. . .... ", . . ■., . : '■"■ \ • '• . . . 5 ' '.■ :■ v :■ ■" ■■ ■■ : 5$Kft vv ■ill iifSli; J> ■ .. . ■: ■.■■■■. ■« v..;- v; sss .-■ ; "v ' ?t: Le Medic -Stat 11111111 : : .:'.■.■..'■■■. ,;■.-■■.<. M : \ 1807-1906 ■•v d'fi CORNE LL UNIV ERSITY THE Jflotw? r Tfptmttanj HJtbrarg FOUNDED BY ROSWELL P. FLOWER for the use of the N. Y. State Veterinary College 1897 Cornell University Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://archive.org/details/cu31924000275572 H ISTORY of the MEDICAL SOCIETY of the STATE of NEW YORK BY harness % &at0f>, JSU&D., #&.2D., %%.%>. In Commemoration of the Centennial of the MEDICAL SOCIETY of the STATE of N. Y. January, 1906 PUBLISHED BY THE SOCIETY 1907 4fytr by nearly one-half, mounting up to 340.- 000, it reached 589,000 in 1800; and in 1810, with 959,000, attained the second rank, very nearly equalling Virginia, and surpassed it by one-third in 1820. The center and the west of the State, which had been the scene of contest, became in this interval the chosen field of immigration. Tryon County, renamed Montgomery in 1784, had furnished territory for more than a score of counties ; and while New York had risen to the head in population, Albany stood in 1820 thir- teenth in rank; while Ontario, Genesee and Oneida were respectively second, third and fourth in number of inhabitants. The incoming multitudes as early as 1796 made necessary the opening of a State road from Whitestown to Geneva, from the Mohawk to the interior lakes ; and in 1798 roads were cut from Genesee to Buffalo and Lewiston, while the water routes from the south, as well as from the east, were much used. Before the eighteenth century closed a regular postrider connected Albany and the Genesee Valley by trips every fortnight, a grand road was opened from the capital to Clinton county, and a regular line of stages beside the Hudson prophesied the swifter travel of later days. Roberts calls attention to the fact that the population of New York State during and just after the Revolution was much more mixed than of any of the other thirteen original States. The comparative mildness of the New York Colonial Government and the commercial opportunities afforded by the harbor and the growing city, with the shipping it attracted, served to bring many Europeans of different nations to Manhattan and the surrounding districts. As a consequence, the population of New York State in the early days of our Government more nearly resembled that which has come to be the characteristic condition 25 all over the country in recent years, than that of any other State. Somehow out of the friction of all these different nationalities, there came a spirit of enterprise, greater than was to be found in any of the colonies in which a more exclusive racial condition obtained. To quote Roberts once more: "But if in the Revolution the population of the State was so inferior, discipline and trial had given it char- acter. If New England was Puritan and Virginia Cava- lier, and both positively English, New York was the first to become distinctively American. In spite of its strong loyal element, its separation from the crown severed fewer ties of blood and nature, because of the diverse races which mingled on its soil. The original Dutch current had run by inter-marriage into the veins of many families whose names bear no testimony of it. Other races also have joined hands. In the framing of the nation many streams of race mingled. To the Declaration of Independence, Philip Livingston sub- scribed with the vigor of Scotch blood; Francis Lewis with the ardor of a Welshman; William Floyd and Lewis Morris, with the prudence of mingled Welsh and English descent. Philip Schuyler, the major gen- eral, was of pure Dutch blood. Nicholas Herkimer, the hero of Oriskany, was the son of a German from the Palatinate. Alexander Hamilton, born in the West Indies, was Scotch and Huguenot in origin; and John Jay, the first chief justice of the United States, was of clear Huguenot strain. George Clinton, the first Gov- ernor of the State, was the son of an Irish immigrant, as was General Montgomery, who fell at Quebec. Eng- lishmen there were who then and afterwards added lustre to the service of the commonwealth; but it is the distinction of New York that its early history was molded in the furnace and from the varied elements which have given to the nation its character and its name as American." Perhaps it is as a consequence of this, then, that New York has always maintained a leader- ship in nearly all of the practical advances that tend to make life more pleasant and more health- ful. We have made this claim already with regard to medical regulation. It will be remem- bered, in addition to this, however, as we shall see in the proper place, that it is to the New 26 York Medical Society that is mainly due the United States Pharmacopeia, and the organiza- tion of a committee to continue the work on this important contribution to progressive medical science. Before the middle of the nineteenth century it was to the initiative of the New York Medical Society that the profession of the cen- tury owed the organization of the American Medical Association. New York's rapid progress in scientific medi- cine, just after the Revolution, was undoubtedly due to the fact that the inhabitants of the colony had taken to heart the precious advice of the old poet-philosopher, that it is the art of a wise man to learn even from an enemy. During the time that New York City was in the hands of the British, and it must not be forgotten that the occupation lasted from 1776 to 1783, there were many opportunities to see the practice of the British Army surgeons, many of whom were men of wide learning, of the best training, and of large experience. Physicians might not be able to go abroad, but some good opportunities were provided them at home. There is no doubt that they were taken advantage of. A previous op- portunity of nearly the same kind had occurred during the French and Indian Wars, only ten years before, and it is Toner who calls attention to the fact of how much the physicians of the colony must have gained from contact with the British Army surgeons. As Toner, in his "Medical Progress," says : "The war which resulted in the conquest of Canada gave perhaps the first material improvement to the con- dition of medicine in America. The English army was accompanied by a highly respectable medical staff, most of them landed in the City of New York, and con- tinued for some years in the neighboring territory, affording to many young Americans, opportunity of at- tending military hospitals and receiving professional in- struction." 27 CHAPTER V. QUACKERY BEFORE LEGAL REGULATION. It might have been expected that in a country as loosely governed as were the original colonies, and under the conditions of lack of opportunities for medical education and proper medical train- ing, that quackery would have flourished exten- sively during the early years of our history. Conditions, however, were not as bad at the beginning as might have been anticipated. In New England, at least, the earliest practitioners of medicine were the clergy, and quite usually the functions of the physician and the divine were performed for each community by the same indi- vidual. As Dr. Beck remarks: "This combination has not been uncommon in the history of the world. In the early dawn of medicine the priests of Egypt and Greece collected and preserved what was known of the healing art, and in the infancy of every country the same association will probably be found to exist. Nor is it by any means an unnatural one. Physical and moral evil are so intimately con- nected that those who are administering to the relief of one cannot be regardless of the other. Hence, in the absence of the regular physician, the priest appears to be his most proper representative. Besides this the character of the first emigrants and the high tone of religious feeling, which drove them for an asylum to this western world, continued for a long time to give a preponderating influence to the clergy in all secular as well as religious concerns of the colony. In the annals of the first colonists, accordingly, will be found the names of several clergymen who practiced the healing art. These men were not, as might be inferred, mere empirics. On the contrary, they were by no means un- qualified to practice medicine. For several years, pre- viously to their leaving England, and anticipating the loss of their situations as clergymen, many of them had turned their attention to the study of medicine, and for upwards of a century after the settlement of New Eng- land, numbers of native clergy were continually edu- cated in both professions. Altogether they were a highly respectable class of men. Besides being good divines, they were skilled in the medical learning of the day and many of them appear to have been good practical physi- cians. Besides the clergy some of the first governors 28 of the eastern colonies also practiced physic. Two of them, of the name of Winthrop, appear to have been particularly celebrated. One of them was Governor of Massachusetts, the other of Connecticut and New Haven. Of the latter, Cotton Mather says : 'He was furnished with noble medicines, which he most charitably and generously gave away upon all occasions.' He was a member of the Royal Society of London, and some of his communications are to be found in their transac- tions." Notwithstanding the adventitious circum- stances that gave many of the early physicians dignity and prominence, and undoubtedly added to the estimation in which all practitioners of medicine were held, it readily can be understood that they represented only a very few of those who practiced medicine, and that the standing of most of the others was, indeed, low. Anyone who will recall the position occupied by the apothecaries who represented the physicians of that day in rural England, about the middle of the eighteenth century, will have forcibly im- pressed upon him the very low station which the medical practitioner in country places, at least, occupied at this time. Thackeray gives pictures of at least one of them that is neither creditable to the personal standing of the men themselves, nor to their professional dignity. There is no doubt, however, that the novelist had plenty of historical details as the groundwork of his picture. It is not surprising, then, to find that Dr. Beck deprecates the condition of medical practice in the American Colonies during the seventeenth and eighteenth centuries. The wonder of it is that he was large-minded enough to see that it had the good qualities of its defects and that our forefathers are by no means so much to blame for the abuses that inevitably crept in at that time, and that, indeed, if we compare conditions at that time with what has come to be the state of affairs in our more cultured nineteenth and twentieth 29 centuries, there will not be room for much con- demnation. Dr. Beck said : .» "As may naturally be presumed, in a country circum- scribed as the American Colonies were for a long period after their original settlement, the medical profession continued for a succession of years in a low and de- graded condition. In point of respectability it undoubt- edly stood lower than either the legal or theological professions. The religious difficulties in England had filled the ranks of the latter with men of learning, talents and piety, while the offices of honor and emolu- ment under the crown offered allurements sufficiently powerful to induce many who were distinguished in the law to emigrate to this western world. With medicine it was far otherwise. It is only in populous towns and cities that our art can flourish, and the wilds of America, however fragrant they might be with the spirit of free- dom, offered no attractions to the medical men of the old world. The advantages attending an emigration were too distant and precarious to warrant such a step ; and accordingly for a long time, with some few excep- tions, none but those who had failed to attain respect- ability or employment at home would venture on so dangerous an experiment. Nor were the young native physicians for a long time calculated to remedy the evil. To become a well qualified physician requires a course of study and a variety of observation which was not to be obtained in any of the colonies. There were neither lectures nor hospitals which could be resorted to, while the great expense attending a foreign education put it out of the power of all except a favored few to avail themselves of the only means of becoming regularly in- structed. Under such circumstances it was not to have been expected for a long series of years after the first settlement of the country that our profession would be at all distinguished for character or knowledge. The progress of civilization, an augmenting population, to- gether with the increasing facilities of European com- munication, tended gradually to ameliorate this con- dition of things, and for many years preceding the Revo- lution, medicine could boast of not a few names who shed a lustre upon the profession to which they be- longed." Just after the middle of the eighteenth century there seems to have been a determined effort made to secure legislation for the regulation of medical practice in the Province of New York. A series of publications pointed out the abuses 30 which existed and necessarily suggested a rem- edy for the evil. The remedy, as usual, was to be found in legal regulation. The steps by which the sentiment in favor of such legislation was created can be traced to various contemporary publications. Dr. Beck quotes particularly from a paper by William Douglass, M.D., entitled "A Summary, Historical and Political, of the First Planting Profession, Improvements and Present State of the British Settlements in North Amer- ica," in which the doctor does not hesitate to state his opinion of the medical evils of the time in a very forcible way. The whole passage as it is to be found in Dr. Beck's article seems worth while quoting because of its chastening character for the abuses of all times : "If we may believe the authority of Dr. Douglass, who wrote about the year 1753, and of Smith,* the historian of New York, the general character of the profession could not have been very elevated, and quackery must have flourished in great perfection. Douglass speaks of it in the following terms: 'In general, the physical practice in our colonies is so perniciously bad that, ex- cepting in surgery and some very acute cases, it is bet- ter to let nature, under a proper regimen, take her course than to trust to the honesty and sagacity of the practitioner; our American practitioners are so rash and officious, the saying in the apocrypha (38 and 15) may with much propriety be applied to them. 'He that sinneth before his Maker, let him fall into the hands of the physician!' Frequently there is more danger from the physician than from the distemper. Our prac- titioners deal much in quackery and quackish medicines, as requiring no labor of thought or composition, and highly recommended in the London quack bills (in which all the reading of many of our practitioners con- sists) inadvertently encouraged by patents for the bene- fit of certain fees to some offices, but to the very great damage of the subject.' 'In the most trifling cases they use a routine of practice. When I first arrived in New England I asked a most noted facetious practitioner what was their general method of practice; he told me their practice was very uniform: bleeding, vomiting, blistering, purging, anodynes, etc.; if the illness con- tinued, there was repetendi, and finally murderandi; *History of New York, by William Smith, A.M., p. 326. 31 nature was never to be consulted or allowed to have any concern in the affair. What Sydenham well ob- serves is the case with our practitioners: Aeger nimia medici diligentia ad plures migret.'" (From overzeal on the part of physician, the patient goes over to the majority) — an expression that might very well have been adopted as a motto for many generations of med- ical men in the 200 years since it was written. William Smith, who wrote a history of New York from the first discovery to the year 1732, notes another effort to influence public opinion for the purpose of securing the legal regulation of medicine, made in the same year. He said : "The necessity of regulating the practice of physic, and a plan for that purpose, were strongly recommended by the authors of the Independent Reflector in 1753, when the City of New- York alone boasted the honor of having above forty gentlemen of that faculty." Smith wrote in 1758, and not unnaturally had something to say about the abuses existing in his own time, in telling the story of the earlier times. He said further: "Few physicians among us are eminent for their skill. Quacks abound like locusts in Egypt, and too many have recommended themselves to a full practice and profitable subsistence. This is the less to be wondered at, as the profession is under no kind of regulation. Loud as the call is, to our shame be it remembered, we have no law to protect the lives of the King's subjects, from the mal-practice of pretenders. Any man, at his pleasure, sets up for physician, apothecary and chirur- geon. No candidates are either examined or licensed, or were sworn to fair practice." Not much immediate improvement was brought about, even by the Act of 1760. It can readily be understood that the system of quack- ery would have so thoroughly established itself as not easily to be eradicated, and then besides, the legislation was not retroactive, nor could it be, according to English law, and consequently all those who had been engaged in the practice of medicine, however unworthy their methods, or however incomplete their education, were 32 allowed to continue. Accordingly, it is not surprising to find Dr. Beck quoting Dr. Middle- ton, who gives a rather striking arraignment of the condition of affairs toward the end of the first decade after the legal regulation of the prac- tice of medicine was supposed to have been accomplished. Dr. Middleton, who was a thor- oughly competent and reasonably conservative witness, said in 1767: "Yet many, too many, are the instances, even in this place, of men, otherwise valuable for their penetration and good sense, who have given up their own judg- ments to the opinions of the credulous vulgar; and joining in the belief of nostrums, or secret cures, have countenanced and even employed the most obscure and superficial traders in physic. While the practitioner of modesty and real merit, conscious of his own integrity and knowledge, and scorning the little arts of such licensed freebooters and secret homicides or to stoop to the unreasonable humors or petulance of every simple employer, has often had very circumscribed practice; or has been abandoned in favor of some ignorant or mercenary sycophant. This conduct in such men will ever discourage genuine worth and the prospect of far- ther discoveries in that useful profession; which in all time, and among all polite nations, has ever been esteemed honorable, and worthy of men of the first rank and learning. Such being the state of physic here, what wonder is it that this city should be pestered in so remarkable a manner with the needy outcasts of other places, in the characters of doctors; or that this profession of all others, should be the receptacle and resource for the refuse of every other trade and employment? The wonder indeed is that we should be such dupes to their effrontery as to employ them, or buy their pernicious compositions ; not that they should frequent so bene- ficial a market. So amazingly easy of belief are some people in these miracle-mongers, that, as if there was something creative in the name of Doctor, seldom any other test of their skill is required than their assuming that title; so that this appellation with a competent presence of mind and a string of ready-coined cures, carefully propagated by such as find their account in carrying on the cheat, have seldom failed of procuring traffic in New- York." * *"A Medical Discourse, or an Historical Inquiry into the Ancient and Present State of Medicine." — New York, Hugh Gaine, 1760. 3 33 CHAPTER VI. Though this act of the Legislature of April 4, 1806, formally created medical societies with legal sanction in the State of New York, there had been at least one important medical society fully organized, for over half a century before this, of the proceedings of which we have only some hints until towards the end of the century when, for more than a decade, the full minutes are extant. There is at the New York Academy of Medicine a manuscript note book belonging to Dr. John Bard, of New York, bearing the date 1749, the first paper in which has the title, "An Essay on the Nature of Ye Malignant Pleurisy that Proved so Remarkably Fatal to the Inhabi- tants of Huntington, L. L, and some other places on Long Island, in the winter of the year 1749, drawn up at the request of a Weekly Society of Gentlemen in New York, and addressed to them at one of their meetings." This Medical Society seems to have held regular meetings or at least to have continued its existence more or less con- tinuously down to the last decade of the century, when it was merged in another society called the New York State Medical Society, of which we shall have much to say presently. Twenty years after Dr. Bard's paper was read before it, Dr. Peter Middleton, in his introduc- tory lecture, at the opening of the medical school in King's College, November, 1769, notices, as one of the advantages of the medical profession, the institution of societies, or well-regulated associations of gentlemen, for promoting the honor of the profession, and adds, "And permit me to add, as one of the many, instances of the utility of these societies, that whatever merit there is in the present institution, it was first planned and concluded upon in a medical society now subsisting in this place, and may it long subsist." Dr. Bard's first paper shows that the scientific 34 character of the proceedings of this medical society of old New York City was well up to the standard that might be expected in a wide- awake community. The closing sentences of his paper are, indeed, not unlike those which might be found, if not in quite the same words, cer- tainly expressing the same ideas, even in our own times. The touch with regard to the pos- sibility of drugs and other remedial measures proving rather harmful than helpful, in spite of confidence and much observation, is indeed quite modern. Dr.' Bard seems to have realized quite well the limitation of the art that he was practic- ing, and must have counted on having many sym- pathetic auditors who also appreciated the many possibilities of error, in the medical empiricism of the day. Dr. Bard said: "From this account, Gentlemen, of acute Diseases, what sagacity and caution appear to be necessary in the Physical Management of them? Where a mistake as to the real nature of a disorder, the true intention of the cure, or application of Remedies, must infallibly pervert the order and economy of Nature, in digesting and expelling the Disease, and very much endanger the Patient. It was this happy Sagacity, joined with a Natural Physical Genius, which (more than his learn- ing) gave Dr. Radclif his Fame, and made his Practice so remarkably successful. It was from these Reflections, Dr. Sydenham used to say, He thought it as much incumbent upon a Physician to Read Nature as Books. And Sir William Temple, convinced of these truths, queried whether the General Practice of Physick, as it was in all hands, had done more good or harm to mankind. From the whole, Gentlemen, I think it Necessarily follows, That tho' the Arts of Physick and Surgery under a Judicious Direction, must derive great Advantages to Society, Yet these Arts, in the hands of the rash or unskillful, too often occasion the most fatal mischief, as errors of this kind are errors of the most dangerous conse- quence." Twenty-five years after Dr. Peter Middleton's mention of the medical society as still existing in New York, and proving the inspiration for the 35 medical school of King's College, there seems to have come a reawakening of interest in medical organization among the members of the profes- sion in New York City. As a consequence, a special meeting was called and a society organ- ized which received the ambitious name of the "Medical Society of the State of New York," though there is no record of any member of the medical profession from outside New York City ever having belonged to it. Fortunately the records of this society have been preserved, and the original minute book was presented to the Academy of Medicine by Dr. Samuel Francis, of Newport, the son of the late Dr. John R. Francis, of New York, to whose interest in medi- cal historical matters is doubtless due the pres- ervation of this precious record of old-time medical society meetings in New York City. The title of this book is "Minutes of the Medi- cal Society of the State of New York, from November 14, 1794, to July 8, 1806." In the minutes of the first meeting it is recorded that "A Number of medical gentlemen, wishing to associate for the purpose of promoting friendly professional intercourse, determined to meet at the City Hall on the evening of November 14, 1794, where there appeared Drs. John Charlton, Thos. Jones, Samuel Bard, Malachi Treat, Richard Bayley, Louis Faugeres, James Tillary, Sam- uel Nicoll, Ab. Bainbridge, David Brooks, Wm. P. Smith, John Gamage, Wm. Hammersley, John Onderdonk, George Anthon, J. R. B. Rodgers, Wm. Post, Wm. Lawrence. Dr. Charlton was appointed chairman." The minutes of the first meeting then proceed : "After some conversation on the subject of the meet- ing, it was unanimously resolved, that the present associates will on the dissolution of the Society, known by the name of the Medical Society, form themselves into a Society by the name and style of the Medical Society of the State of New York, and that they will use the seal of the same." 36 From this it seems evident that the medical society mentioned by Dr. Bard, and twenty years later by Dr. Middleton, still continued to exist, though perhaps there had been some lapse of interest in its meetings. Certain it is that it was still considered as so pre-empting the ground which the new medical society was to take, that the new organizers considered that they would only properly have an existence after the dissolu- tion of the previous medical society. While there is some doubt about it, from the way the last sentence reads, it has even been suggested as possible that they had resolved to use the seal of the old society. It is evident, even from the rather scanty account of the proceedings of this society which we possess, that it took a prominent place in the medical life of New York City at this time, and that it was appealed to with confidence on mat- ters of public health. It is interesting, too, to find that at this early date the medical society took on itself to point out the ravages that epi- demic diseases made in the city, and to suggest what means would be best suited to suppress these epidemics and minimize their dangers as far as possible. The Society had not been in existence for a year before the Governor of New York State appealed to it with regard to the epi- demic prevailing in the upper part of the city, as a consequence of which commercial relations between New York and Philadelphia had been stopped for a while. The following minute shows how the matter came up: "At a meeting of the Medical Society of the State of New York, held at the usual place, Sept. 4, 1795, "The President read a letter from the Governor of the State to him, as President of this Society, on the subject of the present alarm in consequence of the dis- ease in the upper part of the City for the Intercourse having been stopped between this City and Philadelphia by the Governor of Pennsylvania's proclamation. After some conversation, Dr. Bigley, Dr. Tillary, Dr. Smith, Dr. Mitchell and Dr. Bard were appointed a 27 Committee to answer it. Adjourned to meet at this place to-morrow at 12 o'clock at noon. There is no account of the report of this com- mittee, but the following year there is a report of an effort made by this same committee to arouse the mayor, aldermen and commonalty of the City of New York, to a sense of the danger of such epidemics and the methods by which they might be prevented. This report is all the more interesting because it established the fact that, no years ago, the medical societies of the City of New York had begun that series of complaints to the municipality with regard to the lack of cleanliness in the streets, which they have con- tinued to make with almost unceasing regularity ever since. The report is as follows: "At a meeting of the Medical Society of the State of New York, Feb. 29, 1796. On motion, resolved that a Committee be appointed to point out to the corporation of this City the ravages which the late epidemic made amongst that class of emigrants which arrived in the City during the late spring and summer seasons, and to recommend that a suitable provision be made to prevent a similar calamity in future. The Committee appointed Drs. Bayley, Til- lary and Post. Resolved, that the above Committee do deliver to the President of this Society their statement, in order that it may be by him signed and presented to the Cor- poration. Resolved, that the Secretary cause the late com- munications sent to the Corporation transcribed in their book of Minutes. John Onderdonk, Secretary. The Mayor, Aldermen and Commonalty of the City of New York, Gentlemen: The Medical Society of the State of New York, hav- ing taken into their most serious consideration the dreadful effects of the late afflicting calamity with which this Metropolis has been visited, beg leave to suggest the following observations to your honourable board, as the result of their deliberations. _ It would be improper or at least foreign to the design of this address to enter into an enquiry whether the late epi- 38 demic was imported or was generated amongst us, their motive for addressing you at this time is a de- sire to engage and at the same time to assist as far as they are able, your respectable board in applying_ a corrective to some of the causes, which they conceive contributed to extend its influence and increase its malignity. On this head they venture to point out the following objects, as particularly demanding the notice of the magistrates and the interposition of their authority. i. The accumulation of filth in the streets, this being composed chiefly of dead animal and vegetable sub- stances, is when exposed to a hot sun, a source of nox- ious effluvia, which have a tendency to produce the most fatal effects. That such effluvia have been the cause of fever has been confirmed by repeated observation and experience in all parts of the world. They remark fur- ther that the pernicious practice of collecting in heaps on vacant lots the above mentioned offensive matter, for the purpose of manure, as very reprehensible, and they have no doubt it has produced many instances of disease. This was the case (during the prevalence of the fever) at the head of George Street, in which neighborhood it raged with peculiar violence. 2. Obstructed water drains, by occasioning stagnant water, and collecting matter of various kinds which, undergoing decomposition, emit air of qualities ex- tremely prejudicial to health. 3. The situation of lots in certain parts of this city where these and the houses on them are considerably below the ordinary level of the streets, in such places, the necessary consequences must be an accumulation of various substances which, under the influence of heat and moisture, putrify, and thus contaminate the atmos- phere, and communicate to it properties of a nature extremely deleterious. 4. The situation of many of the docks and shores along the East River, it is observed that in many places large surfaces of mud are exposed to low water, which emit (during the heat of summer) an intolerable stench, and this evil is greatly increased by the practice of filling in docks with every species of filth collected from the streets, which prove an unfailing source of unwholesome air. Add to this the mode of erecting stores on piles, leaving a space under them, filled with stagnant water, which is also a receptacle for every spe- cies of filth. When they recollect that the malignant effects of the late epidemic were principally confined to those who resided on or in the vicinity of the new made grounds on the south side of the city, they cannot but express their appreciation. 5. That the extension of such grounds, further into 39 the river, for the purpose of building thereon, may be productive of the most serious effect on the health of the inhabitants. To the causes above enumerated, others might with propriety be added, which endanger the health of the Citizens, such as slaughter houses, manufactories of soap and candles, sillum, leather, starch, &c. In laying this detail before you, they cannot conclude without de- claring that, in their opinion, the malignity and fatality of the late fever was greatly influenced by the afore- mentioned causes, and were it necessary, they could adduce the authority of the most eminent Physicians and Philosophers in corroboration of this opinion, and therefore with confidence they respectfully submit it to your serious consideration and hope that its importance to the health and reputation of the City will receive, as it undoubtedly claims, your early and due attention." We might consider that perhaps the medical society of over a hundred years ago would have very little cause for complaint as to the substitu- tion of drugs or the use of its name by some enterprising druggist for advertising purposes without due warrant. One of the minutes, how- ever, shows that this was one of the difficulties the Society had to encounter before the end of the second year of its existence, and it is encour- aging to find that the members met the issue squarely and stated that if the unwarranted prac- tice of claiming to have their authorization were continued, they should use all possible legal measures to prevent the abuse. "At a meeting of the Medical Society of the State of New York, held at the usual place, Nov. 10, 1796. It having been represented to this Society that Messrs. Lawrence & Schefflin (whose store was formerly in- spected by this Society) still continued to style it In- spected Store, the Agreement between this_ Body and Mr. Lawrence on that subject having long since ceased, wherefore, Resolved that the Secretary be directed to state to Messrs. Lawrence & Schefflin the impropriety of advertis- ing their Drugs as inspected by this Society, being an injury to us, to dealers in drugs and Medicines, and to the Community, and to inform them that if it be con- tinued, the Society will be obliged to protect themselves for any blame which may be thrown on them." 40 At the beginning of 1796 it is evident that there was considerable disquietude felt as to the possibility of an epidemic during the year. New York had recently had some sad experiences in this matter; and, as a consequence, the old com- mittee on infectious diseases was reappointed as an advisory board to prepare a report for the city authorities. "At a meeting of the Medical Society of the State of New York, January 12, 1796, — On Motion, resolved that a Committee of three be appointed to report what pre- cautions shall be recommended, by this Society, to the City Corporation, to be taken in order to prevent the generation among ourselves, or the spread (if imported) of any malignant or infectious disease in future. Doc- tors Bayley, Post and Tillary were appointed." In the springtime of 1796 a second acknowl- edgment of the representative status of the medi- cal society is to be found in communication from the Governor of the State, Mr. John Jay, asking for an opinion with regard to the building of hospitals for contagious diseases. As usual, a committee was appointed for this purpose, an extra meeting having been called in order to receive the Governor's communication and take action upon it, without delay. "Extra meeting of the Medical Society of the State of New York, 26th of April, 1796. A letter from Gov. Jay was read, requesting the opinion of the members of the Medical Society of the State of New York on a plan of a Lazaretto and observations thereon, by Dr. Saml. Bard. The Society went into the consideration of the plans and after some debate it was Resolved, That a committee of three be appointed to draw up an answer, to the Governor's communication which shall be under the signature of the President. The following gentlemen were appointed to that committee: the Pres- ident, Drs. Mitchell and Bard." In the summer of 1796, a further recognition of the Medical Society came in the shape of a communication from the recently organized com- mittee of health, of New York City, asking for the co-operation of the Society, which was, of course, readily granted. This communication 41 seems to have been presented at the regular quar- terly meeting of the Society in July. At the same meeting, the response of the then President of the Society, Dr. John Charlton, was read and evi- dently approved, though there is no mention of this fact in the minutes. These early records of the relations between the municipal authorities and the Medical Society of the city are consid- ered of sufficient interest to be reproduced here, and are as follows: At a meeting of the Medical Society of the State of New York, 12th July, 1796. Present, Dr. Tillary in the Chair. Drs. Bainbridge, Faugeres, Anthon, Mitchel, Ham- ersley, Gamage and Onderdonk. A letter from John Murray, Chairman of the Commit- tee of Health, directed to John Charlton, President of the Medical Society, was read, and the answer from the President of the Medical Society to John Murray. They were ordered to be recorded. New York, 5th July, 1796. Dr. John Charlton: Sir: As President of the Medical Society it is proper to inform you that Robt. Bowne, Ind. B. Coles, Wm. I. Robinson, Henry Will, Thos. Childs, John Campbell and myself, have been appointed commissioners of health for this city, and that we have formed ourselves into a board for transacting such business as may respect the duties of our appointment, and in order to be the better enabled to perform our duties, we shall at all times be happy to consult with you on such measures as may tend to the general good and health of our fellow citi- zens, and I am requested to inform you that such com- munications as it is necessary for the physicians to make to the commissioners, may be for the present di- rected to John Murray, No. 27 Beekman Street, who acts as Chairman of the board, and who will at all times be happy to receive communications from the Medical Society. You will please communicate the contents of this let- ter to the members of the Medical Socty. in order that they may know who the commissioners of health are and where to make the communications required. I remain, very respectfully, Your humble servant, John Murray, Chairman of the Commissioners of Health. 42 Then follows the President's answer: "New York, July 6, 1796. Dear Sir: I have been this day favored with yours of yesterday, The Med. Soct. will meet next Tuesday, when it shall be laid before them. I will venture to report, Sir, that the Society will, at all times, cheerfully co-operate with the Commis- sioners of health, in their exertions to preserve the health of our fellow citizens, but I should be happy (previous to their meeting) to receive from you, for their information, some more particulars, intimations of the nature of the communications, the Commission- ers would wish from them. My motive for this request is that early in the last winter, the Medical Society were at the pains of pointing out to the Corporation of the City the precautions which to them appeared in- dispensably necessary to the prevention in the future of a Calamity similar to that we experienced last sum- mer and autumn, not an article of which (I believe) has been attended to. If the Commissioners have, how- ever, and wish to remove nuisances, which are the pro- ductive causes of our misfortunes, I have no doubt the Med. Soct. will afford all the aid in their power to effect so salutary a measure, or if the Commissioners wish to direct the attention of the Society to any other object, I am confident that it need only be signified to them to ensure their utmost exertions. I am, Sir, Most respectfully your very humble servt., John Charlton, Prest. of Medical Soct., State of New York. Mr. William Murray, Chairman of the Com- missioners of Health, N. York.'' A curious feature of the proceedings of all the medical societies of this time, which we find frequently exemplified in the early transactions of the Medical Society of the State of New York later on, is the evident interest of the members in all the natural sciences, and the manifest feel- ing that a physician must know something about geology and mineralogy, as well as botany and zoology, and the other sciences more closely allied to medicine. One does not often find this interest extending also to astronomy, but there is 43 a minute in the proceedings of the meeting of the Society for November 5, 1796, which shows that this also was considered to be within the sphere of physicians' interest. " A letter from Doctor Joseph Young, directed to the President of the Medical Society, enclosing his pro- posals for printing a new physical system of Astron- omy. On motion, it was resolved to subscribe for two copies for the Medl. Society." Efforts were evidently making from time to time to secure the passage of a law regulating the practice of medicine in New York State. Those who know how difficult it is to procure medical legislation can readily appreciate that there were a number of disappointments before the enaction of the law. Nearly ten years before the first law for the regulation of the practice of medicine did actually come, an extra meeting of this first medical society of the State of New York was held for the purpose of discussing a law then said to be before the Legislature, and a committee was appointed to consider it, and draft a memorial with regard to it. The minutes of this extra meeting are interesting, because they also contain the first reference to the pro- posed union of the Library of the Medical So- ciety with that of the New York Hospital. There evidently had been difficulty in properly housing and caring for the books, and it was thought this could be obviated by uniting their Library with that already proving so serviceable at the Hos- pital. "Extra meeting of the Medical Society of the State of New York, February 14, 1797. Present: The President and Vice-President, Drs. Faugeres, Anthon, Hammersley, Gamage, Bayley and Mitchel. The Society was informed by the President that this meeting was called in consequence of a law now being before the Legislature to regulate the practice of Phy- sic and Surgery. After some debate, it was Resolved that a committee of three be appointed to draft a mem- orial to the Legislature on the subject of the practice of 44 Physic, and that the said memorial be signed by the President and countersigned by the Secretary. The committee appointed was Drs. Bard, Bayley and Mitchel. On motion of Dr. Jones, seconded by Dr. Hosack, Resolved, that at our next regular meeting, the Society do take into consideration the propriety of uniting their Library with that of the Hospital." Two months after this extra meeting at a regu- lar meeting of the Society, the question of the union of the libraries was further considered, and eventually a union was arranged for. Nearly a century later the Library of the New York Hos- pital was given to the New York Academy of Medicine, so that the original contribution of volumes from the profession which for many years was practically so placed as not to be of general use, found their way to a library where the New York physicians could use them very readily. "At a meeting of the Medical Society of the State of New York, nth, April, 1797. Present, the President and Vice-President; Drs Anthon, Tillary, Rodgers, Faugeres, Gamage, Bain- bridge and Hammersley. On motion of Dr. Rodgers, seconded by Dr. Anthon, Resolved, that a committee of three be appointed to con- fer with the Governors of New York Hospital on the subject of uniting the Library of this Society with that of the Hospital, and report at our next meeting. The following members were appointed to that committee, Vice-President, Drs. Tillary and Hammersley." It is rather interesting to find that, even, at this early date and with the limited number of members in the Society, there was still some difficulty with regard to the payment of fees. Finally there seems to have been an open rupture between the Society and one prominent member, and most of the minutes of one regular meeting are taken up with the consideration of his decla- ration that he would pay neither fines, annual subscriptions nor initiation fee. "April 9, 1799.— The Treasurer reported that a Com- 45 mittee had effected a settlement with all the members except Drs. Mitchel and Gamage, who are still delin- quent. The Treasurer further reported that Dr. Mitchel had declared in positive terms that he would not pay any monies to the Medical Society either for fines, annual subscriptions or initiation fee, for which he stands indebted to this Society as appears by the books of the Treasurer : In consequence of which the Society entered into the following resolution. Dr. Samuel L. Mitchel having for several years attended as a member of this Society (on regular ap- plication being made to him), refused to pay his dues. Therefore, Resolved, that he be no longer consid- ered as a member of this Society." Not many of the meetings contain reports of the scientific proceedings. It is probable that this was mainly due to the fact that the secretary- could not find the time to make such a report, and accordingly it was neglected. Occasionally, however, when a matter of more moment than usual in scientific matters came up for discussion, a note with regard to it is to be found. These notes are all the more interesting from their rarity. One of these notes at the meeting in April, 1799, shows that another cure for tetanus had been communicated to the Society, and as the successful remedy is given, we of the modern time are able to conclude that in the course of subsequent experience the members of the medi- cal society found the new prescription no more effective in cases of acute tetanus, at least, than any other of the many recommendations that have been made before for this disease, from time immemorial down to our own day. " Apl. 9, 1799. Dr. Hosack communicated two cases of Tetanus cured by the free use of wine, under some observations of the causes and cure of Tetanus by Drs. Bayley, Rodgers, Hammersley and Hosack." Just at the end of the century the Society put itself on record with regard to the recommenda- tion of young medical men to act as assistant surgeons in the army and navy. There was evi- 46 dently a high spirit of professional dignity in the matter, and it was considered that no one would be recommended for this purpose unless his qualifications were such as to deserve such recommendation, and unless the Society had good reason to know definitely the existence of such qualifications. The minute in this matter is interesting, because it states the attitude of the Society so clearly. " At a meeting of the Medical Society of the State of New York, 14th of January, 1800. The members of this Society having been frequently applied to for the purpose of recommending young men as proper persons to assist as surgeons in the Navy and Army of the United States; it was Resolved, that the members of this Society will not recommend any person as qualified to act in the aforesaid capacity, unless he shall have received a medical diploma from some college or university, or produce a certificate of his having been regularly examined by three of the members of this Society. "And further, Resolved, that the members of this Society will not recommend any person as a practitioner of Physic unless he shall possess the testimonials ex- pressed in the preceding resolution." The midsummer meeting of 1800 is noteworthy as containing the first proposal for honorary membership. The man proposed, Dr. Letsom, was one of the most distinguished of living Eng- lish medical men at the time, and there seems no doubt that the Society considered it was honor- ing itself rather than him in proposing him for membership. The same minute contains a note with regard to the library, which shows the interest taken in this subject. "At a meeting of the Medical Society of the State of New York, held in the City Hall, New York, 8th day of July, 1800, at 8 o'clock P. M. The censors reported that they had appointed Dr. N. Romaine to purchase books in London to the amount of Fifty dollars for the Medical Society. Dr. Hosack proposed Dr. Letsom, of London, as an honorary member of this Society." At the beginning of the new century the So- 47 ciety determined to procure a new meeting place. The report of the committee appointed for this purpose is quaintly interesting in these modern times, because of the details it contains. A room, with fire and candle light in a hotel on Broad Way for two dollars each meeting represents a state of affairs that is eminently desirable, per- haps, from the standpoint of the financial com- mittee, but quite impossible except under the primitive circumstances of the time. At the same meeting the question of the engrossing of the certificate of honorary membership upon vellum, and handsomely, was discussed; and it was decided that the Society should have the right of inspecting it before it was sent to the new honorary member. "At a meeting of the Medical Society of the State of New York, held at South Hotel, in Broad Way, 14th day of April, tSoi. The committee appointed to procure a room for the accommodation of this Society reported that Mr. Lovet would furnish a room at his hotel in Broad Way, to- gether with fire and candle light, for the sum of Two dollars each meeting. Resolved, that this Society accept Mr. Lovet's pro- posal, and that the future meetings be held at his house. The committee appointed to revise the By Laws reported progress and requested leave to set again. The Secretary was requested to have the certificate for Dr. Letsom handsomely written upon Vellum and present it at the next quarterly meeting for inspection." Just about the beginning of the century, the members of the Society established a code of charges for professional services. Knowing something about the purchasing power of money at the time, one might expect that these charges would be ridiculously low, according to our mod- ern standard. This proves, however, to be by no means the case. The physicians of the time had very properly a high appreciation of the value of their professional services. A hall for a meeting in a Broad Way hotel, with fire and candles, might cost only two dollars a month, but the 48 prices asked for visits were nearly as high as the average of the modern time. It is to be presumed that these were considered the highest charges that would ordinarily be made, and that while many physicians might accept less, no one would be expected to ask more. It is interesting to find that the list begins with the two items "Verbal Advice," and "A Letter of Advice," for which respectively, five dollars and ten dollars are charged, showing that the physicians of that period did not consider that the principal item of value in their services was the writing of a pre- scription, but rather the giving of advice. In those days, of course, most of the physicians carried their own drugs with them, and it might be expected that most of the drugs were thrown in for the charge for the visit. This was far from being the case, however. In fact, a reading of the list of charges for drugs will serve to show that they were quite as high as are the modern druggists' charges, if indeed not much higher. Twelve cents for each powder given, and twelve cents for each pill or dose of pills, one might say was quite as much as the tariff would stand. A single dose of medicine dispensed without a visit at sixty-two cents, is considerably dearer than the opportunity to renew a prescription at the drug store afforded by modern custom. Consultations were not appreciated at as high a value in the olden times. The first visit in con- sultation, five dollars, and subsequent visits, two dollars, cannot but seem very small. It is rather interesting to find that mileage was charged at a dollar a mile, a price which obtains at the pres- ent moment, we believe, in many towns much larger than New York at that time. A visit to Brooklyn was only three dollars. One to "Staten Island was ten dollars, and this charge was doubled in the winter time. The scale of charges for infectious fevers, where personal danger was incurred, were higher than ordinary -visits, and remind us that these were the days 49 when smallpox and typhus fever raged virulently, and when yellow fever, then considered to be an extremely contagious disease, often ravaged New York. The charges for the venereal dis- eases are made in lump sums for the whole course of treatment, a practice which early New York physicians doubtless found advisable from the capriciousness of such patients. With regard to the operations, the list given shows that there was much more operating in New York at the beginning of the nineteenth century than might be expected. It is to be pre- sumed that charges were not set down in the list for operations that were not likely to be per- formed, or had not actually been performed. Bronchotomy (tracheotomy) is found in the list of operations. The charges in midwifery cases can scarcely but be considered high, considering that money at that time was worth at least three times as much as now, and had, indeed, for ordi- nary living expenses, at least five times the pur- chasing power of our present currency. The following is the rate bill for professional charges agreed upon : We, the subscribers, practitioners of physic and surgery in the State of New York, do agree upon the following rate of charges for our professional services from and after the first day of July, 1798, agreeably to which rates we do recommend our bills to be presented every six months or oftener, if circumstances permit. Verbal advice $5 -oo- A letter of advice 10.00 An ordinary visit 1 .00 A visit with a single dose of medicine 1 .25 Medicine to be Priced as follows : For powders, each 12 Pills, each dose 12 Boluses, each 25 Electuary, per ounce 5° Mixtures, per ounce 12 Decoctions, $1.50 — 2.00 lb., or per ounce 12 Infusions, $1.50 — 2.00 lb., or per ounce 12 Lotions, per pound 1.25, 50 Tinctures, per ounce $°- 2 5 Vol. Spt, per ounce 5° Ointment and cerate, per ounce. .............. . .25 Blistering plasters, according to their size, from $1.25 to 2 -°° Other plasters, Strom 50 cents to ■ • • ■ 2.50 For a single dose of medicine dispensed without a visit " 2 Consultations. The first visit in consultation S-°° Each subsequent visit in consultation 2.00 A night visit .• S-00 Visit at a distance from town, per mile 1 00 A Visit to Brooklyn 3-°o A visit to Pawles Hook S-oo A visit to Staten Island 10.00 The last two charges to be doubled in winter or m tempestuous weather. The first visit in epidemic fevers, or in other cases where personal danger is incurred 5-0° Each subsequent visit under these conditions 2.00 Charges. For curing a simple or virulent Gonorrhea, from $10.00 to 20.00 For curing confirmed Syphilis, from $25.00 to 100.00 For dressing a blister, from 50 cents to 1 .00 For dressing wounds, from $1.00 to 2.00 For applying cupping glasses 4.00 For bleeding in the arm 1 .00 For bleeding in the foot 2.00 For bleeding jugular vein 2.00 For opening an artery 5 .00 For attending in smallpox, from $5.00 to 10.00 Scarrifycations of the eye 5.00 Punctures in the Oedematous Swellings 2.00 Inserting a Spue ' 2.00 Inserting a Seton 5 .00 Introducing a Catheter first time 5.00 Introducing a Catheter each subsequent time 2.00 Extracting a Calculus from the Urethra 10.00 Reducing a simple fracture, from $10.00 to 20 00 Reducing a compound fracture 30.00 Setting dislocations, from $5.00 to 20.00 For reducing a Polypus ani 5 .00 For reducing Hernia 25 .00 Opening an abscess, from $1.00 to 5.00 Amputating the breast 50.00 Amputating the arm or leg 50.00 Amputating the joint 100.00 Amputating the finger 10.00 Si Amputating the penis $20.00 Extirpating the eye 100.00 Extirpating the tonsil 25.00 Extirpating the testicle 50.00 Extirpating a polypus 25.00 Perforating the rectum, nostril or urethra 10.00 Paracentesis of the abdomen 10.00 Paracentesis of the thorax 50.00 Operation for an aneurism 100.00 Operation for harelip 25.00 Operation for hydrocele 25 .00 Operation for hernia 125 .00 Operation for fistula in ano 50.00 Operation for fistula in erindo 25.00 Operation for Phymosis 10.00 Operation for Paraphymosis 10.00 Fistula Lachrymalis 25 .00 Wry Neck 25.00 Cataract 125.00 For operation of Lithotomy 125.00 For operation of Bronchotomy 25.00 For operation of Trepanning 100.00 Midwifery. For a common case, from $15.00 to 25.00 For tedious or difficult cases, from $25.00 to 40.00 The Medical Society did not continue without a rival in New York City. It is interesting to find, however, that not only was their rivalry not bitter, but that there seems to have been rather kindly relations between the two societies. It is rather hard to understand just why the other Society was founded, though it is possible from its name, the Physical Society, that its member- ship was limited to those who practiced physic only, in contradistinction to those who practiced also surgery. The minute of the Society with regard to this new medical organization shows kindly courtesy, and at the same meeting the president of the Physical Society, Dr. James S. Stringham, was made a candidate for member- ship in the Medical Society. Dr. Stringham was not only admitted as a member, but he became the secretary of the society a year or two later. In 1803 interest in the question of a law for 52 the regulation of the practice of medicine became once more acute, and a committee was appointed to report on the matter. " At a meeting of the Medical Society of the State of New York, held at Lovet's Hotel, 12th day of July, l8 °3- r „ . Resolved, that a committee of five members be ap- pointed to take into consideration the propriety for applying to the Legislature of this State for a law, regulating the practice of Physic and Surgery, or a law of incorporation, and report at the next meeting. Resolved, that Drs. Anthon, Rodgers, Hammersley and Gamage be the Committee." Nothing seems to have come of this attempt at securing legislation, and the minutes of subse- quent meetings of the Medical Society have very little of interest for several years. Indeed, the minutes are so briefly written as compared to some of those at the beginning of the Society's career, that there is more than suspicion that the secretary was neglecting something of his duty, to the detriment of those, at least, of posterity who are interested in medical historical matters, now that a century has passed. In 1806, how- ever, a special meeting of the Medical Society of the State of New York was called for the purpose of considering the law that had been passed in April, by the Legislature of the State. Another special meeting was called two weeks later to take action with regard to it, and the Society practically accepted its legal obliteration and determined, though with many misgivings evi- dently, to abide by the law that had been passed. At a subsequent regular meeting the name of the Society was changed and it evidently passed over into the New York County Medical Society, as it exists at the present time. "At a special meeting of the Medical Society of the State of New York, held by order of the President, June 10, 1806. S3 Present: The President and Drs. Tillary, Hammers- ley, Faugeres, Onderdonk, Gamage, Borrowe, Proudfit, Servant, Barrow and Stringham. Dr. William Turk, having been duly admitted a member, signed his name to the Constitution. The Society, after having considered the late law passed by the Legislature, respecting the regulation of the practice of Physic, adjourned for a further consid- eration of the same until Saturday, June 28th." "Agreeably to adjournment, the Society met on Sat- urday evening, June 28th, 1806. Present: The President, Vice-President and Drs. Hammersley, Bainbridge, Faugeres, Onderdonk, Post, Gamage, Proudfit, Servant, Turk, Buchanan and String- ham. The law passed by the Legislature, April 4th, 1806, entitled, An Act to Incorporate the Medical Society of the State of New York, for the regulation of the practice of Physic and Surgery in this State, being duly considered, it was determined by a majority of the Society, that although many parts of the above Act were highly objectionable, still that, under all circumstances, the profession might be benefited by a meeting of the members of this Society with the other physicians of this City at the time and place appointed by law." " On Tuesday, July 8th, 1806, an ordinary meeting of the Society was held. Present: President and Vice-President, Drs. Fau- geres, Onderdonk, Gamage, Hammersley, Proudfit, Ser- vant, Borrowe, Buchanan, Turk and Stringham. The report of the committee appointed to draw up a code of by-laws, and which had lain over since the last ordinary meeting, was now revived and adopted with amendments. The Society considered that, under existing circumstances, it was necessary that the name of this Institution be changed. Drs. Gamage and Stringham were appointed a committee for this pur- pose, to report at the next regular meeting. Notice was given by Dr. Hammersley that he should propose at the next meeting an alteration of that article of the Constitution relative to the sum to be paid as the initiating fee. Drs. Manley and Neilson were proposed as members. A communication by Dr. Servant was read and ordered to be filed among the papers of this Society." 54 HISTORICAL EVENTS. CHAPTER I. STORY OF THE FOUNDATION. The fact that there had existed in New- York City a society, under the title of The Medical Society of the State of New York, has led in many cases to confusion as re- gards the preliminary history of the medical or- ganization that brought about the enactment of the law of 1806 and the establishment of the present Medical Society of the State of New York. The additional fact that some of the members who had been leaders in the earlier society in New York City became also very prominent in the legally established medical society, has been an added reason for this confusion. Wickes, in his "History of Medical Men in New Jersey down to the year 1800," in the chapter in which he discusses the foundation of medical societies, seems at least to hint at the legal recognition of this earlier, so-called, medical society of the State of New York, as the explanation of the origin of the present State society. Dr. Packard, who is always very careful and usually very clear in these matters of earlier history, in his chapter on the "History of the Medical Societies, founded before the year 1800," does not seem to have had a very definite notion as to the actual relationship of these various societies, in New York.* He mentions the "well regulated association of gentlemen for the advancement of the profession," alluded to by Dr. Middleton, in his introductory lecture at the opening of the Medical School in King's College in November, 1769, and its apparent successor, organized at the City Hall in New York, Novem- 'History of Medicine in the United States, Packard, Phila- delphia, J. B. Lippincott, 1901. 55 ber 14, 1794, which assumed the name and style of the Medical Society of the State of New York, and then comments: "Hence it would appear that the Medical Society of the State of New York is the immediate and legitimate descendant of the medical society mentioned by Dr. Middle- ton in his address ; though he adds, "in 1806 this Medical Society of the State of New York became the Medical Society of the County of New York." The impression that a direct relationship be- tween these various societies could be traced ex- isted at a very early period in the State society's history; indeed, before the society was 25 years old, there had crept into print a number of errors, with regard to the preliminary steps that led to the lesiglation of 1806. In order that there might be a correction of these misunderstandings, the editors of the New York Medical and Physical Journal in 1828 asked Dr. John Stearns to write the history of the preliminary steps that led to the legal establishment of the New York State Medical Society, which he did. This appeared in a series of numbers in the Journal and because of its absolutely authoritative value, deserves a place in extenso here.* The editor of the United States Medical and Surgical Journal introduced Dr. Stearns' articles as follows : From the frequent inquiries made by the medical profession respecting the origin, organization, transac- tions, etc., of the Medical Society of the State of New *This account is usually attributed to the United States Medi- cal and Surgical Journal, and, indeed, the editorial note at the beginning of it can scarcely fail to give the impression that it was an original article prepared for that Journal. At the end of the account, however, there occurs, in small italics, the abbrevia- tion, New York Medical and Physical Journal, 1828. It is in this journal that Dr. Stearns' article was originally published, and it seems to have been especially prepared for it. This journal was one of the best, most widely circulated and de- servedly popular medical journals of the time. It was condusted according to its title page, by Drs. John B. Beck, J. Augustus Smith, Theodric Romeyn Beck, D. L. M. Peixotto, and Alex. H. Stevens. All of these men were members of the faculty of the University of the State of New York, except Dr. Peixotto, who has the designation of Physician to the New York City Dis- pensary. 56 York, we have been induced at the strong solicitation of many of our friends, to give a condensed history of that institution, with a synopsis of its transactions since its origin in 1806, to the present time. We have been greatly surprised to find that the profession in our own State should be so little informed in relation to the proceedings of this institution, and we can only attribute it to the limited circulation of its "Transactions"; pre- suming such to be the fact, we would respectfully sug- gest to the members of the Society the propriety of adopting some more effective mode of circulation. Per- haps the plan now pursued by the Edinburgh Medico- Chirurgical Society, and noticed particularly in our fourth number, page 126, might be deemed the best. The synopsis we are about to give of our State Medi- cal Society will doubtless be regarded as an interesting historical record of the various officers, members and the principal transactions of that institution. In the latter will be found many valuable practical facts from some of the most distinguished men who from time to time have adorned our profession and our State, and many of whom, now mingled with the dead, are cher- ished in remembrance for the high moral, intellectual and social virtues which distinguished them when living. —Ed. Article I. — An Account of the Origin of the Law, "to Incorporate Medical Societies for the purpose of Regulating the Practice of Physic and Surgery in this State"; passed 4th of April, 1806. By John Stearns, M.D., of New York. The influence which medical societies have had upon the profession, and the general misapprehension of their origin, impart an interest to this topic which I trust will not be deemed inappropriate. This interest is enhanced by the consideration that the time will soon elapse when those who were concerned in originating this law will have passed the confines of time, without having left a single record of the fact, by which the numerous errors which have obtained publicity in our scientific journals might be corrected, and justice rendered to whom it is due. From these publications I shall select the following paragraph from a biographical notice of Dr. Bruce, in the first volume of Silliman's Journal of Science : "Pre- vious to the year 1805 the practice of physic in the State of New York was regulated by no public author- ity, and of course, was not in the happiest condition to promote the usefulness and respectability of the profes- sion. To remove as far as possible the existing circum- stances Dr. Bruce became an active agent, and in con- junction with Dr. Romayne and other medical gentle- men of New York, succeeded in establishing the State 57 and County medical societies, under the sanction of the Legislature. This act may be considered among the first efforts made in this country to reduce medicine to a regular science, by investing the privileges of medical men in the body of the members of the profession." The President of the New York County Medical Society in his inaugural address for 1824 also states, "that this is the parent society, from which the other institutions of a similar character throughout the State have emanated." Without multiplying similar quotations to evince the error of public opinion, I take this occasion explicitly to state that neither Dr. Bruce nor Dr. Romayne, nor this medical society nor any physician, then resident in the city of New York, had any knowledge of the pre- liminary measures which led to the formation of this law, or the most remote agency in procuring its pas- sage through the Legislature. These measures were commenced exclusively in the County of Saratoga, with a view to reclaim the profession from that degradation and contempt to which it had been reduced by ignor- ance, professional broils, and the grossest empiricism. Those who witnessed the original and progressive settlement of the northern and western sections of this State since the year 1790, will recognize the mania that infatuated the emigrants from the East and the ambi- tious projects formed by those who assumed the title of doctor. Many who had never read a volume in medi- cine were suddenly introduced to an extensive practice and to a reputation of such imposing authority, as to control the opinions of their superiors in science and to prescribe rules of practice for their government. Con- sultations were generally distinguished for gross contro- versies at the bedside of the patient, whose health and life were often immolated to the ignorance, prejudices or discordant theories of the contending physicians. Their skill was generally graduated by their ability to magnify the cures they had made. Gratifying, indeed, would it be, at this enlightened period, to be able to bear testimony to the total extinction of this relic of quack- ery, and to the abolition of that still more ridiculous and growing imposture, that indignity of our profession, which by the sign of a common vendor converts the medical office, designed for the cure of all diseases, into a private infirmary for curing only those which belong to a particular organ. But so great has been the change in public opinion, that empirics now seldom boast of their intuitive knowledge, their magic incantations, or their initiation into the mysteries of Indian practice; but are compelled to assume the appearance of learning, and to affix to their names the fictitious appendage of M.D. — a proof that scientific physicians will always be patronized as the public mind becomes enlightened. 58 The ignorance of the practitioners so obscured the science of medicine at the period referred to, that reflecting physicians united in the necessity of adopting vigorous measures for a radical reform. In 1796 a series of numbers were accordingly pub- lished in the newspapers of Saratoga, which directed the attention of the profession to the subject of insti- tuting medical societies and ultimately led to the forma- tion of a society in that county, consisting of twenty- one physicians. But so discordant were its materials, and so incompetent to sustain the character of a scientific institution, that the year of its formation be- came the period of its dissolution. This want of success did not prevent the renewal of future efforts. In- November, 1805, another meeting was held, at which committees were appointed and a resolution passed to invite the co-operation of the physicians of the adjoining counties of Washington and Montgomery. The following is a copy of the printed circular issued on that occasion and evidently sent to all the reputable members of the medical profession in the three counties mentioned : "Ballston, November 7, 1805. "Sir, — At a meeting of the physicians of the County of Saratoga, convened this day at the Court House in Ballston, for the purpose of devising means to improve the practice of medicine, we were appointed a com- mittee to impart the object and wishes of that meeting to our professional brethren in the counties of Wash- ington and Montgomery. In that capacity we beg leave to recommend to your earnest attention the necessity of adopting some vigorous measures for the suppres- sion of empiricism, and the encouragement of regular practitioners. The evil calls loudly for the united efforts of all who sincerely wish to remove from that valuable science the imputation of quackery; under which from the ignorance of some of its professors, it not unjustly labors. The wish of the meeting is to procure from the Legislature of the State their sanction to a medical society; and we request your attendance a the court-house in Ballston on the 16th of January, 1806, at ten o'clock, A.M., either in person or by a committee of your county, for the purpose of adopting the best means for obtaining an act of incorporation. We remain, &c, "Wm. Patrick, "John Stearns, "Grant Powell, "Committee of Correspondence.'' Pursuant to the notice in this circular, a delegation from these counties attended the adjourned meeting at 59 the same place on the 16th of January, 1806. A me- morial to the Legislature was then reported, adopted, and signed, and a committee of three, consisting of Dr. Asa Fitch, of Washington; Dr. John Stearns, of Saratoga; and Dr. Alexander Sheldon, of Montgomery, were appointed to carry the same into effect. The committee from Saratoga and Montgomery attended the ensuing session of the Legislature, and fortunately for the cause of science, the latter gentle- man, Dr. Alexander Sheldon, was elected speaker of the House. Although the meeting at Saratoga did not contemplate the extension of the law beyond the limits of these three counties, the committee assumed the responsibility of making it general, and of extending its privileges to every county in the State. Accompanied with this explanatory view of the sub- ject, they presented the memorial to the house of As- sembly on the 25th of February, 1806, who referred it to a committee, consisting of William Livingston and Isaac Sargeant of Washington, Gurdon Huntington of Otsego, John Ely of Greene, and Joel Frost of West- chester. The majority of this committee being medical men, favorably received the proposed plan for a gen- eral law to extend the act of incorporation through the State, which they finally matured and reported to the House. The powerful opposition to the bill threatened its early and prompt rejection by a large majority. The speaker, the committee and several other members gave it a very able and vigorous support. But notwith- standing all the exertions and political influence of its friends, the danger to which the tranquility of the State would be exposed by the incorporation of forty distinct associations of physicians, was so magnified by the opposition, and the impression thereby made upon the House was so great, that but feeble hopes were enter- tained of its success. At this critical juncture, when a decisive vote against the bill was every moment expected to be taken, the late Honorable William W. Van Ness rose its most eloquent and powerful advocate. And perhaps the pre- eminent powers of his parliamentary eloquence were never exerted with better effect. He refuted the argu- ments of the opposition, portrayed the benefits to the profession and to the public in such glowing colors, and with so much energy and zeal, that the opposition be- came feeble, the friends to the bill increased, and from that moment the successful issue was rendered certain. To his memory the profession owes a monument of marble, with their' gratitude deeply engraven upon its tablet. On the first Tuesday of July, 1806, three months after the passage of the law, about twenty societies were 60 organized pursuant to its provisions, and within two years scarcely a county in the State of any considerable population was without a duly organized medical society.— AT. Y. Med. & Phys. Jour., 1828. CHAPTER II. FURTHER LEGAL REGULATION. As might very well have been expected the law of 1806 did not prove sufficient for the legal regulation of the practice of medicine. The attempt had been very bravely made to settle a difficult problem but the details had not all been thought of and in practice the act proved defec- tive. Accordingly the next year the Legislature was appealed to for a further enactment, and this seems to have been obtained without much diffi- culty. It was passed a year later almost to the day, April 3, 1807. There were a number of interesting features in this new law. It created four classes of members from each district, one class of which was to go out of office annually so as to secure a proper succession and rotation in the representatives from the County Medical Societies to the State Society, and thus prevent any monopoly of medical influence. This con- stituted the most important part of the law, and introduced a feature that was to remain promi- nent in the Society for many years of its history. While the previous law of 1806 had deter- mined how the license to practice medicine should be obtained, it had not made any provision to punish those who practiced medicine without a license except that they were debarred from collecting their debts by process of law. It was realized even in the course of a single year that this penalty would not be sufficient and accord- ingly a penal clause was introduced into this new law. To the modern mind the penalty enacted does not seem to have been very stringent. A man who practiced medicine without a license was to be fined five dollars for every month that 61 he had practiced, one-half of which was to go to the informer. Even with the triple value that money bore at the time, this will scarcely appear a punishment likely to prove deterrent, and yet it seems to have been reasonably successful in the accomplishment of the purpose for which it was intended. Toward the end of the act, however, there are some clauses introduced, the full significance of which seem not to have been realized perhaps by the members of the State Society who had the legislation in hand. At least one of these pecu- liar provisions bears very much the character of what would be called in modern parlance a "rider," introduced into the bill during its prog- ress through the Legislature by some one who did not wish the profession of medicine well and who perhaps held a brief for some other parties. It may seem premature in the history of legislation to consider that such a device was successful. There is plenty of evidence, however, to show that the legislators of the olden times, even a hundred years ago, were not so much better than those of the present day as not to know how to accomplish a latent purpose and introduce un- fortunate clauses into legislation that spoiled the effectiveness of expected reform of methods. One of the obnoxious passages in the bill was that which provided that the penalty to be incur- red should not be considered to extend to any apothecary nor to any person administering medicine who does not follow the practice of medicine as a profession. This left it free to the apothecary to prescribe almost at liberty so that many of the unlicensed practitioners found it advisable to open drug stores and do their pre- scribing over the counter. Some of the traveling .quacks succeeded in evading the law under the pretext that they did not practice medicine as a profession because at certain intervals they applied themselves to some other occupation for a while and only set themselves to curing people 62 of their ills when they found themselves in a new neighborhood where the people did not know even the ordinary popular remedies. The most seriously defective paragraph in the act, however, and one which Dr. James Mc- Naughton, subsequently a President of the State Society, did not hesitate to say practically nulli- fied its effectiveness as a penal measure, was the last one, according to which nothing in the act was to be construed to debar any person from using or applying for the benefit of any sick person any roots or herbs, the growth or produce of the United States. This left the field completely open for the herbalists and indeed gave them a certain amount of State encouragement since this paragraph as much as declared that herbal medicines were harmless and that at least no evil could be worked by their administration. Ac- cording to Dr. McNaughton this provision was taken advantage of very generally throughout the State, and there were a great many herb doctors who supposedly prepared their own medicines and who were thought, by at least the ignorant among the population, to possess many secrets that the ordinary practitioner of medicine had never had the opportunity of learn- ing since they came from experience with plants and not from books. The historical interest of this second law is indeed mainly concentrated in these considera- tions with regard to its nullifying provisions. We are accustomed to think of legislative sharp practices as mainly a thing of recent times. With regard to medical laws particularly the gen- eral impression undoubtedly is that the Legis- lature would be either willing or unwilling to grant certain privileges and legal restrictions or else frankly to refuse them. There would be little thought of the possibility of supposedly fav- orable legislation turning out to have such pro- visions in it as gave added opportunities for the 63 unlicensed practitioner of medicine to ply his avocation. We have in this legislative enact- ment, however, a very definite example of the opposite state of affairs, and so the act has a social as well as medical historical interest. Because of this it has seemed worth while to quote the Act of 1807 in its entirety as a warning example, to legislative committees in the new century, of how carefully innocent looking amendments, supposedly meant to prevent in- fringements of individual liberty, must be scruti- nized before definitely being accepted for enact- ment. AN ACT TO AMEND AN ACT, ENTITLED, AN ACT TO REGULATE THE PRACTICE OF PHYSIC AND SURGERY," PASSED APRIL 3, 1807. I. Be it enacted by the people of the State of New York, represented in the Senate and Assembly, that the members now composing the Medical Society of the State of New York, shall at their next annual meeting, divide the members of said Society from each of the four great districts into four classes, and one class of each of said districts shall go out of office annually; and the said Society shall by lot determine which class shall first go out of office, and so for each and every class; and the class whose seats shall first be vacated in each of the said districts, shall be called the first class, and the class whose seats shall next become vacated, shall be called the second class, and the seats of those which shall next become vacated shall be called the third class, and the seats of the members which shall last become vacated shall be denominated the fourth class ; and the members now composing the said Society shall continue and remain members of the same until their seats shall become vacated in the manner above described, and until others shall be chosen in their places. II. That it shall be the duty of the Secretary of the Medical Society of the State of New York whenever the seats of any of the members shall become vacant by the preceding section of this Act, to give information of the same to the respective County Society, to the end that such County Societies may supply such vacancy at their next meeting. III. And be it enacted that in case there shall be an addition to the number of persons composing the Medical Society of the State of New York, that in that 64 case it shall be in the power of the said Society at any of their annual meetings, and as often as they shall judge necessary, to alter and vary the classes to be established at their next annual meeting in such man- ner as that one-fourth of the members from each of the great districts as near as may be, shall annually go out of office. IV. And be it further enacted that if the seat of any member of the Medical Society of the State of New York shall be vacated either by death, resignation or removal from the county, it shall be the duty of the Medical Society of such county to fill such vacancy at their next annual meeting after such vacancy shall happen. V. And be it further enacted that if any person not authorized to practice physic or surgery at the time of the passing of the Act hereby amended, or if any person since the passing of said Act shall have commenced the practice of physic or surgery without being legally authorized, every person who shall so continue to prac- tice unauthorized shall forfeit and pay the sum of five dollars for every month such unauthorized practice is continued, to be recovered with costs of suit before any justice of the peace of the county where such penalty shall be incurred, by any person who shall prosecute for the same, the one moiety of which when recovered, shall be paid to the person prosecuting for same, and the other moiety to the overseers of the poor of the town where the person incurring the penalty shall reside, for the use of the poor of such town; Provided, that the penalty to be incurred by the preceding section of this Act shall not be considered to extend to any apothecary or to any person administering medicine who does not follow the same as a profession, nor shall any prose- cution be commenced by virtue of such section unless it shall be within thirty days after the penalty incurred. Nor shall the second prosecution be commenced or recovery be had in less than thirty days from the date of the first recovery; and Provided, Further, that nothing in this Act contained shall be construed to debar any person from using or applying for the benefit of any sick person, any roots or herbs, the growth or produce of the United States. CHAPTER III. RELATION OF THE STATE MEDICAL SOCIETY TO THE COUNTY MEDICAL SOCIETIES. The best idea of the relationship considered to exist between the State Medical Society and 5 6s the several county medical societies can be ob- tained from the following circular communica- tion, addressed to the county medical societies in 1809. It seems probable that most of this communication was the result of Dr. Stearns' efforts to secure co-operation between the central body and the county organizations. It was he who had first thought of legally establishing a county medical society, and then broadened his ideas to recognize the need for a State organi- zation. While showing the independence of the various societies, this letter also serves to demon- strate how closely they were related and how care- fully an effort was being made to secure the ful- filment of the purpose of the law under which all the various societies were created. Special stress is laid upon the scientific objects of the medical societies and their possibilities for help- ing the development of practical medicine and the diffusion of scientific knowledge among their members. CIRCULAR COMMUNICATION FROM THE MEDICAL SOCIETY OF THE STATE OF NEW YORK, TO THE SEVERAL COUNTY MEDICAL SOCIETIES. FOR THE YEAR I&>9. To the President of the Medical Society of the County of Sir— The Medical Society of the State of New York, view with much satisfaction the organization of the sev- eral Medical Societies of the Counties, by virtue of the law of the 4th of April, 1806, for regulating the prac- tice of Physic and Surgery ; and they entertain no doubt but due exertions will be made by every incorporated Medical Society to satisfy the just expectations of the Legislature and of the public respecting these Institu- tions. This law not only contemplates the establishment of such regulations, in the practice of Physic and Surgery, as may give respect to the Medical profession, and promote the public good; but also such as tend to improve our knowledge of the healing art, and encour- age professional education. The Society do not doubt but that the powers with which the County Medical Societies are invested, will be exercised with modera- 66 tion, and that nothing will be done to give offence to the public: they will recollect that Medicine has been justly considered one of the liberal professions, and that this character can be supported only when it is exercised on principles just and liberal. The Medical Society of the State, at their first insti- tution, deemed it expedient to invite their members to such scientific investigations, as would be interesting to the profession, and important to the public. In a new county, many of whose resources are still unknown, superior beneficial effects must result from favouring scientific researches; and though the pecu- niary means of the Society have been limited, yet they have offered premiums to encourage such inquiries as might be useful and interesting. Few exertions have yet been made to examine and record the various productions of vegetable nature throughout the State; nor has much been done to investigate the several objects connected with the min- eral kingdom, with the formation of the earth, and the aspect of its surface. These subjects the Medical Society of the State ear- nestly recommend to the attention of your Society ; and they make no doubt but a spirit of investigation will be duly encouraged. As the Medical Profession can only be respectable in a well informed community, and as the ignorant and illiterate are only dupes of empiricism, the County Medi- cal Societies will see the usefulness of exerting their influence to promote education, and to unite their efforts with the Regents of the University for such purposes. The Science of Medicine comprehends almost all the sciences and useful arts, which contribute, in some form or other, to preserve health, and to prevent and cure disease; it is, therefore, requisite that the County Societies should unite their efforts with the Agriculture and other Societies of the State, to aid in their labors the promotion of the useful arts. It may also be useful for the Medical Societies to collect and reward such historical facts as are connected with the settlement of their respective counties, and such other circumstances as will elucidate the history of the State. Whatever relates to the causes, the nature and the cure of diseases, will obviously claim the attention of every Medical Society; and they will no doubt invite their respective members to the due exercise of their professional duties, as well as to those observations which may contribute to extend the usefulness and add to the importance of the profession. The Medical Society of the State cannot conclude this circular communication without affording assur- 67 ances of their perfect disposition to promote the respec- tability of the several County Societies, and to exert their efforts to extend the usefulness of the Medical Profession. By order of the Medical Society of the State of New York. John Stearns, M.D., Sec'y. Albany, Feb. 6, 1809. The next year a circular communication of the same kind was sent to the county medical societies, treating of many practical points. The suggestions of the committee of the State So- ciety are nearly all directed to distinct better- ments in the status of the profession. Espe- cially attention is called to the necessity for care- ful medical education not only of students, but also of physicians; and for this purpose it is suggested that lecturers on medicine be chosen by the County Medical Societies to keep the mem- bers in touch with medical progress. The ques- tion of securing for physicians exemption from the law requiring citizens to serve in the militia is discussed, and it was not long before the uni- versal interest aroused by this communication led to the enactment of the proper legislation to secure such exemption. There is a tone of moderation all through the circular, which shows how careful were the officers of the State Society not to hurt the susceptibilities of practitioners living in the more backward districts, nor the feelings of those in attendance at schools where medical opportunities were bound under the cir- cumstances to be imperfect. CIRCULAR COMMUNICATION FROM THE MEDICAL SOCIETY OF THE STATE, TO THE COUNTY MEDICAL SOCIETIES. FOR THE YEAR l8lO. Medical Society of the State of New York, Albany, February 10, 1810. The various relations which the Medical Society of the State has with the County Medical Societies and the public, have been attended to during the present Session, with all the zeal which might be expected from the members of an Institution, to whom were confided by law the important interests of the Medical Profession. 68 The information which the Society has received, of the attention paid to medical education in some of the Seminaries of this State, has afforded the highest satis- faction, and confident expectations are cherished, that the County Medical Societies will yield their collateral aid to the constituted authorities of the State, to favor their laudable exertions to promote the diffusion of knowledge. In the former communications of this Society, the Medical Societies of the Counties were invited to en- courage such observations as might advance the im- provement of the healing art, and it is confidently expected that the Medical Society of the State will be informed of the result of the exertions of the County Medical Societies in the fields of Science. The Medical Society of the State deem it their duty again to invite the Medical Societies of the Counties to grant every encouragement to promote the diffusion of Medical knowledge. Pursuant to a resolution of the Society, it is also recommended that each County Medical Society do ap- point two or more Lecturers, whose duty it shall be to afford such instruction in any of the branches of the Healing Art as may meet the approbation of the Soci- ety by which such appointments may be made. The representations which have been received re- specting the operation of the present Militia Law on the members of the Medical Profession have been duly attended to, and the Society has adopted such measures as they deemed most expedient to obtain a revision of said Law. The Society consider it their duty to sup- port the ancient privileges of the members of the Medi- cal Profession, which in this State were not invaded during the sanguinary struggles of the country for national independence; nor can it be supposed that the Physicians and Surgeons of this State will, when neces- sary, be wanting in patriotic exertions, if it be recol- lected that Warren, Mercer and many others, first in council and not second in the field, were of their Pro- fession. The communications which have been laid before the Society, soliciting an application to the Legislature for an Act to prevent Inoculation for Small Pox, have been attentively considered. As this is a subject of im- portance to the public, and highly interesting to the feelings of many respectable citizens, the Society deem it proper for the respective County Medical Societies to have such communications from the Members of the Legislature, in their vicinity, as may enable them to judge of the expediency of a law for the aforesaid purpose. 69 The Society view with much satisfaction the various Medical Institutions of the State, which they trust will be cherished with care and attention for the benefit of the community. Though all institutions are marked with imperfections, yet when their administration is in conformity with a spirit of moderation and justice, these are corrected ; and it must be recollected that a restless disposition for innovation and change is not always connected with human improvement. By order of the Medical Society of the State of New York. John Stearns, M.D., Sec'ry. CHAPTER IV. NEW YORK MEDICAL SOCIETIES AS CORPO- RATIONS. So much difficulty was encountered in secur- ing the legal regulation of medical practice under the too general provisions of previous laws, that, in 1813, a determined effort was made to secure further legislation that would obviate the diffi- culties that had been encountered in the appli- cation of the preceding enactment. As soon as the County Medical Societies attempted to prose- xute unlicensed practitioners the difficulty arose that there was doubt as to their legal status, that is, whether they had such corporate existence as to sue and be sued. This was true to some ex- tent, also, with regard even to the State Medical Society. Accordingly it is evident that promi- nent legal talent was secured and a very formal bill, bristling with technical legal phraseology and having the many repetitions deemed neces- sary for binding legislation, was drawn up in order to determine definitely the legal status of both State and County Medical Societies. This became the basic law for the regulation of medi- cine in New York State, and it is the one to which all laws go back for more than half a century. There was another and very practical object for the securing of the enactment. The original 70 law creating State and County Medical Societies had given them legal status only on condition that the first meeting be held during the year subsequent to the passage of the law. A certain number of counties had not organized medical societies during that year, and now were not in a position to come into existence with assured legal status. Besides, New York State was grow- ing rapidly, more rapidly than any other State in the Union, and the larger counties of the early years of the century were gradually being divided with the consequent creation of new counties. Many of these desired to have the right to organize county medical societies and this was secured by the Law of 1813. An added feature of this law was that if there were not enough members in any county to justify the organization of a county medical society then medical practitioners in that county had a right to join the County Medical Society in an adjoin- ing county. Another special feature of this act, and one which was to have a far-reaching effect upon the organization of the State Medical Society in subsequent years, was one of its last pro- visions. It provided for the election of not more than two permanent members at each annual meeting, these permanent members to be "emi- nent and respectable physicians and surgeons residing in any part of the State." Because of the fact that this act was for so long the basic legal faculty of the State and County Medical Societies for the regulation of the practice of medicine and, indeed, the most important legal enactment of the first half century of the Society's existence, it has seemed advisable to give it in its entirety especially as all subsequent legislation down almost to our own time was enacted with a definite view of the effect that it would have in broadening or narrowing the provisions of this carefully drawn Enactment of 181 3. 71 AN ACT TO INCORPORATE MEDICAL SOCIETIES, FOR THE PURPOSE OF REGULATING THE PRACTICE OF PHYSIC AND SURGERY IN THIS STATE. PASSED APRIL 10, l8l3.* Whereas, well regulated medical societies have been formed to contribute to the diffusion of true science, and particularly the knowledge of the healing art; Therefore, 1. Be it enacted by the people of the State of New- York, represented in Senate and Assembly, That it shall and may be lawful for the physicians and surgeons in the several counties of this state now authorized by law to practice in their several professions, except in those counties wherein medical societies have already been incorporated, to meet together on the first Tuesday of July next, at the place where the last term of the court of common pleas next previous to such meeting was held in their respective counties; and the several physicians and surgeons so convened as aforesaid, or any part of them, not less than five in number, shall proceed to the choice of a president, vice-president, secretary and treasurer, who shall hold their offices for one year, and until others shall be chosen in their places; and whenever the said societies shall be so organized as aforesaid, they are hereby declared to be bodies corporate and politic, in fact and in name, by the names of the medical society of the county where such societies shall respectively be formed, and by that name shall be in law capable of suing and being sued, pleading and being impleaded, answering and being answered unto, defending and being defended in all courts and places, and in all matters and causes what- soever; and shall and may have a common seal and may alter and renew the same at their pleasure; Pro- vided always, That if the said physicians and surgeons shall not meet and organize themselves at such time and place as aforesaid, it shall be lawful for them to meet at such other time as a majority of them shall think proper; and their proceedings shall be as valid as if such meeting had been at the time before specified. 5 W., 211; 3 W., 426; 24 B, 570. 2. And be it further enacted, That the medical soci- eties of the counties already incorporate, shall continue to be bodies corporate and politic, in fact and in name, by the names of the medical society of the county where such societies have respectively been formed, and by that name shall be in law capable of suing and being sued, pleading and being impleaded, an- *New York Statutes at Large, Albany, N. Y., 1869. Chap. 94. 72 swering and being answered unto, defending and being defended in all courts and places and in all mat- ters and causes whatsoever, and shall and may have a common seal, and may alter and renew the same at their pleasure, and that the president, vice-president, secre- tary and treasurer, of such incorporated societies, shall hold their offices for one year, and until others shall be chosen in their places. 3. And be it further enacted, That the medical society already incorporated, by the style and name of the Medical Society of the State of New York, shall con- tinue to be a body politic and corporate, in fact and in name, and by that name shall be in law capable of suing and being sued, pleading and being impleaded, answer- ing and being answered unto, defending and being de- fended, in all courts and places, and in all matters and causes whatsoever, and shall and may have and use a common seal, and may change and alter the same at their pleasure; and that the said society shall be com- posed of one member from each of the county societies in the state, elected by ballot at their annual meeting, who shall meet together at the time and place appointed by the said society for that purpose, and being met, not less than fifteen in number, may annually elect by ballot, a president, vice-president, secretary and treasurer, who shall hold their offices for one year, and until others shall be chosen in their places.* 4. And be it further enacted, That the Medical Soci- ety of the State of New York, and also the medical societies of the respective counties, shall and may agree upon and determine the times and places of meeting; and the time so agreed upon shall forever thereafter be the anniversary day of holding their respective meetings ; and it is hereby made the duty of the secre- tary of each of the county medical societies to lodge in the office of the clerk of the respective counties, if not already done, a copy of all the proceedings had at their first meeting; and it shall also be the duty of the secretary of the medical society of the State of New York, in like manner, to lodge in the office of the secretary of this state, a copy of their proceedings had at their first general meeting; and the said clerks and secretary are hereby required to file the same in their respective offices, for which they shall each receive the sum of twelve and a half cents. 5. And be it further enacted that the members now composing the medical society of the State of New York from each of the four great districts, shall remain divided into four classes from each of said districts, and shall go out of office annually. •Note.' — See Laws of 1853, ch. 317. Post, p. 717. 73 6. And be it further enacted, That it shall be the duty of the secretary of the medical society of the State of New York, whenever the seats of any of the members shall become vacant, to give information of the same to the respective county societies, to the end that such county societies may supply such vacancy at their next meeting. 7. And be it further enacted, That in case there shall be an addition to the number of persons composing the medical society of the state, that in that case it shall be in the power of the said society at any of their annual meetings, and as often as they shall judge necessary, to alter and vary the classes in such manner as that one-fourth of the members from each of the four great districts as near as may be, shall annually go out of office. 8. And be it further enacted, That if the seat of any member of the medical society of the State of New York shall be vacated, either by death, resignation or removal from the county, it shall be the duty of the medical society of such county to fill such vacancy, at their next meeting after such vacancy shall happen. 9. And be it further enacted, That the medical soci- eties established as aforesaid, are hereby respectively empowered to examine all students who shall and may present themselves for that purpose, and to give diplo- mas under the hand of the president and seal of such society before whom such student shall be examined, which diploma shall be sufficient to enable the person so obtaining the same to practice physic or surgery, or both, as shall be set forth in the said diploma, in any part of this state. 10. And be it further enacted, That if any student who shall have presented himself for examination be- fore any of the medical societies of the several counties of this state shall think himself aggrieved by the de- cision of such society, it shall be lawful for such stu- dent to present himself for examination to the medical society of the State of New York; and if in the opinion of such society the student so applying is qual- ified for the practice of physic or surgery, or both, as the case may be, the president of such society shall, under his hand and seal of such society, give to the said applicant a diploma, agreeable to such decision. 11. And be it further enacted, That it shall and may be lawful for the several medical societies so established as aforesaid, at their annual meetings, to appoint not less than three nor more than five censors, to continue in office one year and until others are chosen, whose duty it shall be carefully and impartially to examine all stu- 74 dents who shall present themselves for that purpose, and report their opinion in writing to the president of the said society. (Section 12 repealed by Laws of 1828, Chapter 21.) 13. And be it further enacted, That it shall and may be lawful for the medical societies of the respective coun- ties of this State, and also the medical society of the State of New York, to purchase and hold any estate, real and personal, for the use of said respective societies : Provided, Such estate, as respectively authorized to hold, shall not exceed the sum of one thousand dollars; and that the estate, as well real as personal, which the med- ical society of the State of New York is hereby author- ized to hold, shall not exceed five thousand dollars. 14. And be it further enacted, That it shall be lawful for the respective societies to make such by-laws and regulations relative to the affairs, concerns and property of said societies, relative to the admission and expulsion of members, relative to such donations and contributions as they or a majority of the members at their annual meeting shall think fit and proper : Provided, that such by-laws, rules and regulations, made by the society of the State of New York, be not contrary to nor incon- sistent with the constitution and laws of this State, or of the United States; and that the by-laws, rules and regulations of the respective county societies shall not be repugnant to the by-laws, rules and regulations of the medical society of the State of New York, nor contrary to, nor inconsistent with, the constitution and laws of this State or of the United States. 15. And be it further enacted, That the treasurer of each society established as aforesaid shall receive and be accountable for all monies that shall come into his hands by virtue of any of the by-laws of such societies, and also for all monies that shall come into the hands of the president thereof, for the admission of members, or licensing students; which monies the said president is hereby required to pay over to the said treasurer, who shall account therefor to the society at their annual meetings, and no monies shall be drawn from the treas- urer unless such sums and for such purposes as shall be agreed upon by a majority of the society at their annual meeting, and by a warrant for that purpose, signed by the president. 16. And be it further enacted, That it shall be the duty of the secretary of each of the said medical socie- ties, to provide a book, in which he shall make an entry of all the resolutions and proceedings which may be had from time to time, and also the name of each and every member of said society, and the time of his admission, 75 and also the annual reports relative to the state of the treasury, and all such other things as a majority of the society shall think proper; to which book any member of the society may at any time have recourse; and the same, together with all books, papers and records, which may be in the hands of the secretary of the society, shall be delivered to his successor in office. 17. And be it further enacted, That it shall be lawful for each of the said medical societies to cause to be raised and collected from each of the members of such society, a sum not exceeding three dollars in any one year, for the purpose of procuring a medical library and apparatus, and for the encouragement of useful discov- eries in chemistry, botany and such other improvements as the majority of the society shall think proper. 18. And be it further enacted, That any student who may receive a diploma from the medical society of this state, shall pay to the president thereof on receiving the same, ten dollars; and for each diploma that a student may receive from the medical society of any county, he shall pay to the president thereof on receiving the same, five dollars; Provided, that the students who have been examined previous to the twenty-sixth day of May, one thousand eight hundred and twelve, and were entitled to receive diplomas, but who have not received the same, shall not pay therefor more than two dollars. 19. And be it further enacted, That the medical society of this State may elect by ballot at their annual meeting, eminent and respectable physicians and sur- geons, residing in any part of the state, which persons so elected shall be permanent members of the society, and entitled to all the privileges of the same ; Provided, that not more than two such members shall be elected in any one year and that they shall receive no compensation for their attendance from the funds of the society. (Sections 20, 21, 22, repealed by Laws of 1823, Ch. 21.) 23. And be it further enacted, That it shall be in the power of the Legislature to alter, modify or repeal this act whenever they shall deem it necessary or expedient. 24. And be it further enacted, That if there shall not be a sufficient number of physicians and surgeons in any of the counties of this state to form themselves into a medical society agreeably to this act, it shall be lawful for such physicians and surgeons to associate with the physicians and surgeons of an adjoining county for the purposes hereby contemplated. 25. And be it further enacted, That this act shall be and hereby is declared to be a public act. 76 CHAPTER V. EARLY PROCEEDINGS OF THE SOCIETY. The proceedings of the early meetings of the Society as published were very meagre. Such as they are, however, they are of surpassing interest, because they serve to make clear just what were considered to be the powers and obli- gations of the Society. They exhibit in a very striking way the effort of the Society to uplift the profession by means of union, and the en- couragement of local organizations, as well as by the offering of prizes, the invitation for the presentation of essays on climatic influences, and other local features, supposed at that time to be connected with the causation of local diseases. Only a few copies of the early transactions were printed and most of them have disappeared. Re- prints were made, however, first in 183 1, and subsequently on two other occasions, and are to be found in the transactions of later years. In spite of this, however, it has been deemed advisable in this centenary volume to give the original proceedings of the first five meetings of the Society, in order to show the general char- acter of the business transacted and the methods of the Society. After this time a modification of the original law that formed the foundation of the Society was secured from the Legislature, conferring some new powers and also making some new limitations with regard to the prac- tice of medicine. These proceedings of the early meetings are printed just as they are found in the original transactions, in Dr. Samuel Purple's set at the New York Academy of Medicine, with the ex- ception of certain lists of names that it seemed unnecessary to repeat since those who are spe- cially interested in them can find them without difficulty in any of the many reprints of the proceedings. The Transactions of the Society at its first meeting in Albany, 3rd February, 1807. "The statute enacted on the 4th of April, 1806, by the honorable the legislature of this state, to incorporate medical societies, for the purpose of regulating the prac- tice of physic and surgery may be considered as among the first efforts made in this country to give the medical profession an honorable station in the community. "By investing the privileges of medical men, in cor- porate communities formed of the members of that pro- fession, the public may be freed from many impositions, and the usefulness and importance of the healing art will be extended. The history of all the learned professions imperiously proves this fact, that no one of those pro- fessions has ever become respectable or extensively useful to mankind, that was not under the restraint of the great body of its own members. Mankind have in all ages and in all communities been too often deceived by men who pretended to professional merit and who by mean practices on the ignorances, follies and caprices of individuals, have gained an artificial importance in society. "This is more especially the case in the medical pro- fession. Hence the importance of the law, placing the regulation thereof under incorporated medical societies. The advantages to the community in placing the regula- tion of the medical profession under the direction of its own members, is already sufficiently manifested, by the promotion of medical education and encouragements given to physical enquiries and observation, and the diminished influence of pretenders to the healing art, throughout the State." The Medical Society of the state was duly organized on the first Tuesday in February, 1807, when the follow- ing members were chosen officers. William McClelland, President; Alexander Sheldon, Vice-President; Moses Willard, Treasurer; John Stearns, Secretary. John M. Mann, Columbia ; William Wheeler, Dutchess ; Lyman Cook, Westchester ; Moses Willard, Rensselaer ; Caleb Samson, Oneida ; Censors. David R. Arnell, Orange; John Ely, Greene; Westell Willoughby, Jun., Herkimer ; Alexander Sheldon, Mont- gomery; John M. Mann, Columbia; Committee of Correspondence. The Society enacted certain bye-laws, and agreed to apply to the Legislature to divide the members of the society into classes and to make some provision for the support of the society. They examined and licensed some candidates for the practice of physic and surgery. At this early period of the establishing of the society, it was considered proper to extend its usefulness in pro- moting medical inquiries in the different counties in the 78 state. Accordingly each member of the society was directed to present a geographical and topographical de- scription of the county in which he might practice and also a history of such diseases as might prevail in his particular place of residence; and that each member should give an account of any remarkable case that might occur in his practice, together with its treatment, at the anniversary meetings of the society. The society then adjourned to meet on the first Tues- day in February, 1808. SECOND MEETING, ALBANY, ON THE FIRST TUESDAY OF FEBRUARY, 1808. 1. Officers and members present. — Drs. Wm. McClel- land, from the County of Albany, President. Alexander Sheldon, of Montgomery, Vice-President. John Stearns, Saratoga, Secretary. Lyman Cook, Westchester; Jesse Shepherd, Schoharie; David R. Arnell, Orange; James G. Graham, Ulster; John Ely, Greene; Westell Wil- loughby, Jun., Herkimer; Reuben Hart, Ontario; John H. Frisbee, Onondaga; Nicholas Romayne, New York; Andrew Proudfit, Rensselaer ; Horatio Powell, Clinton ; Tracy Robinson, Chenango; Jonathan Bush, Lewis; Alexander Morse, Essex. The society then proceeded to arrange its members into four classes, according to the four great senatorial districts of the state, pursuant to law, whereupon it appeared that in the Southern district, the county of New York was drawn into the third class, Nicholas Romayne, member ; Westchester, 2d class, Lyman Cook, member. Middle District, Greene, 4th, John Ely, member. Columbia, 2d, John M. Mann, member. Dutchess, 4th, Wiliam Wheeler. Ulster, 2d, James G. Graham. Dela- ware, 3d, Thomas B. Whitmarsh. Orange, 3d, David R. Arnell. Western District. Oneida, 1st, Caleb Samson. Madi- son, 2d, James Morse. Herkimer, 2d, Westell Wil- loughby. Orange, 3d, John H. Frisbee. Cayuga, 1st, Barnabas Smith. Jefferson, 4th, Hugh Henderson. Chenango, 2d, Tracy Robinson. Ontario, 4th, Reuben Hart. Lewis, 4th, Jonathan Bush. Otsego, 1st, Gurdon Huntington. Eastern District. Essex, 4th, Alexander Morse. Scho- harie, 4th, Jesse Shepherd. Saratoga, 1st, John Stearns. Clinton, 2d, Horatio Powell. Albany, 1st, William Mc- Clelland. Montgomery, 3d, Alexander Sheldon. Wash- ington, 2d . Rensselaer, 3d, Andrew Proudfit. 2. Election of Officers for 1809. The Society pro- ceeded to the anniversary election agreeably to law, when it appeared that Dr. Nicholas Romayne was elected President. Dr. Alexander Sheldon, Vice-President. Dr. 79 John Stearns, Secretary. Dr. James G. Graham, Treas- urer. Dr. Lyman Cook, Dr. John M. Mann, Dr. William Wheeler, Dr. David R. Arnell, Dr. Westell Willoughby, Censors. Dr. John Ely, Dr. Alexander Sheldon, Dr. Jesse Shepherd, Dr. Reuben Hart, Dr. Barnabas Smith, Committee of Correspondence. 3. Prize Questions. — The society taking into considera- tion the importance of promoting philosophical and medical enquiries, which might be interesting to the public, deemed it expedient for that purpose to adopt prize questions, when the following were agreed to, and directed to be published. 1st. A medal, value fifty dollars, for the best disser- tation on the topography, geology and mineralogy of any county in the state, together with an account of the prevalent diseases in such county. 2nd. A medal, value twenty-five dollars, for the sec- ond best dissertation on the same subject. 3d. A medal, value, twenty-five dollars, for the best dissertation on the causes and best method of preventing or curing the typhus mitior, or low nervous fever, which prevails in the different counties of this state. Drs. Sheldon, Graham and Wheeler, who were ap- pointed a committee to determine the most eligible mode of adjudging the preceding prize questions, reported — That it be the duty of the President, Vice-President, Secretary, Treasurer and Censors, to select from the communications, six of the best dissertations on each question, which shall be presented to the society for final adjudication. Thereupon the said report was approved. 4th. Geological Descriptions, &c. — The following mem- bers in pursuance of the by-laws, reported a topo- graphical and geological description of their respective counties, together with the diseases prevalent in the same, viz. Dr. Alexander Sheldon, Montgomery; Dr. David R. Arnell, Orange ; Dr. Willard Wheeler, Dutch- ess ; Dr. John Stearns, Saratoga ; Dr. Hugh Henderson, Jefferson ; Dr. Horatio Powell, Clinton ; and Dr. Lyman Cook of Westchester. Dr. Westell Willoughby com- municated a case of hydrophobia, and Dr. Moses Wil- lard a case of ascites successfully treated. 5th. Amendment to Bye-Laws. — The following ordi- nance was reported to the society by Dr. Arnell, Dr. Willoughby and Dr. Hart, in an amendment to the existing bye-laws : Be it ordained by the Medical Society of the State of New York, that seven members of the society be com- petent to form a quorum, and to transact the business of the society until the first Tuesday in February next. Whereupon the said ordinance was adopted. 6th. College of Physicians, New York. — The society 80 having considered that the population of the county of New York was more than the average population of two other counties in the state; and that it might be inter- esting to the furthering the views of his society in promoting medical education, that the College of Physi- cians and Surgeons in the City of New York should be represented in this society, and have the privileges of a county medical society. Whereupon it was ordained, that the society consent to receive a representative from the College of Physicians and Surgeons in the City of New York. And that the said College should have all the other rights and privileges of a county medical so- ciety, if the honorable the Legislature deem the same expedient. 7th. Honorary Members and Presidents of County So- cieties. — The following gentlemen were elected honorary members of the society. Benjamin Rush, M.D., Phila- delphia. Nathan Smith, M.D., Dartmouth College, New Hampshire. Dr. John Pomeroy, Burlington, Vermont. Dr. John Miller, Onondaga, New York. Dr. Moses Willard, Albany, New York. And it was further ordained that all members of the first class who may not be re-elected by their respective county societies, shall be honorary members of this society. And it was further ordained that all the Presidents of the different county societies, and also those members of the Legislature who were members of any county so- ciety in the state, shall be ex-officio honorary members. THIRD MEETING, ALBANY, FEBRUARY, l80Q. i. Officers and Members present. — Drs. Nicholas Romayne, New York, President; Alexander Sheldon, Montgomery, Vice-President; John Stearns, Saratoga, Secretary; William Wheeler, Dutchess; Lyman Cook, Westchester; John M. Mann, Columbia; David R. Ar- nell, Orange ; John Ely, Greene ; Andrew Proudfit, Rens- selaer; Westell Willoughby, Herkimer; Jesse Shepherd, Jefferson, vice Hugh Henderson, deceased; Walter Col- ter, Onondaga, vice John H. Frisbee, resigned; Abra- ham Allen, Washington, vice Philip Smith, deceased; Amos G. Hull, Oneida, vice Caleb Samson, whose term had expired; Alexander Morse, Essex. 2. Two prizes, Application to the Legislature, and Smallpox. Two prize dissertations on the typhus mitior, and one on the topography, geology, mineralogy and natural history of New York, were presented to the society and committed to Drs. Wheeler, Proudfit and Stearns. Drs. Sheldon, Arnell, Mann and Shepherd were ap- pointed a committee to consider and prepare an applica- 6 81 tion to the Legislature for aid to promote the science and practice of medicine in this state. Drs. Romayne, Mann and Colter, were appointed a committee to petition the Legislature for a law to pho- hibit the inoculation of small-pox in this state. 3. Death of Dr. Henderson. — The society being in- formed of the death of Dr. Hugh Henderson, of Jeffer- son County, Resolved, to wear the customary mourning for a month as testimony of respect to his memory. Pursuant to the bye-laws, and by permission obtained of the Legislature, the president delivered his Anniver- sary Address in the Assembly Chamber. 4. Election of Officers for 1810. — The society pro- ceeded to elect their officers for the year ensuing, when Nicholas Romayne, M.D., was chosen President; Alex- ander Sheldon, Vice-President; Andrew Proudfit, Treasurer; John Stearns, Secretary; Lyman Cook, John M. Mann, Wm. Wheeler, David R. Arnell, Westell Wil- Joughby, Censors; Nicholas Romayne, John Ely, Amos G. Hull, Jesse Shepherd, Abraham Allen, Reuben Hart, Henry H. Sherwood, Committee of Correspondence. Drs. Shepherd, Proudfit and Arnell were appointed a committee to present the thanks of the society to the President for his Anniversary Address, and to request a copy for publication. 5. Honorary Members. — Dr. Abraham Allen nomi- nated the Rev. Alexander Proudfit, A.M., of Salem, in the county of Washington ; and the President nominated John Warren, M.D., Professor of Anatomy and Surgery in the University of Cambridge, to become honorary members of the society. 6. Dr. Morse. — Dr. Morse read a dissertation on the topography, mineralogy and diseases of the County of Essex. 7. Anniversary address by the President, Dr. Ro- mayne. — It being the first we find published, and so well adapted to the occasion, that we shall insert it entire. It will be found among notable addresses. FOURTH MEETING, ALBANY, FEBRUARY, l8lO. I. Officers and Members present. — Dr. Nicholas Ro- mayne, President, New York; Dr. Alexander Sheldon, Vice-President, Montgomery; Dr. Andrew Proudfit, Treasurer, Rensselaer; Dr. John Stearns, Secretary, Saratoga; Dr. Westell Willoughby, Censor, Herkimer; Dr. Alexander Morse, Essex; Dr. John Ely, Greene. The following members presented their credentials which were approved, and they accordingly took their seats. Dr. William Wilson, Columbia; Dr. Henry White, 82 Westchester; Dr. Leer Ward, Genesee; Dr. Asa B. Sizer, Madison; Dr. Benjamin Bevier, Ulster; Dr. Henry I. Hoornbeck, Orange; Dr. Oliver C. Comstock, Seneca; Dr. John Sofford, Lewis; Dr. Oliver Davidson, Clinton; Dr. William McClelland, Albany; Dr. Abra- ham Allen, Washington. 2. Dr. Hosack's Botanical Garden and Report thereon. —A memorial from the Medical Society of the County of New York, to the' Legislature, recommended by the corporation of the City of New York, and the Gover- nors of the New York Hospital, for the purchase of Dr. Hosack's Botanic Garden, was presented to the Society and referred to Drs. Sheldon, Ely and Ward. Dr. Sheldon from the committee to whom was re- ferred the memorials for the purchase of Dr. Hosack's Botanic Garden, reported the following resolution: — That the Medical Society of the State of New York do unite with the Medical Society of the county of New York, the corporation of the City of New York, and the Governors of the New York Hospital, in soliciting the honorable the Legislature to purchase the botanic estab- lishment of Dr. Hosack, if consistent with the funds of the state, or otherwise, to grant a lottery for that pur- pose. And that the establishment, if purchased, be so managed under the direction of the Legislature, as may be most convenient to the diffusion of medical science. Whereupon it was resolved, that the said resolution be engrossed on the aforesaid memorial, and signed by the President and Secretary.* 3. Honorary Members. — John Warren, Professor of Anatomy and Surgery in the University of Cambridge, Massachusetts; and the Rev. Alexander Proudfit, A.M., of Salem, Washington County, having been duly pro- posed, were unanimously elected honorary members of this society. 4. Election of Officers for 1811. — The Society proceed- ed to the annual election of officers, when Dr. Nicholas Romayne was chosen President ; Dr. Alexander Sheldon, Vice-President; Dr. Andrew Proudfit, Treasurer; Dr. John Stearns, Secretary; Drs. Westell Willoughby, jun., William M'Clelland, William Wilson, Abraham *In the reprint of the proceedings in the United States Medi- cal and Surgical Journal there occurs the following note: In pursuance of preceding recommendations, Dr. Hosack's Botanic Garden was purchased by the Legislature at seventy three thousand dollars — that being the amount of which it was esti- mated by three respectable commissioners of the city of New York. It was subsequently ceded to Columbia College on condi- tion that a college edifice should be erected on the ground within ten years. This condition was afterwards revoked. The property at this time is said to be worth more than one hundred thousand dollars, and we understand that it is the intention of the Trustees of Columbia College to erect on the spot a splendid Building. 83 Sheldon, Andrew Proudfit, John Stearns, Henry H. Sherwood, Oliver C. Comstock, John Sofford, and Henry White, Committee of Correspondence. 5. Militia Law. — Dr. Sheldon, from the committee to whom were referred the communications from the county medical societies of New York, Saratoga, and Montgomery, reported the following resolution; That the section of Militia Law which compels physicians and surgeons to do military duty, is contrary to their ancient rights and privileges, and that a committee be appointed to wait upon Dr. Mitchell, and other mem- bers of the Legislature, to represent the same and to request their friendly aid to effect the repeal of the said section. Whereupon Drs. Stearns, Comstock and Romayne were appointed a committee for that purpose. 6. Communications read. — Dr. Stearns read a com- munication on a case of catalepsy, successfully treated. Dr. Hoornbeck read a communication on the topog- raphy, and medical history of the county of Orange. The Secretary read a communication on the like sub- jects, respecting the county of Ontario, from Dr. Hart. 7. County Medical Schools. — The Committee to whom was referred the subject of the County Medical Schools reported that, whereas, the Medical Society of the State feel solicitous to promote the respect, ability and useful- ness of the several county medical societies, by inviting them to promote general diffusion of medical knowl- edge, therefore, it was Resolved, That each County Medical Society do appoint two or more discreet lecturers, whose duty it shall be to give such instruction to medical students as the encouragement they may receive will justify, and that they be requested to communicate to the Committee of Correspondence of this Society, special accounts of their success, for the information of this and the county societies. 8. Honorary Members. — Dr. Samuel Mitchill, Profes- sor of Natural History and Botany, in the University of this State; and Dr. Hosack, Professor of Materia Med- ica and Botany, in Columbia College, were nominated honorary members of this Society. g. Admitted to practice. — Drs. Quackenbos and Bur- rill, of the County of New York, and Dr. Manney of the county of Dutchess, having produced satisfactory testimony of their medical studies, and proficiency in medical knowledge, were admitted to the privileges of physicians and surgeons in this state. FIFTH MEETING, ALBANY, FEBRUARY, l8ll. I. Officers and Members present: Dr. John Stearns, Secretary; Drs. William Wilson, William McClelland, Abraham Allen, and Westell Willoughby, Censors; Dr. 84 Benjamin R. Bevier, Ulster; Dr. Henry H. Sherwood, Jefferson; Dr. Asa B. Sizer, Madison; Dr. Moses Wil- lard, Honorary Member. The following new members presented their creden- tials, which were approved and they accordingly took their seats : Dr. John R. B. Rodgers, New York; Dr. Eli Burritt, Rensselaer ; Dr. Anthony Davis, Orange ; Dr. Adabel E. Paine, Delaware; Dr. William Patrick, Jun., Saratoga; Dr. James L. VanKleek, Dutchess; Dr. Jeremiah D. Fowler, Westchester. The President of the society being absent, Dr. Wil- liam M'Clelland was called to the Chair. 2. Honorary Members. — Drs. Samuel L. Mitchill and David Hosack, having been duly proposed, were elected honorary members of the society. 3. Prize Medal. — The prize medal for "the best dis- sertation on the topography, geology, mineralogy and medical history of any county in the State of New York," was adjudged to Dr. Stearns of Saratoga. 4. Respect to the memory of Dr. Wheeler. — On mo- tion it was Resolved, that the members of this society wear crepe around the left arm for thirty days, as a testimony of respect for their deceased brother, Dr. William Wheeler of Dutchess. 5. Election of Officers for 1812. — The Society pro- ceeded to the annual election of officers, when the fol- lowing gentlemen were chosen: Dr. William Wilson, President; Dr. Westell Willoughby, Vice-President; Dr. Asa B. Sizer, Treasurer; Dr. Benjamin R. Bevier, Secretary; Drs. John R. B. Rodgers, New York; Wil- liam M'Clelland, Albany; William Patrick, jun., Sara- toga; Eli Burritt, Rensselaer; and Jesse Shepherd, Schoharie, Censors. Drs. William Wilson, Columbia; Asa B. Sizer, Madi- son ; John R. B. Rodgers, New York ; Eli Burritt, Rens- selaer; John Ely, Greene; Henry H. Sherwood, Jeffer- son; and Jesse Shepherd, Schoharie, Committee of Cor- respondence. 6. Petition to the Legislature. — Dr. Rodgers from the Committee appointed to inquire into the expediency of petitioning the Legislature for a fund and for other purposes, reported a draft of a memorial praying for aid and sundry amendments to the law, which was ap- proved of and ordered to be left to the care of Dr. John Stearns; and his exertions and influence requested in and with the Legislature, for the passage of a law con- forming thereto. 7. Honorary Members. — Drs. Nicholas Romayne and John Stearns were proposed honorary members of the society. On motion, it was Resolved, That the thanks of the 85 society be presented to Dr. John Stearns for his faithful services as Secretary. 8. Dr. Willard Dissertation. — Dr. Moses Willard read and presented to the society a dissertation on typhus mitior. On motion it was resolved, That the thanks of the society be presented to Dr. Willard for his dissertation. CHAPTER VI. BY-LAWS. The original By-laws of the Medical Society of the State of New York give the best possible idea of what the original intention of the founders of the Society was with regard to the influence it should wield on the professional life and prac- tical medicine of the time. All the details of Society legislation with regard to the licensing of physicians are of historic interest, and the re- lationship to the county societies shows just what these different bodies considered their rights and privileges. Certain features of the by-laws of the State Society deserve special mention because they emphasized the different policy from that of other State Medical Societies of the time, and especially emphasized the ethical relationships which should exist between physicians and the high standard and professional character which the Society hoped to maintain. They have been changed, sometimes even amended, since the original draft, but now that a century has passed their historic interest is greater than ever. Some portions of the original organic law read rather curiously in these modern times, and are expressive of a spirit rather different to that of the modern medical society. For instance, it is now the custom in many parts of this country for medical societies to determine what shall be ordi- nary fees for medical and surgical work under various circumstances, though, according to the by-laws of the New York Society, any member guilty of promoting or encouraging in any way such action shall on conviction be expelled from 86 the Society and be forever thereafter debarred from being again received as a member of it. In general the Society retained the privilege of re- voking the license to practice and definitely threatened with expulsion any member who should be guilty of gross immorality or who shall have improper pretensions to any specific or nostrum. This conjunction of offences, for which so condign a punishment was meted out, forms an interesting reflection on the ethical tem- per of the members of the Medical Society at the beginning, and is an index of the guiding spirit of all their legislation. ORIGINAL BY-LAWS. Whereas, the Medical Society of the State of New York has been duly incorporated, pursuant to the Statute of the 4th of April, 1806. And whereas among other grants and privileges, the said Medical Society are invested with powers to make such by-laws and regulations as they or a majority of the members at their annual meeting shall deem fit and proper. And whereas by the said statute, the by-laws and regulations of the respective county Medical Societies are directed not to be repugnant to the by-laws and regula- tions of the Medical Society of the State. There- fore, Be it ordained by the Medical Society of the State of New York, That the anniversary meet- ing of this Society shall be held on the first Tuesday in February, in every year; and all other meetings may be held at such time and place as may be determined by a majority of the Society convened at any legal meeting, and that seven members shall constitute a board, to trans- act the business of the Society, except that of altering, amending or abrogating these by-laws, when it shall be necessary for eleven members to be present to form a board for such purposes. And be it further ordained, by the authority 87 aforesaid, That the order of transacting business at the meetings of the Society shall be in manner and form as follows, viz.: First. The President or presiding officer of the said Society may declare the same to be con- stituted whenever a quorum is formed, accord- ing to the preceding ordinance. Second. The minutes of the last meeting shall be read by the Secretary, and if no member object to the same, the minutes shall be con- sidered approved. Third. The President or presiding officer, or any member, may introduce any proposition rela- tive to the duties or concerns of the said Society, and the same shall be disposed of according to the pleasure of a majority of the members pres- ent at any such meeting. Fourth. A majority of the members of the Society present at any meeting may direct an adjournment whenever it shall be deemed proper. And be it further, ordained by the authority aforesaid, That every member shall observe order and decorum at all the meetings of the Society, and shall pay proper respect to their fellow members, and to the President and other officers. And all the members shall take their places whenever the President or presiding offi- cer shall declare the Society constituted, and whenever a member shall speak, he shall stand up and address the chair, and whenever any two or more members offer to speak at the same time, the President or presiding officer shall determine the priority in speaking. And be it further ordained by the authority aforesaid, That the President of the said Society shall preside at the meetings, and shall preserve order and decorum in the same; he shall per- form the duties of his office as now are, or here- after may be directed, by the laws of the State, or the ordinances, by-laws and regulations of the Society; he shall nominate and appoint all com- mittees to transact the business of the said So- ciety, unless otherwise directed by a special reso- lution of a majority of the members present ; he shall take the sense of the Society on any motion made and seconded ; he shall have a casting vote in all transactions where the votes of the mem- bers are equally divided, and shall deliver the de- cisions of the Society. And be it further ordained by the authority aforesaid, That the President of the said Society shall, at the annual meeting, and at the end of each year after his election to office, deliver to the Society a dissertation on some appropriate subject; and in case of default in delivering the same, he shall forfeit and pay to the Society the sum of twenty-five dollars; Provided always, That if such President shall duly cause to be pre- sented to the Society a copy of his anniversary dissertation, he may, if the Society deem proper, be excused from delivering the same ; but he can- not be exonerated from the fine of twenty-five dollars for not composing and presenting such dissertation, and a copy of such dissertation, so presented, shall be read to the Society by the Vice-President or President pro tempore. And be it further ordained by the authority aforesaid, that the treasurer shall keep and be accountable for all moneys placed in his belong- ing to the said Society, and shall thereout, pay such warrants as may be drawn by the president or vice-president for the use of the Society ; and shall present at each anniversary meeting of this Society, a minute report of the state of the treas- ury; and the treasurer shall moreover perform all the duties prescribed by law, and the ordi- nances, by-laws and resolutions of this Society. And be it further enacted by the authority aforesaid, that a majority of the Censors shall have power to perform the duties of the whole number; and they are hereby authorized to examine students separately, if they deem the 89 same expedient; and the said Censors shall per- form all such duties as may be directed by law, and the ordinances, by-laws, and resolutions of the Society. And be it further ordained by the authority aforesaid, that all students of medicine who shall have presented, to a majority of the Censors of the said Society, satisfactory testimony that they have studied physic and surgery, as is directed by the statute for incorporating this Society, and who shall upon due examination by the Censors be found qualified to practice physic or surgery or both; and have their said qualifications certi- fied in such manner as is directed by law, shall, before they receive the requisite diploma from the president, sign a declaration in the words following, viz. : "I, A. B., do solemnly declare, That I will honestly, virtuously and chastely conduct myself in the practice of physic and surgery, with the privilege of exercising such profession I am now to be invested ; and that I will with fidelity and honor, do everything in my power for the benefit of the sick committed to my charge." Which said declaration, so signed, by every candidate to practice physic and surgery, shall be filed by the secretary in the archives of the Society. And be it further directed, that the president and secretary be and they are hereby authorized, to grant to every such candidate qualified to practice physic and surgery, agreeable to law, in the name and under the seal of this said Society, a diploma, in the words following, to wit: Omnibus ad quos haec literae pervenerint. S Nos, Societatis Medicae Republicse Novi Eboraci, Prases, Caeterique Socii, hoc scripto testatum volumus (inserting the name and county of the candidate) Artem medicam et chirurgicam sub viris in medicini peritis, tempore praestituto, studio incubuisse, et in hiis studiis progressus, loculento testimonio nobis probasse 90 et commendasse ; Quocirca ex_ authoritate nobis com- missa medicina? et artis chirurgia?, in hac civitate, exer- cenda? et potestatum cum omnibus priviligiis ac has artes pertinentibus concedimus. In quorum testimo- nium hoce diploma, sigillo nostro munitum, donavimus. Datum (the place, day and year to be inserted) . And be it further ordained, that if any candi- date should request a diploma in English, it shall be in the following form, viz. : "To all to whom these presents shall come, or may in any wise concern — The President and Members of the Medical Society of the State of New York send greeting: Whereas (name and county of the candi- date) hath exhibited unto us satisfactory testimony that he hath studied physic and surgery, for the term and in the manner directed by law; and hath also, upon exam- ination by our Censors, given sufficient proofs of his proficiency in the healing art, and of his moral char- acter. Wherefore, by virtue of the powers vested in us by the law, we do grant unto the said (name of the candidate) the privilege of practicing physic and surgery in this state, together with all the rights and immuni- ties which usually appertain to Physicians and Surgeons. In witness whereof we have granted this diploma. Sealed with our seal, and testified by our President and Secretary, at (place, day and year). And be it further ordained by the authority aforesaid, that all students who may hereafter be licensed by any County Medical Society in this State, shall be required to sign a declaration corresponding to that set forth in the preceding ordinance ; and it shall be the duty of each presi- dent of the medical society of every county to exact and demand the same, and to file such declaration in the archives of the Society grant- ing such diploma. And it is also further ordained, that the diploma to be hereafter granted, to every person to practice physic and surgery, by any county medical society in this State shall correspond with the diploma in the preceding ordinance, adapting the same to the name of every such county. And be it further ordained by the authority 91 aforesaid, that it shall be the duty of every mem- ber of this said Society, to present at every anni- versary meeting a copy of the by-laws of the said county society, for which he is delegate, and to furnish this Society with an abridged historical account of the proceedings of every such county society. And be it further ordained by the authority aforesaid, that each and every member shall present to this Society, all proper information respecting the geology and topography of the county in which he resides, together with an historical account of the diseases which prevail at any season of the year; and shall communicate all such information in his power which may contribute to the public good or advance the knowledge of the healing art. And be it further ordained by the authority aforesaid, that the said Society shall appoint a committee of not less than five nor more than seven members, as a committee of correspon- dence, whose duty it shall be, in their joint or individual capacity, to correspond with the liter- ary societies, and men eminent for knowledge, and they shall present such communications as they may deem proper to the Society. And be it further ordained by the authority aforesaid, that the president or vice-president of said Society, shall, together with the secretary, and three Censors, from a Comita Minora to carry into execution the laws and ordinances of the Society during its adjournment. And whereas it is inconsistent with the dignity of the medical profession, for physicians and surgeons, in their corporate capacities to arrange and fix professional charges : Be it further ordained, that any member of this Society who shall hereafter be guilty of pro- moting, favoring or encouraging the members of any medical society in their corporate capacity to form, support and fix medical charges, and 92 who shall he convicted thereof before the said medical society at an anniversary meeting, to the satisfaction of a majority of the members present, shall be expelled from the Society, and shall for- ever after be debarred from being received as a member thereof. And it is hereby further ordained, that no incorporate county medical society shall fix any medical charges, and such proceedings are hereby declared to be discountenanced by this said Society, and to be null and void and of no effect. And be it further ordained, by the authority aforesaid, that any member of the Society who may have been convicted of any serious offense against the laws of this State or of the United States, or who may be guilty of gross immorality, or who shall have improper pretensions to any specific or nostrum, or who shall be repeatedly guilty of improper conduct in the duties of his profession, or his behaviour in this Society, may be expelled at an anniversary meeting, upon a vote of two-thirds of the members present. And be it further ordained by the authority aforesaid, that when any accusation is lodged with the president, vice-president or secretary, of a nature which may subject a member of this Society to expulsion, according to the last two ordinances, such accusation or accusations shall be transmitted to the member accused, and a day shall be fixed at the anniversary meeting for his trial, which shall be fair and impartial; and the verdict of the member on such trial shall be delivered at the first meeting of the Society after the trial. And be it further ordained by the authority aforesaid, that all ex-members of this Society shall be honorary members thereof; and that. the governor and lieutenant-governor of the State, the chancellor and judges of the supreme court for the time being, shall be ex-ofhcio members of this said Society ; and all persons of distinguished 93 literary talents who may be proposed as honorary members of this Society, must be nominated at an anniversary meeting, and shall not be elected before the next succeeding anniversary meeting, which shall be done by ballot ; and there shall not be more than two honorary members elected in any one year. And be it further ordained, that all honorary members shall have all the power of ordinary members, except they shall not vote on any ques- tion, nor be eligible to any office in the said Society, and a majority of votes shall admit an honorary member. And be it further ordained by the authority aforesaid, that any county medical society who shall neglect to perform all such acts as may be required to be done by them, by the law incor- porating medical societies, or any other law in the State relative to the science of medicine, or who shall do any acts which shall be considered derogatory to the honor of the medical profession, or who shall oppose or neglect to comply with the by-laws of the said Society, every such county medical society shall be admonished touching any such proceeding ; and if it be deemed necessary for the public good, that from the improper conduct of any such county medical society, their corpor- ate rights should for a time be suspended, then and in such case it should be lawful and just for this said Society, to make application to the honorable the Legislature for such purpose. CHAPTER VII. EARLY PRESIDENTIAL ADDRESSES. The first presidential address delivered before the Medical Society of the State of New York, by Dr. Wm. McClelland, if there really was a formal annual address prepared for the second meeting, has not been preserved. The earliest an- nual address is that of Dr. Nicholas Romayne, 94 the second President, at the Society's third meet- ing in February, 1809. It is possible that this was the first formal presidential address, and as such it deserves a place in the Society's history. The second and third addresses, delivered by Dr. Romayne, have also been deemed worthy of re- print, because they give an excellent idea of the development of the scope and usefulness of the Society as it appealed to men of intelligence and practical ability one hundred years ago. The sec- ond address serves to show how much Dr. Romayne himself had realized the Society's pos- sibilities during his year's experience as its Presi- dent. The third address has not been, so far as I know, hitherto reprinted from the early trans- actions, which are very rare and difficult to obtain. ANNIVERSARY ADDRESS TO THE MEDICAL SOCIETY OF THE STATE. (Delivered by Nicholas Romayne, the second Tuesday of February, 1809.) Gentlemen : In obedience to the ordinances of this Society, it is made my duty at this time to address you. The statute "enacted on the 4th of April, 1806, to incorporate Medical Societies for the purpose of regu- lating the practice of Physic and Surgery," marks a new era in the progress of science in the State. The Legislature has evinced a confidence in the Medical Profession, that the powers with which it is invested will be exercised with moderation and justice, and that new efforts will be made to promote the knowledge of the healing art and to extend its usefulness. The history of all the learned professions proves that none of them becomes extensively useful or respectable, except under the immediate restraint of its own mem- bers. It is the well-informed Physician or Surgeon who must be the proper judge of the nature and extent of the medical profession and of the qualifications and fitness of those who can be entrusted to exercise the same with safety and advantage to the public. It is such char- acters alone who are capable of guarding the community against that propensity of the human mind to credulity and the marvelous, which subjects a portion of man- kind to the empire of ignorant and enthusiastic pre- tenders. People in general must always be imperfectly in- 95 formed in that special body of useful knowledge which distinguishes any one of the learned professions. If men are most liable to error and deception in their opinions on medical subjects, it must be considered that the healing art embraces an extensive range of objects, and that to comprehend its principles requires a more sound appeal to the understanding and judgment than is commonly possessed. Every community does honor to itself which treats with liberality men conspicuous in the learned profes- sions for their genius and talents. It is only among an illiterate people that they become the subjects of jeal- ousy and persecution. Where ignorance and prejudice abound there empiricism is maintained ; and as the genial influence of science and human improvement prevail, quackery and every kind of imposition diminish. The successful practice of rational medicine is so much connected with an improved state of society that physicians are interested in becoming the patrons of the arts and sciences and all the various branches of education. The success which has attended the exer- tions of medical men in these particulars, especially in France, England and Germany, is conspicuous, and has been honorably acknowledged by those nations. You, gentlemen, in the early establishment of this Society, have manifested a laudable disposition to favor the progress of Science. The members of this institu- tion have been directed by the by-laws to scientific re- searches. Literary premiums have been offered for the last year to invite investigations on the topography, geology and mineralogy of the different counties of this commonwealth and on the nature and cure of those malignant fevers which have often had such fatal effects on our people ; nor have the good effects of these exer- tions of this Society been unpromising or unworthy of notice. Some communications have already been made, which, when the circumstances of this Society will per- mit them to be presented to the public, may not be found uninteresting to the legislator, the patriot, or the friend of science. The Society will no doubt continue to encourage such extensive researches and investigations, as by their happy result may add to the growing importance of the State. In a new and interesting country the resources and riches of which are not yet unfolded, and the effects of its varied climate on the human constitution, as yet but imperfectly examined, ample rewards must attend the labors of ingenious men, if judicially directed. The science of medicine embraces the study and knowledge of nature and of those arts which are con- ducive to the subsistence, comfort and convenience of man. To fulfill our duties to the public the Society will consider it useful to examine .the various vegetable productions of the State, to ascertain their medicinal powers or useful qualities, and to examine the fitness of the soil and climate for the reception of exotic plants. The territories of the United States, extending from the borders of Canada to the northern boundaries of Mexico, contain such variety of soil and climate, as seem calculated for the cultivation of all the medicinal plants and for the support of the different species of animals which inhabit the globe. It is not many years since indigo, rice and cotton plants were introduced into the Southern States, and the merino sheep, lately brought from Spain, promise to furnish clothing and afford wealth to our people. Nor will you be inattentive to encourage an examination of the mineral productions of the country as a source from which many medicines may be obtained, and as furnishing important requisites for public defence and national independence. The waters of the ocean which wash the Southern District of the State are as strongly impregnated with sea salt as those in the Bay of Biscay, from which such quantities of salt are made in France. By establishing salt works on Long Island sufficient quantities of salt might be made to supply the United States. The late worthy Mr. Solomon Simpson, of the City of New York, possessed valuable specimens of silver ores from the mines in the country of West Chester. In the middle district of the State there are several valuable mines. Besides those of iron, there are mines of man- ganese, and from the specimens which have been ob- -tained, probably also of antimony. The eastern district not only furnishes great quan- tities of iron ore, but the mineral springs with which it abounds prove the existence of subterraneous bodies which are constantly subject to chemical changes. In the western district the valuable saline springs evidence the probable existence of large bodies of solid salt at no great distance from the surface of the earth, as the waters seem equally impregnated with salt in dry or rainy seasons. Valuable iron ores and large bodies of plaster of paris or sulphate of lime are found in this district. The Sulphur Springs, near the Seneca Lake, show the probable existence of masses of that mineral substance in the bowels of the earth. In these waters the sulphur is kept in solution by a portion of com- pound salt and an extra portion of sulphuric acid which abounds in the depositions of the sulphur. The coal mines, which exist in Louisburgh and Rhode Island, in Pennsylvania and Virginia, render it -probable that there are connecting strata of coal through •this commonwealth and which may be the subject of future discovery. 7 97 The ingenious and observing in the medical profession will not be inattentive to those facts which may con- tribute to elucidate the origin, nature and cure of those malignant fevers which have raged as a pestilence in many parts of the State, and for which experience has yet afforded no settled mode of cure. While the subjects for medical and scientific research are thus extensive, it must afford you, gentlemen, much satisfaction to reflect on the progress of professional knowledge in the public seminaries of the United States. In the Colleges and Academies of the University of this State the number of students of Medicine exceed one hundred. In the University of Cambridge, in Massa- chusetts, the students pursuing medical studies are sixty. At Dartmouth College, in New Hampshire, the medical students are upwards of seventy, and in the University of Pennsylvania there are upwards of three hundred, besides the students in the Medical College of Maryland. Professor Silliman, of Yale College, has now a class of one hundred students attending his in- structions on Chemistry. Though the nations of Europe are engaged in san- guinary wars, yet at no period have her philosophers been more successful in brilliant discoveries. During the last year Mr. Davy, the professor of chemistry in the Royal Institution at London, pursuing a train of in- genious investigations, has made some of the most important discoveries of which modern times can boast, or which have been presented to the world since the days of Sir Isaac Newton. This indefatigable inquirer found, by a series of ex- periments on the alkalies, potash and soda, that they were convertible by certain processes into metallic sub- stances and which he called potassium and sodium, and of which these alkalies are the bases. In examining the properties of the new metals, Mr. Davy experienced difficulties from their violent attrac- tion for the constituent parts of almost all substances. If, however, covered with a thin transparent film of newly distilled naphtha, by which they are defended from the air, their physical qualities can be accurately examined. The metal of potash resembles mercury in its appearance. At the temperature of sixty degrees, it is less fluid than mercury; at one hundred degrees its fluidity is perfect ; at fifty degrees it is malleable, and at thirty-two degrees it is crystallized. The experiments of Mr. Davy have been repeated by the French philosophers with perfect success. Struck with the wonderful discoveries of this gentleman, the Emperor of France has awarded him a munificent present. The discoveries of Mr. Davy have invited with suc- 98 cess the attention of the Swedish chemists. The French and English chemists have also discovered metals of lime, barytes and of magnesia. They have also suc- ceeded in proving the metallic nature of ammonia, and rendered it probable that the very air we breathe con- tains metal in a gaseous form. Though these brilliant discoveries have been made by the philosophers of Europe, yet the lovers of science and the arts in the United States have not been inattentive to a variety of useful improvements and interesting discoveries. Such, indeed, is the progress of our people in agriculture, manufactures and the useful arts, as to invite the respect of the civilized world. Dr. Romayne having been re-elected President of the State Society, delivered at the annual meeting in 1810 the following address: Gentlemen : In addressing you, at this Anniversary Meeting, as Members of the Medical Society of the State, I cannot be insensible to the respectful consideration you merit from the community. Settled in the different Counties of this extensive State, enjoying domestic comforts, and the advantages to be derived from the professional employments, you subject yourselves to inconveniences; you submit to the loss of private emoluments, to meet at this place, in social harmony and concert to exercise the duties confided to you by law; to superintend the regulation of the Medical Profession in the State, and to favor the diffusion of knowledge of the Healing Art. Nor are these powers confided to you by the Legisla- ture, of small importance to the public. If the useful- ness of the Healing Art be admitted, the necessity of regulating that profession must be obvious. However difficult be the task to perform, yet it is to your wise and salutary regulations that the public must resort for advice against the frauds of ignorant and designing pretenders. It is by your regulations that the com- munity must be guarded against professional injustice or hardships; and it is under your authority and by your example that the practitioners of the Healing Art in this State must, by the fulfilling their respective duties, and extending their usefulness, obtain the respect of the people, and thus an honorable considera- tion for our profession. The Statute of the 4th of April, 1806, contains many wise provisions for the regulation of the practice of Physic and Surgery in the State, and for improving the condition and extending the usefulness of the Medical Profession. The practitioners of Medicine, lawfully exercising their profession, in the several 99 Counties of this State, were by that law permitted to associate themselves in incorporated societies, and each of them were directed to elect a Member to form this central Society of the State, which is invested with a controlling power, by virtue of their Bye-Laws, over the transactions of the County Societies. Wholesome regulations for these purposes must be self-evident. Mankind are not fitted suddenly, but by slow degrees, for the privileges of self-government; and the perfection of human regulations must be the result of experience and reflection. It is not twenty years since a law was first enacted to authorize the Magistrates to require qualifications from those whom they might privilege to practice Physic and Surgery throughout the State. The professional rights and immunities which are now invested in the incorporated Medical Societies will, no doubt, be exercised with cir- cumspection, and in the progress of their transactions, will manifest those useful regulations which may be conclusive of the justice and policy of their establish- ment. The duties, however, of this Society, when consid- ered in all the various relations to the County Societies and community at large, are highly important. To execute them happily and with most advantage to the public, must require from you much circumspection and serious reflection; and it will be a subject for your consideration, whether this Society may not be use- fully aided in their deliberations by the salutary coun- sels of some of those gentlemen who are most con- spicuous in the State for their liberality and Medical knowledge. Certainly, to give stability to this Society, and a requisite degree of independence, are essential to enable it to perform with justice, the respective duties expected by the public. And no doubt, whatever, for this pur- pose, may be suggested, by the wisdom of your delibera- tions, will be confirmed by Legislative authority. In the progress of the proceedings of this Society, some attention has been paid to devise means for the prevention of those frauds which are often practiced on the community by ignorant .and designing pretenders in Medicine. But this subject, when attentively con- sidered, has always been involved in difficulties so extensive, that a remedy has hardly been found for the evil. At a former session of the Legislature a law was passed, which debarred those who were not lawfully authorized to practice Physic and Surgery, from recov- ering, by legal process, any compensation for their ser- vices or remedies. Perhaps the provisions of this law went as far as Legislative power can be wisely ex- 100 tended. Whenever it has exceeded these bounds, the people have too commonly considered the power of the law as favouring of persecution, and instead of dimin- ishing the mischiefs of quackery, they have been in- creased. The propensity to empiricism is, in some measure, connected with the constitution of the human mind, and induces men, when labouring under disease, to look to delusive sources for relief. Nor are persons capable of correctly^ judging for themselves, when tor- tured by pain, or distressed by affliction. Though the evils of quackery seem so difficultly pre- vented by Legislative power, yet it is always remedied by the influence of public opinion, which becomes more imposing, as the state of society is cultivated and improved. When Practitioners of Medicine are diligent and judicious in the exercise of their professions, they manifest to men of any discernment, their superior skill and success in the cure of diseases ; and will show, in a striking point of view, the difference between the well educated Physician and Surgeon, and the mere pre- tender to professional knowledge. It may also be remarked that Physicians have not been sufficiently attentive to correcting certain opinions, which commonly prevail in communities, respecting Scientific Virtues and an Universal Remedy. With little trouble or address, it would be easy to satisfy the meanest capacities, that such is the difference of con- stitutions and habits among men, that what would be useful to one person, might be prejudicial to another; that what would be proper in one stage of a disease, might have deleterious effects in another; that the best and most valuable Medicines only prove remedies when they are administered properly, and under favourable circumstances; and that the knowledge of their successful _ application must be acquired from accurate conceptions of the philosophy of the human body, of the laws of health, and of morbid actions under disease. As the progress of Medical knowledge is more evident, our ideas of Specific Remedies, and of their fallacy become more correct; and it is fact, generally admitted, that the efficacy of all secret medicines, and their wonderful powers, are lost, as soon as the nature of the article be made public. I shall not contend how secret medicines may operate on the mind, and influence the actions of the body, nor dwell on the incorrectness of our passions, and opinions, when not restrained by the power of reason. In forming the ordinances of this Society, you have not been unmindful of the interest of the public, and your own professional dignity. You have prohibited the Medical Societies, in their corporate capacities, from fixing or regulating medical charges. Careful in IOI supporting the respect- of the Medical Profession, you have been attentive to regulate transactions which might injure it in public opinion. While you have admitted the propriety of reasonable compensation, to be obtained for professional services, you have been sensible that no general regulations could be made to apply without manifest injustice.^ In the Medical, as well as in the other liberal professions, there must be difference of qualification, arising from age and experience, from different opportunities of edu- cation, and from genius and talents. Again, in the community we observe the various conditions of men, from the extremes of poverty and wretchedness, to that of wealth and luxury. In diseases, even of the same genus, we observe a difference in their nature in dif- ferent persons ; the one requiring serious attention and study, while the other imposes on the mind no difficul- ties. To exact much professional compensation from those in contracted circumstances, might be oppressive; and not to require ample reward from those, _ who abound in wealth, would be injustice to the profession. Medicine has long been considered one of the liberal professions, in which services were to be compensated by the munificence of the public, not by arbitrary exac- tions or legal demands, which, in the professions, are always odious to the people. It was by conduct truly liberal that, in early ages, the Medical character was often considered in the exalted point of view. In the Scriptures, the character of the Physician is often men- tioned with respectful consideration. Hippocrates re- jected all the wealth and honour which the Persian monarch had to bestow, and refused him his medical aid, because he was the enemy of his Countrymen, the Greeks. In Modern Europe, wherever the Medical Profession is respectable, professional services are liberally rewarded by voluntary compensations. Hitherto, in the United States, the Medical profes- sion has been placed on the footing of the mechanic arts ; and the Courts of Justice have allowed compen- sations for Medical services upon the common principles of a quantum meruit. But it would be injustice in us to suppose that, our countrymen, who are so conspicu- ous for their liberality and enlightened views, who form now one of the richest communities in the civi- lized world, would be wanting in justice to the Medical profession, if the principles upon which compensation should be expected, were explained or generally under- stood. Changes from former habits can only be grad- ually effected; but that justice which the profession has a right to demand, it is confidently hoped, will in time be liberally yielded. These expectations, may be the more readily cher- ished, from the favourable impression which the estab- lishment of the _ Medical Societies, have made on the public mind. You cannot be uninformed of the satis- faction, that has been expressed, on different occasions, by numbers of our respectable citizens, that those to whom they confided the preservation of their health, should meet together in social harmony, to improve their profession, and extend the knowledge of the healing art. To aid the progress of professional improvements, the regular publication of an abridgement of your Jour- nals may have a useful effect. The liberality with which your proceedings have been hitherto conducted, cannot fail of giving importance to this Institution, and favour- ing the confidence of the public in your exertions. — [Passage of non-medical interest omitted. — Ed.] Every circumstance connected with the new Institu- tion which contributes to the success of the establish- ment, merits attention. Though the minds of the people of this State are often agitated, from political zeal, and party considerations, and of which you, as members of the community, must more or less partake; yet it must be mentioned to the honour of this Society, that its members have always kept in view, that the Common- wealth of Science is of no party, that it cherishes a spirit of universal benevolence and improvement, and that it favours a liberal intercourse among men, that it indeed consecrates the fraternity of the great family of mankind. Thus when our countryman, Dr. Franklin, who disarmed the clouds of thunder and taught light- ning to play harmless about our feet, the discovery was made for the benefit of all nations. So the great family of mankind are daily enjoying the improvements of our countryman, the Count Rumford, in domestic economy. And among foreign nations, can you view Jenner, who taught us to elude a loathsome, and often fatal, disease, the Small Pox, but as the friend of human kind? Can you consider Davy, whose brilliant discoveries and laborious researches do honour to the age in which we live, but as a brother, engaged in the fields of science, and exploring and unfolding the hidden combinations of matter. And are not the phil- osophers of France, Germany, and other parts of the world, whose labours and genius are engaged in ex- tending human happiness and exalting our nature, part of yourselves? Are you not encouraged by their high example to diligent investigation and attentive research, to afford some addition to the stock of human knowl- edge, and to view as unworthy of your notice, the bick- erings of party, or the cries of public animosity? While you must reflect, with much satisfaction, on the principles of justice and moderation by which you 103 have been influenced in constituting this Society, as well as in the progress of your proceedings, the instruc- tive example of your conduct, will teach your suc- cessors, that the temple of science was viewed by you, as that of peace, and that its tranquility could not be disturbed, without aiming at the destruction of the only remnant of the Divine origin, which bad passions, have left in the character, and conduct of men. This Society has not only taken a lively interest, in whatever has tended to promote the diffusion of Med- ical knowledge, but has given excitement to those efforts, which are making to cherish education through- out the State; and it must afford the highest satisfac- tion to every member of this Institution, that the result has been so favourable to Science. The City of New- York, at present, affords a greater number of Students of Medicine than at any former period ; and they mani- fest a zeal in their application, which promises the happiest success. The Trustees of the Academy at Fairfield, in the County of Herkimer, with generous sentiments toward the Medical Profession, have af- forded their patronage to two Professors, who are engaged with zeal, and assiduity, in teaching some of the branches of medicine. The Botanic Garden in the City of New- York, founded by Dr. Hosack, continues to be cherished by that indefatigable Botanist, and enriched by additions of domestic and exotic plants. In a short time there will be here collected, under one view, all those plants, which are used by the native Indians for Medicinal purposes. The usefulness of this establishment has been already the subject of your investigation, and you have generously recommended it to the patronage of the Honourable the Legislature. Dr. Bruce, Professor of Mineralogy in the University of this State, is now engaged in publishing a mineralog- ical journal, which will be a periodical work, and prom- ises to be of national importance. This publication will, no doubt, merit the paronage of this Society, and will in- duce the respective members to enrich it with the result of their investigations of the mineral kingdom. This journal will give a minute account of the mineral pro- ductions in the United States, and such discoveries as may be made by future investigation. It will highly deserve the notice of the public as being the first attempt in this State to encourage mineralogical researches. During the last year, Dr. Mitchill, Professor of Nat- ural History and Botany in the University of this State, delivered his courses of instruction on those branches of Science, with such success, as to attract the attention of many respectable citizens. These discourses were luminous in explaining the Natural History of the 104 United States, and will, no doubt, contribute to diffuse a taste for this kind of knowledge, and encourage a spirit of investigation and research. The public have been favored with the outlines of Professor Mitchill's lectures, in the last number of the Medical Repository, and which will be read with much satisfaction by all classes of citizens. The spirit of inquiry among the philosophers of Europe, which for some time past has been attended with so much success, is continued with unremitting attention. The brilliant discoveries of Professor Davy, respecting the Metallic nature of the Alkalies and the Earths, were laid before the public last year. About four months ago, this ingenious inquirer, stated at the New Institute in London, as the result of analysis and attentive research, that of the palpable substances, there were but two in nature in an elementary state, viz., Oxygen and Metal. The Earths and the Alkalies had been demonstrated to be Metallic Oxyds, either by exhibiting them alone, or in alloys with mercury or other metals. The inflammable bodies, Sulphur, Char- coal, Phosphorus, and the basis of the Boracic Acid had all been decompounded, and yielded metal. Accord- ingly, Hydrogen was conjectured to contain a Metallic basis, susceptible to eight degrees of Oxygenation, and by difference of combination, to constitute inflammable matter, Alkali, Water, Oxyds, and even Acids. The facts more lately developed tend to subvert the systems of Lavoisier, and the French Chemists, which for some years has claimed the assent of the Chemical world. The experiments made in confirmation of the French doctrines were so specious, that they were admitted by the celebrated Dr. Black, and other eminent men in Europe, while the American Philosophers, Mit- chill and Priestley, continued to entertain doubts on the subject of those experiments, as not sufficiently con- clusive, to subvert the doctrines, founded on the In- flammable Principle, or Phlogiston, of Becker and Stahl. While your attention may be directed to whatever will, in the remotest degree, improve the Medical Pro- fession, and extend its usefulness, there is one subject which seriously calls for your deliberations. A fever of a most malignant nature, appeared a year or two ago in Connecticut, in the winter season, and proved fatal to many respectable citizens. The reports respect- ing its nature, makes it a disease probably different from the Yellow Fever, or the common Putrid or Ner- vous Fevers of the Country. This Spotted Fever, as it is called, has appeared within a few months, in some parts of the County of Orange, and has in many instances proved fatal. It may appear in other parts of 105 the State. In your present session you will doubtless set on foot such inquiry respecting the nature and suc- cessful treatment of this disease, as may merit the attention of the public. You have already offered premiums to promote Medical researches. Though the funds of the Society be limited, and arise from the voluntary contributions of its members, yet, on the present occasion it must redound to the honour of this Institution, to offer a Prize Medal, for the best Disser- tation, on the nature and cure of this malignant Spotted Fever. It is by such acts of disinterested benevolence and humanity, that the members of this Institution will obtain the respect of their Countrymen, and receive the high rewards which await the merciful and the just. It is by your generous efforts to arrest the tide of pestilence, and relieve the bed of sorrow, that you will merit the blessings of those who are ready to perish. Dr. Romayne was not present at the annual meeting of the Society, held at the end of the third year of his presidency. It is not surprising, perhaps, that he should have been absent once in three years when we consider the great diffi- culties of travel in those days, and especially at the stormy period of the year that is likely to greet the traveler in early February. If there are those who consider, now with all our traveling facilities, that, because of the inclement weather likely to be encountered so frequently at this sea- son and which exposes the traveler to all sorts of' risks, the time of holding the annual meeting should be changed to spring or autumn, it will be easy to appreciate in how much worse case were these old-time medical delegates. Dr. Romayne had forwarded his presidential address to the Secretary, and it was read at the meeting. According to the by-laws of the time the President was bound under a fine of twenty- five dollars to send his address to the Secretary if he was prevented from coming to the meeting. After the reading of the address it was unani- mously voted to have it printed in the Transac- tions, and it actually appears in the original pamphlet form of the transactions of these early meetings. 106 For some reason not easy to determine now Dr. Romayne's third anniversary address as President was not included in the reprint of the Transactions of the early years of the Society, made in 1868. Perhaps it was simply missed, though it is possible that it was deliberately omitted. It contains a certain amount of medical polemics, in which Dr. Romayne's own opinion, always likely to be expressed with vigor, has been stated very explicitly and without much respect of persons. This is unfortunate and yet apparently not sufficient to make the suppression of the address advisable since it is a plain state- ment of the other side of certain medical inter- ests in the early history of New York City and of New York medical education, and, as is well known, there are always two sides to such ques- tions, and the main duty of history is to bring out the other side. Dr. Romayne's address is undoubtedly one of the best sketches of the history of medicine in New York City given in brief that have come down to us from so early and authoritative a source. If for no other reason than this it should be reprinted as a document to which those writ- ing on the history of medicine in New York may thus more easily have access. The reprint of the Transactions gives no hint of the omission, and it is only the fact that Dr. Samuel Purple, in his copy of the reprinted Transactions, now in the library of the New York Academy of Medicine, calls attention to the fact at the place where the address should be, and refers the historical stu- dent to his original edition of the early Transac- tions for Dr. Romayne's address that has called attention to it. Besides New York medicine, however, Dr. Romayne's third presidential address has an ex- cellent summary of the progress of medical edu- cation in modern times, which, while it ( is not correct in all its details, is eminently suggestive, 107 and the errors in it are not mistakes, but are due to the lack of information with regard to the history of medical education at the time. On the whole, perhaps, the best notion of the entire subject of medical education can be obtained more easily from it than from many more lengthy de- scriptions. There is a striking tribute to Phila- delphia and to Benjamin Franklin in the history of medicine and of medical education which may seem surprising in the mouth of a New Yorker until it is remembered that Dr. Romayne made some of his medical studies at the University of Pennsylvania and naturally looked back with kindly feeling to his Alma Mater. ANNIVERSARY ADDRESS TO THE MEDICAL SOCIETY OF THE STATE. (By Nicholas Romayne, read by the Secretary at the Annual Meeting of 1812.) Gentlemen : The constitutional period having arrived, which ter- minates my appointment as one of the Members of the Medical Society of the State, I proceed to execute my last duties by delivering the Anniversary Address. On this occasion I am impressed with those feelings, which must naturally arise in being separated from enlightened Brethren, whose zeal to improve the heal- ing art, to favour the progress of Medical Education, and to protect the people from professional impositions, I have so amply witnessed. If the office you have assigned me in this Institution, has afforded me more opportunities than other individuals to observe your disinterested patriotism and zeal to serve the community in some of its essential concerns ; it inspires me with the fullest confidence, that you will not cease from your labours to improve your profession, and protect the general interests of Medical Literature in the State. Your faithful exertions for the public benefit, and the honour of the Medical Character have gained you much public confidence. You are viewed as the guar- dians of a profession highly important to the com- munity; which is directed to relieve the sick, and to distribute health, and becomes of advantage or detri- ment to society according as it is judiciously or improp- erly exercised. As the patrons, therefore, of the healing art; as my 108 fellow members of this Medical Society, ardent to fulfil the duties confided to you by law; I entreat your in- dulgence, while I lay before you some reflections con- nected with the former and present condition ot tne Medical Profession in this State; that where errors prevail, your exertions may be employed to eradicate or correct them; and that not unmindful of your obli- gations to the public, and the confidence reposed in you, you may cherish what is just, and patronize what contributes to public benefit. . From whatever causes our ancestors were influenced to embark from Europe to settle and possess the pres- ent territories of these United States, they left tne shores of their native land with the strongest preju- dices in favor of their own received opinions, and transported with themselves the habits, customs and manners of the countries they had abandoned. These have been retained by their descendents with wonderful constancy.* „,-•«. The condition, then, of the Medical Profession in the early settlement of this, and other American States, must have corresponded in some measure with what existed in the countries the emigrants had left, and may be best elucidated by a review of the State of Medicine at that period in the countries of Europe which had been the place of their residence. The generous efforts of the Clergy to restore learning after the dark ages, were not confined to what related to Divinity, but were extended both to Medicine- and to Law. In their Colleges and Seminaries, some of their order attended more particularly to Medicine, and the study of the Roman Law. Hence arose the divisions of the different faculties in their Literary Institutions. But an order of men who then possessed all the learn- ing, and soon after, almost all the wealth and power of Europe, would not condescend to what they supposed derogatory, and in comparison to their high considera- tion, somewhat menial employments. Hence became necessary the attornies, procurators, and notaries in the law, and the apothecaries and surgeons in medicine. In these Monkish Colleges, the medical writings of the Greeks, Romans and Arabians were studied, and viewed with so much solemnity that no prescription for the sick could be maintained, unless supported by ancient authority. Such of the students as were com- petent to explain the ancient authorities in medicine were, under certain circumstances, denominated Doc- tors, or Teachers, and were allowed to practice Physic *In some parts of the Eastern States, the people still retain the manners and habits of the age of Cromwell. The attachment to ancient manners applies to many of the Dutch inhabitants of New York and New Jersey, and to the French in Canada. 109 and to direct the surgeons in their operations, and the apothecaries in the administration of medicines, in con- formity with the opinions of Hippocrates, Galen, and other ancient writers. Such was the condition of the Medical Profession throughout Europe for several ages. So late as the reign of Henry VIII, the Bishops of England, by virtue of their clerical office, but without the authority of law, granted licences to practice physic. The colleges in every part of Europe, which were clerical establish- ments, did the same by ancient usage. Such, however, were the impositions on the public from the great abuse of medical degrees, from the European colleges, as to invite Legislative interposition; and by Acts of Parlia- ment of the fourteenth and fifteenth of Henry VIII, the medical graduates of the Universities of Oxford and Cambridge were prohibited practicing physic, un- less their degrees had been granted without favour, and in consequence of twelve years regular study; and all other graduates and licentiates were prohibited prac- ticing physic, unless permitted after examination by the College of Physicians, which was then established in London. And Chief Justice Mansfield, in the case of Dr. Middleton, lately decided such to be now the law in England. The establishment of the College of Physicians in London, consisting solely of medical men exercising authority over their profession in the kingdom of Eng- land, to guard the public from deception, was attended with the happiest effects, and gave in a short time respectability to the physicians, apothecaries and sur- geons of that part of Europe. Hence the condition of the Medical Profession in the English establishments in the United States was at no time viewed with much disrespect. No material changes in the condition of the Medical Profession took place on the Continent of Europe, until the period of the late French Revolution. The Reformation in the United Netherlands did not alter the privileges of Colleges, or the ancient arrangements relative to the Medical Profession. The University of Leyden has long been viewed with reverence by medical men. It was the school of Boer- haave and other distinguished medical teachers. In a period of near two hundred and fifty years from its establishment it never dishonored itself or the medical profession. The Latin language and not the vernacular tongue was then, and has continued to be, the language of the Dutch universities. No education, therefore, could be afforded to young surgeons and apothecaries, who were commonly uninformed in the learned lan- guage; nor was it supposed necessary, as they were no directed in their professional duties by the supposed superior skill and knowledge of those who were doctors of the universities. The Surgeons in Holland, with a few exceptions, were at that time and still are, barber-surgeons. The apothe- caries were by law compounders of drugs only, and had slender pretensions to any knowledge of diseases ; yet these barber-surgeons and apothecaries were without doubt the medical attendants on the original settlers of this State. Nor is it probable that any doctors of the European universities accompanied the settlers to the New Netherlands. It would be painful to intrude on your notice the humble condition of medicine which seems to have ex- isted for more than a century after the first settlement of this State. It could only consist of a statement of the arts and intrigues by which the practitioners of physic succeeded in advancing their private and professional emoluments. The state of humiliation in which the profession of medicine existed in the City of New York so late as the middle of the last century has not escaped notice in the periodical publications of that time. In the 12th number of the Independent Reflector, published in the City of New York on the 15th of February, 1753, "on the importance of the practice of physic andthe dismal havoc made by quacks and pretenders," it is observed "that there is_ no city in the world not larger than New York (containing more than 10,000 inhabitants) that abounds with so many doctors; they could boast of more than forty gentlemen of the faculty, the greatest part of whom were mere pretenders to a profession of which they were entirely ignorant, and convincing proofs of their incapacity were exemplified in their iniquitous practices." The advertisements they published proved them ignorant of the very names of their drugs. Ignor- ant as boys in the lowest class in a reading school of even the little art of spelling. The writer states his proofs of their being low-lived empirics and then says: "How few of the profession can even support a conver- sation upon the most common subjects of physics, with- out betraying their natural stupidity and ignorance, yet so strangely absurd is our conduct that the meanest quack among them insinuates himself into a subsistence. How many of the lives of the good people of this city must annually fall a sacrifice to those pests of society! While we are tenacious of our property, and justly glory in laws wisely calculated for the preservation of our professions, how preposterous is our conduct in trusting our persons to quacks and licensed assassins. By the law of the land, a person is guilty of murder for killing a man by throwing a stone from a house into in the street where people usually pass, though there be no evidence of malice prepense. And shall an illiterate mountebank, who deals out destruction, escape with impunity, and be permitted to fall on the bereaved widow and orphan with an exorbitant bill of fees, to deprive them of the only solace they have left them?" These were the sentiments of a man of the first con- sideration in this State. In the first and second edi- tions of the American Gazetteer, the Condition of the Medical Profession in the City of New York _ is stated in a more humiliating manner. To patronize imposters is always disreputable to individuals and degrading to communities. Such a state of society as favours a degrading con- dition of any of the learned professions can only be changed by the slow operation of time, and may not be effected but by the succession of ages. In medicine especially, when people become attached to professional imposters, their pride and self love are excited to give support to such persons with more zeal than is ever experienced by regular physicians and surgeons. Those who contemplate to cherish the progress of medical science in this State must not imagine that the diffi- culties which long opposed the advancement of knowl- edge are even now entirely dissipated. Though the medical history of our State, for a long period after the first settlement, can only be viewed by professional men with painful reflections; yet soon after the middle of the last century various causes be- gan, and others have continued since, to operate in meliorating the condition of the practitioners of medi- cine. The war which effected the conquest of Canada was, perhaps, the first circumstance which materially im- proved the condition of medicine in this State. The English army employed for that purpose left Europe accompanied by a highly respectable medical staff, most of whom landed in the City of New York, and contin- ued some years in the neighbouring territories, afford- ing opportunities to many young Americans of attend- ing the military hospitals, and receiving such profes- sional instruction as gave them afterwards consideration with the public. The physicians and surgeons of the Anglo-American army gained the confidence of the public by their superior deportment and professional information. The military establishments in this State, after the Canadian war, required medical and surgical attendants, so that the people had the benefit of their professional advice. In this manner a new order of medical men was introduced into the community. About the middle of the last century also King^s Col- lege was established in the City of New York, and some years later able Professors were invited from Europe to fill the Literary Departments of that Institu- tion. This had a happy effect on the sentiments of the community respecting general Literature, and favoured the progress of scientific improvements. The regulating of the Medical Profession has always been an object of attention in all wise governments; if it were only to designate the distinctions arising from examinations, and to confer legal protection, without penalties or forfeiture. Before the American Revolution, laws were enacted to regulate the practice of physic in the City of New York. These improvements were followed by the establish- ment of a Medical School in King's College, about the year 1766. In the year 1774, when I commenced the study of Medicine, about 25 persons attended the Ana- tomical Lectures, some of whom were students from the West- Indies. This school, however, did not flourish in a manner corresponding with the respectability and learning of some of the Professors. The conduct of the governors of the College it was said was injurious to the Medical establishment. Much opposition also ex- isted among some inhabitants, and even many of the Profession, to a Medical Seminary. I cannot but grate- fully remember the early lessons in the healing art which I received from the Professors of this estab- lishment, and from other distinguished Physicians in the City of New York* Perhaps a more rapid change has seldom taken place in favour of Literature and the Medical Profession in any community than was experienced in the City and State of New- York from about the middle of the last century to the beginning of the American war, com- prehending a period of about twenty years. The fear of the American Revolutionary war being much confined to this State afforded opportunities for Medical information in the Military hospitals. In this manner, Professional improvements may be said to have become more generally diffused through the State than at any former period. After the conclusion of the war which established the independence of the State, attempts were made to arrange a medical school in Columbia Collegef: but these failed of success, and were connected with cir- cumstances of so much mismanagement as greatly to affect the feelings of the citizens and produced what has been called the Doctors' Mob, which laid for three days all authority prostrate in the city, and subjected *Dr. Samuel Clossy, Dr. Peter Middleton, Dr. John Jones, Professors; Dr. William Farquhar and Dr. William Bruce, Physicians. tFormerly King's College. 8 113 several medical gentlemen to insult. This unfortunate event tended to degrade the Medical Character in the public mind, and not only to retard the progress of the science, but to excite unpleasant sentiments in the people with respect to the profession. While medicine was about reverting to a humble state in the City of New- York, it was in some measure upheld by some young Physicians and Surgeons who were induced to form a private Society for the improvement of Medical Science and for favouring instruction in those branches of knowledge connected therewith, and the Almshouse and public gaols were made subservient to the purposes of affording practical Information to Students. The Medical Department of the public establishments in the City of New- York had usually been farmed out to the lowest bidder, and had always been granted to persons of little Professional Information. Upon a presentation to the Magistrates of the City, about the year 1787, they established at the public ex- pense an apothecary's shop and accepted the profes- sional services for the sick poor of Dr. William Moore, Dr. Nicholas Romayne, Dr. Benjamin Kissam, Dr. Wright Post, and Dr. Valentine Seaman. These gentlemen afforded their gratuitous attendance for some years, and formed the first practical establish- ment as a Hospital and Dispensary under the Corpora- tion of the city, which existed in the State. The Stu- dents had not only an opportunity of visiting the sick and attending to the Reports and Prescriptions, but also of hearing Lectures on most branches of Medicine, and with such success that in the year 1790 upwards of fifty Students attended the instruction thus afforded. This private association induced the Legislature to pass an act in 1791 to establish a College of Physicians and Surgeons for the sole purpose of promoting medical Science. The Regents of the University, however, at that time declined executing the Charter, and by an arrangement made with the Trustees of Columbia Col- lege a third opportunity was afforded that establishment to become a seat of medical learning. The private teachers introduced 60 Medical Students to that Col- lege, which being reported to the Legislature, a grant of about 30,000 dollars was made to its Trustees for the purpose of enlarging the College buildings and further- ing the objects of education. The Trustees of Columbia College having obtained a number of Students, paying fees, and a grant of money from the public, proceeded to make such ap- pointments as in the opinion of the Students were highly unsatisfactory, and which caused the greatest part of them to abandon the College and erase their names from its register. This circumstance contributed 114 greatly to augment the number of students at the medical school in Philadelphia. The sick poor of the metropolis had for a century or more been attended by practitioners of physic in the manner already stated. The senior practitioners of the city had long viewed this subject with cold indifference, but as soon as the magistrates had employed men of fair pretensions to medical reputation to attend the sick under the public charge their sensibility became wonderfully affected. The passions of envy and jealousy which sometimes excite men to actions worthy of a purer origin induced these practitioners to exert themselves to establish a Dispensary and to carry into effect the establishment of the New- York Hospital, both of which institutions now do honour to the City of New- York as well as to those gentlemen under whose superintendence they are placed. Among the causes which had contributed to improve the condition of Medicine in the State towards the close of the last century it becomes me to mention a periodical publication, the Medical Repository. This work was commenced in the year 1797; a quarterly pamphlet has regularly made its appearance from the time of its first publication, so as to bring the fourteenth volume almost to a close. This publication is a com- pendium of domestic information respecting Medical, Physical and Scientific researches, deserving a place in every public and private library. The example of Pennsylvania and the eastern states has favoured scientific improvement among us. Sev- eral Students from this State have resorted to the College of Philadelphia, Connecticut, Massachusetts and New-Hampshire for instructions. Others edu- cated in these seminaries have established themselves in this State and diffused a love of knowledge and zeal for the improvement of the human mind. Philadelphia is certainly the first seat of science in the American empire. It was the residence of the immortal Franklin; his genius lives in her literary establishments, in her public library, in her Hospital for the relief of the sick poor. How respectable are a people who cherish their philosophers; who clothe them with civil power to exalt their own dignity. The first seminary for medical education in the new world was founded in that City by the late Dr. Shippen, and his professional labours were assisted by Dr. Morgan and Dr. Kuhn, all native citizens. Dr. Ruth, the present distinguished Professor in that establish- ment afterwards aided them by his genius and talents in favouring the progress of Medical Education, and now this celebrated teacher enjoys the satisfaction to "5 preside at a medical school not excelled by many in Europe. The medical profession in this State is also indebted to the exertions of Dr. Warren and other Professors of Medicine in Boston, and to Dr. Smith of Dartmouth College for their labours in disseminating Medical knowledge. The most important event to improve the condition of Medicine in this State is connected with the establish- ment of this Society by virtue of an act passed on the 4th day of April, 1806. This law was enacted at the always merit the respect and attention of this Society, of Washington, Saratoga and Montgomery, who will always merit the respect and attention of this Society. May the establishment of this Institution form an era in the history of the State from which we may here- after trace the successful progress of Medical Science. Among the occurrences which I consider it my duty to lay before the Society is an act of the Legislature making the medical degrees of the Regents of the Uni- versity licences to practice physic in this State. New- York affords the first instance in the modern history of Physic, of professional regulation being placed under the direction of men in power, after being vested in the members of that profession. It may be doubted whether any advantages to the community are likely to arise from this regulation. It is among the im- portant duties of this Society to protect the profession from the intrusion of improper characters and to secure the public from impositions. The Society was intended to unite in the memorials to the Honourable the Legislature for the purchase of a garden on the Island of New- York, belonging to Dr. Hosack. But it was surely presumed that the public expenditure of money would be proportionate to the advantages obtained in favouring the promotion of Medical Science. From general information upwards of 70,000 dollars are to be granted to Dr. Hosack for this garden. In a country where every farm or forest affords a variety of plants sufficient to illustrate the principles of Botany, public animosity may be excited on account of this transaction, especially as no advantages can result to Medical Literature commensurate to this purchase. The society ought not therefore to be impli- cated in the consequences which may probably arise hereafter in the opinion of the public on this subject, nor silently permit the sacred cause of science to be used as a pretence for favouring the views of individ- uals. The researches of Professor Davy into the chemical constitution of Bodies have been continued during the past year and the result has been laid before the Royal 116 Society of London; the abstract of the developments of this enterprising gentleman is laid before you, to- gether with such scientific improvements as have been presented to the public since the last anniversary of the Society. ... . , ,,_ It would be my duty at this time to lay before the Society every occurrence in the State during the last year connected with the interesting subject of our Pro- fession; but many of them may reach the members of the Society in another form. I cannot close this address without expressing to you my obligations for the unmerited attentions you have permitted me to experience, and while I respectfully offer the sentiments of esteem which I shall continue to entertain for my fellow members, I fondly cherish the pleasing expectation that the Society will continue to exist as an Institution creditable to the State and highly honourable to the medical profession. PRIZE ESSAYS. At the very first meeting of the Society it was determined that prizes should be offered in order to encourage medical research. At the time when medical literature was not the filled-up and overflowing measure that it has since become, the need for encouraging medical writers was very evident. At first, as can be seen from the details for the examination of essays, it was thought that many persons would enter into the competitions. Probably there was considerable disappointment in this matter. It is surprising, however, considering the limited opportunities for the consultation of foreign works, and the little time for research observations, that the busy medical practitioners of the early part of the century enjoyed, how many of the early prize essays have a distinct value even at the present time.^ In order to show how much the Medical Society accomplished by its prize es- says, excerpts have been made from the first five of them that are preserved to us. They are valu- able reading even at the present time, though it might be expected that they would treat of sub- jects of little interest at this late date, and dis- 117 cuss medical methods so antiquated as to have only an historical value. Nothing that we know is more chastening for those who boast of recent medical progress than to find that writers in the first quarter of the nineteenth century, on such subjects as consump- tion, the treatment of typhoid fever, the thera- peutics of iodine, delirium tremens, and occupa- tions and disease, should have treated their themes not only so that they are interesting even now, almost a century later, but that the opinions of conservative medical writers of the present day would be expressed in practically the same terms. The two prize essays that follow those from which we have made excerpts, were written by Dr. Nathan S. Davis, the dis- tinguished founder of the American Medical Association, who lived to be a patriarch in medi- cine down to the beginning of the twentieth century. Anyone who knew Dr. Davis well will be assured at once that anything that he wrote in the vigor of his early manhood when he was accomplishing so much for medical organiza- tion, as well as medical literature, will be worthy of perusal at any time. The portion of the proceedings of the first meeting of the Society referring to the matter of prize essays gives a good idea of the liber- ality of the members of the State Medical Society, and also of the breadth of view that dictated the subjects for which the prizes were offered. The Society, taking into consideration the im- portance of promoting philosophical and medi- cal enquiries, which might be interesting to the public, deemed it expedient for that purpose to adopt prize questions, when the following were agreed to, and directed to be published: i. A Medal, value fifty dollars, for the best dissertation on the topography, geology, and mineralogy of any county in the state, together 118 with an account of the prevalent diseases in such county. 2. A Medal, value twenty-five dollars, for the second best dissertation on the same subject. 3. A Medal, value twenty-five dollars, for the best dissertation on the causes and best method of preventing and of curing the typhus mitior, or low nervous fever, which prevails in the different counties of the state* Drs. Sheldon, Graham and Wheeler, who were appointed a committee to . determine the best means of adjudging the preceding prize ques- tions, reported— "That it be the duty of the Pres- ident, Vice-President, Secretary, Treasurer and Censors to select from the communications six of the best dissertations on each question, which shall be presented to the society for final adju- dication." The first prize essay that is preserved is that of Dr. Andrew Hammersley, entitled, "A Dis- sertation on the Remote and Proximate Causes of Phthisis Pulmonalis," to which the prize for the year 1825 was adjudged. It is published in the Transactions of the Medical Society of the State of New York, Vol. II., 1834-5, coming after two prize essays in the same volume that had been awarded prizes in years subsequent to it. The reason for this very probably is that the manuscript of the other essays had been in the printer's hands before this reached him. Al- though it might be expected that there would be little of interest at the present time in a disser- tation on the causation of consumption, written in 1825, it must not be forgotten that in the first *By typhus mitior is evidently meant the fever that we now call typhoid, and which was at that time confounded with true typhus — the typhus gravis or gravior of older authors. Clearly there was a suspicion already becoming prevalent that the milder disease, so widespread in its contagiousness, and so apt to make its appearance in the country at a distance from cities and sea- ports (for typhoid has ever been a rural disease), was distinct from the severe affection so common at # that time on shipboard and in seaboard towns as well as in the jails of large towns. 119 quarter of the nineteenth century the medical profession appreciated certain phases of tuber- culosis more judiciously than at a later period. Dr. Hammersley's discussion of cold as a source of consumption is especially interesting because of his refusal to concede it as an important fac- tor. He says: "Popular prejudice has all along conducted to the belief that sudden exposure to cold, when the body is heated, would be attended with extreme hazard, and this alone has been accounted one of the fruitful sources of disease. The researches, however, of more modern experimenters have tended in no small degree to qual- ify such conclusions. Those of Dr. George Fordyce and Sir Charles Blag- den, familiar to every person, are among the most im- portant in evincing that exposure to a high degree of cold, after violent heat, is unattended with danger to the constitution. This fact is likewise confirmed by the mode in which the practice of bathing is conducted in Russia, and in several other countries, the inhabitants of which, to heighten the luxury and add to the re- freshment of immersion in heated baths or long ex- posure to vapor of high temperature, immediately plunge into contiguous cold baths, or run into the open air and without the smallest covering on their bodies roll themselves in snow. In considering a fact of this kind, there are two particular circumstances to be no- ticed, to wit, the acquired vigor of the subject to whom the practice appertains and the inherent powers of re- action possessed by the animal economy. The hardy Russian, whose every fibre is made tense by the severity of his climate, suffers no harm from such practices, as the principle possessed by the system just adverted to is put in action in a. frame capable of enduring the influence of the opposite media to which it is exposed." A little bit further on Dr. Hammersley dwells particularly on the historical case, that of Alex- ander the Great, which used to be most fre- quently quoted as an example of the danger in- curred by bathing in cold water, while the in- dividual was heated and perspiring. His dis- cussion of this would be acknowledged at the present time as thoroughly sensible. "Much has been said by those who dwell very earn- estly on the case of Alexander, and the great risk he 1 20 encountered by bathing in the River Cydnus when clothed with perspiration. Dr. Currie has, however, in our judgment, very accurately conjectured 'that from the length and difficulty of the march, he must have been cooled as well as debilitated by excessive perspi- ration and fatigue, and under such circumstances im- mersion in the cold and rapid Cydnus was followed by the consequences which we would expect from the principles already laid down.' The vigor of his frame must, we may presume, have been temporarily sus- pended and the temperature of his body to such a degree lowered as to leave not sufficient room for the necessary reaction to occur." With regard to the influence of vitiated air in the predisposition of the individual, to con- tract pulmonary tuberculosis, Dr. Hammersley could not be more explicit were he writing at the present time. The subject of dust-laden air, too, is discussed very thoroughly; and all the various occupations in which irritant particles find their way into the lungs, and as a conse- quence predispose to the development of pulmo- nary consumption, are pointed out even more fully than at the present time, because various sanitary regulations, the result of legal enact- ments, are now enforced in occupations which used to be a fruitful source of pulmonary con- sumption. Because of the historical interest of this, the whole passage with regard to pneumo- coniosis seems worth while quoting: "Among the various artisans Dr. Cullen has enumer- ated stone cutters, millers and flax dressers as partic- ularly subject to attacks of this disease. 'But the most striking example,' says another writer, 'of this species of injury is afforded by one of the processes of the needle manufactory; it is that of dry grinding by which the needles are pointed; the persons employed in this labor are universally affected in a short time with the symptoms of approaching consumption. They go on coughing till they either spit blood or a thick substance having the appearance of matter. They de- cline in flesh and strength and scarcely ever survive to the fortieth year. Dr. Kirkland observes that scythe grinders are subject to a disease of the lungs from par- ticles of sand mixed with iron dust (getting into the lungs and setting up an affection) which among them- 121 selves they call the grinder's rot.' It is moreover as- serted on good authority that the gilders of London die almost universally at a very early period of a sim- ilar disease. Certain other occupations are very prop- erly thought to bestow an immunity from this extensive malady. Such are those of boatmen, watermen, sailors and gardeners. Certain animals of the lower order are moreover supposed to enjoy a marked exemption, as dogs; while on the other hand, cows, it is reported, are particularly subject to it." There is in this last sentence a tribute to the benefit of the open air in such cases, and a rec- ognition of the disease in animals that would seem to belong rather to the end of the nine- teenth century than to its first quarter. The second prize essay that has been preserved is to be found in the "Transactions of the Medical Society for the State of New York for 1834-35." It bears the title, "An Essay on the History, Causes and Treatment of Typhus Fever," to which the annual prize for the year 1828 was awarded. The essay was presented in compe- tition by Dr. Alfred Y. Magill, of Winchester, Va. The essay, of course, was written before the general recognition of the distinction between typhoid and typhus fever, and it is evident that both diseases are confounded. It might be thought that whatever is permanently valuable in this essay would occur in the observations on the causes of the disease, or perhaps in the gleanings from the literature as to its history. As a matter of fact, however, it is under treat- ment that the best part of the essay, and the only part that retains an enduring interest, is to be found. The confusion as to the two diseases grouped under the name of typhus, the lack of definite pathological observations, though there are evident signs even in the literature quoted here, that the enteric basis of what we now know as typhoid fever was coming to be generally recognized, rendered much of the essay a mere vague theorizing from false premises. It is surprising to find in this essay, written seventy-five years ago, a very definite expres- sion of the value of cold water, especially of cold bathing, and, where this is impossible, even of cold air, in lessening the temperature, reducing patients' restlessness, moderating the pulse and tempting him to restful sleep. Here is a typical passage : "No one can peruse Dr. Currie's recent experience in this matter without being convinced that cold water when properly applied is a most important remedy in case of fever. Its utility is not confined to typhus ; it is equally serviceable in all fevers attended with in- crease of heat and arterial action. Its effect upon the pulse is astonishing in many cases. We have often known the mere bathing of the hands and arms of a febrile patient to reduce the action of the pulse from ten to fifteen beats in the minute, and if this partial application of cold water has such an effect on the action of the heart, how much greater must be the effect of a cold bath ! We have many instances on record of its calming at once the most furious delirium; persons in such a situation have often jumped overboard from a vessel into the sea and been taken up perfectly calm and rational and with an almost complete extinguish- ment of the fever. With the many strong instances recorded in various works of its remarkable efficacy in curing fever, it is justly a matter of surprise that physi- cians so seldom call its great powers into requisition. It exercises a more immediate control over the action of the heart than blood-letting. Dr. Currie mentions a striking instance of the effects of cool air in reducing the pulse. 'In the month of May, 1801,' says he, 'I was desired to see a patient ill of fever in Sparling Street. I found him in the tenth or eleventh day of the fever, delirious and restless; the surface of the body dry, and his heat 104 degrees of Fahrenheit. The room was close, and I desired the only window in it opened. The wind from the northwest blew directly into this window, and the bed being situated between it and the chimney, a pretty brisk stream of air passed over it. The patient had just thrown off a considerable part of his bed clothes and was exposed naked to the breeze. I sat by him with my finger on his pulse watching the •effect. In a little time the pulse fell from 120 to 114 in the minute; he became more tranquil, and soon afterwards he sank into a quiet sleep, in which he re- mained when the water for affusion was prepared; of course we did not disturb him; he remained exposed 123 to this cold air until morning, when his pulse was found to be about ioo and his heat 101.' " * Almost needless to say, Magill recognized the fact that there would be much prejudice against the use of cold water, especially as regards bath- ing or affusion, and he therefore suggests cold rubbings and wrappings with cloth. He notes that usually this form of treatment is so conso- nant with the patient's inclinations, once it has been tried, that there is usually no further diffi- culty in its application. In severe cases, peremp- torily requiring the use of active means, he ad- vises the doctor to disregard the prejudice against the use of cold baths, or of cold affu- sions. On the other hand, he did not consider that all patients suffering with fever should be sub- jected to cold applications indiscriminately, but advised the selection of patients and suggested certain contraindications to this method of treatment. His paragraph on this matter is of suggestive interest and practical value, even at the present time, accordingly, we quote it en- tire: "But cold water is by no means to be used indis- criminately in every case of fever; neither is it to be used in all stages of any fever; the rules which Currie has laid down on this subject are excellent and cannot be followed too closely. If we obey strictly his direc- tions, we will always be prevented from misapplying or doing injury to its use. He gives separate rules for the external and internal use of cold water, but as its effect, except in degree, is the same when used either way, so one set of rules will answer as a guide for both. His first general rule is that 'it may be used (either [*It is interesting to note that though the clinical thermometer was not often used for half a century after the date of this observation, indeed, Dr. Keen says that surgeons during our Civil War estimated fever by touch and not by the thermometer, this English observer quoted by Dr. Magill was studying his fever cases very carefully with the aid of a Fahr- enheit thermometer in the early years of the nineteenth century.] 124 internally or externally) when there is no sense of chillness present, when the heat of the surface is stead- ily above what is natural, and when there is no general or profuse perspiration.' We will now give the sub- stance of the particular rules he has laid down on this subject, ist, 'Cold water is not to be used either in- ternally or externally in the cold stage of the paroxysm of the fever, however urgent the thirst; taken at such times it increases the chillness and produces great weakness of the pulse, and if used to any extent might cause the death of the patient.' 2d, 'When the hot stage is fairly formed and the surface is dry and burning, cold water may be used both ways with the utmost freedom; frequent draughts of cold liquid and its external application, under such circumstances, are highly grateful; they diminish very much the heat of the body and lessen considerably the volume and fre- quency of the pulse.' 3d, 'It is also necessary to ab- stain from the use of cold water when the body is under profuse perspiration, and this caution is more important in proportion to the continuance of this perspiration.' " The third of the prize essays published had for its subject, "The History, Preparation and Therapeutic Uses of Iodine," and was presented by Samuel J. Hobson, M.D., a member of the Philadelphia Medical Society. Those who think that at the present time we have any new or re- cent suggestions with regard to the therapeutic value of iodine or its combinations, should read this essay.* There is of course scarcely any pathological condition in any important organ that has not been apparently benefited by iodine, in the hands of some investigator. Even as early as 1830, however, it was true that symp- toms of all forms of chronic disease were at least relieved by iodine or its compounds. The list of diseases given by Dr. Hobson includes such terms as scrofula, enlargement of the mam- mary glands, of the liver and spleen, of the testi- cles, marasmus or disease of the mesenteric glands, all the various forms of tuberculosis in all parts of the body, and nearly everything else •Transactions of the Medical Society of New York State, VoL II, 1834-5- 125 from varicose veins to diseased heart and angina pectoris, and polysarcia or corpulence, and the non-union of fractures. It was especially recommended for enlarge- ments of the various glands that are possessed, as we have since learned, of an internal secre- tion, as the prostate, the thymus, and the thy- roid. The enlargement of the thymus gland, for which it is supposed to be especially useful, is that which by its sudden acute effects produces serious dispnea or even convulsions, so-called thymic asthma which may result in sudden death, an affection that is often thought to be of much more recent observation. It was with regard to enlargements of the thyroid, however, that the most important field of iodine in thera- peutics was found. Dr. Hobson's discussion of this will be of interest even to the modern thera- peutist. As his illustrative case is associated with a special use of the electric current, not very unlike that known in more recent times as kat- aphoresis, the whole passage is quoted. "Bronchocele, or Goitre. Such unparalleled powers has iodine displayed in this disease that it has received, by almost universal consent, the title of specific. We do not conceive it necessary to select any from among the numerous cases, except one, which have been reported as illustrative of the successful employ- ment of iodine in this disease, as its efficacy is too well known. The case we are about to mention is one related by Dr. Coster and was cured in a singular and most in- genious manner — by combining the action of the Vol- taic Pile with that of iodine. A young man had a goitre of large size which had resisted the use of iodine both internally and by fric- tion. Being aware that iodine was attracted by the positive pole, Dr. C. thought it probable that by apply- ing iodine on one side of the tumor and the pole to the other, its absorption would be accelerated ; the re- sult was highly confirmatory. He performed the op- eration twice a day, taking care to change sides at each time of its operation, i. e., in the morning he would rub the ointment on the right side of the tumor and apply the pole to the left ; and in the evening vice versa. 126 He kept the tumor under its influence for ten or twelve minutes, and in the space of twenty days it was en- tirely removed. To show that its effect was not solely owing to the pile he had previously subjected the tumor to a galvanic current without the least sensible effect. He used the pure iodine ointment made in the proportion of two grains to a scruple of lard. It was the only case in which he ever adopted the above plan of treatment, but recommends physicians to give it a trial in all obstinate cases of the disease and also of scrofula. When used in the ordinary way we direct together with the internal use; in bad cases, frictions twice or thrice a day on the tumor, with the ointment either of iodine or hydriodate of potash; it should be rubbed with a portion about the size of a hazel-nut or more until the unguent is absorbed. There is frequently a little hard, knotty lump that remains after the goitre is dissipated which is often difficult and sometimes impossible to remove. Mr. Austin, of England, is in the habit of using strongly camphorated mercurial ointment for its removal. The use of iodine ought never to be imprudently persevered in on account of it." Some of the notes to the essay on iodine con- tain some curious observations made with regard to the effect of this substance on the sexual sphere, especially as regards the mammae and testicles. These observations have not been en- tirely confirmed, yet there has always remained a persistent tradition with regard to the influ- ence of iodine on such glandular structure when used for prolonged periods. "This last effect (that of causing reduction in size of sex organs) has more than once been observed; and from merely remedial doses. Professor Hufeland says he has seen three cases where the mamma? disappeared during its use for disease. — Amer. Med. Record, vol. VIII, p. 624. It is also said that men have been castrated, if I may so speak, from the use of iodine. Such events are apt to create an aversion to the remedy; but they are of extremely rare occurrence and generally proceed from its protracted or injudicious use. These facts demonstrate, however, its potent sway over the absorbent and glandular systems. But what 127 remedy is there whose action is not influenced by temperament or idiosyncracy ?" Dr. Hobson's directions as to the dosage and methods of administering the various prepara- tions of iodine show how far advances had been made in the direction of the most modern thought at a time when this substance and its compounds were as yet scarcely more than a quarter of a century before the medical profes- sion. "With regard to the administration of iodine, we should observe the same general rules with it as with every other active medicine; — to commence with mi- nute doses, and gradually increase it: — to watch its effects : — to attend to the age, temperament and imme- diate condition of the patient: — to suspend it on the manifestation of any untoward symptom, ... Of the tincture of iodine and the solution of hydriodate of potassium, we should commence with six drops of either to an adult three times a day, about two hours after each meal, and to be cautiously augmented, say, another drop every other day until we reach to the amount of twenty drops thrice a_ day; it may, how- ever, by continuance, be gradually increased with safety to 25 to 30, and even to 40 drops, thrice a day ; at least we know that practitioners have occasionally increased the dose to that amount with impunity. At page 247 we mentioned cases where enormous doses were taken daily with no bad effect. Our reason for advising it to be taken some time after eating is that then it would be less apt to produce nausea, an effect frequently complained of by patients under its use. Of the two the solut. potass, hydriod. is found by experience to be far less liable to disagree with the stomach than the tincture of iodine, and hence it is more generally employed especially in private prac- tice, and should always be in delicate females. We may administer either of them in a wine glass full or more of pure or sweetened water with a few drops of tincture of lavender, cinnamon or mint to render it more agree- able. As the tincture of iodine possesses a very un- pleasant taste and smell, it would be perhaps most pal- atable if taken in some of the aromatic syrups. Coindet always exhibited it in capillaire syrup. The solut. potas. hydriod. has no taste whatever. Some may think that the dose we have recommended to begin with is unnecessarily small, but we are con- 128 vinced from what we have read that too many prac- titioners are in the habit of commencing with injuri- ously large doses, hence we so often hear of their having to suspend it from its inducing nausea, headache, febrile excitement, etc. It is moreover a false notion that we can hasten the cure or obtain more good from medicines of this kind by giving them in large doses; we may indeed obtain their poisonous effects, but not their specific constitutional sanative influence, if I may so speak." The closing sentences of these directions have in other words often been re-echoed since Dr. Hobson's time, and the thoroughgoing conser- vatism of his position is all the more remarkable as it is evident from his essay that he was an enthusiast on the subject of Iodine. It is rather curiously interesting to find that the first prize essay published by the New York State Medical Society was on the subject of De- lirium Tremens, though it is not a matter of surprise to find that the essay was written by Dr. James Conquest Cross of Kentucky. How long that State has enjoyed its reputation for distilling is not clear, but in the mod- ern time we would be sure to assume that it was the opportunities provided Dr. Cross by his special Kentucky environment that enabled him to gather the really valuable observations which ■constitute the basis of his essay. I say that this was the first essay published by the New York State Medical Society because it is to be found in the Transactions in what is called Vol. I. for the years 1832 and 1833. The prize was awarded for the year 1831, and as already men- tioned the prize essays for 1825, that of Dr. Hammersley on the Causes of Phthisis, and for 1830, that of Dr. Hobson on Iodine, were published in the second volume of the Transac- tions, issued for the years 1834 and 35. Dr. Cross' essay on Delirium Tremens con- tains a very valuable review of the literature on the subject, published up to the year 1830. Ac- cording to this, delirium tremens was not recog- 9 129 nized as a distinct affection due to a specific cause, until the beginning of the nineteenth cen- tury. He asserts that it was not described as an independent disease until the year 1801. Even then the description of it, issued by Dr. Samuel Burton Pearson, was only meant for private cir- culation in the circle of his personal acquaint- ances. It was not until 181 3 that the value of this article was recognized to such an extent, that in order to make it more generally known in the profession, it was reprinted in the Edin- boro Medical and Surgical Journal. Some quo- tations from Dr. Cross' paper will serve to show how thoroughly conservative he was in the treat- ment of the disease and how much he recognized the necessity for individualization in the pre- scription of remedial measures. The sheet an- chor was opium, but opium used in conjunc- tion with remedies especially indicated by the patient's individual symptoms. "That the energetic enforcement of the opium prac- tice when the system is in a state of obvious unprepara- tion or where it is not associated with suitable auxil- iaries may force the patient into a state of stupor that will terminate in death is intuitively evident. Inde- pendently of every other consideration, this single fact is sufficient to prove how exceedingly preposterous that precept is which recommends the indiscriminate em- ployment of opium. It also enforces the superlative im- portance and indispensable necessity of attending closely to the effects of this drug as they are in succession de- veloped. With blind and heedless impetuosity to push forward this potent narcotic until sleep is produced without regard to any other circumstance, I hesitate not to assert to be the quintessence of quackery. This is the more culpable, as it is in the power of the attentive physician with some degree of certainty to determine from the condition of the symptoms that precede sleep, whether opium is making a salutary or prejudicial im- pression. We lay it down as a rule that if there is not a gradual, although it may be an exceedingly in- considerable amelioration in the symptoms, the convic- tion should- be indelibly impressed upon the mind of the physician, that he has been premature in the exhi- bition of opium. Perhaps this remark should be qual- ified. It will always happen that when a quantity of 130 opium sufficient to overcome the gastric irritation has been given all the symptoms will be exasperated. This conclusion will not, therefore, be authorized unless we have properly prepared the system and are perfectly sure we have given sufficient doses." His discussion of the value of venesection in delirium tremens gives probably the best idea of his broadminded care to treat the individual suffering from the delirium, rather than the de- lirium itself. This discussion will serve at the same time to show to what an extent venesec- tion had been carried by some supposedly con- servative authorities in the treatment of deli- rium tremens. The affection is, of course, one of those in which phlebotomy would seem to be indicated. The violence of the symptoms and their reference mainly to brain, would seem to indicate that the circulation must be relieved at almost any cost. It is then interesting- to see how modern in this matter was Dr. Cross, and the fact that his essay should be selected by the prize committee of the day indicates the conservative temper of representative members of the New York State Medical Society in the early part of the nineteenth century. "While there are those who proscribe venesection altogether and others who commend it guardedly, there are those who wield the lancet with a boldness not surpassed in the treatment of most inflammatory af- fections. Thus Professor Potter, whose high preten- sions as a sound and successful practitioner have never been questioned, declared that, 'in young subjects, and even m patients advanced in life, but recently attacked, we have frequently bled to the amount of 70 or 80 ounces, and several times an hundred in three or four days. In some instances so energetic are the symptoms T?™£ I ' u of . "flanjmatory action that Professor £, ,• been ln duced to conclude that this disease 1«~ P«^.««*phalita, and consequently in accord- IZIZ^ thlS , V - eW , ° f the subject the treatment is H PrP £ exd "t lvel y «P°n antiphlogistic principles. Here, however the same error has been committed by Professor Frank that deserves such severe reprehension m those who obstinately maintain that deliriuS Trent™ is invariably a disease purely asthenic. A little ex- 131 perience, uninfluenced by preconceived opinions, will soon convince the attentive practitioner that while both these opposing hypotheses are true to a certain extent they are, when designed to embrace all the varieties of this disease, radically unfounded. It is this circum- stance which renders the propriety of following their precepts not only questionable, but absolutely dangerous. For if we should embrace the views of those who pro- scribe the lancet entirely, we should doubtless succeed in some instances, but the experience and success of Professors Potter, Frank, etc., afford conclusive proof that we shall meet occasionally with patients who im- periously require venesection and that must inevitably perish under the narcotic or narcotico-stimulant modes of treatment. An adoption of the pure antiphlogistic treatment of Professor Frank would be followed by a greater mortality as there are fewer cases in which the lancet is admissible than in which it is clearly and incontestibly proscribed." The fifth prize essay that has been preserved is that of Dr. Benjamin W. McCready of New York, who wrote on the influence of trades, pro- fessions and occupations in the United States, in the production of disease. His was the prize essay for the year 1837. It may be remarked in passing that this was the first time so far as we know, that the prize was awarded to a New York man. Kentucky, Virginia and Pennsyl- vania had been represented in the list of prize- winners, and it is very evident that the prizes were awarded entirely for the merit of the essays and not for any personal or partial reasons. This fifth essay contains some rather interesting ma- terial, with regard to sanitary problems that are even yet matters of discussion for the medical profession. The question of the overcrowding in the tenement house districts of New York City is discussed just in the same terms that would have been used ten years ago on the same subject, though fortunately recent legislation has brought some amelioration of the worst condi- tions in this matter. The reasons for ill health in the tenement house districts is thus stated: "In other cases the cupidity of landlords has tempted them to build up narrow alleys with small wooden tene- 132 ments which, costing but little, and being let to numer- ous families yield immense profits. The alley is often not more than six feet wide, paved with round stones and with very insufficient means for draining off the water. It is not uncommon in such situations, to find one or two of the apartments in each house entirely underground. Can we wonder if in such a state of things we find moral as well as physical disease, vice as well as sickness? Can we expect men who live thus to be orderly and sober, or women to be cleanly and domestic? In such situations, during the summer months, diarrhoea and dysentery are rife, and among children fatal. Scrofula, in some of its protean forms, is frequently met with and they form the lurking places where smallpox, measles and scarlet fever lie covered under the ashes, or when circumstances are favorable, blaze up into sudden fury." At the end of Dr. McCready's essay there is a rather striking set of passages in which he dis- cusses the evils of the quack and especially the patent medicine vender, and suggests the reasons for the popularity of their products. He has caught the essence of the idea in the declaration that the present popular errors in medicine are always the result of previous supposed knowl- edge among physicians themselves. Medical theories not only do harm, by satisfying the mind of the physician for the moment and thus pre- venting his inquisitiveness from urging him to investigate where he thinks he knows no reason for things, but they prove even more harmful by perpetuating themselves among the populace for at least a generation or two after they have been exploded by the regular practitioners. This is an idea that such men as Virchow and our own Jacobi have often expressed since, and the signi- ficance of which all serious thinkers in medicine will recognize. Dr. McCready's remedy for this unfortunate state of affairs would be the spread of real knowledge. In the seventy-five years that have elapsed since the writing of this many im- provements and advances in education have come, yet his words retain their forcefulness and application. 1.33 "That the present errors of the vulgar were formerly the themes of philosophers, is an old and trite observa- tion. Most of the vague and unfounded notionsof the public concerning the nature and treatment of diseases, which embarrass the young practitioner on his entrance into practice, were once the cherished doctrines of the wise and learned. Can we do nothing to correct the evil our predecessors have occasioned? Can we not substitute truth for falsehood, facts and reasoning founded on facts, for idle notions, and injurious hy- pothesis? I would not wish to instruct the community in a knowledge of the symptoms and treatment of dis-. eases — that were impossible; but I would wish to make a knowledge of the laws and functions of the living body a necessary part of a liberal education, and to communicate to all classes so much information as would enable them to educate their children and regulate their diet, clothing, exercise and habitations. Something of late years has been done to this end, but much, very much, remains to do, and professorships of physiology in our literary colleges, and popular lectures and popular books on the same subjects for all classes, would be productive of benefits widely felt and as widely acknowl- edged. Many of the evils incident to the occupations of civilized society would then be remedied, and others, essentially alleviated. Medical men are bound to urge this matter upon the public, not only from motives of general benevolence, but of private interest; for it affords the surest means of elevating the character of the profession. Then would the public be enabled to judge of the intelligence of their medical attendants, and then in common with the rest of the community, would the young physician feel the truth of the maxim, 'Knowledge is Power.' " Dr. McCready has also an excellent review of the situation as to quack medicines which unfor- tunately has not become an academic question in spite of all our progress in educating the masses; and he thought the newspaper press as responsible for it then as we do now. The evil results to be anticipated from the abuse of medicines are just those that medical writers of the present day insist on. "There is an evil, which has of late years become of excessive magnitude, and which is daily increasing — the consumption of quack medicines. Aided by the immense circulation of a cheap press, many of these nostrums have obtained a sale that exceeds belief. Few patients 1.34 among the lower classes now apply to a physician, who have not previously aggravated their complaints by swallowing numbers of these pretended specifics, and a late resident-physician of the city hospital has informed me that he has met with many cases of derangement and irritation of the mucous membrane of the stomach and bowels, caused solely by the drastic articles which enter into their composition. Formed in most instances of irritating ingredients, and directed to be taken in immense doses, and as infallible remedies in all cases, the mischief which they do is incalculable, and unless some stop be put to the evil by law or by an enlightened public opinion, it will soon claim an unenviable pre- eminence as a cause of public ill health." CHAPTER IX. ESTABLISHMENT OF THE PHARMACOPEIA. Undoubtedly one of the most important prac- tical advances in American medicine was due to the movement initiated by the Medical Society of the State of New York which finally led up to the establishment of the National Committee on the Pharmacopeia and the publication of that work for the benefit of American physicians. The subject had been hinted at several times, and finally a communication from the New York County Medical Society on the subject of a National Pharmacopeia was received at the twelfth meeting of the State Society and referred to a committee consisting of Drs. Willoughby, Patrick and Wendell. This committee met and after discussion reported the following preamble and resolutions, which after some discussion in the open session of the Society were finally adopted. As they state the reasons for the need of the action suggested, and contain some his- torical details as to the confusion in dispensing we give them in full: Whereas, A uniform system of preparing and com- pounding medicines, throughout the United States, would contribute much to the satisfaction of the practi- tioner, and obviate many existing sources of embarrass- ment and danger; and 135 Whereas, Much diversity does now prevail in phar- maceutical preparations in the different sections and States of the Union, in consequence of the various phar- macopeias which are adopted — such as Coxe's Dis- pensatory, the Massachusetts Medical Society Phar- macopeia, Thatcher's Dispensatory, the New York Hos- pital Pharmacopeia, the Edinburgh Dispensatory, the London Dispensatory, the London Pharmacopeia, the Dublin Pharmacopeia, and Parisian Pharmacopeia, etc. — which accounts for a well known fact, that the traveler gets a different preparation, under the same name, in almost every village, town or city in which he may chance to be indisposed. This is not the only evil; for so multifarious are the names of medicines, that a name, which is common in one town, may be unknown in another, or, what is worse, may be applied to a very different medicine. Therefore, Resolved, That it is expedient that an American Pharmacopeia should be formed for the use of the United States. Resolved, That the several incorporated State medical societies, the several incorporated colleges of physicians and surgeons, or medical schools, and such medical schools as form a faculty in any incorporated university or college in the United States, be respectfully invited to unite in the formation of the American Phar- macopeia; and in case there should be any State or Territory in the Union in which there is no incorporated medical society, medical college, or school, that volun- tary associations or physicians and surgeons, in such State or Territory, be respectfully invited to unite in the formation of this work. Resolved, That a general convention be held in the city of Washington, on the first day of January, 1820, to be composed of delegates from the district conven- tions. Resolved, That this Society do now appoint David Hosack, M.D., J. R. B. Rodgers, M.D., Samuel L. Mitchell, M.D., John Stearns, M.D., John Watts, M.D., T. Romeyn Beck, M.D., Lyman Spalding, M.D., Wright Post, M.D. and Alex. H. Stevens, M.D., delegates to meet in district convention, for the purpose of forming a Pharmacopeia. Resolved, That the delegates appointed by this Society be a special committee to correspond with all the incorporated State medical societies, etc., in the Union, and such other influential medical men as they may deem proper. Resolved, That if a majority of the incorporated State medical societies, incorporated medical colleges, medical schools and faculties of medicine in the United States, 136 approve of the formation of an American Pharmacopeia, that it ought to be undertaken. Resolved, That as soon as it shall be made known that a majority of the societies, etc., approve of the forma- tion of the Pharmacopeia, that the special committee of correspondence of the New York Medical Society shall give public notice, as well as notice to all incorporated State medical societies, etc., that an American Phar- macopeia will be formed. Resolved, That in order to fix on times and places for holding the several district conventions, the special committee of correspondence be directed to request the several societies, etc., to name what time and place in their opinion, would be most convenient for the meeting of the convention in this district; and when the formation of a Pharmacopeia is agreed on, that the aforesaid committee transmit to each society, etc., the names of the several places in their district, and at the times which have been mentioned, and point out what time and place have the most votes, and submit to the several societies, etc., if such time and place would be most convenient. Resolved, That this Society would propose the first day of June, A. D., 1819, and the City of Philadelphia, as a convenient time and place for the meeting of the convention in the district known by the name of the Middle States. Resolved, That it be recommended to the different county societies, to raise money by subscription, or otherwise, to defray the expenses of the delegation to the district convention. At the next annual meeting there was a report of progress of the most encouraging kind. Dr. Samuel L. Mitchell, one of the committee, to whom was referred the resolution, passed in Feb- ruary, 18 18, to adopt measures to establish a National Pharmacopoeia, made the following re- port: That your committee have diligently attended to the subject referred to them; and they congratulate the Society on the accession of the requisite number of Medical Societies and Colleges, to the important undertaking in forming such a necessary and great professional work; and moreover on the prospect of its eventual ratification in a manner which the en- larged view of its authors contemplated. In the following annual meeting, 1820, the 137 definite success of the enterprise that had been so ably forwarded by the Society was announced. In his annual address, as President, Dr. John Stearns referred with pardonable pride to the successful termination of the labors of the Phar- macopeia Committee. He said: "I trust the time is not remote when the opinions of American physicians will be referred to as the highest authorities in medicine. This event will be accelerated by the liberality of opinion and discussion that is tolerated in our schools, unshackled by the restraints of authority imposed upon the graduates of the colleges of Europe. The late effort to form a National Phar- macopeia, is a strong illustration of this position. An effort which has never been equalled, and the magnitude of which intimidated many of its ardent friends; but which our diversified climate, abounding in medicinal plants, alone sufficient for the indigenous diseases of our country, urgently required. The delegates originally appointed by this Society per- formed the duties assigned them, in the City of New York, and reported a complete Pharmacopeia to the District Convention of the Middle States, assembled, in June last at Philadelphia. The work executed by this, and the other District Conventions, held at Boston for the Eastern, at Lexington for the Western, and at Columbia for the Southern States, was reported to the General Convention of the United States, recently held at Washington. From the whole of which a judicious and satisfactory selection has been made. It is, there- fore, with no ordinary satisfaction that I announce the final completion of a work which will constitute a new era in medical history. The benefits will be extended to every practitioner, and perhaps to every individual in the United States. We search the annals of the world in vain for a precedent. From Maine to Georgia, from the Atlantic to the Mis- sissippi, we behold the medical public, animated by one spirit, merging all private considerations in this grand object, and spontaneously congregating in State, Dis- trict and General United States Conventions. An inter- course of correspondence, then commenced, have excited the medical energies of America, and will produce im- portant consequences, co-extensive with our empire, and durable as its existence." 138 CHAPTER X. A SYSTEM OF MEDICAL ETHICS. The Medical Society of the State of New York very early concerned itself with questions of ethics. There are examples of the expression of the feelings of the presidents of the Society, evi- dent reflections from those held by the members, even in the early presidential addresses. It was evidently felt, however, that a system of ethics to serve as a guide in doubtful questions and as a manual of instructions for those who are en- tering upon the practice of the medical profes- sion to be drawn up. Accordingly a committee consisting of Drs. James R. Manley and John H. Steele, both of whom were to be afterwards presidents of the Society, and Dr. Pascalis, who had been a prominent member, were appointed a committee for this purpose. They drew up a system of medical ethics which was reported to the Society in February, 1823, and unanimously adopted. The most interesting feature of this system of medical ethics is the lofty spirit of professional honor in the relation of the physician to brother physicians, to patients and to the State which it breathes. It is a monument to the lofty aims of our forefathers in medicine here in New York with which every modern physician in the State should be familiar. While not transient or radi- cal in its declarations it points out with no uncer- tain language the dangers that beset professional life, and suggests how they may be best avoided. There is scarcely a circumstance in the physi- cian's relation to others which is not touched upon and illuminated in this comparatively brief document. For this reason and because later so much of the history of the Medical Society of the State of New York was to be occupied with ques- tions of a medical code, it has seemed only fit- ting to reprint this system of medical ethics once more. 139 It is interesting to find that, in the same volume of the transactions of the Medical Society of the State of New York, 1861, in which this code is printed, the code of medical ethics of the Ameri- can Medical Association, adopted May, 1847, is also republished. The reading of the two codes makes it clear that that of the National Associa- tion was founded to a considerable extent on the system of ethics of the New York State Society. This is not surprising if we recall that the Ameri- can Medical Association originated from the efforts of the State Society of New York. While there has come considerable development in the professional aspect of many duties of physi- cians in the early quarter of a century that sep- arates the two documents, there is no doubt at all about the influence exerted by the original system of ethics, and no ethical document adopted by any other State Society had anything like the same influence. This is, of course, all the more interestng in the light of the fact that when the further development of medical ethics was to come after another fifty years, New York was again to be a leader in the evolution. The following is the code of Medical Ethics adopted by the Society: A SYSTEM OF MEDICAL ETHICS. A System of Medical Ethics comprises all the moral principles and regulations which should govern phy- sicians and surgeons in the exercise of their profes- sional avocations with the public in general, in private and confidential _ cases, as well as in their intercourse with other medical men, and before magistrates and courts of justice. Such a system may be reduced to the form of a code of medical police, exhibiting maxims and precepts in five respective divisions of medical ethics, under the following heads : 1st. Personal Character of Physicians. 2d. Quackery. 3d. Consultations. 4th. Specifications of Medical Police in Practice. 5th. Forensic Medical Police. 140 First Division. Personal Character of Physicians. It would be difficult to determine which of the three learned professions in society requires the most virtue or the most purity and perfection of personal char- acter. Those only can judge who are themselves ac- quainted with the difficulties to be surmounted in the study of medicine and surgery, and the labor and ex- tent of the long course of experimental observation which it is necessary to pursue, before the confidence of the public can be attained. The life of a physician is, on the whole, a continual struggle against prejudices and erroneous habitudes of the mind, and not infre- quently against ingratitude, exclusive of the personal hazard among the sick, the fatigue, and the loss of ordinary comfort and rest which it necessarily involves. i. A physician cannot successfully pass through his career without the aid of much fortitude of mind, and a religious sense of all his obligations of conscience, honor and humanity. His personal character should therefore be that of a perfect gentleman, and, above all, be exempt from vulgarity of manners, habitual swear- ing, drunkenness, gambling, or any species of debauch- ery, and contempt for religious practices and feelings. 2. The confidence of the public cannot be awarded to a physician who has rendered himself notorious for felony or misdemeanor, or who has incurred penalties for crimes. 3. A physician in indigent circumstances is not per- mitted to embrace or exercise any business which would degrade the character of his profession, such as keeping a tavern, lottery offices, gambling, victualing or play- house. Any low trade or servile mercenary occupation is incompatible with the dignity and independence of medical avocations. In such extreme and derogatory situations a physician forfeits the privilege of his pro- fession. Second Division. The importance of the medical profession requires that it should be exercised with fidelity to its scientific principles and approved doctrines, with honor to all its members, and with justice and humanity to the sick. A departure from the above principles constitutes Quackery, which degrades the medical character by ignorance, artifice, unapproved methods of practice, and by the use of remedies dangerous to life. < 4. Any physician or surgeon who divides his respon- sibility with a known quack and associates with him in medical consultations, receiving a fee or the usual 141 charges for such services, or practices with nostrums, secret medicines, or patent remedies, is guilty of quack- ery. 5. The right of a patent medicine being incompatible with the duty and obligation enjoined upon physicians to advance the knowledge of curing diseases, it consti- tutes quackery and cannot be professionally counten- anced. .6. Public advertisements, or private cards, inviting customers afflicted with defined diseases; promising radical cures; engaging for no cure no pay; offering advice and medicines to the poor, gratis; and producing certificates and signatures even from respectable in- dividuals in support of the advertiser's skill and success, and the like, are all absolutely acts of quackery, which medical institutions should always repress, and punish by the rejection or expulsion of those who commit them. Third Division. Consultations. All the individuals composing the colleges and medical societies constituted by the Legislature of this State, are by them, qualified physicians and surgeons. The two professions of medicine and surgery are blended by the law, both in the schools and in practice. The examina- tions by the censors of the County and State societies of candidates for the degree of license, and by the pro- fessors of colleges for the degree of doctor are equally directed to embrace in their exercises the elements and doctrines of both sciences, establishing thereby the candi- date's proficiency, not only in medicine, but in surgery. There are no degrees of qualifications, nor are different rights assigned to the members of the same profession, but such as result from their individual choice, skill and fitness. Practical surgery is more properly attended to by the younger members, but the more experienced should be deemed competent to direct or inspect either the theoretical or practical departments. These remarks are offered, to show that the distinction frequently adopted in practice, and especially in consul- tation, between physicians and surgeons, confining each other to surgical or medical, external or internal cases, has no foundations in propriety, and, if adhered to, arises from the wish to indulge in personal or interested motives. It is admitted, however, that when the ques- tion is merely to perform some operative process a practical surgeon should be selected in preference; but this exception is only applicable, when a physician de- clines (on such accounts as he may think proper) to perform a necessary operation, and by no means invali- dates the principle established in the State of New York, in conformity to medical ethics. 142 J. A consultation of one or many physicians is like a deliberating committee, over which a senior in age or experience presides, each one, however, being equally responsible for the trust assigned to him, of the cure or relief of the patient. The attending physician is exclu- sively charged with the execution of the treatment from day to day, nor is any consulting physician ever allowed to visit or inspect, unless it be with his colleagues, or by agreement, or in cases of emergency. When a surgical operation is required, it devolves upon the senior practitioner of surgery in the consulta- tion, or one especially appointed. 8. A diversity of opinion in consultation is to be regretted; for, if unavoidable, it must cause much delay and many inconveniences before a medical umpire can be obtained. It is needless to point out what a correct sense of delicacy will in this sense require from a gentle- man who in spite of his opposition finds himself in the minority; he should politely retire from the consulta- tion, and if he be the family physician, he should consist- ently resign his deliberate vote. o. A great reserve, and even secrecy respecting the deliberations of a consultation, is indispensible. No communication is to be made to the patient or friends but by unanimous order or consent; because, whatever opinions are emitted become subject to frequent altera- tions or inversions from mouth to mouth, and many become a source of contradiction perhaps injurious to some of the physicians in attendance. 10. It is the duty of a consulting physician to take care that his visits be not multiplied without necessity. He is, through courtesy, at liberty to decide when to discontinue his attendance. A consulting physician, however, cannot be dismissed without the consent of the patient as well as the attending physician. 11. Physicians are justly censurable if their patient be in danger and they do not in time procure advice and responsibility beside their own. Whatever be the motive that induces them to dispense with a consulta- tion, they certainly may expose their reputation by an incorrect judgment or misapprehension of their pa- tient's case and weaken the confidence reposed in them. And a physician does not acquit himself correctly to- ward his patient if he does not benefit him with the best advice that can be procured. Poverty or the nar- rowness of means to remunerate an additional prac- titioner is no reasonable excuse, for he can scarcely deserve the name of a practising physician who can not find at least one medical friend to consult when the life and limb of a fellow being is in jeopardy. 143 Fourth Division. Specifications of Medical Ethics in Practice. 12. Physicians are often requested to declare to the patient his danger and to urge his observance of re- ligious and testamentary acts; but medical aid in ex- tremely dangerous cases would seldom be of any avail if, in place of composing the mind of the sufferer, phy- sicians were to doom it to despondency and despair. Such services are incompatible with their duty of administering hope and comfort, without the influence of which many doubtful cases of disease might at once become positively fatal. To a Christian minister alone, or to some other au- thorized person, therefore, appertains the task of dis- closing to the patient his alarming situation and preparing his mind to meet with composure that event, which to his friends may appear inevitable. Physicians should not interfere in the final settlement of their patients' worldly affairs. These are eventually composed of various family claims and pretensions, and a physician's interference in their distribution may be taxed as arising from interested motives or be thought by those concerned to be a disgraceful viola- tion of the confidence reposed on his humane functions as medical attendant. In order to protect himself and to place his name be- yond the reach of any implication he should, ist. Give timely and explicit information of the dangerous situation of the patient to those who have the best right to advise him in his religious and tem- poral concerns. 2d. He should inform them of the possibility of a change in the prognostic in order to prevent any relax- ation of care and attention on the part of nurses and others, that no chance of the patient's recovery be lost through neglect. 3d. The physician in such a case, should continue his personal attendance, which is the more proper, as he entertains or has acknowledged some hope of a favorable change ; should he be dismissed from pecuniary motives, his responsibility nevertheless requires a friendly or gratuitous attention. 13. It is not intended in this system of medical ethics to instruct physicians and surgeons upon every felonious act of infanticide, murder, etc., for which the penal statutes of this country have made sufficient provision. It is incumbent upon medical authorities to consider, condemn and punish as criminal, such acts of medical practitioners as offend the respective obligations of mar- ried persons, or the chastity and modesty of the youth of both sexes. This restrictive definition is to be applied : 144 ist. To the personal conduct of medical men, who abuse the confidence of families and become exposed to legal damages for crim. con.,* or seduction, &c. 2d. To those who, with a view of curing diseases or correcting certain natural imperfections, prescribe reme- dies or advise remedial means that must interfere with matrimonial rights and the observance of a chaste and moral life. The scope of opinion on this subject may be wide, and the pretexts in palliation numerous, but the depend- ence of the public upon our labors, for the preservation of health, and the cure of diseases, ought to be held sacred; nor can confidence be granted to a profession that should allow any of its members to violate hos- pitality, to promote immorality, or to be accessory to vicious and criminal conduct. 14. Honor and justice particularly forbid a medical practitioner's infringing upon the rights and privileges of another who is legally accredited, and whose char- acter is not impeached by public opinion, or civil or medical authority; whether it be a native or a stranger settled in the country. There is no difference between physicians but such as results from their personal tal- ents, medical acquirements, or their experience; and the public, from the services they receive, are the natural judges of these intellectual advantages. In all proba- bility, every good physician would receive a merited share of patronage, were there not many who usurp a portion through artful insinuations, and slanders of others, or combinations against, or improper interfer- ences with the more worthy practitioner. Any physician thus molested or injured is justifiable in applying for redress to the county medical society to which he is attached. 15. A physician is not to visit a patient placed under another practitioner's care, without previous and osten- sible friendship or business, nor without first informing the attending physician; if then he thinks it proper to advise he may do it, but it must be in conformity to the rules of consultation as above explained. 16. Libelous attacks among physicians are no doubt subject to the same mode of redress by damages as the law points out to other citizens; but we hold that matters of libel include professional and practical acts, whether true or false, published or stated to any person who is not a competent judge, with a view to injure the professional reputation of a physician. This identical principle was adopted by the Suprehe Court of Penn- *Criminalis conversatio. The apparent hesitation to use the word adulter here, and the employment of the Latin legal term instead, and that only in abbreviation, is an amusing comment on a certain prudery of the time. IO 145 sylvania, in the trial of Benj. Rush vs. Wm. Cobbett, alias Porcupine, in which a verdict of $4,000 damages was awarded to the plaintiff for a libel founded on a malicious representation of the plaintiff's practice, made to the public by the defendant. 17. If medical controversies are brought before the public in newspapers or pamphlets, by contending medi- cal writers, and give rise to, or contain assertions or insinuations injurious to the personal character or pro- fessional qualifications of the parties, such papers are unquestionably disreputable to the medical community; for those who should be foremost in the pursuit of truth ought to be the last to set an example of an illiberal, indecorous and revengeful deportment, so con- trary to what is expected from literary and scientific gentlemen. Such papers are therefore to be reported by the censors to their respective county medical societies, and the authors are liable to such punishment as the case may require. It is a matter of justice, necessity and propriety, that the business of a physician and surgeon should be al- ways considered of a confidential nature. Even secrecy in certain circumstances, as will be explained hereafter, is the privilege of the faculty, and inviolable even in a court of justice. In ordinary practice, common sense, decency and delicacy should in familiar conversation with females and persons uninstructed in medicine, al- ways exclude such topics as patients, diseases, remedies, operations and the like. A display of terrific and wonderful relations and diseases, remedies, wounds, operations and cures, is frequently indulged in, no doubt, ad captandum, yet in most cases they produce but an equivocal admiration for the narrator, and prove, beside, his very imperfect knowledge of human nature. Those who are not familiar with the subjects of medical art and study, are liable to draw mistaken and contradictory inferences from what they hear concerning them. Hence, many people suppose that a physician is an un- feeling man ; and assimilate a good surgeon to a butcher. The more talk, therefore, the more numerous the mis- representations set afloat, and the greater the diffidence, distrust or disrespect excited. 18. The exposure of the nature of the complaint, which a physician is called upon to judge or cure, sub- jecting the patient to public shame or impeaching his moral character, is an unpardonable breach of medical ethics. 19. "The poor,'' says Boerhaave, "are the best cus- tomers, because God will be the paymaster." Instead of fee, they give in exchange the benefit of experience, of useful observation, and subsequently the gratification of successful advice, which is more exactly followed by 146 them than by the rich, who too often spoil the best direc- tions by their whimsical notions and love of comfort. The most lucrative and extended patronage a physician can enjoy, far from being an honorable pretext for not affording some attention to the poor, stands as a proof of his selfishness or want of humanity. 20. In urgent cases of sickness, or of injuries occa- sioned by accidents, a call for medical or surgical help should be obeyed immediately, unless such compliance be to the detriment of some other sufferer. It often happens in such cases that many physicians, and more than are required, meet on the spot. Courtesy then assigns the patient to the first physician or surgeon who arrives, and if he should want assistance he has a right to request it from a physician or practical sur- geon present, according to the nature of the case. But if the physician or surgeon who usually attends the family or patient be of the number then the present urgent case is assigned to him. In the event of concurring attendance of many med- ical gentlemen no fee is to be exacted for the trouble of coming, unless called upon by some authorized person. An accidental injury is distress, and help for a fellow being in distress is claimed by the laws of nature.* 21. The fees for the compensation of medical services are regulated by the value of currency and the price of necessaries in different countries and cities; by the customs approved and established among experienced and reputable practitioners, and sometimes by a re- corded rate of charges such as individuals belonging to any trade or profession adopted by general consent. Public opinion in civilized nations and among the more enlightened classes of society will always highly esti- mate and liberally compensate medical services. A strict sense of justice and honor towards each fel- low member of the profession should prevent a phy- sician from undervaluing his services by items and charges in his bill beneath the customary rate with a view to draw patronage by exciting comparisons. A practitioner may settle his demands with his patrons on whatever terms he pleases, but he has no right to make the low charge an established usage to the prejudice of his brethren. The reputation of a cheap doctor, after all, is neither dignified nor enviable. *Dr. Gregory says (p. 179) "that under such circumstances, considerations of benevolence, humanity and gratitude are wholly set aside: for when disputes arise, they must he suspended or extinguished; and the question at issue can alone be decided on the *principle of commutative justice.' If a physician would therefore contend for remuneration, it could not be as a medical fee, but an indemnity only for the expenses of transporting him- self there, where he might be wanted. The question is the more easily settled, as it has no further reference to medical service." 147 Others will follow quite a contrary method. They will place an exorbitant value on their time and labor and exact oppressive demands for their services. The conduct of such has a very injurious influence upon the lower and middle classes of society, who, needing medical aid, are deterred from applying to any phy- sician lest they should incur ruinous charges. These expensive doctors should be reminded that whenever a person pays a bill which he thinks extravagant and unreasonable, he easily repays himself and gratifies his vanity if not his resentment by divulging how much money he has been willing to bestow; what liberality he has exercised, or to what imposition he has been exposed. Some physicians more intent on acquiring wealth than a good name exact from their patients their charges, whether great or small, with unrelenting severity, re- fusing time to procure the necessary means, often hav- ing recourse to law suits, disregarding the plea of low circumstances, or absolute want, thus creating much distress; such conduct is as disreputable to the phy- sician as it is disgraceful to humanity, for the highest aim of the profession is to reach its utmost requisitions. These extortioners, as they dishonor the medical pro- fession by a single act of such oppression, deserve a public reprimand, if not a prompt expulsion from their county medical society. Whenever a physician is reduced to obtain his pro- fessional fees by compulsory measures, it is his first duty to propose, and to refer the settlement of the matter in contention by a reference to arbitrators. 22. It is enjoined in the sacred obligations which Hippocrates imposed upon the pupils of the noble science of medicine and surgery, which is also the model of the like engagement offered to the candidates for graduation in this and other countries, that they shall respect and assist their preceptors and mas- ters, their seniors by experience or age, and shall contribute as far as in their power, to the honor, improvement and utility of their professions. Ac- cording to this precept, physicians and surgeons have something more to do, than to procure their livelihood. As they are indebted to the labors, talents and experience of their predecessors in the healing art for all that con- stitutes its admirable body of doctrine, so present and future generations look to them for some additional improvement, because much can yet be done to extend its usefulness. This obligation is unbecomingly violated by many physicians who pretend to eminence; they estrange themselves from medical associations — never have any observation or improvement to communicate — their degree of skill and experience always remains un- 148 known and mysterious — they screen themselves from sci- entific labors and controversies ; and, if competent, never contribute by any effort, however small, to the ad- vancement of the medical character. Such practitioners, although they are frequently popular and wealthy, are, nevertheless, only comparable to drones in the bee- hive; medical associations should refuse to confer upon them offices, appointments, or even employments in com- mittees ; on the principle that proofs are wanting of their talent, zeal, judgment and professional emulation. Fifth Division. Forensic Medical Police. 23. There are numerous accidents and offenses, the nature and degree of criminality of which are determined by medical opinion. Human passions daily occasion acts of violence which- fall under the cognizance of public justice; and diseases of the mind, whether arising from vice, intemperance, sickness or accident, have also their share of influence in the commission of crime; and often lead their unfortunate victims to suicide and murder. Crimes so originating could be perpetrated in ways so disguised as to conceal the author, or the means by which they were accomplished, were it not that juries can be assisted by medical men in evidence related to physiology. A physician should al- ways be in readiness to answer in these judicial inquisi- tions, and to give an opinion, on facts referred to his judgment, according to the approved practice of medi- cine and surgery, as far as these are ascertained. Ignorance or an imperfect knowledge upon matters which place life, honor and innocence in a fatal pre- dicament, is unpardonable, and should subject any phy- sician, so illiterate, to disqualification for the privileges of his profession. 24. To well instructed physicians only two rules need be recommended. The one relating to their conduct when they are called upon to give professional evidence ; and the other, to the nature and extent of the secrecy which they are bound to maintain in relation to their patients. 1st. When physicians, engaged in the decision of a forensic question, are unbiassed by the parties, and have no interest for plaintiff or defendant (being well in- formed of all the facts alleged in evidence), they have only to decide by known medical principles, and, there- fore, can rarely disagree. It is their duty to obtain every possible information upon the case, and, before giving in their declaration, candidly and conscientiously canvass each other's opinions, so that erroneous ideas 149 may be removed, and information participated.* Two or more physicians, on one side of the question, should in the same manner freely communicate, in order to guard against versatile and contradictory declarations, for which the trivial sarcasm, "doctors differ," is no ex- cuse, and they always invalidate their opinions, author- ity, decision and respectability. 2d. The second rule is that the secrecy upon facts with which physicians become professionally acquainted, or invited to ascertain; such as, whether an apparent pregnancy be real; the gestation and birth of a child; its parentage, color and age; the judgment and treat- ment of syphilitic and gonorrhoeal diseases ; the able or disabled state of a person, in limb and constitution; the fallacy of virginity and other circumstances, to the confession of which a degree of shame, and the idea of exposure are attached, and which are never mentioned but with an engagement to secrecy. This duty has been defined by comparing it to that of the Catholic confessional, which admits of no dis- closures except in cases of treason or murder.f This inference has been acknowledged by the judi- ciary of New York, and in its application to medical matters admitted by that of Pennsylvania, in the year i8oo.J The Revised Statutes of our State have, however, prescribed the duty of the physician on this point. In the second volume (page 406) is the following enact- ment: "No person duly authorized to practice physic and surgery shall be allowed to disclose any information which he may have acquired in attending any patient in a professional character and which information was necessary to enable him to prescribe for such patient as physician, or to do any act for him as a surgeon." *When two or more gentlemen of the faculty are to offer their opinion or testimony, it would sometimes tend to obviate contrariety, if they were to confer freely with each other, be- fore their public examination. — T. Percival, Med. Ethics, ch. 4, p. 107. tThe sacred duty or privilege of a Catholic priest not compel- lable to disclose the secrets of auricular confession was main- tained by a decision of the Court of Sessions of New York, 14th of June, 1813, in the case of the Rev. Mr. K., refusing his tes- timony in a matter of felony. Vid. Cathol. quest, report, by Wm, Sampson, Esq. tMany persons would rather suffer or die, than be exposed to shame or disgrace from the complaints they are laboring under. It is a law of nature that they should seek for cure or relief, and be protected by professional secrecy, even if a matter of prosecution should arise therefrom. 150 CHAPTER XL HONORARY DOCTORS OF MEDICINE. The Medical Society of New York soon came to the realization that many of its members who had entered into the practice of medicine under the old regime, by which study with a physician and examination before a Committee of a Medical Society were sufficient for a license, would wish to possess the degree of Doctor in Medicine. Many of these men had in the course of long years of practice shown their thorough fitness for such a degree and had kept themselves con- stantly abreast of what was latest and best in medical progress. For the sake of these men whose early opportunities had not allowed them to obtain a degree in course in a regularly con- stituted medical school, the Society appointed a committee at the annual meeting of 1826 to ask the privilege of selecting certain physicians each year and presenting their names to the Board of Regents of the University of the State of New York for the Honorary Degree of Doctor in Medicine. The Committee presented to the Regents the following memorial which was drawn up by Dr. T. Romeyn Beck : To the Honorable the Regents of the University: The Medical Society of the State of New York, now in session, have, in the course of their deliberations, been induced to address your honorable body on a sub- ject which they deem of some interest to the profession that they represent. It will be readily understood that medical education during the last thirty years has been not only increasing in importance, but also becoming more and more dif- fused. The number of individuals who have availed themselves of its advantages has greatly augmented, and we cannot present a more striking proof of this than the fact that in 1796 there were only five medical schools in the United States, with one or two hundred pupils, whereas at present there are seventeen medical schools, with two thousand pupils attending them. 151 The results of such a state of things are favorable to the cause of general education, and through it to that of liberty and civilization. The medical profession, which in every European country has held a distinguished rank in science, prom- ises to take the same stand in this favored country, and thus in a small degree to repay the benefits it derives from the institutions devoted to its prosperity. But while the effects of extended medical education are so benign and useful, there are some minor and contingent evils attendant on its rapid diffusion. One of these has come under the notice and appears to de- serve the attention of the Society. The course of medical education has varied greatly during the last quarter of a century. At the commence- ment of that period it was generally the custom (with, however, exceptions) to complete the required term of study in the office of some respectable practitioner, and then in a very small proportion of cases, if pecuniary and other circumstances favored, to attend lectures at some of the widely scattered medical institutions. The preliminary attendance for the degree of doctor of medicine was expensive; the time to be consumed in its attainment was deemed too valuable; and as it was not sought for except among the residents of our larger and more populous cities, so its absence was not considered as a mark of the want of medical knowledge. The number of gentlemen who held the degree of M.D. in this State thirty years ago probably did not exceed thirty. Now, however, from the number of medical schools and the requisition of the laws throughout nearly the whole of the United States demanding attendance as a preliminary requisite for the practice of medicine and surgery, and above all from the force of public opinion, which justly views a proper education as indispensable in this as in every other profession, nearly two-thirds of the medical students in the United States attend lec- tures, and of these a number every year obtain the degree of doctor of medicine. They go into practice and settle by the side of those who have only a license, although the latter in their day complied with all the legal requisitions, availed themselves of all the advan- tages which their institution at that time permitted to them, and have since, in many instances, pursued the profession with honor to themselves and benefit to the community. That some unpleasant feeling should result from this state of things is natural. True, it is a consequence of the improved state of medical education, but it some- times operates unfavorably not only on that, but also on individuals who are thus placed in contact. The 152 young man with the degree of doctor of medicine may presume on his newly obtained honors, while the aged physician, practising under a license only, may be dis- posed to repress or underrate his youthful competitor. This effect, however, can only continue for a single generation, and it has occurred to the Society that much of the practical evil may be obviated by the inter- position of your honorable body. The Regents have the sole power in this State of granting the honorary degree of Doctor of Medicine. In other States the medical colleges possess this power, and they have accordingly exercised it — and particu- larly in some of the New England States, as Connecticut and Massachusetts, in granting the honorary degree to aged and respectable practitioners and thus obviated the very difficulty which has been noticed. In Con- necticut it is understood, there is every year a number recommended by the medical convention (equivalent to the State Medical Society) to Yale College, for this honor. In Massachusetts, Harvard University an- nually confers the honorary degree on a number of individuals; and in other States, medical institutions are more or less in the habit of giving it. The proposition, therefore, of this Society is, that the Regents be pleased annually to confer the honorary degree of Doctor of Medicine on a certain number of individuals, not to exceed six, to be recommended by the State Medical Society at its regular meeting, by the votes of two-thirds of the members present. In this way, it is believed, a sufficient guarantee is offered, that the individuals will be deserving of the honor, since every profession is the best judge of the talents of its members, and at the same time a mark of distinction will be bestowed, and that will be at once a reward for a life of honorable usefulness, and an in- centive to promote the cause of medical education. All of which is respectfully submitted, T. Romeyn Beck, Chairman. This communication was received after the meeting by the Regents of the University and as might have been expected was acted upon favorably by that body. What the text of the Regents' communication was, however, there is no means of knowing, though its purport can be readily gleaned from subsequent notes in the transactions. Evidently the Board of Regents replied that they considered it either improper or inadvisable to state absolutely that they would 153 confer the degree on all nominated by the Society, but they suggested that if the Society would each year present the names of those upon whom it wished the degree to be conferred the Board of Regents would probably act favorably upon them. In the Report of the Transactions at the annual meeting of the following year there is under date of February 8th, 1827, the following note with regard to the matter : The committee to whom was referred the communi- cation from the Regents of the University, report, that as a preliminary to their nomination, it is deemed necessary (in conformity to the application to the Regents) to consider age as a requisite, as well as professional standing; and therefore, that it is inex- pedient to offer any name, where the person has not attained the age of 45 years. With the desire of dis- charging their duty conformably to the intentions of the Society, both in respect to qualification and age, the following gentlemen are nominated to the Society for recommendation to the Regents, for the honorary degree of Doctor of Medicine: (The names are omitted until the pleasure of the Regents be known.) At the annual meeting of the following year, 1828, the President reported that in compliance with the request of the Society, the Regents of the University had conferred the honorary de- gree of Doctor of Medicine on the following gentlemen, nominated by the Society at its last meeting, viz : Drs. John Onderdonk, New York ; Jonathan Eights, Albany ; Laurens Hull, Oneida ; James Stevenson, Washington; Thomas Fuller, Otsego ; Gain Robinson, Wayne. At the same time a committee was appointed to nominate to the Society six gentlemen to be presented to the Regents for the honorary de- gree of medicine during the following year. The six men who were first to receive this honorary degree of Doctor of Medicine at the request of the Medical Society of the State were distinguished members of the organization, of whose medical skill and liberal education there 154 could be no doubt. Two of them were subse- quently to receive the honor of being elected President of the State Society and the others were to be widely and honorably known in their professional capacity. It is evident that they were selected from different parts of the State delib- erately in order that there might be no possible ground for the complaint that perhaps personal influences had had much to do with the selection. In spite of the fact that it was suggested that the committee should select six names to be recommended to the Regents during 1828, the Transactions of 1829 only report three men as having received the degree. They were Drs. Thomas Broadhead, of Columbia; John B. Hen- roy, of Monroe, and Eleazor Gedney, of Orange. Whether the three other names proposed were rejected by the Regents there is no way of de- termining from the transactions of the Society. CHAPTER XII. MEDICAL CURIOSITIES OF OPINION AND OBSERVATION. The volumes of the transactions of the State Medical Society for the first half century of its existence do not contain many direct contribu- tions to the science of medicine. The reading matter is mainly composed of minutes of the meetings with addresses of the Presidents for the first twenty-five years, and then, prize essays and addresses of various kinds with a few medi- cal articles in the stricter sense. Some of these articles have quaint medical notions not yet gone, some contain observations of great clinical value, and some of them describe distinct rari- ties in medicine and surgery. As the earlier vol- umes of the Transactions are now not easy to ob- tain and very few people have the opportunity of consulting them, it has seemed wise to select cer- tain notable contributions to the medicine of these early years in order to call attention to a i55 fruitful field in which information for the his- tory of medical and surgical progress in America may be obtained. Only the more striking obser- vations have been selected. MALARIA VERSUS CONSUMPTION. Those who are interested in the history of American Climatology as it relates to pulmonary tuberculosis especially will find matter for re- flection in the following notes, to the anniver- sary address as President of the Medical So- ciety of the State of New York, by Dr. John Stearns in 1819. "The proportion of deaths by consumption in the bills of mortality in New York and Boston are 1-4, in Philadelphia, 1-5, while all accounts concur in repre- senting it to be a very rare disease in Kentucky, Ohio, Indiana and up the Missouri. A knowledge of this fact has induced some consumptive patients to seek re- lief in that section of the country. The success equalled their most sanguine expectations. This peculiar salu- brity, probably, originates from the march miasmata with which the atmosphere is surcharged, and which recent experience has proved to be highly salutary in this disease. May we not anticipate the period when our western deserts will become the Montpelier of America, and be as much resorted to for health as they are now for subsistence?" SELF-PERFORMED CESAREAN OPERATION. One of the most striking stories in the Tran- sactions gives the details of a Csesarean operation performed by the patient upon herself under cir- cumstances that would seem to preclude all possi- bility of recovery, yet with an uneventful conva- lescence. Most of these stories have been dis- credited, but the present instance rests on such good authority and is so thoroughly substanti- ated that it does not seem possible to doubt, in any way, of its occurrence. In the year 1823, when President of the Rensselaer County Medical Society, to which office he had # been elected the second time, Dr. McClellan communicated to that Society that singular case of self-performed Caesarean section on the person of a mulatto girl living in Nassau. Twins were extracted, the wound cleansed 156 and properly dressed and the girl recovered. The time she chose for the operation was while the family were at dinner; the place, behind the barn on a snowbank; and her instruments, her master's razor and a darning needle. The case was copied in several medical jour- nals. It was first published in the New York Medical and Physical Journal for March, 1823, page 41, to which journal it was sent by order of the Rensselaer County Medical Society. It was also published in the London Medieo-Chirurgical Review, vol. 5 (1823), page 236. The editors of the latter journal doubted the correct- ness of the story. It was nevertheless true, and only tends to show how tenacious of life the human body sometimes is, and to what extreme injuries it may be subjected, and still, life continue and health be re- stored. Dr. Bassett, whose patient she was, is still liv- ing, as the subjoined letter will prove: Nassau, N. Y., January, 1857. My dear Doctor: The obstetric case referred to in yours of the nth inst. occurred January 29, 1821. The wound healed by the first intention. Bleeding was resorted to once. There was suppression of urine which required the use of the catheter for about a week. She left Nassau the May following perfectly well. Six years after I saw her in Troy. She was living with a Mr. Rogers in the capacity of a servant girl. Since then I have not heard of her. With respect, truly yours, E. D. Bassett. Dr. T. W. Blatchford. FATAL RUPTURE OF VEIN IN BROAD LIGAMENT. In Volume IV of the Transactions, Page 334, Dr. James McNaughton, who was afterwards President of the State Society, reported a sudden death from rupture of the spermatic vein which is probably one of the first of these cases on rec- ord. The patient was not as might be expected from the title a male, but a female, and in the broad ligament there were a series of tortuous varicose veins, one of which ruptured. The ac- count reads very much like that of a case of rup- tured extra-uterine pregnancy, but the autopsy was made very carefully and it is explicitly noted that there was not pregnancy, uterine or extra- uterine. All the observations in this case were made with the greatest care and it is an excellent iS7 example of the diligent study which the men of these early times gave to their cases. ' EQUIVOCAL GENERATION. In Volume VI there is a medico-legal article on Equivocal Generation by Thomas W. Blatch- ford, who was subsequently a President of the Society. He had been summoned in a case of slander to give a medical opinion. The slander consisted in a declaration by the defendant that the plaintiff had given birth to a creature that partook of the nature of a dog. The whole sub- ject of the possibility of such equivocal genera- tion is discussed very conservatively and with a thoroughness of scientific treatment that is a little surprising seeing that the interest in biological subjects generally had not as yet been aroused by the coming of Darwinism and that medical men particularly dabbled much more in botany, mineralogy and other sciences allied to the thera- peutic side of medicine at that time, rather than in the biological sciences. Some of the authori- ties quoted, however, lay down rather amusing principles in the light of our modern knowledge. EARLY REMOVAL OF OVARIAN TUMOR. In the Volume of Transactions for 1849 which is bound in with those for the preceding years, 1847 and 1848, Dr. Alden March, who was to be subsequently a President of the Society, reports the successful removal of an ovarian tumor weighing some eighteen pounds. The tumor was an ovarian cyst of the monolocular variety and had not as yet contracted any adhesions to surrounding structures. Dr. March considers that he would prefer to operate without previous tapping except in as far as the tapping might be done for diagnostic purposes. In discussing the case he suggests that where adhesions exist the operation would be very difficult. He hints in conclusion that the ease with which certain of these operations may be done will almost surely 158 tempt physicians to do more of them than is ab- solutely necessary. This operation was per- formed December io, 1849, and is one of the very early successful cases of its kind. FEMALE DRESS AND DISEASES. It is not surprising to find that one of the prin- cipal articles in Volume VII of the Transactions treats of that very interesting subject Dress and Disease in Females. It is, however, of the nature of a surprise to find that just exactly the same faults were found at that time with woman's dress as at the present time, and that notwith- standing the protests of physicians for consider- ably more than half a century, there has been so little amelioration of the faulty condition. Dr. William D. Purple, who writes the article, com- plains that by the decree which comes down from fashion's throne the female must be moulded into a more angelic form and be made to approximate by an hour-glass constriction to the sylph-like form of the ant upon the mole-hill. After the corset he finds the most objectionable feature of women's dress the hanging of heavy skirts from their waists rather than from their shoulders. No man, he considers, would be able to go on with his work if he had to wear the heavy petti- coats of those days dragging down as a burden from his waist. The evils that Dr. Purple considers to flow from these unfortunate mistakes of dressing ac- cording to the dictates of fashion are just those which have been emphasized ever since. The displacement of the abdominal organs leads to interference with the blood supply of the uterus, affecting the veins more than the arteries and so causing congestion with all its train of attend- ant pathological conditions. After the genital organs the most important affection is that of the bowels, and the constipation, which even then was so common among women, Dr. Purple does not hesitate to ascribe to a considerable extent 159 to faults in dress. Of the liver he has less to say, though there is a hint of congestion here also. The increased pressure within the abdo- men he thinks must interfere with the movements of the diaphragm and constantly with respira- tion. For him many of the anemic conditions which develop especially in young women must be attributed to this concatenation of circum- stances. SECRET NOSTRUMS. In the Transactions for 1851 there is a special prize essay which because of recent develop- ments can scarcely but prove of great profes- sional interest. Dr. Alonzo Clark, of New York, offered a special prize for an essay on the sub- ject, "The Pernicious Effects of Nostrums or Secret) Remedies upon the Morals and Health of the Community." The prize was awarded to the essay written by Dr. John G. Sewall, of New York. The main features of the essay are ex- actly those which come up in the discussion of the same subject in our own time more than half a century later. Dr. Sewall complains of the for- mation of drug habits, of the exploitation of the poor and of those suffering from chronic ail- ments, and does not hesitate to say that many of the certificates of cures issued by the nos- trum people were false. In the matter of moral- ity the most serious thing is the advertising in public newspapers, where young folks may read them, of all the hideous details with regard to private diseases; and he registers his complaint that newspapers which expect to circulate in a family should be allowed to admit such adver- tising material to their columns. The conclusions of his essay are far in ad- vance of his time and show a conservative esti- mate of the real value of drugs that is rather surprising considering our usual ideas as to the evolution of medicine before the middle of the nineteenth century. Dr. Sewall says : 160 "First: That, the idea that there is any necessary and direct connection as of cause and effect between the administration of drugs and the eradication of disease, is idle and visionary, by which it is not implied that they are of no utility when in wise hands, but always of subordinate utility, the best never being substitutes for but adjuvants of nature. Second: That, no treat- ment of disease can be a rational one save such as fol- lows the indications of nature founded upon an earnest and persevering study of her laws as manifested in health, and in those irregularities of normal life in which disease consists, with their application to the individual constitution; a study which finds that the nearer the arcana of nature are approached the more simple are these elements with which she deals and the greater the confidence that should be yielded to her own restorative powers." INEBRIETY AS A DISEASE. A very interesting passage from the inaugu- ral address of Dr. Fordyce Barker, of New York, at the meeting held in February, 4860, referred to the recent establishment of an inebriate asy- lum, and called the special attention of the State Medical Society to the good that might be accom- plished by such an institution. It is the custom sometimes to say that the recognition of inebriety as a pathological condition is much more recent than this. But Dr. Barker's declaration will help to show that even in the middle of the nineteenth century physicians were definitely of the opinion that dipsomania should be treated as a disease rather than as a malicious mental condition. He said: "It is now an accepted opinion of the medical pro- fession that inebriety is a constitutional disease, some- times hereditary, sometimes acquired, as much as any malady which man is heir to. To that untiring philan- thropist, Dr. J. Edward Turner, belongs the merits of first having called the attention of the profession and the public to the necessity of an asylum where the in- ebriate could be morally and medically treated, with sufficient restraint to control the patient. The State of New York has the honor of having chartered, in 1854, the first inebriate asylum in the world. At the laying of the corner stone of this institution, Mr. Everett remarked that 'in laying the foundation of an asylum 11 161 for this State, if it succeeds, you have laid this day a corner stone for a similar asylum in every State of this Union, in every kingdom of Europe.' Already has this prophecy partially become history, for efforts are now being made to establish similar institutions in other states and in some parts of Europe. "It is characteristic of the profession that more than fifteen hundred leading physicians were petitioners to the Legislature for an appropriation for this institution, and that nine hundred physicians of this State subscribed $10 each for building the hospital. The State Medical Society has also unanimously recommended it to the favor and earnest support not only of the Legislature of the State, but of the public at large. I am informed by Dr. Turner that since the institution was chartered, the trustees have received three thousand ore hundred and thirty-two applications for admission as patients to the asylum, although the walls of the hospital are not yet completed. The trustees state in their appeal, that 'among the applicants are twenty-eight clergymen, thirty-six physicians, forty-two lawyers, three judges, twelve editors, four army and three naval officers, one hundred and seventy-nine merchants, fifty-five farmers, five hundred and fifteen mechanics, and four hundred and ten women who are from the high walks of life.' The above statement is alone a comprehensive argu- ment for the zealous and continued interest of the pro- fession in this institution." CHAPTER XIII. FOUNDATION OF THE AMERICAN MEDICAL ASSOCIATION. As the foundation of the American Medical Association was due to the effort of the Medical Society of the State of New York, it naturally forms a chapter in the history of the Society. The American Medical Association as it exists at the present time owes its origin to a resolu- tion introduced, as we shall see more fully later, by Dr. Nathan S. Davis, at the meeting of the Medical Society of the State of New York, in 1844. The subject had been originally called up by Dr. McCall by a resolution in 1839. It was not until 1846 that the Society was to see the fruition of its labor, but during all this time there was gradually gathering strength an 162 undercurrent of feeling that was to serve an ex- cellent purpose in overcoming rather acute op- position which developed just about the time of the culmination of the movement for the erection of the national medical body. As with regard to the foundation of the Med- ical Society of the State of New York itself, the desire for the organization of a national associa- tion arose from the wish to raise the professional standard among physicians in this country. There had come to be an extremely low level of medical education. Many medical schools had been founded, often when they were not needed, and the competition among them had finally brought medical education to such a pass that it is hard to understand how physicians of any professional dignity could defend the position that had been assumed. The opposition to the new movement that would bring about reform came mostly from the medical schools. Among the profession in general, the Medical Society of the State of New York encountered more of apathy than of actual opposition. As the proj- ect for the establishment of a national organiza- tion approached fruition, the jealousy of teachers in medical schools flared out very threateningly, and many bitter expressions were used in the discussion of the subject, in the medical journals of the time, and in personalities indulged in almost without end. The dramatic moment of opposition to the society came when the delegates who were even- tually to organize the American Medical Associa- tion were already convened in the hall of one of the New York Medical Schools. A prominent member of the faculty of this medical school proposed as the first business of the meeting that since delegates were present from only one half of the states and institutions to which invitations had been sent the meeting should adjourn sine die. This motion was seconded by another member of the same faculty. When put 163 to the vote, however, it was lost by a unanimous vote, with the exception of the mover and seconder of the resolution, who were the only yeas. The whole subject of the organization of the American Medical Association deserves, how- ever, to be treated by an actor in the scenes, and by a contemporary of the events. Hence we pre- fer to reprint the account of the organization of the society which appeared in the New Jersey Medical Reporter, Volume VII., signed as, "By one of its Members." This account, called the "History of the Amer- ican Medical Association," begins with an essay of nearly 1,000 words on "The Necessity for Union" in every phase of life among educated people, and dwells especially on the need for union among physicians. After pointing out some of the benefits that might be expected to accrue from such union, the incapacity of the many scattered medical societies throughout the country to succeed in raising professional dignity is pointed out, and some of the abuses that have crept in hinted at. This portion of the account, however, scarcely seems to be of historical value, and accordingly it has been omitted here. History of the American Medical Association. The American Medical Association completed its organization and commenced its actual existence in the City of Philadelphia, during the first week in May, 1847. But a correct knowledge of its origin, and a just appreciation of the motives of those to whom the pro- fession is indebted for its existence, requires a knowl- edge of the doings of certain individuals and societies during several years previous to the date mentioned. If the reader will turn to the statistics of the Medical Colleges, compiled by Dr. T. R. Beck, of Albany, and published in the transactions of the New York State Medical Society; or to the little volume, entitled, "History of Medical Education," etc., by Dr. N. S. Davis, he will learn that, during the fifteen years inter- vening between 1830 and 1845, the number of medical colleges in the United States more than doubled, lead- ing to a most active rivalry, and a competition unre- 164 strained by any mutual intercourse with each other, or social connection with the profession at large. Such institutions, having full power to confer degrees, which were very generally recognized as sufficient to entitle the holder to membership in the profession, would be strongly tempted, under the circumstances mentioned, to add to the more important and legitimate induce- ments, short courses of instruction, and easy terms of graduation. Hence, sixteen weeks was very generally adopted as the length of the college term, and in some of the schools it was reduced to thirteen. The marked inadequacy of so short a term, and the evils resulting from a want of concert among the colleges, early at- tracted attention in New England, and led to some unsuccessful attempts to remedy both. In .1835, the faculty of the Medical College of Georgia formally pro- posed the holding of a convention of delegates from all the medical colleges of the Union, and advocated the same through the columns of the Southern Medical and Surgical Journal. The proposition seemed to meet the approbation of those connected with many of the colleges, but failed of being carried into effect, through the indifference of some of the older and more influential schools in the .Atlantic cities. The first movement of which we have any record, which contemplated a convention of dele- gates, not only from all the medical colleges, but also from the regularly organized medical societies through- out the whole country, was made in the Medical Society of the State of New York, at its annual session in February, 1839. During the same session the sub- ject of medical education had been a prominent topic of discussion, and a resolution, declaring that the busi- ness of teaching should be separated as far as possible from the privilege of granting diplomas, had been adopted by a large majority. It was in view of this discussion that Dr. John McCall, of Utica, offered the following preamble and resolution, viz. : "Whereas, A National Medical Convention would advance, in the apprehension of this Society, the cause of the medical profession throughout our land, in thus affording an interchange of views and sentiments on the most interesting of all subjects— that involving men's health, and the means of securing, or recovering the same; therefore, "Resolved, That in our opinion, such convention is deemed advisable and important; and we would hence recommend that it be held in the year 1840, on the first Tuesday in May of that year, in the City of Phila- delphia; and that it consist of three delegates from each State Medical Society, and one from each regu- 165 larly constituted medical school in the United States, and that the President and Secretary of this Society be, and they are hereby instructed, and required to transmit, as soon as may be, a circular to that effect to each State Medical Society and Medical School in said United States." This proposition was adopted, and all the necessary steps taken by the Society of the State of New York for carrying it into effect. But neither the societies, nor the schools of other States, not even those of Phila- delphia, where the proposed convention was to be held, responded to the invitation, and consequently no meet- ing took place. The subject of medical education, however, continued to be a prominent topic of discussion in many of the medical societies throughout the Union; and especially the evils supposed to result from the union of the power to teach, and to confer degrees, or licenses to practice, in the same hands. And at the annual meet- ing of the New York State Society, in 1844, attention was again strongly directed to the whole subject of medical education, and the necessity of a higher stand- ard of qualifications, both preliminary and medical, by two series of resolutions. The one was offered by Dr. Alexander Thompson, of Cayuga County, and the other" by Dr. N. S. Davis, then a new delegate from Broome County, N. Y. These resolutions declared a four months' college term too short for an adequate course of lectures on all the branches of medical science, and the standard of education, both preliminary and medical, required by the schools previous to the granting of their diplo- mas, altogether too low; while the union of the teach- ing and licensing power in the college faculties was represented as impolitic, and consequently liable to abuse. These resolutions elicited some discussion, and were referred to the standing corresponding committee, of which Dr. Davis was made chairman. Through his agency, the subjects embraced in the resolutions were urged upon the attention of most of the county societies in that State, and in many of them elicited action acknowledging their importance, and sanctioning the principles they embraced. This gave the subject a more general interest, and at the next annual meeting of the State Society, held in February, 1845, two reports were presented by the Corresponding Committee; one from the Chairman, embodying the action of the county so- cieties, and recommending the principles involved in the original resolutions ; the other from Dr. M. H. Cash, of Orange County, taking a different view of the subject. These reports led to a protracted discussion 166 of the whole subject of medical education, more espe- cially in reference to the standard of attainments that should be required before admission into the ranks of the profession. On the one hand, it was claimed that the standard of attainments, both preliminary and medical, exacted by the several medical colleges, was too low, or too limited, to be consistent with either the honor of the profession, or the well-being of the community; and farther, that the union of the power to teach and grant diplomas in the several college faculties, co-operated with the active rivalry among the schools to depress the standard still lower. On the other hand, while some of these allegations were promptly admitted to be true, it was claimed that the standard of qualifications exacted by the colleges of New York was as high as that required by the colleges in any of the surrounding States; and consequently, the adoption of measures calculated to compel the schools of one State to adopt a higher standard would have no other effect than to induce the students to abandon such schools for. those of other States, where less extensive attainments were required. The latter view was more especially urged by the friends of such colleges as were represented in the Society; while the advocates of a more liberal professional education claimed that such position precluded all progress. For the institutions of each State would claim that their standard of qualifications, required before conferring the degree of M.D., was as high as that exacted by the schools of other States, and consequently no one would venture to advance a step beyond its rivals. [This competition in the maintenance of low standards for the sake of attracting students shows how low all sense of professional dignity had fallen. — Ed.] It was at the close of this debate, when the whole subject was about to be postponed until the next annual meeting of the Society, that Dr. Alden March, of Al- bany, privately suggested to Dr. Davis, who had taken an active part in the discussion, that the objection might be obviated by calling a convention of delegates from all the colleges, and thereby inducing the insti- tutions of the several States to act in concert. The last named gentleman, not knowing that any previous attempts to assemble a National Medical Convention had been made, immediately rose, and submitted the following preamble and resolutions, viz. : "Whereas, It is believed that a National Convention would be conducive to the elevation of the standard of medical education in the United States; and where- as, there is no mode of accomplishing so desirable an object, without concert of action on the part of the 167 medical colleges, societies and institutions of all the States ; therefore, "Resolved, That the New York State Medical Society earnestly recommend a National Convention of dele- gates from medical societies and colleges in the whole Union, to convene in, the City of New York, on the first Tuesday in May, in the year 1846, for the purpose of adopting some concerted action on the subject set forth in the following preamble. "Resolved, That a committee of three be appointed to carry the foregoing resolution into effect." This proposition led to a brief conversational dis- cussion, in which some of the older members of the Society related the former unsuccessful attempts to assemble a National Convention of medical men, which elicited a very general expression that the project was impracticable, if not positively Utopian. The resolu- tions, however, being strongly urged by the mover — who contended that if the object to be accomplished was one of acknowledged importance, its friends should persevere, although a dozen failures should be encoun- tered before their efforts met with entire success — were adopted, and Drs. N. S. Davis, of Binghamton, Broome County; James McNaughton, of Albany, and Peter Van Buren, the Secretary of the State Society, were named as the committee to carry them into effect. The chairman of this committee, soon after his return to Binghamton, issued a circular containing the pre- amble and resolutions quoted above, and sent a copy to each of the colleges and societies known to exist throughout the United States, and to many prominent members of the profession in sections of the country where no social organizations had been formed. The correspondence thus begun was actively continued throughout the whole year. An examination of this correspondence shows that the proposition to hold a National Convention met with a favorable response from societies, colleges and individuals, throughout the whole Union, except those colleges located in Phila- delphia and Boston. To the circulars and letters ad- dressed to the Medical College in Boston, and the two oldest colleges in Philadelphia, answers were returned, respectfully declining to take any part in the proposed convention. The then recently organized Pennsylvania College, located in the latter city, returned a more favorable answer, with a promise that delegates from that school should be appointed to attend the conven- tion. The extent to which the correspondence had been carried, and the degree of favor with which the proposi- tion for a convention had been entertained by the pro- fession, may be inferred from the following extract 168 from a report of the chairman of the special committee, made at the annual meeting of the New York State Society, in February, 1846, viz. : "Replies to these circulars and letters have been re- ceived from the following officers of medical societies and colleges, and private members of the profession, viz. : Drs. W. W. Morris, of Dover, Delaware ; A. H. Buchanan, of Tennessee ; W. P. Johnston, of Washing- ton City; T. T. Hewson, R. M. Huston and W. E. Thorne, of Philadelphia; Luther Ticknor, of Con- necticut; W. H. McK.ee, of North Carolina; E. H. Peaslee, of New Hampshire; Paul F. Eve, of Georgia; J. H. Thompson, of New Jersey; J. W. Davis, of In- diana; A. Twitchell, of New Hampshire; John W. Draper, A. H. Stevens, Willard Parker, and C. A. Lee, of New York; D. Drake, of Ohio; Lawson, of Ken- tucky, and Carpenter, of Louisiana. And delegates have been freely pledged from medical societies and colleges in Maine, New Hampshire, Connecticut, New Jersey, Delaware, District of Columbia, South Carolina, Georgia, Mississippi, Louisiana, Tennessee, Kentucky, Ohio, Indiana and New York. Nearly every medical journal throughout the whole Union has not only favor- ably noticed, but warmly commended, the holding of such a convention." . ... It will thus be seen that, in far the larger part of the Union, the invitation of this Society has met with a prompt and hearty response from the profession ; and it is with much regret that we find even a few institutions declining to take any part in so important a movement. But when we consider the wide extent of our territory, and the great number of our insti- tutions, all engaged, we should hope, in a generous rivalry with each other, the expression in favor of a convention is certainly more unanimous, and more promising of good, than could have been anticipated. Indeed, the leading and influential members of the pro- fession have long felt the necessity of some national action ; some central point of influence around which the active and choice spirits of the whole profession can rally, and from which may be made to radiate an elevating, healthful and nationalizing influence over the whole country. In accordance with the recommendations of this re- port, the State Society appointed sixteen delegates to attend the proposed Convention and accepted the invita- tion of the Faculty of the New York University to hold the Convention in their college edifice, commencing at 10 o'clock A.M., on the first Tuesday in May following. Besides the editorial notices, commending in general terms the proposition to hold a National Convention, which appeared in nearly all the medical journals of the country during the year 1845, and which aided very much in rendering the movement successful, The New York Journal of Medicine and the Collateral Sciences published several communications from the author of the proposition, Dr. N. S. Davis, and also one from Dr. L. Ticknor, the President of the Medical Society of the State of Connecticut. This may be found in the num- bers of the Journal for November, 1845, and January and March, 1846. The communication of Dr. Ticknor contains the first distinct proposition to perpetuate the action and influence of the contemplated National Con- vention by organizing out of it a permanent "National Medical Society." He says: "Considering our extent of territory, and the number of States into which the Union is divided, it is by no means strange that the medical schools in the several States should gradually yield to other motives than a desire to promote the best interests of society by a thoroughly educated and prop- erly disciplined medical faculty. It is fairly enough implied, if not perfectly obvious, that there exists no small degree of rivalry among our medical insti- tutions and leading medical men ; not, I fear, who shall furnish the most valuable and best wrought article, but who shall furnish the greatest quantity. To furnish some antagonism to this tendency of our profession, which is from year to year gaining strength, influence and popularity, the writer knows of no one effort the profession can make that promises so much as to or- ganize a National Medical Society, to meet annually, biennially, or triennially, having, if you please, a Vice- President and committee of correspondence in each State, etc." The communication of Dr. Davis contains a more ex- tended consideration of the whole subject of medical education. Its then existing condition throughout the country is clearly set forth and its defects clearly crit- icised by the writer, while he earnestly recommends such action as is calculated to accomplish the following definite objects, viz. : "First — The standard of preliminary or preparatory education should be greatly elevated, or rather, a standard should be fixed, for there is none now, either in theory or in practice. "Second — We should elevate the business of private teaching to that position which its intrinsic importance demands. "Third — A more uniform standard of qualifications should be required of the candidates for medical honors. "Fourth — We should devise some mode to stimulate the ambition and arouse the energies of the profession 170 to a higher state of intellectual activity and scientific inquiry." The importance of these propositions he illustrates at considerable length, and prominent among the means he urges for their practical accomplishment is the organi- zation of a "permanent National Medical Society, by whose annual discussions an exciting, vivifying and healthful influence will be exerted over the length and breadth of the country until a correct and noble senti- ment is engendered in the bosom of every member of the profession."* In the same number of the New York Journal, from which I have just quoted, the editor, Dr. C. A. Lee, in earnestly appealing to the profession to make the pro- posed Convention truly national, by the attendance of delegates from every section of the country, makes the following allusion to a more representative organization, viz. : "But there are various other subjects which would naturally come up before such a Convention, of scarcely less interest and importance, and we should hope, as already intimated, that a permanent National Society would grow out of it, which would, like the "British Association," meet annually, and at which es- says and reports on different branches of medicine would be read and discussions held." In alluding to the call for the National Convention, the editor of the Buffalo Medical and Surgical Journal in the number for October, 1845, says : "None can doubt the propriety, nay, the urgent necessity for the adoption of some means to elevate the standard of medical education and advance the dignity and usefulness of the profession. . . . . We fervently hope that this movement will meet with general concurrence and cordial co-opera- tion." The editors of the New Orleans Medical and Surgical Journal, and indeed, of almost all the other journals, were equally explicit in commending the general object. Thus far, though the faculties connected with the col- leges in Philadelphia and Boston had declined to co- operate in the general movement, no open opposition had been manifested from any quarter. But like all other great movements affecting more or less the interests of a large number of persons, the effort to convene a National Convention of the mem- bers of the medical profession was not to be crowned with success without encountering decided and strong opposition. The movement having originated in a State society and during a discussion in which some of the practices and privileges of the medical colleges were severely criticised, it is not surprising that it excited *See New York Journal of Medicine, etc., March, 1846, p. 290. 171 such a feeling of distrust in the minds of many of those connected with the colleges as to deter them from cordially uniting with it. And this distrust was doubtless increased in certain quarters by the strong language, and perhaps, too sweeping assertions con- tained in one of the communications of Dr. N. S. Davis in the New York Journal of Medicine already referred to. The latter were made the pretext for a severe attack upon the writer, the State Medical Society of New York, and all concerned in the movement for a National meeting, by Prof. Martyn Paine, of the Medical De- partment of the New York University in the form of a valedictory address to the graduating class of that in- stitution delivered March n, 1846. The address was styled "A Defence of the Medical Profession of the United States," and was based on the assumption that the active members of the Medical Society of the State of New York generally, and the chairman of their committee (Dr. Davis) in particular, had been slander- ing and defaming the profession to which they be- longed. An assumption, however, so fully refuted, by the whole history and conduct of that society and the individuals concerned, as to require no comments or explanation at the present time. As a very large edition of this address was published and widely circulated throughout the Union, it may not be amiss to quote a paragraph or two for the purpose of enabling the reader to appreciate its spirit and design. On page 20 Dr. Paine says: "Nor shall I have discharged the office which I have assigned to myself till I also place on record who they are that malign the great mass of American physicians who are rendering more service to the cause of humanity than any equal proportion of the same profession in the most favored States of Europe. It is not the man who has officially promul- gated the views of the State Medical Society, nor the journals through which the contumelious representa- tion of the profession is circulated, that should be held responsible, any farther than as they, also, hold an influence over the public mind, and according also to the animus and the extent to which that influence may be exerted. We must rather go to the fountain from which it emanates and with acids and caustics try its purity. We must go to the State Medical Society itself, interrogate the general character of those who annually convene at Albany during the very opportune session of the Legislature, inquire how far, and in what way, they contribute to the dignity of the profession, and advance the interests of medical science. Nor would I invite any investigation of this nature for the same reasons that I have quoted Percival's Medical Ethics, 172 were those members of the State Medical Society who annually convene at Albany and do the mining opera- tions, more than a bare handful of the outs, and were they not so erroneously supposed to represent the voice of the profession." Again he says : "And now, per- haps, we shall have no difficulty in understanding why it is so earnestly desired to extend the term of instruc- tion in our medical colleges and also as a preliminary requisite to admission into these institutions. There is an aristocratic feature in this movement, of the worst omen, however the spirit by which it is prompted, may belong to the agrarian policy. It is oppression towards the poor, for the sake of crippling the medical colleges." The foregoing are among the least exceptional para- graphs of this address, and yet they plainly indicate a feeling of bitter opposition, if not contempt, towards those who were laboring to unite the profession of the whole Union in one general Convention. The actual influence of this address, exhibiting as it did, a curious mixture of egotism, disgusting flattery of the class to which it was addressed, and bitter opposition to the movement for a National Convention, was very im- portant, though widely different from what was de- signed by its author. It has already been stated that the medical department of the University of Pennsyl- vania, the Jefferson Medical College, and the local soci- eties of Philadelphia, had declined to appoint delegates to the proposed Convention, and the chief apprehension felt by the committee having charge of the subject was that the absence of any. representation from so impor- tant a locality would seriously lessen the influence and success of the movement. But scarcely had the address of Professor Paine reached the remoter sections of the country before the Chairman of the Committee of the New York State Society received a second letter from Professor Huston, of Philadelphia, stating briefly that they had heretofore declined to appoint delegates to the proposed Convention because, as it had been called to meet in the City of New York, and at the College edifice of the New York University, they had thought it calcu- lated to attract undue attention towards the medical schools of that city. But on reading "the very singular address of Professor Paine," they were satisfied that whatever might have been the motives of those who called the Convention, it was not designed particularly to benefit the medical schools in the City of New York ; and hence he would immediately convene the Society over which he presided to take into consideration the propriety of appointing delegates. This was done, and twelve eminent and active members of the profession in that city were appointed to attend the meeting in New York, thereby greatly adding to the success of 173 the movement. We have in these details a most striking illustration of that jealousy and mutual distrust which is engendered by rival interests unmodified by free and frequent personal intercourse. We find the Faculty of the Medical Department of the New York University violently opposing the movement for a National Con- vention and stigmatizing its authors as "miners'' and "outs" even after they had consented to have the meet- ing held in their own college hall, because it originated in a State Society whose meetings they had entirely neglected, and of whose influence they were jealous, while other most influential schools were withholding their aid and co-operation because they suspected the whole movement calculated, if not designed, to favor in a special degree that same school in New York. It would be difficult to illustrate more strikingly that sleepless jealousy which pervaded more or less all our medical schools, springing into existence in rapid suc- cession, as they had done, or the necessity of some gen- eral organization, by which the representatives of all should be brought into personal contact and intercourse, until mutual distrust should give place to mutual re- spect and a common object. On Tuesday, May 5, 1846, the delegates and members of the profession from different parts of the United States who designed attending the proposed National Convention assembled, in accordance with the invita- tion of the New York State Society, in the Hall of the Medical Department of the New York University. They were called to order by Dr. Edward Delafield, of New York, on whose motion Dr. John Bell, of Philadel- phia, was appointed Chairman, and Dr. William P. Buel, of New York, Secretary, until permanent officers should be duly chosen. A Committee was then appointed to receive the credentials of delegates, consisting of Drs. H. W. Baxter, of Maryland, N. S. Davis, of New York, and Richard D. Arnold, of Georgia. This Com- mittee soon reported the reception of credentials con- taining the names of one hundred and nineteen dele- gates, eighty of whom were present at the opening of the Convention. The latter number was subsequently increased to near one hundred, representing societies and colleges in six- teen different States, viz. : New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, Pennsylvania, Delaware, Maryland, Vir- ginia, Georgia, Mississippi, Indiana, Illinois and Ten- nessee. A Committee of one from each State represented re- ported the names of the following gentlemen for per- manent officers of the Convention, and they were unan- imously elected, viz. : For President, Dr. Jonathan 174 Knight,* of New Haven, Conn. ; for Vice-Presidents, Dr. John Bell, of Philadelphia, Pa., Dr. Edward Dela- field, of New York City; for Secretaries, Dr. Richard D. Arnold, of Savannah, Ga. ; Dr. Alfred Stille, of Philadelphia, Pa. Thus was completed in the midst of the most perfect harmony and good feeling the organi- zation of the first National Convention of members of the medical profession ever convened in the United States- And when we remember that the number in attendance was at least respectable; that among them were many of the most eminent in the profession; that they were gathered from all sections of the Union, from the hills of New England, the broad prairies of the West, and the sunny plantations of the South; not, however, for purposes of political preferment or pecuni- ary gain, but to give each other the warm hand of friendship and unite in the adoption of measures for the elevation and advancement of the noblest of tem- poral pursuits, we are constrained to regard it as one of the most interesting assemblages ever convened since the organization of the benign government under which we live. As soon, however, as the officers elect had been con- ducted to their respective places, Dr. Gunning S. Bed- ford, the colleague of Dr. Martyn Paine, and a dele- gate from the faculty of the Medical Department of the New York University, arose, and, after some general remarks in reference to the benefits of a general Con- vention of medical men, moved the following preamble and resolution, viz. : "Whereas, The Call of the State Medical Society of the State of New York for a National Medical Society, to be held in the City of New York on the first Tuesday in May, has failed in a representation from one-half of the United States and from a majority of the medical colleges, and "Whereas, The State Medical Society has emphati- cally stated that there is no mode of accomplishing the object of the Convention without a concert of action on the part of medical societies, colleges and institutions of all the United States; therefore, "Resolved, That this Convention adjourn sine die." This proposition was immediately seconded by Dr. G. S. Pattison, the colleague of Professor Bedford, and delegate from the same faculty. This proposition, com- ing at such time, and directly from the representatives of the school in whose college building the Convention had assembled, took every member by surprise. But after one or two minutes of entire silence, the question *For Biography of Dr. Knight, see New Jersey Medical Report for January, 1854, page 34. 175 was very generally called for, and being taken by yeas and nays, resulted as follows, viz. : Yeas, 2, Drs. Bed- ford and Pattison. Nays, 74. , The result of the vote having been announced, con- siderable warmth of feeling was manifested by many members, who regarded the motion of Dr. Bedford as a deliberate attempt to break up the convention, and as little less than an insult to all its members. Several motions were made, having for their object the immediate withdrawal from the college edifice of the New York University, but after explanation and apologies from both Drs. Bedford and Pattison, the subject was laid on the table. A committee of nine was then appointed "to bring the subject of medical education before the convention, in the form of distinct propositions, suitable for discussion and action." This committee readily agreed upon the following proposi- tions, viz. : First — That it is expedient for the medical profession of the United States to institute a National Medical Association. Second — That it is desirable that a uniform and elevated standard of requirements for the degree M.D. should be adopted by all the medical schools in the United States. Third — That it is desirable that young men, before being received as students of medicine, should have acquired a suitable preliminary education. Fourth — That it is expedient that the medical pro- fession in the United States should be governed by the same code of Medical Ethics. These were reported to the Convention, with the recommendation that a committee of seven be ap- pointed on each subject, whose duty it should be to report at a meeting to be held in the City of Phila- delphia, on the first Wednesday in May, 1847. The same committee also recommended the appointment of a committee of seven "to prepare and discuss an address to the different regularly organized medical societies and chartered medical schools in the United States, setting forth the objects of the National Medical Asso- ciation, and inviting them to send delegates to the convention to be held in Philadelphia in May, 1847." After the signal failure of the delegates from the New York University to interrupt the progress of the convention which assembled in New York, no further open opposition to the movement, which had been com- menced, was manifested previous to the next meeting. On the contrary, the President, Dr. Knight, shortly after the first meeting, issued an address to the pro- 176 fession on behalf of the committee appointed for that purpose, in which he set forth briefly and clearly the objects aimed at, and urged upon the profession the importance of a more full representation at the meeting to be held in Philadelphia. The medical periodicals of the country, very generally, published the proceed- ings of the Convention in New York, and thereby aided much to bring the subject to the notice of a much larger number of members of the profession. In the meantime, valedictory and anniversary addresses, discussing, more or less, the subject of medical educa- tion, were written and widely circulated by Drs. John W. Francis, John Watson, and F. Campbell Stewart, of New York; Drs. Samuel Jackson and Alfred Stille, of Philadelphia; Dr. S. H. Dickson, of Charleston, and many others. The combined influence of all these agencies, with the continued exertions of those who first put the ball in motion, served to awaken an almost universal interest in the subject. On the fifth of May, 1847, the delegates appointed by the societies, colleges and other medical institutions throughout the several States assembled in the Hall of the "Academy of Nat- ural Sciences," in Philadelphia, and were cordially welcomed by Dr. Isaac Hays, Chairman of the Com- mittee of Arrangements, who called the convention to order, and nominated Dr. Jonathan Knight, of New Haven, as temporary chairman. This nomination was unanimously confirmed, and Drs. Arnold, of Georgia, and Stille, of Philadelphia, were appointed secretaries. A committee for the recep- tion of credentials of delegates was appointed, and an- other, consisting of one member from each State rep- sented, to report the names of suitable candidates for election as permanent officers of the Convention. The first committee reported, as present, the names of near two hundred and fifty delegates, representing more than forty medical societies, and twenty-eight colleges, embracing medical institutions in twenty-two States and the District of Columbia. The Committee on Nominations recommended for President, Dr. Jona- than Knight, of Connecticut; for Vice-Presidents, Drs. Alexander H. Stevens, of New York, George B. Wood, of Pennsylvania, A. H. Buchanan, of Tennessee, John Harrison, of Louisiana; and for Secretaries, Drs. R. D. Arnold, of Georgia, Alfred Stille, of Pennsylvania, and F. Campbell Stewart, of New York. These were all unanimously elected by the Convention. The first business of importance which engaged the attention of the Convention was the reports of the committees ap- pointed at the previous meeting in New York. Reports were received during the first day from Dr. John 12 177 Watson, of New York, Chairman of the Committee appointed "to prepare a plan of organization for a National Medical Association," from Dr. John H. Griscom, of New York, Chairman of the Committee appointed to consider the subject of procuring, from the State governments, uniform and efficient laws for the registration of births, marriages and deaths; also, from the same, on a general nomenclature of diseases; from Dr. Jamesi Couper, of Delaware, Chairman of the Committee "on Preliminary Education" ; and from Dr. Isaac Hays, in the subject of Medical Ethics. These several reports, except the last, were received, laid on the table, and ordered to be printed. During the following morning session, additional reports were received from Dr. John Bell, Chairman of the Committee appointed to prepare a code of Medical Ethics; from Dr. James McNaughton, of Albany, Chairman of the Committee appointed to con- sider the subject of the union of teaching and licensing in the same hands, signed by a minority of the Com- mittee; and another report on the same subject, from Dr. Isaac Parrish, of Philadelphia, signed by a majority of the Committee. These reports were also received and ordered to be printed. The report of Dr. Couper, from the Committee on the subject of "Preliminary Education," was first taken up for consideration; and after a free interchange of opinions, the report, with the resolutions appended thereto, was adopted, and ordered to be published as a part of the proceedings of the Convention. The resolutions as adopted were as fol- lows, viz. : "Resolved, That this Convention earnestly recom- mends to the members of the medical profession throughout the United States, to satisfy themselves,, either by personal inquiry or written certificate of com- petent persons, before receiving young men into their offices as students, that they are of good moral char- acter, and that they have acquired a good English edu- cation, a knowledge of natural philosophy, and the ele- mentary mathematical sciences, including geometry and algebra, and such an acquaintance, at least, with the Latin and Greek languages as will enable them to ap- preciate the technical language of medicine and read and write prescriptions. "Resolved, That this Convention also recommends to. the members of the medical profession of the United States, when they have satisfied themselves that a young man possesses the qualifications specified in the preceding resolution, to give him a written certificate stating that fact, and recording also the date of his ad- mission as a medical student, to be carried with him as 178 a warrant for his reception into the medical college in which he may intend to pursue his studies. "Resolved, That all the medical colleges in the United States be and they are hereby recommended and re- quested to require such a certificate of every student of medicine applying for matriculation, and when publish- ing their annual lists of graduates to accompany the name of the graduate with the name and residence of his preceptor, the name of the latter being clearly and distinctly presented as certifying to the qualification of preliminary education." Moderate as is the standard of preliminary attain- ments required by these resolutions, there were some in the Convention who spoke in opposition to its adoption, on the ground that it would prevent many young men of limited means from entering the profession whose natural endowments would carry them to the highest rank, notwithstanding their inadequate preliminary prep- aration. On the other hand, it was admitted that there had been countries and periods in the world's history when the obstacles, pecuniary and otherwise, in the way of gaining a knowledge of the ordinary branches of sci- ence, were so numerous as to preclude all but the fa- vored few from its enjoyment. In such places and at such times the objection to the resolutions might have some force. But in our country of schoolhouses and almost unlimited facilities for ac- quiring a knowledge of, at least, the ordinary branches of learning, that a young man who had not mental en- ergy and perseverance enough to comply with the stand- ard proposed in the resolutions certainly had not enough to enable him to do justice to a profession as extensive, intricate and arduous as ours. The latter view was urged with much force by Dr. N. S. Davis, then a delegate from the New York State Medical Society. The resolutions were adopted by nearly a unanimous vote, and the recommendations they contain have been reaffirmed by almost every meeting of the American Medical Association since. The Convention next took up the report of Dr. R. W. Haxall, of Virginia, Chairman of the Committee ap- pointed to recommend a uniform standard of require- ments for the degree of M. D. The several resolutions appended to the report were considered seriatim, and after receiving various amendments, were adopted as follows, viz. : "Resolved, ist, That it be recommended to all the colleges to extend the period employed in lecturing from four to six months. "2d, That no student shall become a candidate for the degree of M. D. unless he shall have devoted three en- 179 tire years to the study of medicine, including the time allotted to attendance upon the lectures. "3d, That the candidate shall have attended two full courses of lectures ; that he shall be twenty-one years of age, and in all cases shall produce the certificate of his preceptor to prove when he commenced his studies. "4th, That the certificate of no preceptor shall be re- ceived who is avowedly and notoriously an irregular practitioner, whether he shall possess the degree of M.D. or not. "Sth, That the several branches of medical education already named in this report, (viz. : theory and practice of medicine, principles and practice of surgery, general and special anatomy, physiology and pathology, materia medica, therapeutics and pharmacy, midwifery, and diseases of women and children, chemistry and medical jurisprudence), be taught in all the colleges, and that the number of professors be increased to seven. "6th, That it is required of candidates that they shall have steadily devoted three months to dissections. "7th, That it is incumbent upon preceptors to avail themselves of every opportunity to impart clinical in- struction to their pupils, and upon medical colleges to require candidates for graduation to show that they have attended on hospital practice for one session, whenever it can be accomplished, for the advancement of the same end. "8th, That it be suggested to the faculties of the vari- ous medical institutions of the country to adopt some efficient means for ascertaining that their students are actually in attendance on their lectures. "9th, That it is incumbent on all schools and colleges granting diplomas fully to carry out the above requi- sitions. "10th, That it be considered the duty of preceptors to advise their students to attend only such institutions as shall rigidly adhere to the recommendations herein con- tained." Much opposition was manifected by some of those connected with the colleges to the adoption of the first of the foregoing resolutions. It was alleged that the great majority of medical students could not be kept in attendance on the colleges continuously for six months, there being many in all the colleges who practically cut short even a four months' course by coming late or leaving before the close. This, together with all the other resolutions, were adopted, however, -by large ma- jorities, and it is worthy of remark that very few, if any, were found to claim that less than six months was really sufficient to present the various branches of 180 medical science with that fulness which ought to be enforced in a college course. The report on Medical Ethics made by Drs. Bell and Hays was very full and explicit, and was unanimously adopted by the Convention. The same was true of the reports of Dr. Griscom on "a registration of births, marriages and deaths," and on "nomenclature of dis- eases adapted to the United States, having reference to a general registration of deaths." These were all adopted, and may be found in the first volume of Trans- actions of the American Medical Association. Another subject which elicited discussion and much attention was that embodied in the following resolution, viz.: "Resolved, That the union of the business of teaching and licensing in the same hands is wrong in principle and liable to great abuse in practice. Instead of con- ferring the right to license on medical colleges and State and county medical societies, it should be restricted to one board in each State, composed in fair proportion of the representatives from its medical colleges and the profession at large, and the pay for whose services as examiners should in no degree depend on the number licensed by them." [How much Mr. York's influence preponderated in the organization of the National Association can be thor- oughly appreciated from the makeup of the important committee whose report is thus summarized. — Ed.] Perhaps the most important subject which engaged the attention of this Convention was the report of the Committee on a Plan for Organizing a Permanent Na- tional Association. This Committee, consisting of Drs. John Watson, John Stearns, F. Campbell Stewart and N. S. Davis, of New York; A. Stille, of Philadelphia; W. H. Cogswell, of New London, Conn., and E. D. Fenner, of New Orleans, La., reported in full, a con- stitution designed to effect a permanent National or- ganization. The Committee adopted as the basis of organization the principle of representation by making the active members of the Association consist of dele- gates from medical societies and institutions in accord- ance with a fixed numeral ratio. In the preamble at- tached to the constitution, the purposes for which the Association is organized are declared to be "for cul- tivating and advancing medical knowledge, for ele- vating the standard of medical education, for promoting the usefulness, honor and interests of the medical pro- fession, for enlightening and directing public opinion in regard to the duties, responsibilities and requirements of medical men, for exciting and encouraging emulation and concert of action in the medical profession, and for facilitating and fastening friendly intercourse between those engaged in it." 181 To more certainly effect these objects the Committee deemed it important to hold out the strongest induce- ments for the formation of State and local associations which should be auxiliary to the national one. Hence, they so framed the constitution as to make the great majority of the members of the National Association consist of delegates from permanently organized State and county medical societies throughout the Union. To insure, also, a due share of the attention of the Association to the cultivation of medical science and literature, the constitution provided for the annual ap- pointment of standing committees, each consisting of seven members, on the "following subjects, viz.: A Committee on Medical Sciences; on Practical Medicine; on Surgery; on Obstetrics; on Medical Education; on Medical Literature, and on Publication. The Articles of the Constitution were considered separately, and also various amendments, only one of which, however, proposed to alter essentially the basis or principle of organization. This was presented by Dr. Isaac Hays, of Philadelphia, and was as follows, viz. : "Resolved, That the report be referred back to the Committee, with instructions to report a plan of organi- zation in accordance with the following sketch: "ist. The Society to consist of members to be elected by the Association, directly or through its council. "2d. Members, before admission to the Association, to sign a promise to conform to the laws of the Asso- tiation. "3d, Members who violate this pledge to be liable to expulsion, and to be deprived of the rights of brother- hood. "4th, For the appointment of a council, to consist of the officers of the Society and of councillors to "be elected annually, or all the former, and a portion, at least, of the latter, to be elected annually. The councillors to have the superintendence of the concerns and publications of the Association, and to report the proceedings of the Association at its annual meeting." [New York constantly kept the basic question of the reform of medical education before the convention. — Fj>.] These propositions were all adopted by the conven- tion, and the required committees appointed. Dr. N. S. Davis, who was Chairman of the Business Com- mittee, urged the following resolution as one suitable to be recommended as an additional subject for the •consideration of the Convention. It was opposed by Dr. Hays, and other members of the committee, on 182 the ground that it would be likely to excite discord, and was rejected by the committee. "Resolved, That the union of the business of teach- ing and licensing in the same hands is wrong in prin- ciple, and liable to great abuse in practice. Instead of conferring the right to license on medical colleges, and State and county medical societies, it should be re- stricted to one board in each State, composed in fair proportion of representatives from its medical colleges, and the profession at large, and the pay for whose services as examiners should in no degree depend on the number licensed by them." The same resolution was subsequently handed to Dr. O. S. Bartles, and by him presented to the Convention. An interesting and spirited discussion followed, which was participated in by Drs. Sumner, F. Campbell Stewart, Meredith Clymer, Isaac Parrish, H. W. Bax- ley, J. R. Manley, S. Hasbrouck, and N. S. Davis. Motions were made by those opposed to entertaining the* resolution to lay it on the table, and to refer it to some one of the committees already appointed. These motions were either withdrawn, or severally voted down, and the resolution was finally referred to a special committee of seven, with instructions to report on the same, at the meeting proposed to be held in Philadelphia, in May, 1847. On motion of Dr. John H. Griscom, committees were appointed to report at the same time and place on the most efficient measures for effecting a registration of births, marriages, and deaths, throughout all the States of the Union; and also on a nomenclature of diseases adapted to the United States, having reference to a general registra- tion of deaths. After passing the usual resolutions, complimenting the officers of the Convention, and thanking the medical colleges of the city for freely tendering the use of their rooms for its meetings, the session was adjourned sine die on the evening of May 6, 1846. All the business of the Convention was con- ducted with decorum, and the most cordial friendship, except that relating to the preamble and resolution introduced by Dr. Bedford, and even this gave rise to only a momentary feeling of excitement, or rather in- dignation, which was quickly lost in the universal de- termination to act solely for the elevation and advance- ment of the whole profession. The Convention was fortunate in the selection of its officers. Dr. Knight not- only presided with dignity, but displayed a famil- iarity with parliamentary usages, and promptness, and pleasing urbanity rarely united in the same individual. In looking over the list of delegates in attendance, the reader will be surprised at the disparity of representa- 183 tion from States located equally contiguous to the place of meeting. Thus, of the New England States, Connecticut had five delegates ; Massachusetts, one ; Rhode Island, one ; Vermont, three; New Hampshire, two; and Maine, none. Of the middle States, Pennsylvania had fourteen, two of whom represented the Medical Department of Pennsylvania College, while all the rest were dele- gates from the Philadelphia Medical Society; Dela- ware had five, all of whom represented medical so- cieties; and New Jersey had only two, who were made members by invitation. Of the Southern States, Mary- represent the State of New York, while Maine, North and South Carolina, Alabama, Louisiana, Kentucky, States, Indiana had one; and Illinois, one. This leaves little more than half of the entire number present, to represent the State of New York, while Maine, North and South Carolina, Alabama, Louisiana, Kentucky, Missouri, Ohio, Michigan and Texas were entirely un- represented. Eleven medical colleges were represented, constituting only about one-third of the whole number in the United States. The absence of a representation from so large a number of States and colleges was owing to various causes. In some States, neither medical societies nor colleges existed, and individual members of the profession did not feel free to take upon themselves the office of delegates. This was the case in North Carolina, and virtually so in most of the unrepresented States in the South and West. For though State and district medical societies had been previously organized in most of them, yet they had ceased to maintain an active existence. Another cause was a want of confidence in the success of the move- ment. Many who ardently desired a full convention, and were friendly to any measures calculated to elevate the standard of medical education, were deterred from attending by the belief that not a sufficient number of others would attend to warrant the transaction of any business of importance. But still another cause, which affected more particularly the medical colleges, was a feeling of distrust in regard to the motives of those who issued the call for the Convention. There was a feeling of apprehension, increased to some extent, doubtless, by the address of Professor Paine, that the whole movement originated in a spirit of radicalism and enmity to the schools. And though such a feeling was without the shadow of a foundation in fact, yet it was evidently the chief cause of preventing the attendance of delegates from a majority of the medical colleges in the Union. Another feature which will strike the mind, in looking over the list of delegates in attendance, is the absence of those to whom the pro- fession had long been accustomed to look as leaders in all important professional matters. We look over the list in vain for the names of Warren, Murray, Stevens, Chapman, Drake, and other veteran teachers in medicine. Almost the only ones present belonging to this class were Drs. Knight, Manley, Stevens and Delafield. Hence it may be said with propriety that the Convention was composed of the younger, more active, and, perhaps, more ambitious members of the profession. And yet, both the discussions and action of the Con- vention were characterized by that moderation, coupled with a spirit of determined perseverance, which was well calculated to inspire confidence alike in the motives of its members, and the final success of the enterprise in which they had engaged. It will be noticed, that all the proceedings of this meeting were made to assume the character strictly of preliminary action. Instead of hastily declaring their sentiments by formal resolutions, or at once recommending measures about which there might be differences of opinion, they simply selected the most important topics connected with the education of the profession, and referred them to able committees, with instructions to report after ample time for de- liberation. PART III. CHAPTER I. SEMI-CENTENNIAL OF THE SOCIETY. The only formal celebration of the fiftieth anniversary of the foundation of the State Med- ical Society seems to have been the semi-cen- tennial address delivered by Dr. Alden March, the President of the Society, in the capitol at Albany, February 4, 1857. Dr. March reviewed the progress of science and industry during the preceding half century and called attention to the fact that medicine had kept pace with the rest of progress in the arts and sciences. Because of the occasion of its delivery, this address has seemed worth while presenting in rather lengthy abstracts. There are included in Dr. March's address, lists of the original charter members 185 and the presidents of the Society up to his time, which more properly find their place in other parts of the present volume, and consequently have been omitted here. Dr. March's address has an additional interest on account of a cer- tain naivete of expression and an "enthusiastic recognition of advances in the arts and in indus- trial applications that we are much more apt to think of as a characteristic of the latter half of the nineteenth century rather than the middle of it. As a matter of fact, however, there are so many things in his laudatory review of the ac- complishments of the preceding half century, that would occur to us of the twentieth century as probably much more near to us than the date he assigns to them, that the reader is sure to be impressed by the rapid progress made by the American people at a time when we are inclined to think of them as rather backward. Dr. March's address contains an immense amount of precious knowledge, condensed into a very short space, and really serves to give a very vivid pic- ture of the times he wished to recall. This is true not only with regard to medicine, but with regard to practically all the arts and sciences and even agriculture. It is extremely interesting to find that a half century ago the president of the State Medical Society of New York considered that patholog- ical chemistry should be studied much more than had been hitherto the custom. At the pres- ent time this is still, and since the beginning of the twentieth century even more insistently, the advice of those of largest experience in medicine. In 1857, Dr. March expected that the explana- tion of the cause of disease would be found in various chemical changes in the fluids of the body. The study of diseased tissues had meant so much for medicine that at least as much more advance might be expected from the detailed 186 investigation of the changes in the fluids of the body, and he pointed to the then comparatively recent work of Dr. Bright as a proof of this. At that time there was as yet no hint of the de- velopment that bacteriology was to take, a de- velopment that was to have as one of its prin- cipal results the diversion of attention from pathological chemistry to that of the minute organisms directly causative of disease. Those who are interested in vital statistics will find an extremely informing review of certain phases of the death-rate and of the average length of life in the large cities of the civilized world that may not readily be encountered in such short space elsewhere. Dr. March notes that, during the half century of the existence of the Medical Society of the State of New York, the length of life had been increased very materially. At the beginning of the twentieth century at least one-half the population of the large cities of the world perished before the age of eighteen years. At the time of the celebration of the semi- centennial one-half the population reached the age of nearly 44 years. ABSTRACT OF THE SEMI-CENTENNIAL ADDRESS, DE- LIVERED BEFORE THE MEDICAL SOCIETY OF THE STATE OF NEW YORK AND MEMBERS OF THE LEGISLATURE IN- THE CAPITOL AT ALBANY, FEBRUARY 4, 1857, BY ALDEN MARCH, M.D., PRESIDENT OF THE SOCIETY. The poet speaks of the wheels of time — the philoso- pher of the irresistible march of time — and the good old patient and afflicted man of God compared the course of time of the "days of his years" to the rapid flight of the eagle, as he cleaves the vault of heaven in seeking his prey ; or to the lightning speed of the weaver's shut- tle, as it flits across the eye's field of vision. Swift and irresistible as is the course of time, never- theless, by the ingenuity of man, it has been measured and divided into periods. The steady and unvarying tick — tick — of yonder clock marks its -smaller divisions. A certain number of these ticks make a second — a minute — an hour — a day-^-a week — a month — a year! And when we come to in- crease the last division by fifty — half a century! — we 187 arrive at a period which indicates the semi-centennial anniversary of the Medical Society of the State of New York — an event which we are now convened to cele- brate. In youth we are full of ambition and look to the de- velopments of riper years to crown the joys of our high- est aspirations. The prospective is the most prominent. In manhood we begin to feel our strength, both phy- sically and intellectually. At an advanced period of life we are more prone to dwell on the retrospective. As a Society we have passed the season of youth, and have accomplished half of the journey of a centennial existence. We have arrived at a stage of life and at a position where it may be proper for us to look in both directions — backwards and forwards. It is enough to show that the whole face of the civil- ized physical world is stamped with progress ; and that her motto is "Onward." And has there been no corresponding advancement in the art and science of medicine during the last fifty years? To aid in the solution of this question, let us refer to the origin and progress of our Society; to the power it has exerted in extending new discoveries ; and to the social and happy influence its annual gatherings disseminate among its members. To say that medical knowledge has increased in the same proportion as that of other arts and sciences would not be sufficient. We should most likely be called on to particularize; and to show wherein the greatest achievements have been accomplished during the past half a century. In pursuing our enquiry we shall, from necessity — for want of time and the necessary ability to do the subject justice, pass by the consideration of the accessory or collateral branches, and proceed to refer at once to the practical, the demonstrative part of our subject. It is only within the last half century that pathologi- cal anatomy has attained to anything like a high posi- tion in the education of a good physician or surgeon. For a long time the discoveries in pathological anatomy were unfolded only by use of the scalpel. Quite recently the solids and fluids of the body, both in health and dis- ease, have been examined with the aid of the micro- scope in a way that has thrown new light on a great many points heretofore shrouded in darkness. Patho- logical chemistry, or that science by which the changes of the elementaiy principles, or constituents of the or- ganism may be detected, should be more thoroughly cultivated by medical chemists. The secretions of the kidneys and urinary calculi may be analyzed by a chemical process with so much ac- curacy as to decide the proportions of alkalies, of acids, 188 of earths and of the animal matter each specimen may contain; as the somewhat recent investigations of Dr. Bright will show. Prof. Simpson says, "If we knew the pathological chemistry of the blood and fluids, as well as we do the pathological anatomy of the solids of the body — a knowledge, I repeat, that is to be longed for, but which has been only yet most slightly acquired — then in medicine, both as a science and an art, would prob- ably make a forward march of the greatest moment." If the fluids_ which enter into the formation of animal existence are in the proportion of ten to one of the solid- ity, as it is alleged by physiologists, is it not reasonable that we should look for still further developments of the nature of disease by a thorough chemical analysis of the fluids? It has been suggested whether some peculiar form of toxemia or blood poisoning may not produce specific inflammations of the skin, as smallpox, scarletina, measles, erysipelas, phlebitis and inflamma- tion of puerperal fever. If we compare the extent and the variety of use of the means of physical diagnosis of the present day with those of half a century ago, we shall find that great advances have been made in this important branch of our science. Of late years the special senses have been educated and trained to detect the most minute distinctions in color, in form and in density, of morbid structures. By the eye, the ear and the fingers, often the signs of diseased parts may be as clearly indicated as by the scalpel of the dissector after death. Fifty years ago, who ever heard of the physician or surgeon making use of the stethoscope, or of his apply- ing his ear to the chest of his patient to ascertain the physical condition of his lungs, or the heart's action? The terms "ausculation" and "percussion," as applied to physical diagnosis, were altogether unknown. Similar means have been employed to detect the ex- istence of diseases in other cavities and organs. If precision and accuracy in detecting the physical signs of disease stamp the present as a new era in physical diag- nosis, our means of successfully treating diseases have been enlarged and improved in a corresponding degree. The exploring needle, which is a modern invention, is used by, the surgeon to ascertain the character of the structure of a tumor, or the contents of a cyst or sac. Quite recently there has been invented the instrument called Ophthalmoscope, by which the diseases of the deep tissues of the eye may be examined with ease and ac- curacy. In June last I found this instrument extensively used by the ophthalmic surgeons of Vienna and Berlin; and at that time I thought it was hardly known to the profession in America. But in the Boston Medical and Surgical Journal, of the 28th of June, I found the in- strument described and its use explained by our country- man, John H. Dix, M.D., of Boston. This will not only serve to show that we are constantly making new discoveries and improvements in our profession, but also the rapidity with which they are hurried across the Atlantic or pass from continent to continent. In the domains of materia medica some most re- markable advances have been made within the last few years. New medical agents have been added to our list of remedies : such as iodine, with its various compounds — hydrocyanic acid, gallic acid, cod liver oil, etc. — whilst by a chemical process many of the old vegetable and bulky articles that were in use have been converted into alkaloids or the alkalies extracted from them in which all their medical potency resides. Obstetrics and the diseases peculiar to females are now far better understood and managed than formerly. Although surgery at the commencement of the past cen- tury was in advance of some other departments of medicine, yet we observe a marked change within the last twenty-five or thirty years. To point out the contrast between the present and former practice of surgery, we need not go back to the days of barber practice, as was exhibited in the operative art of our profession. Now medical surgery is studied as a science, and with the unbounded resources of an enlarged and improved materia medica, diseases and lesions that were once deemed incurable, are now medi- cated successfully. In the treatment of wounds, hemor- rhage, inflammation and ulcers, there is great improve- ment. It is but a few years since the subject of tenotomy was introduced as a means of correcting deformity. Twenty years ago club feet and crooked eyes were to be met with at almost any turn in our streets. Now, especially in young persons, scarcely any such deformity is to be seen. The success of the operation for dividing tendons and muscles, and subsequent mechanical treatment to correct deformities and malpositions of the extremities, may be calculated on with great certainty, among in- fants and young children. The great variety of plastic operations for removing other kinds of deformities are of modern invention and work wonders when nicely executed. Less than fifty years since, in almost all cases of compound dislocation of a large joint, the practice was to resort to amputation. Now but few pri- mary amputations take place in compound dislocations. Before the day of Sir Benj. Brodie and the improved treatment of diseases of the joints for saving the life of the patient under such grave affections, amputation was deemed indispensable. Now we remove decayed bone, 190 excise joints and save limbs of far more utility and comfort than the best Palmer's artificial leg ever manu- factured. By a limited explanation of the subject, we shall see that practical medicine, within the last fifty or sixty years, has advanced in the same proportion as surgery. This has been chiefly brought about by a more accurate knowledge of pathology, of diagnosis and of the nature and powers of many new remedies. The resources of nature have been more thoroughly studied, and the ob- servant physician knows better when to proffer his ser- vices to aid nature, and when to withhold the interfer- ence of art. The improvements in the healing art that may be regarded of recent date are not to be considered as solely dependent on a more accurate pathological knowl- edge, and a more extended acquaintance with materia medica; but we now entertain more correct views of prophylactic and hygienic measures. Air and exercise, food and raiment, pure water and cleanliness, are as important to health and contribute as much to the lon- gevity of our species, as the best medicines when judi- ciously employed. The following statement will serve to illustrate these facts : "Formerly, towards the middle of the last century, fifty or sixty out of every hundred children born in London, died before they had reached their fifth year of age; but the mortality has gradually and stead- ily diminished, so that now not above thirty-five in every hundred die at that early period." At the present time there are more than 600,000 chil- dren born annually in Great Britain. According to the above scale of mortality, more than 300,000 of these would have perished formerly before they were five years of age; now only about 200,000 die during the first five years of life, thus showing a saving of human life in this item alone in the population of the British Isles, to the extent of 100,000 a year. By reference to the tables of Vital Statistics we far- ther learn that "in the latter part of the 16th century one-half of all who were born died under five years of age; the average longevity of the whole population was but eighteen years. In the seventeenth century one- half of the population died under 12 years of age. But in the first 60 years of the eighteenth century one-half of the population lived over 27 years. In the latter 40 years one-half exceeded 34 years of age. At the beginning of the present century one-half exceeded 40 years of age, and from 1838 to 1845 one-half exceeded 43 years. The average longevity of these successive periods has been increased from 18 years in the six- teenth century up to 43 7-10 by the last reports." 191 There are certain classes of moral as well as physical defects and derangements that have of late years, and I am quite certain within the last half century, at least, attracted the attention of the humane physician. And I think we may say with confidence and pride that no class of men, professional or otherwise, have done more to ameliorate the moral and physical condition of the unfortunate, the poor and the degraded and to aid the cause of religion than our profession. Fifty years ago, where were our medical and surgical hospitals, our houses of correction for juvenile delin- quents, our insane hospitals, our asylums for the deaf and dumb, our retreat for the idiot, and, as is now con- templated, a refuge for the poor, besotted inebriate? My sensitive and sympathizing audience hardly needs to be excited with the recital of the dark picture of the condition of the unfortunate and unhappy maniac pre- vious to the commencement of the present century. Then his habitation was either a dark, narrow cell, or a cage; he was secured by a straight- jacket or mana- cled and chained with as much unfeeling severity as a galley slave; his treatment was starvation and filth, stripes and bruises, scorn and hatred. Now the body and mind are cared for and scientifically treated. All these benevolent and praiseworthy institutions are under the superintendence of kind-hearted physicians. Let us next devote a few minutes to the consideration of the agencies that have been employed during the last half century in enlarging the field of medical knowl- edge. At the present time colleges and schools devoted to medical instruction, and hospitals managed by physi- cians and surgeons, afford the chief means of educating young men in the practice of physic and surgery. In 1807 there were not half a dozen medical schools in the United States ; nor scarcely a greater number of hospitals. Now there are about forty medical colleges or associations where medicine and surgery are taught and it is probable that there are twice that number of hospitals scattered through the cities and towns of the United States. The names and dates of the organization of the five oldest medical institutions in this country are the fol- lowing: The Medical Department of the University of Pennsylvania was established in 1765. The College of Physicians and Surgeons of the City of New York was instituted in 1768, in connection with Columbia College, and in 1807 obtained an independent charter. The Med- ical School of Boston, Mass., now the Medical Depart- ment of Harvard University, was organized in 1782. The Medical Department of Dartmouth College in 1798; and the University of Maryland, Baltimore, in 1807. 192 When our medical colleges or schools were limited to five, and the hospitals of this country but a little more numerous; when the whole apparatus, chemicals, and chemical tests of the chemist's laboratory could be almost packed in a bushel; when the anatomical mu- seum of the college consisted of two or three smoky skeletons, a handful of disjointed bones and a few in- jected preparations; and when a pathological cabinet was not known in the country; it requires no very great stretch of the imagination to draw the contrast between the advantages of 1807 and those of 1857, for obtaining a thorough practical medical education. We are now prepared to ask the question: What agency do medical societies exert in advancing and im- proving medical science ? If the act to incorporate med- ical societies had been made to read, "for the purpose of extending and improving medical science," instead of simply "for the purpose of regulating the practice of physic and surgery," it would have been more in conformity to the spirit and practical working of our Society as it is now organized. In addressing the Medico-Chirurgical Society of Edinburgh on the modern advancement of physic, Prof. Simpson says : "I believe that at the present time there exists but one opinion in relation to the fact that the study of medicine, like the study of other departments of practical science and art, has been vastly promoted by associations like our own." Professor Wood, late president of the American Med- ical Association, in his address before that body, in speaking of the tendency of that profession to become indolent, careless and mercenary, in protecting the best interests of the profession, says : "The medical mind, anterior to the birth _ of this association, was in a state of comparative inertia. In all the departments and of the profession, the educational as well as the practical, material interests began to preponderate. The great struggle seems to be in the teaching department to gather pupils; in the practical to gather patients; in both, to swell the pockets. No wonder that quackery, boomed upwards as regular medicine, began to sink." He adds : "But the Association arose, and a new spirit was awakened. Many had been watching this apparent abasement of the profession with sorrow, but they were powerless in their isolation. No sooner had the flag of the Association been given to the breeze than they hastened to join its standard. From all quarters and from the remotest bounds of the country volun- teers poured in to join this great crusade against the evils which had been usurping the sacred places of the profession. The mass of medical society was moved 13 193 to its very depth. _ Hundreds upon hundreds came forth from their sheltering privacy and threw their souls into the grand movement which was to conquer, to purify and regenerate the prostrated glory of their calling. The feeble voice of opposition was heard for a mo- ment, but it was soon drowned in the overwhelming shouts of the masses crying, 'Onward ! Onward !' " Those who felt but little confidence in the anticipated good that was to arise from the organization of the American Medical Association, either to the public or to the profession, must acknowledge that a new impulse has been given to the science of medicine in this coun- try since it was founded. And the glory of starting the ball is due to the State of New_ York — to this Society ; and almost entirely to the untired exertions of Prof. N. S. Davis, now of Chicago, in the call of a conven- tion, suggested by the writer, out of which the Asso- ciation grew. It appears on record that Dr. Hays, of Philadelphia, first suggested the idea of instituting a "National Medical Association"; and that the honor of submitting the plan for the permanent organization of the American Medical Association is due to John Wat- son, M.D., of New York, Chairman of the Committee of Organization. Well may we be proud not only of our own Society and its achievements in literature and science, butalso of the agency it has had in promoting the national prosperity of our noble profession. Let us, then, con- tinue to act honestly and faithfully in the discharge of our professional duties to each other, and to the pub- lic, even if our motives should be impugned or fail to be properly appreciated. We may meet with discour- agement, neglect and insult, but let us not weary in well doing. The storms and tempests of quackery may assault the citadel of the science of medicine and surgery. The good, old and well-tried "Regular," commanded by officers and recruits of the orthodox profession of medicine, may be tossed and veered about by the popu- lar "isms" of the day — nay, she may occasionally lose a spar, or receive a breach of continuity in some of her light cordage, yet her mainmast stands erect without fracture of her beams, without dislocation of her helm, and with a hull as sound and as safe as on the day she was launched. She still floats on the sea of "Confi- dence," and even though she may now and then be threatened with a mutiny among some of her undisci- plined recruits, yet we find the captain in command, the pilot at his post, the helmsman on duty and the watch- man at mast-head, warning us of approaching danger. Rapid and imperfect as has been our sketch of the past, may we not see enough in it to fill us with high 194 and encouraging hopes for the future? As we look forward through the vista of another half century, may we not confidently hope that our successors will be able in their turn to leave upon record an account of far greater and more numerous achievements in the arts and sciences and advancements of our profession than has been our privilege to record. Our social relations and the kindly feelings our an- nual reunions are calculated to promote, are well fitted to exert a happy influence on our hearts and to inspire confidence in and respect for each other. Let these sentiments be cherished, and whether it shall be our lot again to meet here, or hereafter, may it be one of severe and unalloyed enjoyment. A COUNTRY DOCTOR OF THE FIRST HALF CENTURY. For many years the oldest member of the New York State Medical Society was the Hon. John Miller, M. D., of Truxton, Cortland County, N. Y., who died on the 30th of March, 1862, in the 88th year of his age. Dr. Miller seems to de- serve a special biography for many more reasons than the happy accident that for over ten years he was the dean of the society. His life is in many ways thoroughly representative of that of the practitioners in country places, in New York State, in the first half of the 19th century. His wonderful powers of endurance that enabled him to stand more fatigue than the horses that he road to his distant patients, so that during times of epidemic at least he kept relays of animals along roads that he was likely to travel, only gives some idea of the wonderfully strenuous life that he led. There is in addition to this a tinge of romance about his earlier years, that his biographer, Dr. George W. Bradford, the Sec- retary of the Cortland County Medical Society, has brought out very effectively. Besides the tender regard in which he was held by many friends during his life and his sympathy for animals, especially his favorite faithful horse, stamped him as a man of eminently humane 105 nature, a true devotee of what are so well called the humanities in the midst of all his strenuosity. Those who might doubt that such country doctors as the Rev. Mr. Watson has painted so delightfully for us in his portrait of Weelum MacLure, the Scotch country doctor, in "Beside the Bonnie Briar Bush," developed also in this country, will find ample proof in this sketch of Dr. Miller's life. Besides being a busy practitioner of medicine, however, Dr. Miller took his full share of duties as a citizen, even serving as a justice of the peace for nearly ten years. He was a county judge for three years, was elected to the Assembly for several terms, and represented his district in Congress for one term. His life is typical in many ways of the busy, almost over full careers of his con- temporaries, who did so much for themselves, for their fellowmem and for their fellow-practi- tioners. He was one of those present at the celebration of the semi-centennial by special in- vitation. The following is from the Transactions of the State Society of 1862. MEMOIR OF HON. JOHN MILLER, M.D., LATE OF TRUX- TON, CORTLAND COUNTY, N. Y. BY GEO. W. BRAD- FORD, M.D., SECRETARY OF CORTLAND COUNTY MEDICAL SOCIETY. "It is a remark as true as it is old, that the life and labors of the most eminent physicians are known and appreciated by a very limited number of their contem- poraries. Their abstracted and almost isolated position in society arises from the very nature of their avoca- tion." His daily routine of attendance on the sick, in relieving the pains and ministering relief for the ills flesh is heir to, forbid his striving for wealth and power in the very marts of commerce, or in other scenes where these are acquired almost in a day. Even in the toils and sacrifices of war, his arena is in the chamber of suf- fering and death, while all the glory that gilds the bat- tle-field is lavished freely upon others. True as the above remarks are in relation to a very large portion 196 of the medical profession, yet instances do occur in which by a combination of strong natural abilities, and physical endurance, indomitable perseverance and moral courage, so overcome all obstacles that the possessor at- tains to an eminence of position, professionally and pub- licly, that is wide and permanent. Such, if we mistake not, is the one whose name stands at the head of our sketch, and whose useful life we would attempt to delineate. John Miller was born in the town of Armenia, County of Dutchess, N. Y., on the tenth day of November, 1774. His advantages for early- education were very limited, he having attended the dis- trict school about one year and enjoyed the privilege of attending a classical school in Connecticut about the same length of time, his boyhood being spent in labor- ing on the farm. He commenced the study of his pro- fession with Dr. Miller, an uncle of his, in Dutchess County, in the year 1793. At the expiration of a little more than a year he went to Washington County, N. Y., and entered the office of Dr. Moshier, of Easton, in that county. While residing with Dr Moshier, young Miller received a severe injury by being thrown from a horse. From this injury he was unable to pursue his professional studies for more than two years. During this period he returned to his home in Dutchess County. After several months residence at home he was induced by the advice of Dr. Baird, of New York, to seek an appointment in the then small Navy of the United States. For this purpose, though much against the wishes of his family, he went to New York, where he was presented, by Dr. Baird and others, with letters of recommendation to Dr. Benjamin Rush, of Philadel- phia, whither he repaired, and presented Dr. Rush with his credentials. At that time Miller was in poor health, and being tall, more than six feet in height, and thin in body, Dr. Rush was somewhat amused that so ghostly looking a young man should think of going into the Navy, and said to him: "Young man, you look better fitted for a skeleton in my office than for a post in the Navy." After recovering from the fatigue of his jour- ney, Dr. Rush went with him to visit the President of the United States, the venerable John Adams, residing in Philadelphia, then the seat of the general government, and through the influence of Dr. Rush obtained the place he sought, and was directed to report himself to the surgeon of the United States brig New York, then soon to sail for Tripoli. At this interview with Presi- dent Adams, Dr. Rush and young Miller were invited to dine with the President, and did so, where he met General Washington, Fisher Ames and several other distinguished characters of that day. Upon further ac- quaintance, Dr. Rush advised Miller to resign his post 197 in the Navy and proffered him a position in his family and office as a private pupil. This offer he readily em- braced, and remained for nearly two years, accompany- ing the doctor on his rides into the country, and attend- ing the lectures of Dr. Rush and Dr. Shippen at the University of Pennsylvania. From Pennsylvania he re- turned to Washington County, N. Y., in 1798, and en- tered into co-partnership with Dr. Moshier, his former instructor, where he remained until 1801. He was li- censed to practice medicine by the Vermont Medical Society in 1800. The law regulating the practice of medicine in New York was not enacted until 1806. On leaving Washington County, in 1801, he came into the then town of Fabius, Onondaga County, now Truxton, Cortland County, N. Y, and established himself in the practice of his profession, where he almost unremit- tingly attended his duties for about twenty-five years, and occasionally some five years longer. From his early physical training on the farm, he was well prepared for the laborious duties of his profession in a new country. Few men possessed to an equal degree the capacity for physical endurance and unwearied perseverance. The country being new, the roads always poor, many times almost impassable, yet he performed an amount of labor almost incredible, frequently riding on horseback thirty, forty and more than fifty miles a day, at all times, by night or by day, through storms and sunshine, with an energy that no obstacle could prevent. Many are the anecdotes that are related of his adventures in the woods and by-paths of Truxton, frequently by torch- light, to attend upon some family who, perhaps, were unable to render him any remuneration. The poor as well as the rich were alike the recipients of his toils. As a practitioner, Dr. Miller possessed to an eminent degree the confidence of his employers. His strong mind and retentive memory enabled him to read- ily discriminate the phases of diseases and his prompti- tude and readiness in the administration of relief to the sufferer, at once secured the confidence of the sick. His strict attendance to those entrusted to his care, his kindness of heart led him to sympathize deeply in all their sufferings, these all convinced his employers that his whole energies were enlisted in their welfare. He loved his profession, and while attending to its duties, amidst all of his incessant labors, he found time to cul- tivate his mind by reading much of the current pro- fessional literature of the day, and his well-balanced ming and retentive memory enabled him to make the best use of what he read; He was elected an honorary member of the New York State Medical Society in 1808, and at the time of his death was the oldest living member of the Society by nine years. At the semi-cen- 198 tennial anniversary meeting of the Society in February, 1857, Dr. Miller was present by special invitation. He entered into the spirit of the meeting with all the ar- dency of his nature, and many of the members present, who for the first time there saw him, will long remem- ber the "old man eloquent," and their pleasant and pro- fitable acquaintance with their venerable fellow-member. He was the last of that band of physicians, who, in Aug- ust, 1808, organized the Cortland County Medical So- ciety, and its first vice-president and the oldest living member by ten years. Such was his character and standing in the profession and gentlemanly intercourse with all members of the society that all loved to meet him, and to confer honor and their kindest favors upon one so much esteemed and highly venerated. Having spent the first years of his life in laboring on the farm, Dr. Miller while yet in the vigor of his days, left his profession and turned his attention to agricul- ture. Notwithstanding he had relinquished the practi- cal duties of his profession, he still manifested an inter- est in its welfare, always greeting its members with warm cordiality and to the day of his death no one abhorred and detested the varied systems of quackery, with which our country abounds, more than he did. The intelligence and the energy with which Dr. Miller entered into all the affairs of State, as well as into his professional avocations, was such that he early be- came prominent in public life. His first public office was that of coroner, which appointment he received from Governor George Clinton, in 1802. He was ap- pointed postmaster in the town of his residence in 1805 and retained the office for twenty years. He was ap- pointed a justice of the peace in 1812 and discharged its duties until 1821. He was one of the judges of our county courts from 1817 to 1820. He was elected a member of the Assembly from this county in 1816, again re-elected in 1820 and again in 1846. This same year he represented the county in the Convention for revis- ing the Constitution of the State. In 1826 and 1827 he represented the 22d district in the Congress of the United States. In all these positions of public trust he evinced the same energy and determined will and prompt action he had shown in his professional career. His readiness to sacrifice personal interest and ease to the public good and his experience in public life, with the honesty of purpose manifested in his intercourse with his associates, enabled him to exert a commanding influence over any deliberative body. _ These, with his usual energy, his eminent social vivacity, rendered him a welcome guest in all social gatherings. "He loved his friends, his profession and his country, and ardently labored for the improvement of each. He was free and 199 frank in manner, generous and friendly in disposition, engaging in address, of active temperament and indeed possessed all the social qualities of a gentleman and the stirring energies of the man of business. He was tall and erect in stature, and even in his last years still retained his firm step and erect position and never exhibited the decrepit old man in appearance, or in loss of intellect, but entered into conversation with all the energy and fire of his youthful days. He left the impress of his character on all he said or touched. He was zealous in all he believed to be right, yet kind and gentlemanly to all who differed from him in views. He was no bigot. Always expressed his opinion of men and measures freely and fearlessly and was always ready to listen to those who believed differ- ently. We have alluded to Dr. Miller's indomitable energy and restless perseverance in anything he felt his duty to perform or which he was anxious to accom- plish. What he had to do he did with all his might. No difficulties or opposition dismayed him, but seemed rather to infuse in him a more determined purpose to overcome all. We cannot but relate one of the characteristic events of his life, his determined will to overcome seeming im- possibilities, which he accomplished in securing to him- self the lady who afterwards became the sharer of his fortunes, the intelligent, amiable, loving partner of his life. Before coming into this (Cortland) County in 1801, he had formed an attachment to, and an engagement with, a young lady living in Rensselaer County, N. Y., whom he expected to become his partner and helpmeet in and through the journey of life. After his settlement here they held a constant correspondence, and while the doctor was laboring with all his energies to prepare for his chosen one a home, she remained behind making preparations for a residence in the wilds of the West. Matters went smoothly on with them for some months, each frequently receiving assurances of faithfulness and mutual attachment. After some time letters were not as frequently received by either party as formerly, and at last ceased entirely. The doctor wrote often, but re- ceived no reply to his anxious enquiries for the cause of this total silence on the part of her he so ardently loved. Just so with the lady, she, too, had written time and again, seeking to know the cause of his seeming cool- ness, this abandonment of him to whom she had plighted her first love. Each had come to the conclusion that the other was false to the sacred engagement promise. Matters remained thus for some time without either hearing anything from the other. At last the doctor re- ceived a letter from a friend of his living in Troy (the place of the young lady's residence) informing him that the young lady in question was to be married to some one there, on such an evening, but a few days from that date. The friend, knowing something of the previous engagement of the doctor to the lady, learned she had been induced to marry the person of her second en- gagement from the belief that the doctor had cast her off — had forfeited his plighted honor, she not having heard anything from him in reply to her letters for many months. The friend at once suspected something wrong. He knew John Miller would never be guilty of so base an act as to leave one to whom he was betrothed in such a manner. That if it were possible for him to fulfil his engagement, or if he desired to cancel the obligation, Miller would at once frankly and honestly inform the young lady. That he was far too honorable, too noble to do so base an act. Believing this, he wrote the doctor of the intended wedding to take place on the day designated. At that early day our country mails were "like angel visits — few and far between," conse- quently Miller did not receive his friend's letter until less than twenty-four hours before the time appointed for the wedding. This was in the latter part of the month of March, when the snow was melting away by the rays of the warm sun of spring, the roads were in bad condition, riding exceedingly bad and in some places dangerous, and the doctor one hundred and thirty miles from Troy. Stages or railroads were at that time out of the question. What should he do? Give up his heart's desire, his long-wished-for and earnestly sought companion; her, on whom his most ardent love had centered, and remain during all his future life under the imputation of forfeiting his plighted faith and act- ing in a dishonorable manner with a noble, worthy lady, or should he make one effort to retrieve all? His mind was soon made up. He mounted his faithful horse, "Gershom," one he had often tried in cases of urgent necessity; one, too, in all respects possessed of the phy- sical endurance — the determined energy never to be out- done — equal even to his master. "Gershom" was headed for Troy, a distance of one hundred and thirty miles, to be passed in less than twenty- four hours, not- withstanding all the snow, mud or dangers by the way. Faithfully and nobly did "Gershom" perform his task. . Near the close of the day, when the doctor had ar- rived near the west bank of the Hudson River, he discovered the ferry-boat just leaving the shore to pass over to Troy. It was almost dark, every moment of time was precious, fearing_ he should be too late for a successful termination of his hopes, his hard day's labor and all might be lost, he raised his voice to its utmost pitch, swinging his hat; "Gershom" at once responded, made his last charge and arrived on the bank of the river in time to pass. This proved to be the last time the boat went over that night. At an early hour in the evening "Gershom" stood at the door of the residence of the young lady, just as the guests were assembled to witness the marriage _ cere- mony. The doctor, covered with mud and wet, riding- stick in hand, walked up the steps of the mansion and knocked at the door. The father of the young lady answered the call, and who should he see standing there but John Miller, who, without ceremony, makes the enquiry, "Is Phoebe at home?" "Yes," was the reply. "Can I see her?" asks the doctor. The father replies, "I will inform her you are here — walk in." The doctor went into the hall and remained standing with his hat in hand. In a few minutes Phoebe made her ap- pearance, an interview was solicited by the doctor, ex- planations followed, and a perfect reconciliation was the result. Their letters had been intercepted on both sides by the man who had almost obtained possession of the prize by his rascality, but who that night went home wifeless. They were married in 1805, and a happy union it proved to be. Mrs. Miller was a lady of rare accom- plishments, of ardent piety and in all respects a fit com- panion for her worthy husband. They had eight chil- dren — five sons and three daughters. Mrs. Miller died much lamented in 1834, aged 59 years. Of the family only one of the sons and two daughters survive. All arriving to mature age, and most of them falling a vic- tim to that destroyer of our race — consumption. In the temperance cause Dr. Miller took an early and active part._ During his days_ of pupilage he once saw a beautiful child sacrificed in consequence of the intoxication of the physician called to its relief in an hour of suffering. This made a deep and lasting im- pression on his mind, and led him at the commencement of his labors as practicing physician firmly to resolve to abstain entirely from all intoxicating drinks as a bever- age. In this determination he persevered to the end of his _ life. In his prescriptions for the indisposed he avoided in all practical instances ordering alcoholic or any other intoxicating article. No one can ever charge Dr. Miller with being the means of their becoming lov- ers of strong drink. He was long an officer in the New York State Temperance Society, and frequently attended its meetings at Albany, and by his wise counsels and sound judgment obtained a commanding influence in that body. At an early age the doctor gave to the Presbyterian Church and Society of Truxton two valuable lots of land in the center of the village, as sites for a church and parsonage, also one other lot as a site for a public schoolhouse; and in the expenses incurred in erecting these public buildings, the doctor was a liberal con- tributor. It was entirely through his influence and lib- erality that the church edifice was finished in a neat and tasteful manner. His seat in the church was always oc- cupied by himself or his family. In the support of the varied objects of benevolence of the_ age and in the institution of the gospel in his own vicinity, Dr. Miller was a firm friend and a contributor. The church and society of the town of his residence are greatly indebted to him not only for his liberal aid in erecting their house of worship, but for the yearly sup- port of its ministry. For_ the last two years the doctor's health had been declining, and he has been out but little, yet he always most cordially received visits from his friends and en- tered with all his usual vjvacity into conversation, and where any subject was introduced in which he felt deeply interested, he would arouse to his accustomed vigor of mind and pour forth the feelings of his heart with great rapidity and eloquence, his thoughts fre- quently outrunning his utterance which sometimes led him to hesitate, but all who heard him were at once re- minded of his youthful energy. He retained his wonted faculties almost to the last hour of his long life, was perfectly sensible to the steady and sure approach of death ; yet with calmness and life-long carefulness, made every preparation _ for the end._ Having made every necessary and equitable disposition of his property, he gave explicit directions to the undertaker about his coffin and burial, that all should be done in a plain, un- ostentatious manner, avoiding all needless expense. Thus he actively and usefully lived, thus he calmly and quietly died, on the 30th day of March, 1862, in the 88th year of his age, leaving behind him abundant evidence of his preparation for, and acceptance through, the grace of our Lord and Saviour, into the rest prepared for the just. His funeral was attended by a large concourse of his neighbors and friends from distant parts of the country. Notwithstanding his request that he should be buried quietly, his long and useful life had secured too many friends that desired to manifest their love for his char- acter, their veneration for his age, and their sympathy for his family, to permit him to be interred without mingling their tears with his friends. An impressive funeral sermon was delivered by Rev. Caleb Clark, who for more than forty years had been the confidential friend and the spiritual adviser of himself and family. His funeral was also attended by a large number of 203 the members of the Cortland County Medical Society, who to the last manifested their love and veneration to their aged fellow-member. CESSATION OF RELATIONS WITH THE AMERICAN MEDICAL ASSOCIATION. During the quarter of a century after the cele- bration of the semi-centennial of the organiza- tion of the State Medical Society, it continued to be as it had been before the leading State Medical Society of the country. Its efforts to maintain the dignity of the profession and to uplift medical education and medical practice were uniformly successful, and were accepted as models by other State organizations for their work along similar lines. The relations of this society with the rest of the medical profession throughout the country were always extremely cordial. Almost needless to say New York had come to occupy from the very beginning the most prominent place in the councils of the American Medical Association. This was only .what might have been expected. The National Association owed its origin to the efforts of members of the New York State Medical Society, and it was the initiative and unflagging zeal of New Yorkers that had overcome the original difficulties of bringing physicians of such varying interests all over the country together, and then of maintaining and confirming the cordial rela- tions which gradually arose. Unfortunately this ideal state of affairs was not destined to endure and the story of long years of estrangement between mother and daughter association must be told. For several years in the later seventies some dissatisfaction had been expressed at the meetings of the Medical Society of the State of New York with the code of ethics which was then supposed to rule the conduct of members of the regular medical profession. The discussions culminated 204 at the annual meeting in 1881 in the appointment of a committee who drew up a new code of ethics to be substituted for the one then in force. Their recommendation was adopted by the State Society in February, 1882, but met with considerable opposition from many of the County Societies. In June, 1882, the American Medical Associa- tion at its annual meeting held in St. Paul, re- fused to receive the credentials of the delegates from the Medical Society of the State of New York or to admit them to its proceedings because of the adoption of the revised code of medical ethics by the State Society. The old code had been accepted for over thirty years and had come to be considered as one of the fundamental laws of the American Medical Association. This was the beginning of a rupture in the formal relations between the American Medical Association and the New York State Society which was destined to last for nearly a quarter of a century. At the annual meeting of the State Society, held in February, 1883, a resolution was offered which was meant to take the place of the formal code of ethics that had been adopted in the pre- vious year. This resolution was carried. Em- bodied in it was the statement "that the only ethical offences for which the profession of New York claim and promise to exercise the right of discipline are those comprehended under tfne commission of acts unworthy a physician and a gentleman." The circumstances under which the resolution was offered and the debate before its adoption may be found in the Transactions of the State Society for 1883, page 78. The Medi- cal Society of the State of New York thus for- mally became a "no code" organization. The adoption of this "no code" resolution and the failure of all attempts on the part of many and influential members of the society to secure the readoption of the old code, or at least some 20s formal legislation that would forbid consultation on the part of members of the society with irregular medical practitioners, or with those practicing on a sectarian basis, finally led to so much dissatisfaction that the formation of a new organization was suggested by those who wished to maintain their affiliation with the American Medical Association. It was realized, however, that with the constitution of the State Medical Society as it then was and with the membership as determined by it, it would be practically impossible to obtain any legislation of such a nature as would bring about a reunion with the national body. A good deal of care was exercised in finding out just what were the sentiments of the members of the medical profession in New York State, with regard to the question of the national code, the new code and the abrogation of all codes. A personal canvas by letter was made of all the members of the profession in this State, with a result that justified the idea that a majority of New York State physicians was unwilling to be separated f/om the National Association of Physicians because of the code question. The determination of this matter seemed to point directly toward the advisability of the founda- tion of another medical organization within the State. In order to show how strong the opposi- tion seemed to be, we give the detailed result of the ballot secured by those who were resolved to form a new association if they found them- selves to be representative of the State Medical profession and if they felt it were impossible to look for an amelioration of existing condi- tions within the State Society itself. Note. — See Transactions of The New York State Medical Association, Vol! I. In this same number will be found a copy of the old code. The new code and arguments for its adoption, too lengthy to print here, can be found in the Transactions of the Medical Soci- ety of the State of New York. 206 The result of the canvass of the opinions of all the physicians of the State was as follows: For the National Code, 2,547 ; for the New Code, 1,040 ; for No Code, 239 ; Unclassified, 34 ; total, 3,860. It was apparent from these figures, that there was a majority of the New York State Profession for the National Code over the whole number of committed and uncommitted, more- over, there was a majority of more than two- thirds for the National Code over the New Code and a nearly two-thirds majority for the National Code over the "New Code," "No Code," and "Unclassified" combined. As the result of this canvass it was resolved to form a new organiza- tion. The New York State Medical Association was accordingly organized in February, 1884, and held its first annual meeting in the fall of the same year. REUNION OF THE TWO STATE ORGANIZATIONS The rival State medical organizations con- tinued to exist side by side in New York for about twenty years. During the last few years of the nineteenth century the sentiment began to make itself felt very generally throughout the medical profession of New York State that the maintenance of two State medical organiza- tions was without any proper reason in the nature of things. A new generation of physi- cians had come into practice since the events which had brought about the disunion, and among them especially opinions in favor of the reunion of the two State organizations began to be expressed freely and frequently. A rather anomalous condition, though interestingly hope- ful for affairs, developed in New York City, which was a sign of the feeling on the part of many members of the profession that the reasons for disunion were not near so important or so profound as had seemed, or at least that, in the natural development of things, many of the 207 older reasons for separation from the national body had lost their weight. Many New York City physicians belonged to both their county medical society and their county medical asso- ciation. This state of affairs could scarcely be allowed to continue for long. If the members of the med- ical profession could belong to both organiza- tions, then the differences between them were surely not essential, and the reasons for separa- tion had evidently lost their weight. It was in the Nfew York county organizations, therefore, that the movement for reunion took form and gradually gained the strength necessary to bring about the fusion of the two State organizations. Owing to legal difficulties, mainly dependent upon the indefinite character of certain of the early by-laws of the medical organizations, the actual accomplishment of reunion was delayed longer than had been expected. It was com- pleted, however, in time for the celebration in a compact body by the medical profession of New York State, of the Centenary of the founda- tion of the New York State Medical Society in 1906. The story of the movement that brought about this consummation eminently to be wished will be told by some future historian. The events are too near us yet to have assumed the per- spective that they will have in history. EAGLE PRESS, BROOKLYN-NEW YORK