite common to meet in the streets persons 
badly marked with small-pox; at present such cases are very 
rare, and, where one is seen now, ten or twenty were met with 
a quarter of a century ago. It has thus been proved that 
small-pox, although one of the most fatal diseases known, can 
by proper vaccination be rendered almost harmless, or even 
be stamped out altogether. It is demonstrated by experience 
that every child vaccinated before it is two months old, if the 
operation be afterward repeated every three or five years, will 
receive an almost complete protection from that loathsome 
disease. In this country, vaccination was first performed in 
1799, by Dr. Waterhouse, of Boston. Soon afterward, it was 
introduced into this city. Dr. Valentine Seaman was the first 
to perform it here, in 1801. With the usual energy of the 
American character, the profession pushed forward the new 
preventive. In 1802 a vaccine dispensary was established in 
this city, and wTas placed under the charge of Dr. Seaman; 
he encountered great opposition at first, and an interesting 
story might be written of the early struggles, subsequent suc- 
cess, and final popularity, of the first vaccine dispensary on 
this continent. 
With regard to the efficiency of vaccination there has 
been much discussion, and it will probably be actively kept 
up throughout a great part of the next century. Simon re- 
ports that in 6,000 cases he found the ratio of deaths to be 
.seven and a half per cent, wdien there was one vaccine cica- 
trix ; four and an eighth per cent, when there were two cica- 
trices ; one and three-quarters per cent, when there were three 
cicatrices; and three-quarters per cent, when there were four 16 
Anniversary Discourse. 
or more cicatrices. The Spanish Government attached so 
much importance to vaccination that, in 1803, it sent an ex- 
pedition to Spanish America with several physicians and chil- 
dren, to be vaccinated on the way. This introduced the oper- 
ation into that continent, and numerous societies were formed 
for its perpetuation. 
Next to vaccination the discovery of anaesthetics was per- 
haps the greatest boon ever bestowed by medical science upon 
mankind. The anaesthetic properties of sulphuric ether were 
first demonstrated to the public in the Massachusetts General 
Hospital in October, 1846, and soon came into general use 
and appreciation throughout this country. The next year 
Prof. Simpson, of Edinburgh, while experimenting with dif- 
ferent substances, discovered the anaesthetic virtues of chloro- 
form. Since that time several other substances, such as ni- 
trous oxide, chloric ether, bichloride of methylene, etc., have 
been used as substitutes, but as yet none of them have stood 
the test as well or performed the office as satisfactorily as 
ether and chloroform. In the United States, and especially 
in this city, the general preference is given to ether,- as it is 
considered the safer of the two; while in Europe, and particu- 
larly in England, chloroform is for the most part preferred. 
It is well known that the use of ether or chloroform is by no 
means entirely free from danger, but that danger is so small 
when proper care is used, and when proper cases are selected, 
that the element of danger may be eliminated from our con- 
sideration. From some statistics which I have been able to 
collect, I find that in Guy’s Hospital, London, one death oc- 
curred in 12,000 cases when chloroform was used. In the 
Crimean War no death occurred in 25,000 cases. In fourteen 
of the London hospitals one death occurred in 3,461 cases, 
Dr. Andrews, of Chicago, collected from different American 
and European hospitals 117,078 cases, with forty-three deaths, 
or one in 2,723 cases.1 The danger from sulphuric ether has 
been much less than that which attends chloroform. The 
statistics give four deaths in 92,815 cases, or one death in 
1 Gross’s “ Surgorv.” Anniversary Discourse. 
17 
23,204 cases; this certainly shows a very low average of 
mortality. When a mixture of ether and chloroform was 
used, one death occurred in 5,588 cases. The average num- 
ber of deaths from these three preparations is about one in 
8,744 cases. Much is claimed for the bichloride of methylene, 
introduced by Dr. Richardson in 1867, but it does not seem 
to take the place of ether or of chloroform. Local anaesthe- 
sia, by means of ether-spray thrown upon a part, is frequently 
used while removing small tumors. Who was the first to 
practise this treatment is not stated, we believe, in any pub- 
lished records of our medical history. It is a curious circum- 
stance that, although many deaths have occurred from the 
use of chloroform, they have usually taken place where the 
anaesthetic has been administered for trivial operations. Yery 
few cases are on record in which death has occurred in severe 
operations from the use of chloroform or ether. It is specially 
worthy of note that no death has ever yet been ascribed to 
chloroform when that anaesthetic has been used during partu- 
rition. 
In discussing the merits of vaccination and of anaesthetics 
we have distinctly brought before us the principles which have 
stimulated one important part of the progress which our 
profession has realized during the last century: we refer to 
the prevention of disease, and the conserving of the strength 
of the patient. As a further illustration of these principles 
we might mention various improvements in auscultation and 
percussion for obtaining a knowledge of the pathological con- 
dition of the chest in phthisis, pneumonia, pleurisy, and other 
maladies. It has often been said that a skillful surgeon, if he 
would be successful in his operations, should have eyes upon 
the tips of his fingers, and sensation at the point of his knife. 
By auscultation and by the various instruments which have 
been invented for stethoscopic purposes, the medical observer 
can go even further, and can, as it were, look into the living 
organism to learn there facts which are of the highest im- 
portance, and on which the life of the patient may depend. 
Did time permit, wTe might extend these remarks to the in- 18 
Anniversary Discourse. 
yention of the laryngoscope, otoscope, the various specula, 
and fracture-apparatus, as well as to a multitude of ingenious 
instruments, all of which have been devised for the purpose 
of aiding in the diagnosis, prognosis, and treatment, of dis- 
ease. Or we might speak of the stethometer for measuring 
the amount of expansion during inspiration, and the pelvim- 
eter for measuring the size and shape of the pelvis. There 
are also the ophthalmoscope, the lithotrite, the atomizer, the 
hypodermic syringe, the aspirator, and the sphygmograph. 
The thermometer also, as is well known, is now indispensable 
for obtaining accurate information as to the temperature of 
the body (so as to diagnose malarial from continued fever, 
and neuropathic affections from inflammations). 
Fifty years ago Laennec laid the foundation of our pathol- 
ogy and treatment of pleuritis. Except Laennec, there has 
perhaps been no man, since Haller, who effected so great a 
change or stimulated so conspicuous an advance in the knowl- 
edge of particular diseases as Dr. Richard Bright, of London. 
He was the first to point out the connection between dropsy 
and albuminuria and disease of the kidney; previous to the 
year 1824, when Dr. Bright made this discovery, dropsy was 
considered as a primary disease, dependent upon a deficient 
action of the absorbents. We may also mention the fact that 
to Chomel and Louis is due the credit of showing that typhoid 
fever is a distinct species of continued fever, having a definite 
group of symptoms. Moreover, scurvy, once the great scourge 
of armies and navies, seldom makes its appearance in our time, 
when proper precautions are taken in regard to diet. Another 
illustration was suggested when we were speaking of small- 
pox. This malady formerly caused the death of from fifty to 
seventy-five per cent, of those affected with it; it is now fatal 
to not more than five to seven per cent, of its victims. We 
have not time to detail the improvements which have been 
made in the resuscitating of drowned persons. A century ago 
scarcely anything was known by the profession on this subject 
which was not equally familiar to the layman. The history 
and details of Marshall Hall’s method of resuscitation are well Anniversary Discourse. 
19 
known, as are also the improvements made upon it by Sil- 
vester. 
Let us now look at the results of medical progress upon 
public health and the rate of mortality. It is just a hundred 
years since the statistical facts were collected on wdiich the 
Carlisle tables were made. These tables show that out of 
603,Y24 men and women of the age of thirty, there will sur- 
vive at the age of forty, 538,584; at the age of fifty, 464,280; 
at the age of sixty, 369,831; at the age of seventy-five, 161,124. 
Such was the expectation of human life from seventy-five to 
one hundred years ago. Complaints were made by the old 
life-insurance companies that the mortality in actual life was 
greater than it is set down in the Carlisle tables. But we have 
a significant illustration of the growth of medical science, and 
of the improvement of prophylactic methods, that human life 
is now longer on the average, and these tables err now in the 
contrary direction. To show that, notwithstanding the dis- 
eases incident to the high pressure at which in our day the 
majority of people live and work, the length of human life is 
on the average extending, we may state that the Mutual Life 
Insurance Company of this city published lately a revised set 
of tables, founded upon their actual experience with insured 
lives. Referring to this table, we find that, of 603,724 persons 
at the age of thirty, there survive, at the age of forty, 553,431; 
at the age of fifty, 502,049; at the age of sixty, 427,588; and 
at the age of seventy-five, 215,177. Comparing these figures 
with those given by the old Carlisle tables we find a very great 
difference in favor of the recent table. The evidence is thus 
very strong in favor of the theory that human life is lengthen- 
ing. "VYe have thus a gratifying illustration of the conservative 
forces which are developing themselves in modern times by 
the impulse of advancing medical knowledge. There are, 
however, not a few influences at work in society of an opposite 
character; to these we must presently direct attention for a 
few moments. 
First, however, we must speak briefly of the revival in the 
use of electricity as a medical agent. During the last few 20 
Anniversary Discourse. 
years the claims made for it by some of its too enthusiastic 
devotees have often been excessive. According to some of 
these gentlemen, electricity was to be the great panacea, and 
its use was to supersede that of almost every other remedy; 
time, however, has modified these extravagant anticipations. 
Like many other remedies for which too much has been claimed, 
electricity is now perhaps in some danger of being under- 
estimated. The advantages which it is capable of conferring 
in certain classes of nervous disorders are well known. It is 
to be regretted, if the errors of the first introduction of elec- 
tricity as a therapeutic agent should cause any of the younger 
or less instructed members of the profession either to over- 
value it on the one side, or to neglect it on the other. 
The first systematic treatise on medical electricity was 
published in 1781, by Dr. Grappingiesser, of Berlin. Since 
that time many works of various merit have been published 
of which we need not here speak in detail. 
We must also omit the still more tempting subject of or- 
ganic chemistry. A century ago the science scarcely had an 
existence; and I should far exceed the limits of a short 
address were I to attempt to sketch the history of the exten- 
sive discoveries which have immortalized the names of Dalton, 
Gay-Lussac, and a host of distinguished investigators. At 
certain epochs the profession and the public have had their 
attention attracted by men who have suddenly appeared upon 
the stage, and, by their brilliant discoveries, have revolution- 
ized old theories and established new and more rational sys- 
tems. It is thus that the theory and practice of medicine have 
made progress by the discovery of Jenner in vaccination, of 
Harvey in the circulation of the blood, of Pare in the use of the 
ligature, of Laennec in auscultation and percussion, of Bright 
in the relations of dropsy to renal disease, of Morton in anaes- 
thesia, and of many others in various departments which have 
attracted less notice. It is worthy of remark, however, that 
the progress which has been thus made is due to the labors 
of men belonging to the regular school; and these men have 
rarely won distinction or achieved any valuable progress with- Anniversary Discourse. 
21 
out two great qualifications: 1. They have had a solid 
groundwork of education as to the facts and principles of 
medical science. 2. They have devoted themselves not only 
to the exploration of new facts, but to the comparison and 
collating of them with established principles, so as to unite 
them with the older parts of the fabric of medical knowledge. 
Before we leave the consideration of electricity and chem- 
istry, we may mention it as one of the benefits conferred upon 
medical science that the separation of the active principles of 
various drugs, which forms so conspicuous a feature in mod- 
ern practice, is almost entirely due to the rapid growth of 
chemical analysis. To the same cause also we must ascribe 
the discovery of a number of new remedies which promise 
hereafter to be extremely valuable,- and indeed have already 
rendered distinguished service. 
¥e must not omit to mention the impulse of the four 
years of civil war, as a means of promoting the progress of 
medicine, and especially of surgery. The long period of 
peace, previous to 1861, was not favorable to the efficiency of 
the medical departments of the army and navy. The small 
standing army, and the still smaller navy, were but poorly 
equipped for such a gigantic struggle as that to which the 
country was summoned by the bombardment of Fort Sumter 
sixteen years ago. The medical department was not slow, 
however, in its preparations to meet the stupendous difficul- 
ties of the situation. Very soon the medical service was so 
completely remodeled and improved as to be on a par with 
the other departments. 
The amount of labor performed by the medical staff dur- 
ing the war was enormous. When the hospitals were closed at 
the end of the struggle, all the reports connected with the 
medical service were returned to the Surgeon-General for 
inspection and analysis. These reports showT that 183,287 
soldiers died of disease, and 96,089 of wounds. The volumes 
of the medical and surgical history of the war contain reports 
of 207,000 cases. In no other country, perhaps, has there 
been anything like this number of cases treated in the same 22 
Anniversary Discourse. 
length of time; or, if so, no such careful records have ever 
been published. These reports show that there were during 
the war 2,789,893 enlisted men in the army. 
Of surgeons there were 11,608, and of these surgeons 
409 1 died, showing a high rate of mortality as compared with 
that of other branches of the service. 
These facts, and a multitude of others which time forbids 
us to adduce, demonstrate the fact that medical men as a class 
are not lacking in devotion to duty or to their country in the 
hour of need, any more than they are remiss in times of peace 
in caring for public health, in attending the poor, and in per- 
forming other beneficent services, especially during those epi- 
demics by which various sections of our country are so fre- 
quently visited. 
In the language of Rev. Dr. Wheeler, “ without the medical 
profession, where would be our knowledge of physical life, or 
of the laws of its growth, the causes which modify it. or the 
means of perfecting it and the expedients for arresting its pre- 
mature dissolution. When followed as a liberal profession 
and not as a trade, it is one of the most beneficent occupa- 
tions open to the aspiring ambition of man. Its eye is fixed 
upon life as the organific power of all ; on life as permeating 
and modifying all growth; on life as working ceaselessly tow- 
ard the production and improvement of its kind. To watch, 
therefore, this life in the functions and tissues of the human 
frame, is the more immediate purpose of the profession as a 
practical power in society. But its highest end is to be a ser- 
vant, a minister of life.” 
As has been hinted, there are but few instances in which 
medical men have been rewarded by the government in any 
substantial way for the discoveries which they had made. 
The British Government gave Jenner $150,000 for the dis- 
covery of vaccination. The French Government considered 
the discovery of quinine of so much importance, that they 
awarded to Pelletier and Caventou the sum of 10,000 
francs. In 1819, the Emperor of Russia settled a pension on 
1 “A Century of American Medicine,” p. 208. Anniversary Discourse. 
23 
a Russian army-surgeon for ligating the internal iliac artery. 
The first Napoleon mentioned Baron Larrey in his will, and 
left him a bequest for his fidelity and skill as surgeon-in-chief 
of the imperial army. Finally, we may mention the legacy 
left by Washington to Dr. Craik, whom he described in his 
will as “ my compatriot in arms, my old and intimate friend.” 
These, however, are exceptional cases. We may say of 
medical progress as of so many other beneficent movements 
perpetually taking place around us, that it has little to be- 
stow upon its champion beyond the calm approval of con- 
science and the satisfaction of scientific aspirations. Not only 
governments but the public also are often found treating the 
physician with cruel neglect, especially, when old and for- 
merly-valued services are no longer supposed to be needed. 
An old writer celebrates this with bitterness and not wdthout 
humor, in the following doggerel lines: 
“God and the doctor we alike adore, 
But only when in danger, not before ; 
The danger o’er, both are alike requited— 
God is forgotten, and the doctor slighted ! ” 
To sum up the services rendered to the public by medical 
men, I wmuld state that during the last year there wrere 
treated in the hospitals and asylums of this city 40,000 pa- 
tients, and in the dispensaries 228,000 more. These sta- 
tistics do not include the patients in some of the smaller hos- 
pitals and dispensaries whose reports we have been unable to 
obtain. In almost all of these institutions, the services of the 
physicians are gratuitous. Certainly it cannot be said of the 
medical profession that it does not bear its share of the bur- 
den of taking care of the sick and unfortunate who may need 
its services. No other class of our citizens contribute so 
largely to charitable work as do physicians. 
We must now say a word or two about medical illusions : 
“ They differ from all other deceits because their consequences 
are visited by penalties wdiieh cannot be remitted. There is 
no potent field to correct the errors of quackery ; the unhappy 
victim may be made sensible of his folly, he may be willing 24 
Anniversary Discourse. 
to submit to the laws of necessity, and to die when, in the 
language of the multitude, ‘ His time has come,’ but who 
does not know that the exhibition of poisons will hasten the 
event ? who does not know that the prescribing of palliatives 
is but wasting time, and allows disease to spread its ravages 
throughout the system during the precious period which should 
be improved for recovery; and who does not know that for 
time so wasted nothing can replace it ? And yet he finds in 
the experience which every day, every hour presents, that 
ignorance and imposture, aided by knowledge of human weak- 
ness which knows how to flatter, are permitted to fatten on 
human suffering, and to make merchandise of human hope.” 1 
I quote this striking passage from an author whose senti- 
ments are so just that they will be at once assented to by all 
of us. The history of medical delusions is a very singular one, 
and affords extraordinary proofs of the credulity of the human 
mind in matters pertaining to disease: In 1796 a Hr. Per- 
kins, of Connecticut, claimed that, with two small pieces of 
metal called tractors, he could cure almost all diseases ; these 
two metallic rods were supposed to produce their effects by 
means of a galvanic current which they started and kept in 
motion ; two years later, the inventor took them to England, 
and in a short time he performed such wonderful cures, that 
a Perkinean Institution was established in London. Among 
its managers were the titled, the learned, and even the Church 
was represented there. The institution at first flourished : 
very many cases were reported cured ; testimonials of the 
highest character were written ; soon a great demand sprung 
up for the new American tractors. These little rods of metal, 
made in a Connecticut village at a cost of a shilling, readily 
sold to the credulous Englishmen for live guineas a pair. Not- 
withstanding their great reputation, there were, however, 
some unbelievers. They proceeded like the magicians who 
wished to compete with Moses, furnished themselves with 
instruments like that of their great rival, but they did not 
know of what material the tractors should be made. As an 
1 Dr. J. E. Manley’s Anniversary Discourse, 1848. Anniversary Discourse. 
25 
experiment they constructed them of wood, and painted them 
so as to resemble the original tractors. Singularly enough, 
they performed the same cures, and the wooden tractors were 
just as valuable in controlling disease as the Connecticut in- 
vention which cost twenty-five dollars. Within ten years from 
its first appearance, Perkinsism was numbered among the 
things of the past, and is only mentioned to illustrate the cre- 
dulity of the public, which, indeed, is the first condition of all 
medical quackery. Some fifty years before Perkins brought 
out his tractors, Bishop Berkeley had in tar-water discovered 
a universal remedy which was taken by all sorts of people who 
were cured by it, as was supposed, of every imaginable disease. 
This remedy had its day, and is now only spoken of as one of 
the absurdities of the past. 
About the year 1800 Samuel Thomson started a fanciful 
doctrine which took his name;1 one of its leading principles is, 
that “ the human body is composed of four elements, earth, air, 
fire, and water; and consequently, that as metals and minerals 
are in the earth, and are extracted from its depths, they have a 
tendency to carry down into the earth all who use them ; on 
the contrary, the tendency of all vegetables is to spring up 
from the# earth. Hence, vegetable remedies tend to uphold 
man from the grave, and for this reason they should be ex- 
clusively used, while mineral remedies should be always 
avoided.” Thomsonianism degenerated into eclecticism, and 
is on its way to oblivion; like the theories of tar-water, Per- 
kinsism, and of other empiricisms, in which the past century 
has been so fertile. 
Sects in medicine have always existed, and probably al- 
ways will exist. They flourish for a while, and finally go 
down. Whatever they may have originated is soon absorbed 
and utilized by the regular profession, whose course is ever 
upward and onward, ready to use anything and everything 
that may be of benefit to the science and practice of medicine, 
from whatever source it may be obtained. Perhaps the great- 
est delusion ever started in the scientific "world was homoe- 
1 Dunglison’s “ Medical Dictionary.” 26 
A nniversary Discou rse. 
opathy, which, on account of its inherent absurdity, found no 
favor with the regular profession, and was not adopted by it. 
A few practitioners who could not succeed by honest means 
adopted it, and have flourished on the pretended opposition 
of the “ old school,” as they affected to designate the regular 
profession. It is a fact, as we have already hinted, which is 
frequently observed in human nature, that, no matter how ab- 
surd or ridiculous a doctrine or system may be, it will always 
find supporters, especially if its advocates can create a preju- 
dice in the public mind toward its alleged opponents or per- 
secutors. They soon make it appear to the uninformed pub- 
lic that there is something marvelous about the new theory, 
and that it is opposed by rival sects on account of its superior 
merits. An adroit advocate of such new systems will soon 
find friends among people who are incapable of forming a 
correct judgment on such matters. The adherents of the sys- 
tem or so-called “school” of homoeopathy have of late years 
changed their methods. To all intents and purposes they 
have abandoned their peculiar system and renounced their 
distinctive principle; they no longer believe and practise the 
axiom, “ Similia similibvs curantur,” nor in infinitesimal doses. 
They use medicines of the same kinds as the regular profes- 
sion, and in equally large doses. They are, in fact, homoeopa- 
thists only in name, and, so long as they continue in that course, 
they assist in perpetuating a delusion and in sustaining a prac- 
tical fraud. If I am not mistaken, there are visible indica- 
tions on both sides of the Atlantic that the system will be 
numbered at no distant day among its numerous predecessors, 
and that people will wonder at the lack of knowledge and 
judgment on the part of the public, in which such a system 
could exist together with so much activity of material and 
intellectual progress. At least this prediction has been made 
in Europe, where homoeopathy has had a fair trial; if it fall 
into oblivion there, it cannot fail to undergo in due time 
the same inevitable fate here. 
Within the last twenty or twenty-five years there has been 
a tendency to specialties in the profession. The ophthalmolo- Anniversary Discourse. 
27 
gists, the orthopedists, the dermatologists, the gynecologists, 
and throat-doctors, have enlarged their specialties so much as 
to make the held of medicine much more extensive than for- 
merly. 
The discovery of the ophthalmoscope has, in a measure, 
revolutionized our knowledge of the treatment of diseases of 
the eye ; it has also discovered new diseases, discarded old 
ones, and in some instances enables us to predict and diagnos- 
ticate incipient renal and mental disease. The laryngoscope 
enables us to detect and treat successfully lesions heretofore 
only suspected, and to remove in some instances foreign bod- 
ies that could not be reached without it. By means of the 
microscope, the dermatologist has discovered the causes of 
many skin-diseases, and has traced them, in numerous cases, 
to animal or vegetable parasites heretofore not suspected. 
The gynecologist, by means of the ingenious specula, liga- 
tures, and clamps, which have been invented, many of them 
in this country, within the last few years, is now enabled to 
cure or to palliate the evil of many lesions which formerly 
baffled the best medical skill. The orthopedist, by means of 
extension, resection, and the subcutaneous division of muscles 
and tendons, is enabled to make the crooked straight, and to 
preserve and make useful limbs that under the old surgical 
regime would have been of necessity amputated and lost. 
The theory that the variola, scarlatina, measles, typhus, and 
typhoid, originate spontaneously, was formerly accepted uni- 
versally by medical science; it is now almost everywhere 
abandoned, and the newr theory, which is firmly believed by 
many of the leading men in the profession, is that each of 
these maladies, and perhaps many others also, originates in its 
own specific germ. Indeed, they have in this revolution of 
medical doctrine done no more than to revive the old theory, 
“ Omnes ab ovo.” Harvey applied this old axiom to the gen- 
eration of animal and vegetable life, and made thereby signal 
discoveries in embryology, which, unfortunately, were lost to 
the world in the great revolution under Harvey’s patron, 
Charles I. of England. In our day this axiom has been util- 28 
Anniversary Discourse. 
ized in a different field of investigation. Harvey deduced 
the great general principle that living organisms, both vege- 
table and animal, spring from a seed. We now deduce the 
principle that every disease springs from its own peculiar spe- 
cific germ, and cannot originate in any other way. These 
germs, it is true, have not as yet been studied with as much 
completeness and accuracy as might be wished; the theory is 
as yet but in its infancy; still, as Cuvier said, natural history 
will yet have its Newton, and in a few years it is probable 
that great discoveries in this field of biological investigation 
will repay the labors of the microscopist and the physiologist. 
Enough is known to show us many important indications for 
the prevention and treatment of diseases, for the germs may 
long remain latent, and can only receive development under 
favorable circumstances. If we were obliged to point out the 
direction in which the next great improvement in medical 
science and practice will be realized, many of us would not 
hesitate to point to this germ-theory of disease, as promising 
brilliant rewards to the patient student and observer. 
Of the nature of those contagions, as they are called, by 
which diseases are propagated, we know and can know with 
our present faculties but a limited number of facts. What 
we have to do is, to learn these facts thoroughly, just as Newton 
learned and pondered those facts which immortalized him by 
suggesting the great law of gravitation. The germ-theory of 
disease helps ns even in its present imperfect condition to ex- 
plain many things which formerly were deemed very mysteri- 
ous ; and, though we do not by any means affirm that all the 
opinions are true which have obtained currency on this sub- 
ject, the conflicting opinions will destroy each other, and will 
contribute to establish the truth on a settled and useful foun- 
dation. 
Among the physicians practising in this city one hundred 
years ago, perhaps the most upright, energetic, and benevo- 
lent, was Dr. Samuel Bard,who was born in New York, about 
the middle of the eighteenth century. He graduated in 
medicine at Edinburgh in 1765, and soon afterward com- Anniversary Discourse. 
29 
menced practice here. In 1769, he delivered a public address, 
recommending the establishment of a hospital in this city. 
He was so well received, that a subscription was at once 
started, and on the same day the sum of eight hundred pounds 
was collected for the establishment of the Hew York Hospi- 
tal. The first building erected for this institution was de- 
stroyed by fire when near its completion. The war soon 
afterward broke out, and the edifice was not rebuilt and ready 
for occupancy until the year 1791. Dr. Bard was one of its 
physicians from the first, and he continued to visit it daily 
until his retirement from practice in 1798. His compendium 
of obstetrics was the first work of the kind published in this 
country. 
The influence of Mr. Percival Pott upon English surgery 
was very great, and few men contributed more to its improve- 
ment. He was one of the most skillful operators of his time, 
and made many improvements. The most important, perhaps, 
was his proposal to take up the femoral artery on the anterior 
part of the thigh, for the cure of popliteal aneurism. This 
operation was performed by his pupil, John Hunter, in 1785. 
Mr. Pott’s essay on fractures had great influence. He was 
the first to discriminate in cases of curvature of the spine, be- 
tween caries or abscess and other changes of form in the 
hones. He opposed the general use of the actual cautery 
and escharotic unguents. He improved the cutting instru- 
ments employed in surgery, and was more disposed to trust in 
the vis medicatrix naturae than many of those about him. 
John Hunter, though not as skillful an operator as Mr. 
Pott, was successful from his great knowledge of physiology 
and pathology in doing more than any of the surgeons of hi& 
day for the advancement of his art. His operation for aneu- 
rism, his doctrine of adhesion, granulation, and inflammation, 
his essay on venereal diseases, all bear witness to his genius. 
At that time the method of treating amputation was 
to keep the flaps separated by means of lint or bandages, 
in order to promote suppuration. The principle of this treat- 
ment wTas, that this process was necessary to insure the union 30 
Anniversary Discourse. 
of tlie parts. Now the object is to procure union by first in- 
tention, if possible. Here, again, we see how correct principles 
have tended to improve in this case as in thousands of others. 
Lister’s method of closing the wound hermetically while a 
spray of carbolic acid is thrown upon the part, and the sur- 
rounding air filled with it by means of the atomizer, is well 
received by surgeons, and bids fair to be more extensively 
used. 
Fifty years ago the zeal and success exhibited by Ameri- 
can practitioners were already well known in England. In 
1825 Mr. Samuel Cooper made the following remark, “ In- 
deed, it appears to me that the zeal and talent with which the 
practice of surgery is now cultivated in that part of the world ” 
(the United States) ‘‘will soon render it a frequent source of 
valuable suggestions.” Since that time Mr. Cooper’s predic- 
tion has certainly been fulfilled. 
The first clinical instruction in surgery established in this 
city wras given in the New York Hospital, in 1801, by Dr. 
Valentine Seaman, who was also the first to perform vaccina- 
tion, as we have previously stated. 
To American surgeons belongs the credit of having per- 
formed many original operations upon the large arteries. The 
venerable Mott was the first to tie the arteria innominata in 
1818, and though unsuccessful, he always maintained that it 
was a justifiable operation, and that it wTould at some time be 
successfully performed. He lived long enough to know that 
the operation was done with success. It was performed May 
15, 1864, by Dr. A. IV. Smyth, house-surgeon of Charity 
Hospital, New Orleans. This was the only successful case in 
about a dozen operated upon. Dr. Mott is said to have tied the 
carotid artery fifty-one times. He tied the common iliac suc- 
cessfully in 1827. Dr. Gibson, of Philadelphia, was the first 
who tied that artery, in 1812 ; but his patient died from haem- 
orrhage and peritoneal inflammation on the thirteenth day. 
The subclavian was first ligated by Mr. Keate, of London, 
in the year 1800. In this country Dr. Wright Post was the 
first surgeon to perform this operation, in 1817. Anniversary Discourse. 
31 
Dr. Stevens was the first to ligate the internal iliac artery in 
1812, while residing at Santa Cruz, West Indies. John Hun- 
ter, of London, was the first surgeon who tied the femoral artery 
for the cure of popliteal aneurism. He performed this opera- 
tion in the year 1785, at the suggestion of his tutor, Mr. Pott. 
The same operation was first successfully performed in this 
country by Dr. Wright Post in 1796. 
The first well-authenticated case of ligature of the carotid 
was that of Mr. Fleming, an English naval surgeon, who tied 
the artery for a wound in the throat, October 17, 1803. Dr. 
Cogswell, of Hartford, Connecticut, tied the artery for a tu- 
mor, not being aware at the time that the operation had ever 
been performed before; it is supposed that Mr. Abernethy tied 
the carotid artery somewhere about 1778, but there appears 
to be a doubt about the exact date. On June 25, 1817, Sir 
Astley Cooper placed a ligature upon the abdominal aorta, 
just about its bifurcation ; the patient lived only a few hours. 
In this country Dr. Carnochan wTas the first to ligate the fem- 
oral and the external iliac arteries for the cure of elephantia- 
sis of the face and neck. Dr. J. C. Warren, of Boston, was 
the first to perform a surgical operation while the patient was 
under the influence of ether; the operation was done at the 
Massachusetts General Hospital in October, 1846. 
Dr. J. Syng Dorsey, author of the first treatise on surgery 
published in this country, was the first surgeon to ligate the 
external iliac artery in the United States; it was done in 
1811. In England this operation was first performed in 1796, 
by Mr. Abernethy. 
In a case of dislocation of the clavicle, wdieri the bone could 
not be kept in place by any expedient then in use by surgeons, 
the late Dr. E. S. Cooper, of San Francisco, used silver wore 
for that purpose. 
The profession is indebted to Dr. Alexander Wood, of Edin- 
burgh, for the hypodermic syringe. The first physician to use 
sedatives by means of this instrument, in the United States, 
was the late Dr. G. T. Elliot, in 1857. 
Much of the stimulus to the study and improvement of 32 
Anniversary Discourse. 
surgery must be ascribed to the invention of photography. 
A celebrated teacher of surgery, in London, used to tell his 
students that one of the indispensable conditions of success 
was to learn to draw; by means of sketches from morbid 
specimens the pupil, he said, was able to gain ten times as 
much in a given period by his own rude efforts and drawings, 
as if he relied upon the best specimens of printed plates. 
In his day photography did not exist. 
The benefits which this invention now confers upon the 
students and practitioners of surgery it is impossible to over- 
estimate. A large volume might be written on the pathologi- 
cal, surgical, physiological, and diagnostical value of the new 
art of photography. If we have been, in this country, active 
in the use of this art as an aid to medical progress, we have 
also been active in improving and perfecting it; and some 
of the most important improvements it has received owe their 
origin to scientific men in this country. 
In photography we have an illustration of the advantages 
which chemistry is capable of conferring upon the progress of 
human knowledge. During the last century thirty-two simple 
elementary bodies have been discovered which were not known 
to the chemical analists of the eighteenth century. But the 
chief triumphs of chemistry consist, as we have said, in the 
beneficent agencies which it has multiplied to promote the 
welfare of mankind. 
There has been of late a very singular and mischievous 
attack made against vivisection. Among other opponents of 
this beneficent aid to physiological research, we regret to find 
actively engaged those philanthropic societies which have 
been organized in several of our large cities for the prevention 
of cruelty to animals. The conspicuous usefulness of these 
societies, when confined within their proper sphere, causes re- 
gret that they should provoke hostility to themselves by over- 
leaping the limits within which their proper work applies. 
One example of their mistakes is that to which we have re- 
ferred. In their efforts to relieve the lower animals, they have 
of late attempted to influence legislation in such a way as to Anniversary Discourse. 
33 
prevent vivisection in this country and in England. The rea- 
son assigned for this spurious zeal and imaginary benevolence 
is, that the experiments of physiologists upon living animals 
are barbarous and cruel. The great advance in physiology 
during the last three generations has been due, in a much 
greater degree than formerly, to experiments upon the living 
organism of inferior animals. The men who oppose these ex- 
periments are not members of the medical profession, nor are 
they versed in the knowledge of physiology; they are there- 
fore unable to judge of the necessity of the advantages of those 
experiments which they endeavor to suppress. Nor can they 
measure the amount of good to the human race which they 
would prevent, were it possible that they could succeed in their 
purpose. To the medical man it is not needful to state the 
advantages of vivisection, but to others it may be of use; to 
insist upon and to give the widest publicity to the fact that 
almost all the great truths in regard to digestion, to the circu- 
lation, to nervous diseases, to repair of tissues, have been im- 
proved or demonstrated by experiments performed upon the 
lower animals. Many of these experiments have settled the 
questions for which they were made, hence they need not be 
repeated; but in other cases, and these the most important, 
it is necessary to repeat these experiments over and over again 
until some definite conclusion is arrived at. The prevention 
and treatment of numerous diseases have received and are 
continually receiving improvements resulting more or less di- 
rectly from such experiments; and, since the introduction of 
anaesthetics, the animal suffers no pain during the operation, 
as in most cases it is killed before the return of consciousness. 
If the well-meaning men joined in this crusade against vivi- 
section were better informed, they would know that the scien- 
tific observer, in his physiological experiments, avoids in every 
possible way the infliction of unnecessary pain. 
In 1774 William Hunter published hi|s work on the gravid 
uterus, and perhaps did more than any one before him in ele- 
vating obstetrics to the rank of a science—previous to that 
time obstetrics had been chiefly in the hands of women. 34 
Anniversary Discourse. 
Probably tlie first man to systematically practise it in this 
country was Pr. James Lloyd, who began to practise it in 
Boston in 1753. The first course of lectures on that subject 
was delivered by Pr. William Shippen, Jr., at Philadelphia, 
in 1762. To Pr. John Stearns, the first President of this 
Academy, is due the credit of having introduced to the profes- 
sion the use of ergot. 
The great improvement of forceps, during the last few 
years, has rendered their use much safer than formerly, and 
in tedious cases the great amount of suffering has been pre- 
vented and many lives saved. 
Pr. Ephraim McPowell, of Kentucky, was the first to 
perform ovariotomy in a rational manner; his operation was 
performed in Pecember, 1809, and was successful, the patient 
lived to the age of seventy-nine years. He operated thirteen 
times, and eight of his patients were cured. 
Although so successful in what was considered so grave an 
operation, his procedure was not at once generally adopted. 
At that time, and until within a very few years, there was 
such a dread of severe peritoneal inflammation following the 
admission of air into the abdominal cavity, that few were 
bold enough to repeat the operation. In 1822 Pr. Hathan 
Smith followed McPowell, and since that time the operation 
has been performed many hundreds of times; indeed, it has 
now become one of the established operations in surgery. The 
estimate is, that it has been the means of saving the lives of at 
least two thousand women. A century ago gynecology could 
scarcely be said to have existed. 
In 1801 Recamier adopted or invented the vaginal specu- 
lum. To him is due the credit of having advanced gyne- 
cology more than any other surgeon. The speculum had been 
used by the Greeks, but, when Recamier introduced it, it had 
for ages fallen into disuse and been forgotten. 
Pr. Sims, in 1852, published an article on vesico-vaginal 
fistula, in which he described the use and advantages of his 
improved speculum. He thus opened up a new field for con- 
servative surgery, and this instrument has done more than Anniversary Discourse. 
35 
any other to afford facilities for operation in the treatment of 
vesico-vaginal lesions. 
Among the prominent obstetricians and gynecologists of 
this country, may be mentioned Drs. Bard, Dewees, Meigs, 
Hodge, McDowelJ, Peaslee, the Atlees, Bedford, Hott, Sims, 
and Emmet. 
Dr. Bard was the author of the first American treatise on 
obstetrics, published in 1807. Dr. W. P. Dewees, for a long 
time Professor of Obstetrics in the University of Pennsylva- 
nia, was the author of several works on tliat subject, and on 
the diseases of women and children. These treatises passed 
through many editions, and were verj' popular as text-books 
in their day. Through these books and his lectures, Dr. 
Dewees exerted a great influence upon the study of obstetrics 
and gynecology. Dr. Meigs was the first to discover that 
sudden deaths, jpost partum, were due to cardiac thrombosis, 
though Yirchow, the eminent pathologist of Berlin, has for 
many years enjoyed the credit of the discovery. 
Dr. Hodge, the successor of Drs. Dewees and Meigs, has 
left to the profession his forceps and pessary, as monuments 
of his ingenuity and professional skill. 
Dr. Bedford wTas the first in this country to establish a 
clinic in connection with a medical school for the treatment 
of diseases peculiar to women. 
We are tempted to extend these interesting records indefi- 
nitely, but we are warned to bring our discursive and some- 
what desultory narrative to a close. There is one subject, 
however, on which we cannot refrain from offering a passing 
suggestion. In no other country but our own has so much 
difficulty existed during the greater part of the last century in 
drawing the line between the regular profession and the nu- 
merous factions who do not belong to it. Dr. J. M. Smith, 
in 1849, referring to this subject, said: “ There are commu- 
nities in which no means exist that enable the majority of the 
people to distinguish empiricism from sound medical learning. 
Such was the fact in this city until within a recent period.” 
The reference here is to the organization of this Academy, 36 
Anniversary Discourse. 
which was intended to discriminate clearly between medical 
science and quackery, and, during the last twelve years, its 
efforts for this purpose have been nobly seconded by the 
Medico-Historical Society. This latter association, by a care- 
ful registration of such practitioners as are supposed to abide 
by the code of ethics of the American Medical Associa- 
tion, has rendered great service to sound medical progress. 
In this city, and generally throughout the States of Hew 
York, Hew Jersey, and Connecticut, the status of every prac- 
titioner of medicine is pretty accurately defined. That great 
improvements in this respect may not be made, we, of course,' 
refrain from affirming. A similar collection of statistics might 
be extended with advantage to the other States of Hew Eng- 
land, as well as to the Western and Southern sections of our 
country; still, considering the fact that under our popular 
institutions, and in our peculiar form of government, we can- 
not derive the aid from legislation which has been craved in 
some quarters, the success which has been to so great an ex- 
tent achieved in the past is our best warrant for believing that 
the course we have adopted in this Academy, and in other like 
institutions, is the right one ; and we have only to persevere 
in the right course to secure more complete results hereafter. 
In conclusion, we may say, with the venerable Dr. Francis: 
“ There has ever been a faith in the medical art, wide and un- 
wavering, among all conditions of men, rude or refined ; but 
that faith has been purest and deepest where society is most 
matured, because of the truths she inculcates in her several 
departments for human well-being.”