' $0iwll Kutemtg |f itatg THE GIFT OF .©^.^AiAiaJjJfe P.....^ju«^..(£dii£ftii Aj4^M fofenr.j.i.o 6896.2 ^W ,/ X The date shows when this volume was taken. To renew this book copy the call No, and give to the librarian. HOME USE RULES. All Books subject to Recall. Books not used for instruction or research are returnable within 4 weeks. Volumes of periodi- cals and of pamphlets are held in the library as much as possible. For special purposes they are given out for a limited time. Borrowers should not use their library privileges for the bene- fit of other persons. Books not needed during recess periods should be returned to- the library, or arrange- ments made for their return during borrow- er's absence, if wanted. Books needed by more than one person- are held on the reserve- list. Books of speciaf value and gift books, when the giver wishes- it, are not allowed to- drciilate. Readers- are asked to- report all cases of books marked or mutilated. Do not deface hooks by mark* and writing. AS i John V. Shoemaker, M. D. Chairman of the General Committee on Scientific In- stitutions. Medical Col- leges and Hospitals of Philadelphia, and ex-officio of the Committee on Pub- lication. v COMMITTEE ON PUBLICATION: CHARLES K, MILLS, M, D.. CHAIRMAN. JAMES M. ANDERS. M. D,, EDWARD J. NOLAN. M D.. ARTHUR V. MEIGS. M. D,, JOSEPH WILLCOX. Esq, WHARTON SINKLER. M. D., SAMUEL D. RISLEY. M. D.. A. O. J. K£LLY. M. D. SECRETARY. FREDERICK P. HENRY. M. D.. EDITOR. Founders' Week Memorial Volume OF THE Scientific Institutions Medical Colleges and Hospitals, OF PHILADELPHIA The Chairman of the General Committee on Sci- entific Institutions, Medical Colleges and Hospi- tals of Philadelphia, and the Chairman and members of the Committee on Publication of the Founders' Week Memorial Volume, take pleasure in presenting you with the accompanying copy of the same. The Committee respectfully requests that receipt of the Volume "be acknowledged to Dr. Fred- erick P. Henry, Editor, 114 South 18th Street, Philadelphia', Pa. 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://www.archive.org/details/cu31924029693672 Hon. John E. Reyburn mayor of Philadelphia. Founders' Week Memorial Volume Containing an Account of the Two Hundred and Twenty-fifth Anni- versary of the Founding of the City of Philadelphia, and Histories of its Principal Scientific Institutions, Medical Colleges, Hospitals, etc. EDITED BY FREDERICK P. HENRY, A.M., M.D. JOHN V. SHOEMAKER, M.D. Chairman of the General Committee on Scientific Institutions, Medical Colleees and Hospitals of Philadelphia, and ex-o§cio of the Committee on Publication. COMMITTEE ON PUBLICATION CHARLES K. MILLS, M.D., Chairman JAMES M. ANDERS, M.D. WHARTON SINKLER, M.D. EDWARD J. NOLAN, M.D. SAMUEL D. RISLEY, M.D. ARTHUR V. MEIGS, M.D. A. O. J. KELLY. M.D., Secntar, JOSEPH WILLCOX, Esq. FREDERICK P. HENRY, M.D. Published by the City of Philadelphia in Commemoration of the Tivo Hundred and Twenty-fifth Anniversary of its Founding. PHILADELPHIA, 1909 D F. A. Davis Company Publishers and Printer* Philadelphia, Pa. Preface \ PEEFACE is in some respects a paradox. It is the reader's -*■*■ introductory and the writer's, or, as in this case, the editor's, valedictory. It cannot be written until there is something either to introduce or to take leave of, so that in point of time it is of necessity a postscript. It is an announcement that the work is completed and a statement of its character and scope and the reasons for its undertaking. In former days it was sometimes called an "apology," and, although what we now understand by this term is applicable to many books of the day, the editor has no apologies to offer for the publication of the Memorial Volume of Founders' Week. On the contrary, he feels that he can con- gratulate the municipal authorities and the public in general upon the fact that such a book is in existence and assure them that it will be consulted for all time as a standard history of the scientific and charitable institutions of Philadelphia. He can go still fur- ther, and tell them that it is the work of experts, that is, of men and women selected by the institutions they represent as those best qualified to write their history. The preface is welcomed by the editor for another reason than that of satisfaction at the completion of his task. It affords him an opportunity of expressing his grateful acknowledgments to his numerous collaborators for their cordial co-operation. Among them are men far advanced in years, but all the more fitted on that account to contribute to a work of this character. In many instances they describe events in which they were prominent actors, and of which but for their modesty they might truly say, quorum magna pars fui. While the editor is satisfied with the work and takes a just pride in his connection with it, he does not assume thp position (iii) iv Preface that it is beyond criticism. He is aware that there are societies eminently scientific which are not included in it, and while he has no apologies to offer for this fact, he feels that it calls for explana- tion. This is easily made, and will, it is believed, be satisfactory to all concerned. The vast majority of the institutions included in the volume being of a medical character, it was decided by the Publication Committee that the scientific institutions therein represented should be general rather than special. Medicine, in SO far as it is scientific, is based upon the generally accepted laws and facts of science, and especially upon those derived from the fields of natural history, chemistry, physics and biology. The societies in which these sciences, the fundaments of medicine, are cultivated, are the ones that are described in this volume. The Philadelphia Museums were at first not included among them, but it was soon decided that their omission would be a grave mistake. Our recently acquired possessions have not only opened new fields of research, but have made the study of tropical diseases an essential part of medical teaching. Without entering into details, the editor would express his opinion that a visit to the Philadel- phia Museums under competent guidance should be, if possible, included in such a course of study. The order in which the articles have been arranged is in no way indicative of their relative importance, but of their age. This is a point concerning which there might be differences of opinion, for in at least one instance the date of incorporation has preceded by ten or more years that of the actual opening of an institution. The date on which a charitable institution began its beneficent functions has been adopted as that of its birth, the time, if any, between that and its incorporation being regarded as a period of incubation. In all such instances the statements made by the writers of the various histories have been tacitly accepted as accurate. The two last articles of the volume were included, both because of their intrinsic historic interest and also because the Preface v truest scientific exponents of hospital work are medical journals and medical societies. In conclusion, the editor would express, if he could find words to do so, his thanks to his fellow-members of the Publication Com- mittee for their hearty support and inspiriting encouragement throughout the prosecution of his work. A glance at their dis- tinguished names will reveal better than any words, however eloquent, the nature of the encouragement and assistance to be derived from the men who bear them. To Dr. Mills, in particular, special thanks are due for valuable collaboration in the preparation of the Introduction, and in this connection it is but just to mention the fact, upon which all acquainted with the circumstances are agreed, that but for the energy, perseverance and business ability of the chairman of the General Committee, Dr. John V. Shoemaker, it is questionable whether the work could have been carried success- fully to its completion. Table of Contents PAGE Preface iii List of Illustrations xi Introduction 1 Scientific Institutions 105 The American Philosophical Society. J. G. Bosengarten, L.L.D 105 The College of Physicians of Philadelphia, J. Norman Henry, M.D. 124 The Academy of Natural Sciences of Philadelphia, Edward J. Nolan, M.D 153 The Franklin Institute, Persifor Eraser, A.B., A.M., Dr. es Sci. Nat. 187 The Wagner Free Institute of Science of Philadelphia, Henry Leff- mann, Joseph Willcox, Sydney T. Skid/more 206 The Philadelphia Museums, Wilfred H. Schoff 214 Medical, Phaemaceutical, and Dental Colleges 223 The University of Pennsylvania, Edward P. Cheyney, A.M. 223 The Jefferson Medical College of Philadelphia, J. W. Holland, A.M., M.D 265 Hahnemann Medical College and Hospital of Philadelphia, Thomas Lindsley Bradford, M.D 291 The Woman's Medical College of Pennsylvania, Clara Mar- shall, M.D 305 The Medico-Chirurgical College and Hospital, T. H. Weisen- burg, M.D 319 The Temple University, L. H. Carnell, Litt.D 341 The Philadelphia Polyclinic and College for Graduates in Medi- cine, R. Max Goepp, M.D 366 The Philadelphia College of Pharmacy, George M. Beringer. A.M.. Ph.M 377 The Pennsylvania College of Dental Surgery, Henry Leffmann, A.M., M.D., D.D.8 409 Hospitals and Allied Institutions Under Municipal Management. 419 The Philadelphia General Hospital : From the inception of the Philadelphia Almshouse and Hospital to the consolidation of the County and City of Philadelphia, in 1854, Roland G. Curtin, M.D 419 The Philadelphia Almshouse and the Philadelphia General Hos- pital from 1854 to 1908, Charles K. Mills, M.D 465 The Municipal Hospital for Contagious and Infectious Diseases, William M. Welch, M.D 517 The Development of Public Health Work in Philadelphia, A. C. AUott, M.D., Sc.D 563 (vii) viii Table of Contents PAGE General Hospitals and Dispensaries 593 The Pennsylvania Hospital, Francis R. Packard, M.D 593 The St. Joseph's Hospital, Joseph M. Spellissy, M.D 613 The Hospital of the Protestant Episcopal Church in Philadelphia, Israel W. Morris 632 The Howard Hospital, Albert E. Roussel, M.D 642 St. Mary's Hospital, James A. Kelly, M.D 648 The German Hospital of the City of Philadelphia, Henry F. Page, M.D 652 The Charity Hospital of the City of Philadelphia, Joseph H. Lopez, M.D 659 The Jewish Hospital Association of Philadelphia, Henry A\ Wessel. 663 The Germantown Dispensary and Hospital, Frank J. Firth 682 The Presbyterian Hospital in Philadelphia, James E. Talley, M.D. . 690 St. Agnes' Hospital, B. Franklin Staid, M.D 706 Women's Homoeopathic Association of Pennsylvania, Fanny L. Skinner 710 The Methodist Episcopal Hospital in the City of Philadelphia, James Hendrie Lloyd, A.M., M.D 713 St. Timothy's Memorial Hospital, J. Vaughan Merrick 720 The West Philadelphia General Homoeopathic Hospital and Dispen- sary, H. M. Gay, M.D 722 Frederick Douglass Memorial Hospital and Training School, Prepared by the Editor 725 St. Luke's Homoeopathic Hospital of Philadelphia, William H. Keim, M.D 726 The Woman's Southern Homoeopathic Hospital of Philadelphia, Lydia Webster Stokes, M.D 729 The Mt. Sinai Hospital, Henry B. Shmookler, M.D 731 The Frankford Hospital, B. Frank Walters, M.D., and Charles M. Stiles, M.D 735 The Chestnut Hill Hospital, Henry H. Kingston 737 The Stetson Hospital of Philadelphia, Charles B. Warder, M.D 739 Mercy Hospital and School for Nurses, J. Imogen Howard 742 The Philadelphia Dispensary, Francis W. Sinkler, M.D 745 The Northern Dispensary, L. Brewer Hall, M.D 751 The Southern Dispensary, W. X. Seary 754 Special Hospitals and Dispensaries 757 The Philadelphia Lying-in Charity, W. Reynolds Wilson, M.D.. . . 757 The Wills Hospital, Samuel D. Risley, M.D 763 The Children's Hospital of Philadelphia, Frederick A. Pack- ard, M.D 770 The Woman's Hospital of Philadelphia, Alice M. Seabrook, M.D.. . 776 The Preston Retreat, Richard C. N orris, M.D 781 The Philadelphia Orthopaedic Hospital and Infirmary for Nervous Diseases, Charles Sinkler 794 The Maternity Hospital, James Y. Ingham. M.D 803 Table of Contents ix PAGE St. Christopher's Hospital for Children, William H. Bennett, M.D. 808 The Children's Homoeopathic Hospital of Philadelphia, Augustus Eomdoerfer, M.D 821 The Kensington Hospital for Women, Charles P. Noble, M.D 826 The Gyneeean Hospital, Charles B. Penrose, M.D 831 The West Philadelphia Hospital for Women, Amy Comegys 834 Rush Hospital for the Treatment of Consumption and Allied Dis- eases, T. Mellor Tyson, M.D 837 The Henry Phipps Institute for the Study, Treatment and Pre- vention of Tuberculosis, Charles J. Hatfield, M.D 840 The American Oncologic Hospital for the Study and Treatment of Cancer and Other Tumors, George H. Stuart, Jr 844 The American Hospital for Diseases of the Stomach, Lewis Brinton, M.D 847 The South Eastern Dispensary, Elizabeth Graham Hirst 850 The State Dispensary for Tuberculosis, Albert P. Francine, A.M., M.D 851 Asylums, Homes and Training Schools 854 Friends' Asylum for the Insane, Robert Houoland Chase, 3I.D 854 The Pennsylvania Institution for the Deaf and Dumb, James Arthur Weaver 858 The Philadelphia Home for Incurables, Isabel Mcllhenny Nichols. 863 Home of the Merciful Saviour for Crippled Children, Helen L. Innes. 866 The Pennsylvania Home Teaching Society and Free Circulating Library for the Blind, Robert C. Moon, M.D 867 Home for Consumptives, Rev. Herman L. Duhring, D.D 869 The Widener Memorial Industrial Training School for Crippled Children, De Forest Willard, M.D., and J.. Bruce Gill, M.D 874 Medical Societies and Medical Journals of Philadelphia 880 History of the Medical Societies of Philadelphia, J. Madison Taylor, M.D., and Rufus B. Scarlett, M.D 880 History of the Medical Journals of Philadelphia, C. E. de M. Sajous, M.D., LL.D 894 Index 901 List of Illustrations PAGE Hon. John E. Reyburn, Mayor of Philadelphia Frontispiece. American Philosophical Society: Benjamin Franklin. Painting by David Martin, about 1766 106 College of Physicians of Philadelphia : John Redman 124 John Morgan 126 William Shippen, Jr 128 Picture House 132 Hall of the College before Addition of Third Story 134 Hall of the College at Thirteenth and Locust Streets 135 Lecture Hall 136 Lewis Library 144 Reading Room 148 Hall of the College at Twenty-Second and Ludlow Streets 150 Academy of Natural Sciences of Philadelphia: Academy of Natural Sciences, 1826 to 1840 158 Academy of Natural Sciences, 1840 to 1876 159 William Maclure 160 Academy of Natural Sciences, 1876 to 1909 168 W. S. W. Rusehenberger 170 Joseph Leidy 174 Franklin Institute: Benjamin Franklin (After Painting of Duplessis) 188 Electrical Machine (Used by Dr. Franklin) 188 One of Class Rooms 188 William Penn Tatham, Jacob Brown Knight, Robert Empie Rogers, James Ronaldson, John Vaughan Merrick, Henry Morton 196 William Sellers, William Henry Wahl, Coleman Sellers, Joseph Miller Wilson, John Chapman Cresson, Samuel Vaughan Merrick 197 Exhibition Building 204 Institute Building, 1825 204 Proposed New Building 204 Wagner Free Institute of Science of Philadelphia: William Wagner 206 Wagner Institute 207 Museum 210 Lecture Hall 211 (Xi) xii List of Illustrations Philadelphia Museums: page Worth Facade 214 Bagobo Warrior 216 Hut and Dwelling, Bagobo Tribe 217 Visayan Woman Weaving 218 Group of Public School Children Visiting Museums 219 University of Pennsylvania: First Buildings, 1740; Logan Hall; William Pepper Clinical Laboratory; Laboratory of Hygiene; Wistar Institute; Hare Laboratory of Chemistry 232 Medical School, 1829 to 1872; Adam Kuhn; Philip Syng Physick; Medical School, 1765 to 1S02 233 New Veterinary Building 238 William Pepper 244 University Hospital 252 Dental Hall 254 Biological Hall 258 New Medical Laboratories 260 New Clinical Laboratory 261 Jefferson Medical College of Philadelphia: Group of Buildings 270 College Building, Walnut Street Front 276 Physiological Laboratory 276 Clinical Amphitheatre 282 Hahnemann Medical College and Hospital : Homoeopathic Medical College of Pennsylvania 294 Homoeopathic Hospital, Cuthbert Street 294 First Homoeopathic Hospital in Pennsylvania 298 Hahnemann Medical College, Broad Street 298 Hospital Buildings 302 Nurses' Home and Maternity Hospital 303 Woman's Medical College of Pennsylvania, Main Building 314 Medico-Chirurgical College and Hospital: Original Medico-Chirurgical Hospital, and Philadelphia Dental College 326 Clinical Amphitheatre 328 Interior Clinical Amphitheatre 330 Laboratory Building 330 Main Hospital Building 332 Students' Club House 334 Group of College Buildings 336 Temple University: College Hall 342 Philadelphia Dental College 350 Garret3on Hospital 354 Samaritan Hospital 358 List of Illustrations xiii Temple University {Continued) : page Nurses' Training School 362 Dental Room 362 Philadelphia Polyclinic and College for Graduates in Medicine : Children's Ward 368 Amphitheatre 369 Kay House 372 Sketch of Proposed New Building 374 Philadelphia College of Pharmacy: Carpenters' Hall 380 Henry Troth 380 Peter Lehman 380 German Hall 382 Zane Street Building 383 Laboratory Annex 384 First Laboratory 384 College of Pharmacy, 1868 to 1892 386 Philadelphia College of Pharmacy 390 Charles Marshall, Charles Ellis, Dillwyn Parrish, Charles Bullock. 394 Franklin Bache, John M. Maisch, George B. Wood, Samuel Jackson. 404 Pennsylvania College of Dental Surgery: College Building 410 Prosthetic Laboratory 412 Reading Room 412 Chemical Laboratory 416 Clinic Room 416 Philadelphia General Hospital: Friends' Almshouse 420 Philadelphia Almshouse, 1767 to 1834 428 Shinplaster Issued by Contributors for the Relief and Employment of the Poor 430 Philadelphia Almshouse, 1840 446 D. Hayes Agnew 456 Bird's-Eye View of Almshouse, 1890 468 Front Entrance, Administration Building 470 Hospital Gate, 1899 480 Birds'-Eye View of Courtyards, 1899 482 House for Nurses 498 Pavilions for Consumptives 506 Municipal Hospital for Contagious and Infectious Diseases: Main Building, 1865 526 Diphtheria Pavilion, 1900 546 Main Building, 1900 550 Panoramic View of Hospital Buildings, 1901 552 New Philadelphia Hospital for Contagious Diseases: Administration Building 560 Private Ward Building 561 xiv List of Illustrations New Philadelphia Hospital for Contagious Diseases (Continued) : page Isolation Buildings 560 Building for Isolation and Treatment of Measles 561 Public Ward 560 Interior of Public Ward 561 Pennsylvania Hospital: Admission Card, 1797 594 Communication from Medical Staff, 1770 595 Pennsylvania Hospital, Pine Street 600 Old Clinical Amphitheatre 602 Order for Admission of Patient 602 East Wing of Hospital 603 South View of Hospital 603 Cells 604 Corner-Stone 604 Law Regulating Election of Managers 605 "Tranquilising Chair" 605 Benjamin Rush 606 Bird's-Eye View of the Pennsylvania Hospital 608 St. Joseph's Hospital : Group of Buildings 614 Interior Views 614 Interior Views 618 Interior and Exterior Views 619 Some Members of the Medical Board, 1848 to 1859 620 Some Members of the Board of Managers, 1848 to 1858 621 Some Members of the Medical Board, 1859 to 1909 626 Some Members of the Board of Managers, 1859 to 1909 627 Episcopal Hospital: View of the Hospital 632 Ingersoll Receiving Ward 636 Harrison House 63$ Howard Hospital: Howard Hospital g^ Main Hall g^s St. Mary's Hospital : Hospital in 1882 g 4 g Hospital in 1891 g 4 g Hospital in 1901 g 5 n German Hospital of the City of Philadelphia: Hospital from Corinthian Avenue 654 Hospital from Girard College 655 Charity Hospital, Group 660 Jewish Hospital: Hospital 666 Loeb Dispensary g 7 n Home for Aged and Infirm Israelites 671 List of Illustrations xv Jewish Hospital {Continued) : PAQE Lucien Moss Home 674 Meyer Guggenheim Building 676 Eisner Home 677 "Pennsylvania Building" 678 Germantown Dispensary and Hospital : Views of Hospital Buildings 684 Views of Hospital Buildings 688 Presbyterian Hospital in Philadelphia: Administration Building 692 Children's Ward 696 Kortright Ward 697 Richardson Home 700 Catheart Home 701 St. Agnes' Hospital: View of Hospital 706 Bear View of Hospital 707 Methodist Episcopal Hospital in the City of Philadelphia: Scott Stewart 714 View of Hospital 716 Nurses' Home 717 Children's Ward 718 Women's Ward 719 Operating Room 719 St. Luke's Homoeopathic Hospital 726 Woman's Southern Homoeopathic Hospital 730 Frankford Hospital 736 Chestnut Hill Hospital 738 Stetson Hospital 740 Philadelphia Lying-in Charity 758 Wills Hospital 766 Children's Hospital: Children's Hospital 772 Country Branch 774 Preston Retreat: Silver Vase Presented to Dr. Preston 782 Views of the Retreat Before and After Alterations 788 Philadelphia Orthopaedic Hospital and Infirmary for Nervous Diseases : Men's Nervous Ward 796 Girl's Ward 797 Hospital Building 800 Maternity Hospital 804 St. Christopher's Hospital for Children: Hospital and Nurses' Home 810 Surgical Ward 814 Solarium 816 xvi List of Illustrations Children's Homoeopathic Hospital of Philadelphia: PAGE Hospital Building 822 Clark Memorial 824 Kensington Hospital for \\ omen and Operating Room 828 West Philadelphia Hospital for Women 834 Rush Hospital for the Treatment of Consumption and Allied Diseases : Group of Hospital Buildings 838 Group of Hospital Buildings 839 Phipps Institute 842 American Oncologic Hospital 846 State Dispensary for Tuberculosis 852 Friends' Asylum for the Insane: Friends' Asylum 854 South Front 855 Front Lawn 856 Pennsylvania Institution for the Deaf and Dumb: Broad and Pine Streets, 1831 858 Cresheim Hall 859 Wingohocking Hall 860 Wissinoming Hall 861 Philadelphia Home for Incurables 864 Home of the Merciful Saviour 866 Pennsylvania Home Teaching Society and Free Circulating Library for the Blind: Moon Type for the Blind S68 Blind Reader 869 Home For Consumptives: Administration Building, Powers Cottage 870 Roof Garden 870 Powers Cottage, Mid- Winter 872 Wilstach Cottage, Mid-Summer 873 Widener Memorial Industrial Training School for Crippled Children: View of Buildings gyg View of Grounds 877 Gateway nyo One of the Wards §79 FOUNDERS' WEEK MEMORIAL VOLUME INTRODUCTION FOUNDEBS' WEEK, October 4-10, 1908, received its name from the fact that as the result of careful investigations made by a commission appointed by Hon. John E. Eeyburn, Mayor of Philadelphia, it was determined that the true date of the founding of the city of Philadelphia was 1683. The commission appointed by the Mayor, which was composed of some of the most eminent citizens of Philadelphia and Pennsylvania, recommended to his Honor that the 225th anniversary of the founding of Philadelphia should be celebrated in a suitable manner by commemorative exer- cises under the auspices of the city government and a committee of citizens. This recommendation, which was approved by the Mayor and was transmitted to the Select and Common Councils of Phila- delphia for their action, was endorsed by these bodies, who at once appointed a committee to co-operate with a committee of citizens to arrange a plan of celebration. The celebration thus launched and arranged was one of the most notable events in the history of Philadelphia, and was highly successful in every way. To the energy and enthusiasm of Mr. G. W. B. Hicks, statis- tician to the mayor, much of the success of the celebration of Founders' Week was due, and we are indebted to him for valuable documents relating to the celebration and to the events leading up to it. We also express our acknowledgments to Mr. William W. Matos for valuable material contained in his "Official Historical Souvenir of Founders' Week." l 2 Founders' Week Memorial Volume The particular object of this memorial volume is to record the history of the scientific institutions, colleges, and hospitals of the city of Philadelphia. The reader is referred to other sources for the history of the founding and development of the city, for an account of its seals and charter and the historical facts which sup- port the date of the founding of the city as 1683, for an account of its importance as a great commercial, industrial, and financial centre, for a review of the great historical events occurring in Philadelphia, and for a description of its points of historic and general interest. We shall, however, as a matter of special interest, give the report of the committee appointed by Hon. John B. Eeyburn, Mayor of Philadelphia, to determine the year of the physical and legal founding of the city. This committee was appointed December 13, 1907, and by means of sub-committees, entered upon a series of researches which included an investiga- tion of the state and municipal archives, and other important sources of information. The general committee recommended to the Mayor that the date, 1701, should be removed from the seal of the city, and if it was thought advisable, 1874 inserted, but at all events that 1701 should be removed. The Mayor recommended to Councils, that proper legislation be passed authorizing the striking from the present seal the date 1701, inserting 1874 as the date of its adoption or leaving it without date. The report of the committee appointed by the Mayor was as follows : — THE REPORT January 11, 1908. To His Honor, John E. Reyburn, Mayor of the City of Philadelphia: Dear Sib: — The undersigned, your committee, appointed December 13, 1907, to determine, as near as may be, the date of the organization of the Government of the City of Philadelphia, beg leave to report as follows: Your committee has had several sessions at .the Historical Society of Pennsylvania where we have had access to all the original documents in the possession of that society, and where we have had also the means of determining original documents in the possession of the Philadelphia Library, the American Philosophical Society, the Archives of the State of Pennsylvania, and the Archives of the City of Philadelphia. From a careful investigation of these original documents we have been enabled to ascertain the following facts concerning the matter referred to this committee: 1. We find that William Penn arrived at the present site of the City Introduction 3 of Philadelphia, from Chester, early in the spring of 1683. He presided at a meeting of the Council of the Province of Pennsylvania at Philadel- phia on March 10, 1683 (10th of First Month, 1682-3). Prior to this time the County of Philadelphia had been formally organized and its officers appointed, and at this meeting the Sheriff of the County of Philadelphia, John Tost, made report to the Council. 2. We find that there was a completely organized Municipal Govern- ment for the City of Philadelphia, with Humphrey Morrey as Mayor, in 1691. This government was created by charter issued by Thomas Lloyd, as Deputy Governor of the Commonwealth, and bearing date Third Month, 20th, 1691. The original of this charter is in the Historical Society of Pennsylvania, and a copy of this charter, together with a photograph of the same, is herewith submitted. (Appendix "A.") At a meeting of the Council, held at Philadelphia, on the 3d of the Sixth Month, 1691, Humphrey Morrey, the Mayor of the City of Philadel- phia, appeared before the Council on behalf of the said city, and moved for the paying out and regulating of the Landing Place at the end of the street near the Blue Anchor Tavern. The original record of this transaction is found in Deed Book "H," No. 7, page 95, in the office of the Recorder of Deeds, Philadelphia, and a copy of the complete minute is herewith appended. (Appendix "B.") There is also in the Archives of the Historical Society of Pennsylvania an agreement attested officially by Humphrey Morrey, Mayor of Philadel- phia, bearing the date 1697. It is, therefore, clearly manifest that a com- plete Municipal Government was in operation as early as 1691. 3. In this charter reference is made to the Borough of Philadelphia, from which it would appear that this borough was created at some date between the coming of Penn and the charter above recited. 4. The real question, then, to be determined is what form of govern- ment existed at Philadelphia for the inhabitants thereof prior to 1691. In answering this question your committee finds that there exist at Harrisburg three (3) distinct seals bearing date as early as 1683, namely: The Seal of the Province of Pennsylvania. The Seal of the County of Philadelphia. The Seal of the City or Borough of Philadelphia. The fact that there was a separate seal for Philadelphia independent of the County Seal and independent of the Seal of the Province would, of course, indicate that there was a separate government for Philadelphia as early as 1683. Through the efforts of Mr. G. W. B. Hicks, Statistician to the Mayor, we have been enabled to secure from the Archives of the State copies of these seals. (Appendix "C") 5. As early as 1683 there was clearly in the mind of William Penn a City of Philadelphia. The evidence of this is found in his letter to the Free Society of Traders, published in London in 1683, and dates at Phila- delphia the 16th of the Sixth Month, call'd August, 1683. In this letter William Penn says : "Philadelphia, the Expectation of those that are con- 4 Founders' Week Memorial Volume cerned in this Province, is at last laid out to the great Content of those here, that are any wayes Interested therein," and as a supplement to the printed letter the Surveyor-General, Thomas Holme, submits "A short advertisement upon the Seituation and Extent of the City of Philadelphia and the ensuing Plat-form thereof." (Appendix "D.") It is manifest, therefore, that both the founder and the Surveyor- General recognized the City of Philadelphia as early as 1683, and began in that year the sale of lots within the City of Philadelphia. For example, William Penn, under date of April 28, 1683, directs Surveyor-General Holme to lay out for Elizabeth Barker a lot in the City of Philadelphia. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for Louis David on the 17th day of the Fourth Month, 1683. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for John Deming on the 28th of the Ninth Month, 1683. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for John Colcpuct Turnor on the 19th of the Sec- ond Month, 1683. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for James Kirell on the 17th of the Eleventh Month, 1683. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for Randall Vernon on the 22d of September, 1683. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for Thomas Kenderlin on the 29th day of August, 1683. William Penn authorized Thomas Holme to survey a lot of ground in the City of Philadelphia for John Kingsman on the 5th day of the Fourth Month, 1683. The originals of these parchments were examined by the Statistician to the Mayor, Mr. G. W. B. Hicks, and Mr. Thomas Lynch Montgomery, State Librarian, in the office of the Secretary of Internal Affairs, Harris- burg. Under date of the 22d of the Ninth Month, 1683, Surveyor-General Holme certifies to the Governor, through his Secretary, that he has laid out according to the Governor's warrant a certain lot in the City of Phila- delphia, purchased by one John Osten. Under date of the 16th of the Third Month, 1683, the Governor directed the Surveyor-General to survey and lay out for one Philip Alford his lot in the City of Philadelphia. Under date of the 28th of the Ninth Month, 1683, the Governor directed the Surveyor-General to survey and lay out for one Thomas Andrews a lot lying and being in the City of Philadelphia. Under date of the 22d of the Ninth Month, 1683, the Governor directed the Surveyor-General to survey and set out for one William Buckman a certain lot in the City of Philadelphia. Under date of the 19th of the Twelfth Month, 1683, the Governor Introduction 5 directed the Surveyor-General to survey and lay out for one Charles Brig- ham a, certain lot in the City of Philadelphia. Under date of the 15th of the Second Month, 1683, the Governor directed the Surveyor-General to survey the lay out for one Jane Blanchard a lot of ground in the City of Philadelphia. Under date of the 21st of the Tenth Month, 1683, the Governor directed the Surveyor-General to survey and lay out unto one Francis Plumsted his lot in the City of Philadelphia. (See Appendix "E.") On the 28th of the First Month, 1684, a bill was read in the Provincial Council, providing for the selection of three (3) members for the Council and six (6) for the Assembly; these members to represent the City of Philadelphia. The bill passes in the affirmative. On the following day the same bill was considered and passed the second reading. It would appear, therefore, that from this date the City of Philadelphia, separate and apart from the County of Philadelphia, had its own representatives both in the Council and in the Assembly. (See Colonial Records, vol i, pages 99-100.) At a meeting of the Council on the 25th of the Sixth Month, 1684, Thomas Lloyd, Thomas Holme, William Haigue were regularly appointed "to draw up a Charter for Philadelphia to be made a Burrough, Consisting of a Majr and six Aldermen, & to call to their Assistance any of ye Coun- cil." (See Colonial Records, vol. i, page 117.) We are led, therefore, to conclude that Philadelphia was formally organized and surveyed as a city early in 1683; that its government was under the direct control of the Provincial Council and its county officers as early as the 23d of the First Month, 1683; that an attempt was made to establish a City Government on the 28th of the First Month, 1684; that a commission was appointed on the 26th of the Fifth Month, 1684, to draw up a Charter with a Borough Government, and that, so far as we know, this form of Government prevailed until the Charter of 1691. From these considerations, together with many collateral evidences to support the same, we believe that the founding of the City of Philadelphia as an official act of its Proprietor dates from 1683, and that its complete Municipal Government dates not later than 1691. The declaration of th» Proprietor, together with the issuing of a seal, would seem to confirm 1683 as the date of the birth of the City of Philadelphia. Your Committee has consulted all the available historical references bearing upon this question, and they submit herewith such extracts from the same as would seem to be of value as corroborative evidence of the con- elusions herein set forth. (See Appendix "E.") The history of Philadelphia is so important within itself and has such far-reaching influence upon the whole history of this great nation that it is impossible to study the beginnings of the City of Philadelphia and it^ development without being brought clearly in contact with the whole his- tory of our national life. Your Committee makes bold to suggest that suitable recognition should be taken of the 225th Anniversary of the birth of our city, to the end that historians and the people at large may come to appreciate more than they have in the past the commanding influence 6 Founders' Week Memorial Volume of the Province of Pennsylvania and the City of Philadelphia upon the his- tory of the development of the United States of America. We desire also to express to you, as the Mayor of the City, our sincere appreciation of your interest in the history of our great city and your desire to establish, as fully as possible, the date of its beginning. We wish also to express our sincere appreciation of the very valuable services of your Statistician, Mr. G. W. B. Hieks, for his invaluable assistance in bringing to our attention important documents bearing upon this important matter. Respectfully submitted, Thomas L. Montgomery, Chairman, State Librarian. John W. Jobdan, Secretary, Librarian of the Historical Society of Pa. Geo. W. B. Hicks, Statistician to the Mayor. John Thomson, Librarian of Free Library of Phila. John Ashhubst, Ass't Librarian of Free Library of Phila. MOKEIS JASTBOW, Jb., Librarian of the University of Penna. W. J. MlLIIGAN, Chief Clerk of Select Council. M. G. Brumbaugh, Superintendent of Public Education. I. Minis Hats, Librarian American Philosophical Society. Geo. Maurice Abbot, Librarian of Library Company of Phila. The organization which resulted from the investigations and recommendation of the original committee appointed by the Mayor was composed of an Executive Committee of fifty representative officials and prominent citizens, the Hon. John B. Eeyburn being chairman and George W. B. Hicks, Secretary. Subordinate to this were nine main committees: Finance, Military, Eeligious, Indus- trial, Historical, Naval Display, Eiver Display, Transportation and Store Decoration. Working under these main committees were eighty-five sub-committees, of which each Chairman reported to the Chairman of his main committee who made his report to the Chair- man of the Executive Committee. The entire membership of the committees numbered eight hundred and ninety-eight. The Historical Committee was composed of one hundred and sixty-six individuals of which eighty were physicians. Dr. John V. Introduction 7 Shoemaker was made chairman of the sub-committee on Scientific Institutions, Medical Colleges and Hospitals which held its first meeting at Room 208, City Hall on March 21, 1908. Twenty rep- resentatives of the principal Scientific Institutions, Medical Colleges and Hospitals of Philadelphia were present. Meetings of this general committee were held at the City Hall on March 21, 27, April 2, 6, 10 and 17, and from it were selected the various sub- committees concerned in the celebration of Pounders' Week, from the Scientific and Medical standpoints. At a meeting of the general committee on Scientific Institu- tions, etc., on September 15th, the chairman, Dr. John V. Shoe- maker, and Mr. G-. W. B. Hicks announced that the Finance Com- mittee of Founders' Week celebration had approved of the appro- priation of $7,500.00 for the expenses of a historical museum exhibit, for those of the committee on Medical Day and for those attending the publication of a memorial volume of the scientific institutions, hospitals and medical schools of Philadelphia. Mr. Hicks stated that he had pleasure in officially informing the Com- mittee that $7,500.00 had been asked for and had received the endorsement of the Finance Committee to meet the expenses they proposed to incur. He also said that he had secured the old Walnut Street Theatre for Medical Day. He desired to say how greatly the Mayor appreciated the sacrifices which the members of the committee had made and the faithful manner in which they had performed their duty. He wished it to be understood that the details of the arrangements were entirely in the hands of this body. The last meeting of the General Committee was held on September 30, 1908, when Dr. L. Webster Pox, the chairman of the committee on Medical Day, reported that all the arrangements for its celebration had been completed and submitted the program, which was adopted. Numer- ous meetings of the Publication Committee were held at the residence of the Chairman, Dr. John V. Shoemaker, during the Spring and Autumn of 1908, of which the most important were those of April 6th, when the Editor was appointed and November 5th, when the contract for printing the Memorial Volume was awarded to the P. A. Davis Company, the lowest bidder. The following is the list of the General Committee and of the sub-committees on Scientific Institutions, Medical Colleges and Hospitals, as furnished by the Secretary, Dr. Prank Woodbury : — 8 Founders' Week Memorial Volume GENERAL COMMITTEE Dr. John V. Shoemaker, Chairman De. Frank Woodbury, Secretary Dr. A. C. Abbott Dr. Charles K. Mills Dr. J. M. Anders Dr. Robert C. Moon Dr. W. Easterly Ashton Dr. E. E. Montgomery Dr. Clarence Bartlett Dr. Joseph Neff Dr. A. P. Bbubaker Dr. E. J. Nolan Pbof. 0. H. Bueritt Dr. F. R. Packard Dr. L. Webstee Fox De. H. F. Page Dr. A. P. Fbancine De. L. P. Posey Dr. Melvin Franklin Prof. Joseph P. Remington Dr. R. M. Goepp Dr. W. L. Rodman Dr. Harriet Hartley Prof. W. D. Sheldon Mr. B. Hevessy Dr. Wharton Sinkler Dr. J. W. Holland Dr. Comly Shoemaker Dr. W. H. Keim Dr. I. Newton Sntvely Prof. H. F. Kellee Dr. M. J. Stern Dr. A. 0. J. Kelly Dr. J. E. Talley Dr. Wilmer Krusen Me. D. M. Test De. Ernest Laplace Dr. James Tyson Capt. E. F. Leipeb Dr. S. Wolfe Dr. Clara Marshall COMMITTEE ON FINANCE, WAYS AND MEANS Dr. H. F. Page, Chairman Dr. M. J. Steen Capt. E. F. Leiper Mr. B. Hevessy Dr. Comly Shoemaker Dr. I. N. Snively Dr. Harriet Hartley COMMITTEE ON PUBLICATION Dr. Charles K. Mills, Chairman Dr. James M. Anders Mr. Joseph Willcox Dr. Edward J. Nolan Dr. Wharton Sinkleb De. Arthur V. Meigs Dr. Samuel D. Risley Dr. A. 0. J. Kelly Dr. Frederick P. Henry, Editor Dr. John V. Shoemaker, ex-officio COMMITTEE ON SOCIETIES. SCIENTIFIC AND MEDICAL JOURNALS Dr. A. 0. J. Kelly, Chairman De. Wilmer Krusen De. C E. de M. Sajous Dr. J. Madison Taylor d b . A. P. Brubaker Introduction 9 COMMITTEE ON CREDENTIALS Dr. J. W. Holland, Chairman Dr. Clara Marshall Dr. W.' L. Rodman Dr. James E. Talley Dr. E. Laplace Dr. J. Gurney Taylor Dr. A. C. Abbott Dr. L. P. Posey COMMITTEE ON HISTORICAL EXHIBIT Prof. Joseph P. Remington, Chairman Dr. L. Webster Fox Dr. R. C. Moon Dr. Clarence Bartlett Prop. H. F. Keller Francis R. Packard Dr. Joseph Nefp Dr. Frank Woodbury Dr. W. Easterly Ashton Mr. D. M. Test Dr. James Tyson Capt. E. R. Landis Dr. E. E. Montgomery COMMITTEE ON MEDICAL DAY Dr. L. Webster Fox, Chairman Dr. E. E. Montgomery Dr. M. Stern Dr. J. M. Taylor Dr. Charles K. Mills The following program of the proceedings of Medical Day at the Walnut Street theatre was carried out with the exception that, at the last moment Dr. S. Solis-Cohen supplied the place of Dr. John C. Da Costa. Dr. Solis-Cohen's remarks were extemporaneous and have never been prepared for publication. This is a matter of much regret, both to the editor and, doubtless, also to all who heard Dr. Solis-Cohen's eloquent speech at the Walnut Street theatre on the eighth of October, 1908. On that day, the historic theatre was well filled with an audience composed, for the most part, of repre- sentative physicians and undergraduates from the different medical schools. 10 Founders' Week Memorial Volume PROGRAM FOR MEDICAL DAY Thursday, October 8, 1908 At Walnut Street Theatre, Ninth and Walnut Streets, Philadelphia Exercises begin at 10 A.M. Report of the Committee on Scientific Institutions, Colleges and Hospitals. ^ ^^ y SHOEMAKER> M D Report of the Committee on and Editor of the Volume of Scientific Institutions, Colleges and Hospitals. ^ ^^ r ^^ M ^ ^ FREDERICK P. HENRY, M.D. Report of the Committee on Historical Exhibit. By JOSEPH P. REMINGTON, Ph.M. Report of the Committee on Medical Day. By L. WEBSTER FOX, M.D. Address — "On the Medical Colleges and Allied Institutes of Philadelphia." By PROFESSOR GEORGE A. PIERSOL, University of Pennsylvania, Address — " On the Great Medical Teachers of Philadelphia." By PROFESSOR S. SOLIS-COHEN, Jefferson Medical College Address — " On the Development of Practical Med- icine in Philadelphia." By PROFESSOR JAMES M. ANDERS, The Medico-Chirurgical College of Philadelphia. Other eminent scientists are expected to be present and address the meeting in commemoration of the 225th Anniversary of the founding of the City of Philadelphia and in celebration of the growth and development of the Scientific Institutions, Colleges and Hospitals of Philadelphia. The medical profession and members of all other scientific bodies and the public are invited to attend the meeting. Visitors are invited to see the Historical Exhibit of relics from the scientific institutions, colleges and hospitals of the city. FRANK WOODBURY, M.D., Secretary. JOHN V. SHOEMAKER, M.D., Chairman. Introduction 1 1 OPENING ADDRESS By the Chairman, Dr. John V. Shoemaker, at the Exercises of Medical Day of Founders' Week, at the Walnut Street Theatre, October 9, 1908 Physicians of Philadelphia, Invited Guests: Ladies and Gentlemen : — By the authority vested in me as Chairman of the Committee on Scientific Institutions, Colleges and Hospitals of the celebration of Founders' Week, I now declare the exercises of Medical Day to be formally opened. I beg to invite your attention to the program, which has been carefully prepared by the Special Committee, of which my col- league, Dr. L. Webster Fox, is Chairman. I think it is only just and proper to state that the successful issue of this meeting is largely due to the ability, energy and enthusiasm of Dr. Fox and his able committee, who will please take this acknowledgment in the place of a formal vote of thanks. Before taking up the regular appointments of the program, let me say a word or two in explanation of the significance of Medical Day. It was acknowledged, early in our preparations for Founders" Week, that the celebration would be glaringly incom- plete without adequate recognition of the important part which Philadelphia has played in the past, and is still playing, in pro- moting education and the advancement of medical science. It was determined, after due consideration, to devote one day entirely to this great topic, and incidentally to the paying of a well-deserved tribute of honor and respect to the memory of those medical worthies who built up the reputation of this City as a great medical center; in fact, as every one knows, it is the great- est medical center in this western hemisphere. You are invited to assist in these exercises. Addresses have been prepared on the "Medical Colleges and Allied Institutions of Philadelphia," "On the Great Hospitals of Philadelphia," and "On the Development of Practical Medicine in Philadelphia," and will be delivered by representative members of the faculties of our three medical schools for men. Apparently there is an omission. K"o representative from the Woman's Medical College is an- nounced to speak on this occasion. By this no intentional disre- spect is intended to this excellent institution. 12 Founders' Week Memorial Volume It would take much more time than we have now at our disposal to tell of the honored career of this great school and its past and present services in the cause of medical education of woman. It is everywhere known and recognized as the standard- bearer of higher medical education, and is one of our institutions of which every Philadelphian may well be proud. I hasten to state, however, that a member of the faculty of the Woman's Medical College, Dr. Frederick P. Henry, has con- sented to be the editor of the Memorial Volume that will be issued by the City authorities to fittingly commemorate the past achievements and present attainments of the medical profession of this City. ' A report from Dr. Charles K. Mills, Chairman of the Com- mittee having in charge the preparation of this volume, in con- junction with Dr. Henry, will be presented for your consideration in a few moments. Professor P. Eemington, of the Philadelphia College of Phar- macy, also will present a report on the "Historical Exhibit." When you have listened to his report, yon will all of one accord promise yourselves the pleasure of a visit to this remarkable his- torical collection, which has been gathered for the occasion by this able and indefatigable committee under Professor Eeming- ton's direction. I have now explained the object of our meeting. Let me now briefly call your attention to the appropriateness of our con- gregating for our historical celebration in this building, which is the oldest theatre in the United States. Originally built for a circus in 1809, it was enlarged and opened as the Olympic Theatre on the first day of January, 1812. Six years later, the building was purchased by an Association, and improvements made under the direction of a Board of Trustees, who placed the enterprise upon a thoroughly secure foundation and insured its ultimate financial success. I ask you to notice that the leader in this movement, who was in fact Chairman of the Board of Trustees, was a well-known Philadelphia physician, Dr. John Eedman Coxe, a grandson and namesake of the Dr. John Redman, who was the first President of the College of Physicians of Philadelphia. Dr. Coxe, as you know, was a member of the staff of the Pennsylvania Hospital, and Professor of Chemistry, and later of Materia Medica and Introduction 13 Pharmacy in the University of Pennsylvania. He was also the editor of the first regularly issued medical periodical in the City of Philadelphia, and the editor and publisher of the first American dispensatory in 1808. He was likewise the author of a standard medical dictionary. He was a living refutation of the celebrated sneering criticism of Sydney Smith, as his books were read and studied in England as well as in America. I will mention a characteristic incident, which will illustrate his medical knowledge and zeal. He was, as you know, an early and earnest advocate of the advantages of vaccination. To demonstrate to his fellow- citizens his faith in its harmlessness and efficiency as a protective against contagion, he vaccinated his own child, then an infant, and subsequently brought him in contact with a case of well- developed small-pox, thus affording a most convincing object- lesson of the security of the foundation of his faith and medical knowledge. This reference to small-pox recalls to my mind the outbreak on the "Welcome" when the Proprietary was on his first voyage to Pennsylvania in September, 1682. About this time of the year, 226 years ago, William Penn and his friend, the Welsh surgeon, Dr. Thomas Wynne, acted as physicians and nurses to their fellow shipmates, who were stricken with the loathsome malady, soon after their departure from Deal on the last day of August. I hesitate to picture the scene upon that small crowded sail- ing vessel of 300 tons, when small-pox broke out among an unpro- tected gTOup of emigrants, without sufficient medical attendance, without experienced nurses, without delicacies for the sick, and with only such remedies as the ship medicine chest could supply. Good Dr. Thomas Wynne, Chirurgeon, however, was the hero of the occasion, and by his skill the epidemic was finally conquered, but of one hundred brave adventurers, who started with Penn to aid in promoting his "Holy Experiment," thirty died of small-pox before the fifty-three days of the voyage were completed. I will not delay the proceedings any longer by reminiscences, however interesting. The first appointment on the program is the report of the Committee on Scientific Institutions, which I now beg to submit. 14 Founders' Week Memorial Volume REPORT OF JOHN V. SHOEMAKER, M.D. The Chairman, Dr. John V. Shoemaker, of the Committee on Scientific Institutions, Medical Colleges and Hospitals, in opening the exercises of the day, first referred to the illustrious medical men who had made Philadelphia famous as a medical centre in the Colonial, Eevolutionary and post-Kevolutionary periods to the present time. He especially dwelt upon the founders of the University of Pennsylvania and of the Jefferson Medical College and of some other institutions such as the Polyclinic and the Medico- Chirurgical College. Continuing his remarks, he spoke in part as follows : — "Anyone who has diligently read the medical history of Phila- delphia and the biographies of the eminent physicians of its early days will find that these were not only physicians, but also members of Councils and of the Legislature, and filled many other important official positions in the Co mm onwealth. Their advice was given on other than medical problems. Their influence was felt in public affairs, especially in times of danger. Both in war and in peace they served their generation well and filled a large place on history's page. The contrast is great between that elder day and this. In many things it is in favor of the present time, but perhaps there has been something lost. If the physicians of the present day should mightily resolve to give as much time to public service as their predecessors, it might come to pass that both the state and the medical profession would be benefited by such practical and patriotic devotion to the common weal. "It has been said that a specialist is a doctor and something more. Why, then, should not a physician make a specialty of serv- ing the state ? If the times, as Hamlet says, are out of joint, who is so fitted to reduce the luxation as the surgeon? If political affairs need purging who can apply the remedy so well as the doctor ? "In conclusion the speaker said that it was now his pleasure, before calling on the orators of the occasion, to introduce the chair- men of the several special committees who would report what had been done by their respective committees and what was expected to be done in the future in connection with the celebration of Founders' Week." Introduction 15 REPORT OF CHARLES K. MILLS, M.D. This day belongs to the orators of the occasion — Drs. Pier- sol, Anders and Solis-Cohen, who will, I have no doubt, instruct and entertain you with addresses which will duly honor this anniversary week. Under the general chairmanship of Dr. Shoemaker, the committee which I have the honor to represent, has been concerned with what I regard as one of the most important ends to be accom- plished during this celebration — the production of a volume which will commemorate the history of the scientific and medical institu- tions and hospitals of Philadelphia. The pageants and parades of Pounders' Week will long live in the memories of those who have had the opportunity of witnessing them. The parents of the future will recall them to their children and grandchildren as the fathers and grandfathers of to-day recall the marching thousands who passed through our city in the days between 1860 and 1864. It will be the part of our committee to prepare a volume which will, in print and in picture, reproduce and perpetuate for future genera- tions a story, not only of this week, but of the many institutions which were commemorated by the celebration. REPORT OF THE EDITOR OF FOUNDERS' WEEK MEMORIAL VOLUME The memorial volume of which I have the honor to be the editor, will require, for its completion, the collaboration of about sixty individuals connected with as many scientific institu- tions, medical colleges and hospitals. If present plans are carried out, it will be one of the most interesting memorials of Pounders' Week. It will show to future generations that the Philadelphia of 1908, while occupying the front rank of scientific research and progress, was not unmindful of its sick and poor, in other words, of all those who, through no fault of their own, were unable to main- tain themselves in the fierce struggle for existence. It will prove that the spirit of altruism, that is, of brotherly love, was dominant in the minds of the Philadelphians of 1908, as it was in the minds of those of 1683. The collaborators in this volume have all expressed not only willingness but eagerness to take part in its production and they have done so, not through hope of reward or fame, but solely be- cause of their interest in the institutions they represent and their 16 Founders' Week Memorial Volume loyalty to this great municipality. I hope their enthusiasm will not flag and that I may soon be supplied with the indispensable "copy." REPORT OF COMMITTEE ON HISTORICAL EXHIBIT Philadelphia is rich in historical associations, and her world- renowned medical schools have collected in their museums veri- table treasures, which have also become valuable illustrative material; for while they serve to educate the students of to-day, they stand primarily as silent reminders of the noble men who now numbered with the "silent majority," have left behind them thousands of specimens testifying to their skill and ability. These collections in the various institutions are open during rounders' Week to the members of the medical profession who are here from all parts of our country. Your committee, soon after its appoint- ment, found that the Historical Loan Industrial Exhibit Committee had sent through the City and State a large number of invitations inviting exhibitors to loan historic objects and this invitation included many objects found in the departments of medicine, chemistry and pharmacy. It was realized that it would be far better to merge the two exhibits and the Historical Loan Industrial Committee cheerfully accepted the proposition and there will be found in City Hall on the fourth floor, ancient medical books, diplomas, historical pharmaceutical books and objects of historic interest from old Philadelphia. THE PENNSYLVANIA HOSPITAL Founded in 1751, entrance on Eighth Street below Spruce, contains a magnificent library of old medical books and a most interesting collection of rare objects bearing on the early medical history of the United States. The Hospital will welcome medical visitors and gladly extends to them the opportunity of viewing its objects of interest. THE COLLEGE OF PHYSICIANS OF PHILADELPHIA Founded in 1787, situated on the northeast corner of Thirteenth and Locust Streets, contains the third largest medical library in the United States, and has a very extensive collection of rare and inter- esting objects connected with the history of medicine, not only in Philadelphia, but throughout the world. It also contains the Introduction 17 famous Mutter collection of anatomical and pathological specimens. The College is open daily from nine until five p. m. and its Librarian, Mr. Charles P. Fisher, will gladly show medical visitors any courtesy in his power. Pharmacy, represented by the oldest college of the kind in America, The Philadelphia College of Pharmacy, is prepared to show her collection. Hahnemann College has a fine collection of antiquities to which your attention is invited. The spirit of hos- pitality and the interest in Pounders' Week manifested by these institutions have added greatly to the pleasure with which your committee invites physicians to accept their invitations. It was believed by the committee that it would be far more interesting to the visitor to see not only the collections found in these institutions, but the institutions themselves. This is particularly the case with the Pennsylvania Hospital, which is crowded with historic associa- tions, and historical objects which can be viewed in connection with their natural surroundings ; in addition to this, it must be remem- bered that while many of the specimens are of interest to physicians, they are hardly suitable for exhibition to the general public. In conclusion, your committee trusts that our visitors and citizens, while enjoying the hospitality of Philadelphia, will find something of interest and profit in attending the exhibitions. Joseph P. Kemington, Ph.M., Chairman. REPORT OF THE COMMITTEE ON MEDICAL DAY Thursday, October 8, 1908 The Committee on Medical Day begs leave to make the fol- lowing report of its work relative to this meeting in the Walnut Street Theatre. The committee has held weekly meetings, and from time to time has reported its progress to the General Medical Committee. Our committee was very fortunate in securing distinguished physi- cians to make memorial addresses. We report, with great pleasure, that the University of Pennsyl- vania is represented by Professor George A. Piersol, whose address will be on "The Medical Colleges and Allied Institutions of Phila- delphia" ; the Jefferson Medical College by Professor Solomon Solis- Cohen who will speak on "Some of the Great Medical Teachers of Philadelphia"; and the Medico-Chirurgical College by Professor 18 Founders' Week Memorial Volume James M. Anders, whose subject is "The Development of Practical Medicine in Philadelphia." The usual routine work of securing the place of meeting, badges for the committee, music, etc., was accomplished by the sub-com- mittee with little difficulty, all concerned contributing their labors with pleasure, and so enabling the committee to complete their program with ease. This committee extends a vote of thanks to Mr. Frank M. Howe, Jr., for the use of the Walnut Street Theatre — the oldest theatre in the United States — for the place of holding these exercises. L. Webstbe Fox, M.D., Chairman. The proceedings of Medical Day at the Walnut Street Theatre were closed by addresses from Drs. Piersol, Solis-Cohen and Anders. As previously stated, Dr. Solis-Cohen's address was extemporaneous, and has never been prepared for puhlication. The addresses of Drs. Piersol and Anders are here appended: THE MEDICAL SCHOOLS AND ALLIED INSTITUTIONS OF PHILADELPHIA By GEORGE A. PIERSOL. M.D.. Sc.D. Professor of Anatomy, University of Pennsylvania Ladies and Gentlemen : — In accordance with the program arranged for this occasion, "The Medical Schools and Allied Institutions of Philadelphia," is the subject upon which I am to speak. This theme, however, is so comprehensive that I shall limit myself to sketching an outline of the most important events in the history of the institutions which have been such momentous factors in establishing and maintaining the prominence of Philadelphia as a centre of medical and kindred science. Prior to the arrival, in 1682, of the good ship "Welcome," bearing Penn and his band of chosen followers, the combined medical resources of the settlements along the Delaware afforded little more than the uncertain skill of the humble barber-surgeons, supplemented by the traditions of the housewife. When we recall the ethical standards and high purpose of the men, who voluntarily exchanged the comforts of civilization for the Introduction 19 hardships of life in a remote continent;, it is no cause for surprise that Penn's colony included many men of superior education and mental attainment. Among these came, either in the van, or in the company of the proprietor himself, a group of physicians whose professional standing at home had been of acknowledged merit, or, indeed, as in a few cases, of distinction. The high standards set by these men, not only as to professional qualifications, but also as to public service, Philadelphia must ever hold in grateful remembrance, for to the influence of these standards she owes, in no small measure, her early rise to distinction as a centre of medical learning. Of the medical companions of Penn, Dr. Griffith Owen was the first well-known practicing physician in Pennsylvania, his efficient skill and warm sympathy winning for him, during five and thirty years, a cordial welcome throughout a wide territory. The year 1717, which marked the death of Owen, witnessed the inauguration of medical instruction that was destined to impress profoundly the future of professional education in America. At this time, Dr. John Kearsley, a talented young Londoner, who six years before had joined Penn's colony, assumed the duties of pre- ceptor and teacher to young Americans desirous of qualifying them- selves for the practice of medicine. The instruction given by Kearsley was of such unusual excellence that he soon found himself surrounded by a group of young men destined for prominence in the early records of their profession in this country. Kearsley's activities, moreover, were not restricted to profes- sional duties, numerous as these were, for he served with distinction as one of the city's representatives in the Assembly, and demon- strated his ability as an architect by the erection of Christ Church. He also submitted plans for the projected State House, later Independence Hall, which, although finally superseded by those of Hamilton, received serious consideration and thus associated the name of this early Philadelphia physician with the edifice that for more than a century and a quarter has been, and for succeeding generations shall be, the Mecca for the world's pilgrims of Liberty. Excellent as was the instruction given by Kearsley, some of his pupils resolved to profit by the best training abroad, and thereby to prepare themselves to assume commanding positions at home, and, in this way, to relieve the colonies from dependence upon the mother country for an adequate supply of competent practitioners. 20 Founders' Week Memorial Volume Fired by such ambitions, Thomas Cadwalader was the first native Pennsylvanian to undertake the long voyage and the con- siderable expense to secure for himself the advantages of medical study abroad. To such good purpose did young Cadwalader improve his opportunities, that when he returned to Philadelphia in 1730, his proficiency in dissection, an accomplishment then rare even in Europe and unknown at home, was utilized in giving demonstrations to his less skillful associates. These efforts claim the distinction of being the first public medical lectures and demonstrations given in America. Among the advances of far-reaching influence on medical education in Philadelphia, were the establishment, in 1731, of the hospital department of the Philadelphia Almshouse, and, twenty years later, the founding of the Pennsylvania Hospital. In 1762, the last named institution was the recipient of a number of anatomical drawings and casts presented by Dr. John Fothergill, of London, through his young friend, Dr. William Ship- pen, Jr. The latter had just returned from the British metropolis, where, as well as in Edinburgh, he had enjoyed the advantages of study and association with some of the most distinguished teachers of his day. During the last years of his sojourn abroad, Shippen had the companionship of Dr. John Morgan, another young Philadelphian bent on acquiring the best professional training that Europe afforded. The conferences of these young men, both anxious to promote and to improve the educational facilities at home, resulted in the establishment of the first medical school in this country. Stimulated by this aim, Shippen proposed to the manager? of the Pennsylvania Hospital, that he give a public course of lectures on anatomy, and, to that end, be allowed the use of the drawings and casts just received from London. This request being favorably considered, Dr. Shippen arranged for his undertaking, and in the Pennsylvania Gazette of Nov. 11, 1762, formally announced a course of anatomical lectures — quoting his words — "for the advantage of young gentlemen now engaged in the study of Physic . . . and also for the entertainment of any gentlemen who may have the curiosity to understand the anatomy of the human frame." By this course Shippen not only supplied needed instruction to Introduction 21 the provincial students, but also paved the way for the more ambitious venture of establishing a medical school. With the return of Morgan to Philadelphia, three years after the inauguration of Shippen's anatomical course, the plan to found a medical school in this city gained an enthusiastic advocate. During his five years abroad, the dream of establishing a medical school worthy of Penn's city had become Morgan's absorbing purpose. To the realization of this ambition, he at once directed his energies, and proposed to the Trustees of the College of Phila- delphia — an institution already in existence for sixteen years — that the scope of its activities should be broadened by the introduction of instruction in medicine. So convincingly did Dr. Morgan plead his cause, that the Trustees approved the proposal and unanimously elected him Professor of the Theory and Practice of Physic. In this way was created, in 1765, the first medical professorship in this country — a chair destined to be associated with names illustrious in the annals of American medicine. Four months later, the Trustees elected Dr. Shippen Professor of Anatomy and Surgery, and in the autumn of the same year, 143 years ago, these two young Philadelpbians had the satisfaction of beginning the first medical lectures in this country given under the auspices of an established institution of learning. Eecognizing the imperative necessity of supplementing didactic teaching by clinical instruction, Dr. Thomas Bond was invited to co-operate with Morgan and Shippen and in December of the follow- ing year the clinical facilities of the Pennsylvania Hospital mate- rially reinforced the lectures given in the infant medical school. June, 1768, brought an occasion of much interest, namely, the conferring of the first medical degrees in this country upon the completion of a prescribed course of study. It should be noted that until 1789, a period of twenty-one years, the degree granted was Bachelor of Physic, and not Doctor of Medicine, the latter title being a subsequent and honorary one conferred only after the expiration of three years and the presentation of a thesis. Disregard of this distinction is responsible for the claim made by the friends of Kings College, the predecessor of Columbia Univer- sity, that to the New York school belongs the distinction of having granted the earliest honors in medicine. As a matter of record, 22 Founders' Week Memorial Volume however, the first graduate in medicine in this country, John Archer, was an alumnus of the College of Philadelphia. During the year which marked the first medical commencement in Philadelphia, a young Pennsylvanian destined to become a con- spicuous figure in the profession of this city, received the degree of Doctor of Medicine from the University of Edinburgh. This was Benjamin Push, then only twenty-three years of age, who, while still a student abroad, aspired to a medical professorship in the Philadelphia school. This ambition was realized when, in 1769, he was elected to the chair of chemistry by the Trustees of the College. The medical faculty, as then constituted, included five teachers : John Morgan, Professor of Theory and Practice of Physic ; William Shippen, Jr., Professor of Anatomy, Surgery and Midwifery; Adam Kuhn, Professor of Materia Medica and Botany; Benjamin Push, Professor of Chemistry, and Thomas Bond, who, although not hold- ing a professorship in the school, was the able exponent of clinical medicine in the wards of the Pennsylvania Hospital. The disturbance and readjustment of social conditions incident to the struggle for independence, could not fail to affect the fortunes of the College and its Medical School. So profound was this impression, that the charter of the College of Philadelphia was abrogated by an Act of Legislature in 1779, its officers removed, and its property transferred to a new institution entitled the Uni- versity of the State of Pennsylvania. When the Trustees of the newly created institution organized a faculty of medicine, they invited the members of the old teaching staff to resume their respective chairs under the auspices of the University. With the exception of Shippen, however, these gentle- men declined this invitation, and not until three years later did Dr. Shippen's old colleagues consent to serve in their former capacities. Notwithstanding this concession and the progress of the new institution, the friends of the old college — and conspicuous among these was Benjamin Franklin — chafed under the injustice of its suppression. Their efforts to secure the repeal of the act were finally crowned with success, and in 1789, ten years after its deposal, the College of Philadelphia was restored to its original powers and possessions. The University of the State of Pennsylvania, however, retained its position — two institutions, the restored College and the Univer- sity, continuing in bitter rivalry during the ensuing three years. Introduction 23 The disadvantage of maintaining two medical schools became so manifest, that the officers of these institutions joined in petitioning the Legislature to bring about an amalgamation. This fusion was effected on September 30, 1791, the resulting institution being designated the University of Pennsylvania. To recount even the more important changes and advances in the Medical School of. the University would carry us far beyond the purpose of this occasion. Time forbids more than mere mention of some of the teachers identified with this venerable school. Among the famous clinicians who have graced the chair of medicine have been Morgan, Eush and Chapman, George B. Wood and Alfred Stille, and William Pepper — than whom no man did more for the cause of medical education. Surgery has had its acknowledged leaders in Physick and Gib- son; in the scholarly Ashhurst and in Agnew, whose dexterity as an operator, force as a teacher, and wisdom as a counsellor, im- pressed all who knew him. Beginning with James, the first incumbent in this country of an independent chair of midwifery, the importance of obstetrics was successfully maintained by Dewees, Hodge and Penrose. The natural association of botany with materia medica early developed a spirit of scientific inquiry in the occupants of this chair. Hence the distinction of Barton and of Carson, to culminate in the genius of Horatio C. Wood, the champion of rational thera- peutics. The institutes of medicine, later physiology, claimed the abilities of Jackson and of Prances Gumey Smith. Chemistry, one of the earliest branches to receive recognition, has been favored by brilliant teachers, among whom were Wood- house, Hare, Bogers and Wormley. Anatomy may well be proud of its representatives. Shippen, Wistar, Physick and Horner in turn added to the efficiency of teaching and to the justly noted museum. The latter is now per- petuated in the Wistar Institute of Anatomy and Biology whose broadened activities and interests have assumed truly national proportions. But the crowning glory of the chair of anatomy was Joseph Leidy whose distinction reflected lustre not only on his alma mater and on this, his native city, but also upon American science, for Leidy's fame as one of the world's great naturalists, spanned an ocean and linked two continents. Societies and institu- 24 Founders' Week Memorial Volume tions of learning abroad joined with those at home to do him honor, and Philadelphia has symbolized her appreciation of his greatness in enduring bronze. In his inaugural address, delivered after his election as Professor of Physic, in the Philadelphia College, Morgan said: "Perhaps this medical institution, the first of its kind in America, may collect a number of young persons of more than ordinary abilities and so improve their knowledge as to spread its reputation to distant parts. It may give birth to other useful institutions of a similar nature, calculated to spread the light of knowledge through the whole American continent." That this prophecy, ventured almost a century and a half ago, has been fulfilled in generous measure, is attested by the achieve- ments of the more than 13,000 graduates of the University Medical School. Eepresenting every civilized nation, these sons of Pennsyl- vania have gone forth to serve humanity, not only throughout the length and breadth of this great land, but also to reclaim from ignorance and superstition lands far remote. During the last few years her medical graduates have dispensed the benefits of modern medicine among a people sorely in need of the physician's skill, and to-day in far off China, the University Canton Medical School is doing noble work in relieving suffering and in educating native students to become qualified practitioners of medicine. The fulfillment of Morgan's prediction, that from the medical department of the College other schools would arise, was inevitable. But not until sixty years had elapsed did a second school of medicine in Philadelphia become a reality. Some years before this event, Dr. Xathaniel Chapman had secured the cooperation of a number of fellow preceptors in giving private pupils the advantage of comprehensive instruction as a supplement to the curriculum of the medical school. In this man- ner, and under the name of "The Medical Institute," was established the first of the extramural courses which became a feature of medical instruction in this city and led to the popular system of "Quizzes." Two years later, in 1820, Dr. Jason Lawrence founded the most enduring of these private enterprises, which, as the Philadelphia Anatomical Rooms, and later, as the Philadelphia School of Anatomy, became famous in the medical annals of this city. About this time, Dr. George McClellan began another lecture course, which was destined to lead to momentous results. Owing to Introduction 25 the unusual ability, tireless energy and striking personality of its founder, an alumnus of the Medical School of the University, the venture was crowned with immediate success, the classes soon over- flowing the original accommodations and compelling removal to more adequate quarters. Encouraged by his continued success and the unusually large number of students in attendance at the University, Dr. McClellan concluded that the time was ripe for the establishment of a new medical school. Eealizing the advantages of association with an established institution of liberal culture, in 1824 Dr. McClellan proposed to the Trustees of the Jefferson College, at Cannonsburg, Pa., the creation of a medical school in Philadelphia. This new department was to be known as the Jefferson Medical College and to form a constituent part of the parent institution. The proposal was accepted by the trustees of the college and four professors were elected. It was not, however, until the follow- ing year, 1825, that the first actual faculty was organized. This staff included: George McClellan, Professor of Surgery; John Bberle, Professor of Theory and Practice of Medicine; Benjamin Ehees, Professor of Materia Medica and Institutes of Medicine; Jacob Green, Professor of Chemistry; Frances Beattie, Professor of Midwifery and Nathan Smith, Professor of Anatomy. The old Tivoli Theatre, on Locust Street below Sixth, was secured as a temporary home for the entering class of 107 students. The year 1838 brought important changes in the status of the school, its independent corporate existence being then assured by a new charter conferring upon the Jefferson Medical College of Philadelphia "the same powers and restrictions as those of the University of Pennsylvania." The ensuing years of this independence, however, witnessed the disintegration of the faculty, even to the withdrawal of the founder of the college, Dr. McClellan, and a complete reorganization of the teaching staff. The year 1841 marked the beginning of a new epoch in the history of the Jefferson College— one remarkable for the true rise and healthy growth of the school and the ability of its faculty. The latter included men who became distinguished, not only in the annals of the College, but also in the history of American medicine. There were: Eobely Dunglison, the learned scholar, the lucid teacher, the accomplished physiologist and the facile writer; Josepn 26 Founders' Week Memorial Volume Pancoast, whose rep^ltation as a brilliant surgeon and skilful anatomist shed distinction on the two chairs— Surgery and Anatomy — which he successively occupied; Eobert Huston, the acceptable exponent of Materia Medica; Thomas D. Mutter, who shared with Pancoast a reputation as one of Philadelphia's greatest surgeons; John K. Mitchell, the zealous investigator, the distinguished clinician and the profound teacher of medicine ; Charles D. Meigs, who brought to the chair of Obstetrics, wisdom and eloquence as a teacher, and learning and culture as an author; and Franklin Bache, whose methodical and conscientious presentation of chemistry comported well with the distinction of being the great grandson of Benjamin Franklin. To the ability and magnetism of this faculty Jefferson owes much of the success which made the decades pre- ceding the civil war so notable in her career. Shortly before the dark days of the early sixties, the chair of Surgery became vacant in consequence of the withdrawal of Miitter, necessitated by his failing health. The Jefferson College was fortunate in the selection of a successor destined to continue the line of eminent teachers who had invested the chair of Surgery with such distinction. The new incumbent, elected in 1856, was Samuel David Gross. In accepting the call to Jefferson, Dr. Gross was returning not only to his native State, for he was a Pennsylvanian, but also to his alma mater from whom he received his diploma in 1828. A truly great surgeon, an enthusiastic teacher, and a learned writer, his fame was international. Among other teachers of note who have added to Jefferson's prestige have been Dickson, the younger Gross, Da Costa, Bartholow, Brinton and Keen, while her now more than 12,000 graduates have carried her fame and influence far and wide on their missions of mercy. The successful establishment of the -Jefferson College en- couraged other attempts to multiply the medical schools of this city. Dr. McClellan repeated his efforts, this time in connection with the Pennsylvania College at Gettysburg, and in 1840 had the satisfaction of launching the Pennsylvania Medical College as the third school in Philadelphia. Six years later a fourth school, the Franklin Medical College, was founded, and in the following year an additional venture, the Philadelphia College of Medicine, completed the quintette. Of Introduction 27 these new schools, the Franklin College survived only two sessions. The other two were more fortunate, since their combined career — fusion between the Pennsylvania and the Philadelphia College having been effected in 1859 — continued for a generation, to succumb finally to the exigencies of the civil war. The multiplication of the medical schools during the decade just noted, no doubt suggested to the supporters of the doctrines of Hahnemann that the time was opportune for the establishment of a school devoted to that cause. Accordingly a charter was secured, and in October, 1848, the Homoeopathic Medical College of Phila- delphia, began its instruction. Its first faculty included William A. Gardner, Matthew Semple, Alvan B. Small, Jacob Jeans, Caleb B. Matthews, Walter Williamson, Francis Sims and Samuel Freedly. After trying vicissitudes, the college lost its identity by con- solidation with a second school, which, meanwhile, has been founded as the Hahnemann Medical College. From the cramped quarters of the ancestral school on Arch Street, where, too, was opened the first homoeopathic dispensary in this city, the Hahnemann College has progressed in a notable degree, and at present enjoys an equip- ment, including a large hospital, commensurate with its importance as the oldest institution of its kind. Its graduates now number almost three thousand and among the members of its former faculties have been many of the leaders of homoeopathy in this country, Constantine Hering, Adolph Lippe, and Charles Raue having been teachers and practitioners of distinction. The increased opportunities for acquiring a medical education, which the middle of the last century brought, not only in Phila- delphia but throughout the country, invited the serious attention of the advocates of a widened sphere of activity for women. Encouraged by the privileges accorded by the Medical College at Geneva, New York, to Elizabeth Blackwell who, in 1848, became the first woman graduate in medicine in this country, women applied for admission to the various medical schools in this city, but with- out success. Being thus excluded from sharing the opportunities accorded to men, with the energy characteristic of American women, they set about enlisting the active support which resulted in founding the Female Medical College of Pennsylvania. This school opened in October, 1850, with a class of forty students and had as its first faculty: A. D. Chalmer, W. W. Dickeson, C. W. Gleason, James 28 Founders' Week Memorial Volume McCloskey and Joseph P. Longshore. At the commencement in December, 1851, the members of the graduating class, composed of eight of the earliest matriculates, won for themselves the distinction of being the first graduates of the first woman's medical college ever established. From the view-point of to-day, accustomed as we are to see women sharing with men so much of the world's work, it is difficult to realize the obstacles overcome by those brave pioneers and their immediate successors. Eidicule, prejudice and lack of confidence met them on almost every side, and only after the years of achieve- ment and high purpose had been patiently wrought by the earnest women who entered medicine, came the tardy recognition of their worth and place in the ranks of their profession. Founded nearly threescore years ago, and, since 1867, known as the Woman's Medical College, the institution virtually established by Dr. Ann Preston and Dr. Elizabeth Cleveland has unfalteringly sought the high ideals advocated by the women of its early faculties. To-day it enjoys the well-earned reputation of being the first of the colleges devoted to preparing women for medicine by reason not only of priority, but also of achievement. No further important addition to the medical schools of Philadelphia was made until the spring of 1881, when the Medico- Chirurgical College inaugurated its first regular session. Although not assuming the functions of a medical school until the time just mentioned, this institution was founded in 1849, the first decades of its existence being devoted, as set forth in its constitution, to "the dissemination of medical knowledge, the defense of the rights and the preservation of the repute and dignity of the medical pro- fession." It was, consequently, a "college" in the sense of a scientific body, and not in that of a medical school. Eighteen years later, Dr. George P. Oliver, secured a modifica- tion of the charter, whereby the Medico-Chirurgical College was empowered to exercise all the rights of a medical school. The first teaching faculty included : George P. Oliver, George E. Stubbs, Charles L. Mitchell, William F. Wangh, Abraham S. Gerhard, William S. Stewart and Frank 0. Nagel. " The first five years in the modest quarters at Broad and Market Streets— years not without vicissitudes and discouragement — were succeeded by a period of rapid growth. Then, joining with the Philadelphia Dental College, extensive property was acquired and a Introduction 29 new era in the development of the school attained. The remarkable strides which the last decades have witnessed are familiar to all. Admirable buildings and equipment, a great hospital, and a faculty composed of enthusiastic and accomplished teachers, are realities of which the Medico-Chirurgical College may well be proud. Notwithstanding the unsurpassed facilities which Philadelphia offered to students seeking a general medical education, it became evident that additional opportunities could be provided for physi- cians, who desired more detailed instruction in the specialties than that legitimately included within the scope of the college curriculum. To meet this need, a new venture was undertaken, and, in 1883, a post-graduate school— the Philadelphia Polyclinic and College for Graduates in Medicine— was established. Prom the modest dis- pensary opened at Thirteenth and Locust Streets to the thoroughly appointed hospital on Lombard Street, is a long advance — an advance, moreover, which attests the success crowning a quarter century of conscientious work by conscientious teachers. To mention the men who have served on the professorial staff of the Polyclinic, would be to name most of Philadelphia's specialists during a generation. The hundreds of physicians who have gathered from near and far to avail themselves of the advantages here offered, are adequate endorsement of its success. Convinced that among those engaged in winning a livelihood were men and women desirous and capable of becoming worthy practitioners of medicine, the Temple University of this city recently established a medical school to meet these conditions. The imperative demand for adequate training of everyone who assumes the duties of a medical career has been recognized and provision has been made to meet such requirements. The handicap of outside duty is to be overcome by a logically ordered curriculum embracing, for the present at least, day and evening hours, the complete course extending over a correspondingly lengthened term of years. The rapidly growing equipment and increasing facilities secured during the six years of its existence, and the standards demanded of its students, give assurance that the Temple School will not be unmind- ful of the exactions of the medical profession in its anxiety to extend a helping hand to "the strong men and women who can labor with both mind and body." The combined output of the medical schools of this city, from the first alumnus of the College of Philadelphia to the present, 30 Founders' Week Memorial Volume numbers approximately 35,000 graduates— a vast army of earnest men and women, whose sendees to humanity are beyond compute. "By their fruits ye shall know them!" and by the excellence of these fruits Philadelphia's medical schools have won the renown spanning more than a century! Turning to the institutions of Philadelphia closely allied to her medical schools, our attention is directed, naturally, to the colleges devoted to that important specialty of medicine — dentistry. Educa- tion in this field, so far as colleges were concerned, began relatively late, since not until three quarters of a century after the pioneer medical student matriculated, did the first dental school open its doors. It must not be supposed, however, that competent practitioners of dentistry were wanting prior to the establishment of these institutions, for such was not the case. On the contrary, even during the earliest days of the Eepublic, Philadelphia had the services of some skilful specialists, notably those educated in Prance. In passing, it may be mentioned that George Washington, with commendable patriotism, availed himself of native talent, and in the museum of the first American dental college reposes the set of artificial teeth, carved in ivory by the first American dentist, for the first President of the United States. It was not until 1840, that the long contemplated founding of a dental school was actually accomplished, and then by Horace H. Hayden, who, ably seconded by Chapin A. Harris, organized the Baltimore College of Dental Surgery. This was not only the first dental school in America, but also the pioneer school of the world. Philadelphia, therefore, cannot claim in dentistry, as she does in medicine, precedence in providing systematic instruction. Indeed, it was not until the Baltimore school had existed for a decade, that a charter was obtained for the first Pennsylvania school. The latter, known as the Philadelphia College of Dental Surgery, began its work in 1852. Owing to disagreements with the Board of Corporators, the faculty organized a new institution, and in 1856 the Pennsylvania College of Dental Surgery began its career — virtually in con- tinuation of the old school. During the fifty years and more that have elapsed since its establishment, the Pennsylvania College has persevered in elevating Introduction 31 the standards of both practical and theoretical instruction, and among the men identified with the school as teachers have been many who have risen to professional distinction. The session of 1867 and 1868 was notable as marking the admission of the first woman matriculate in Philadelphia — the second in the United States. Among its three thousand alumni, the hundred and more women graduates of the Pennsylvania College have done much to demonstrate the possibilities of dentistry as a successful profession for women. The gratifying progress made by the early school, encouraged the founding of another in this city, and in 1863 the Philadelphia Dental College had its birth. The early years, full of uncertainty and burden, were carried to success by the sacrifices and devotion of the faculty, so that by the end of its first decade the college was firmly established. On reaching the quarter-century mark, the school entered into an agreement with the Medico-Chirurgical Col- lege for the erection of buildings for joint occupancy. This affilia- tion terminated some years later, when the dental school disposed of its interests to its cotenant and erected buildings for its own use. For the forty-five years which have elapsed since the founding of the Philadelphia College, its graduates number about 2,500 and include many who have now high honors in their professional call- ing. The school has recently entered upon a new epoch in its history, having joined forces with the Temple College, whose dental department the school has now become. An event of much consequence to dental education occurred in 1878, when the University of Pennsylvania determined to add a department of dentistry to its professional schools. To this end, an invitation was extended to the Pennsylvania College of Dental Surgery to unite with the University as its dental department. This proposition was not accepted by the College, and, consequently, a new dental school was organized by the University. Three members of the faculty of the Pennsylvania College, however, accepted chairs in the University school, while the pro- fessors of anatomy, chemistry, physiology and materia medica in the medical school became, ex-officio, the occupants of the corres- ponding chairs in the dental department. The close relations thus established between the two departments gave assurance that in the new school the same high standards would prevail, which had earned for the medical department an international reputation. 32 Founders' Week Memorial Volume That this promise has been fulfilled, and that this fulfilment has been appreciated, is attested by the character and achievements of the 2,300 graduates who have received their diplomas from the school and who have represented every civilized nation of the world. The autumn of 1897 brought the establishment of the youngest of Philadelphia's dental schools, as the dental department of the Medico-Chirurgical College. The equipment of this institution included so many of the facilities requisite for the condition of a modern dental school, that this expansion of its sphere of instruc- tion was most natural. With the addition of four professorships to cover the branches pertaining particularly to the specialty, the chairs of anatomy, chemistry and physiology of the medical department completed the first dental faculty. With each succeeding year, the school has augmented its teaching staff and improved its course of instruction, so that the beginning of its second decade finds the dental depart- ment of the Medico-Chirurgical College occupying a recognized posi- tion among the successful institutions of its kind. The bequest of the late Dr. Thomas W. Evans, an honorary alumnus of the first dental college of this city, is about to add to Philadelphia's already noted dental educational equipment. In complying with the conditions of this trust, it is to be hoped that the new Evans' Dental Institute will not be an unnecessary duplica- tion of existing facilities, but by a judicious plan will be enabled to supply opportunities lor supplementary study and original investigation, which lie somewhat beyond the province of the usual curriculum. Philadelphia may justly be proud of her dental schools and their more than 8,000 alumni. These graduates have carried her fame as a centre of dental education throughout all lands, and everywhere command recognition as practitioners unexcelled in skill and accomplishment. Enough has been said concerning the early leaders of the medical profession in Philadelphia to stamp them as men in active sympathy with every movement undertaken for the advancement of the education and welfare of the colonies. It is not surprising, therefore, that the membership of the earliest scientific societies claimed many prominent physicians. This was notably true of the American Philosophical Society. In Introduction 33 fact, the suggestion to form a society for the encouragement of all branches of science seems to have come to its founder, Benjamin Franklin, from Dr. Cadwalader Colden. Acting upon this suggestion, in 1743, Franklin effected the organization of the Philosophical Society, prominent among whose nine original members two, Thomas and Phineas Bond, were physicians. A few years later, in 1750, a second body, the Ameri- can Society for Promoting and Propagating Useful Knowledge, came into existence. The interest of the medical profession in this society was shown by the number of prominent doctors on its roll, Morgan, Cadwalader, Eedman, Kuhn and Shippen being among its active supporters. After a decade and a half, these two societies wisely joined forces, the resultant being the American Philosophical Society for Promoting Useful Knowledge. Not only in the personnel, but also in the deliberations of this society, medicine occupied a conspicuous place, and in its transactions are to be found many notable con- tributions to early American medical literature. Among the dis- tinguished men who have served as presidents during the 140 years of its career, six have been eminent physicians — Wistar, Chapman, Patterson, Baehe, George B. Wood, and Keen. The Catholicism of its interests has been maintained and the scientific program of the Society's annual meeting includes communications pertaining to almost every branch of knowledge. Some years after the formation of the early medical societies, Dr. Benjamin Bush determined to carry into effect his plans for the organization of a deliberative body which should include the city's foremost practitioners. In this manner was founded, in 1787, the College of Physicians, whose object, as set forth in the constitution, was "to advance the science of medicine and thereby to lessen human misery." To review the activities of this institution, venerable in years but young in spirit, would be to recount the development of Ameri- can medicine, for every important advance in the understanding and treatment of disease has been laid before its Fellows. The acquisition of a medical library was one of the earliest ambitions of the College. The first donation of books was made by John Morgan, the founder of the pioneer medical school. The growth of the library, however, was extremely slow ; so slow, indeed, that in 1836, 291 volumes represented the accumulation of over 34 Founders' Week Memorial Volume forty years! Even in 1863, when the College took possession of its building at Thirteenth and Locust Streets, the collection amounted to only 4,500 volumes. Since then, owing to donations, bequests and benefactions of Fellows of the College, the growth of the library has been remarkable, the number of volumes at the present time exceeding 84,000. Prom the modest nucleus of a generation ago, the library of the College has expanded until now it surpasses, in importance of its contents, all other collections of medical works in this country, with the single exception of the library in the Surgeon-General's office in Washington. Housed successively in the old Academy, the hall of the Philosophical Society, the "picture house" on the grounds of the Pennsylvania Hospital, and its present building, the College anticipates with satisfaction the coming occupancy of its new home in course of erection. Mindful of the inestimable service which its treasures have been, the College has the assurance that its splendid library and rich museum, in their adequate setting, will stimulate to new achievements in medical literature. During the one hundred and twenty years of its existence, the College of Physicians has stood close watch over the medical needs of this city, and, as occasion arose, has lent the weight of its advice to urge the adoption of measures necessary to protect the welfare of this community, and, at times indeed, of the nation. Nor was it only by the exercise of its advisory function, that the College has earned the gratitude of the people of this city; for, ever since those terrible closing years of the eighteenth century, when Phila- delphia was swept by the devastating scourge of pestilence, when Benjamin Push and his colleagues heroically ministered to the sick and the dying, have the Fellows of the College responded to the cry of a stricken city! The high ideals which dominated the professional activities of Dr. John Morgan soon led this far-seeing Philadelphia physician to urge the substitution of the services of the experienced apothecary for the uncertain skill of the practitioner in compounding his prescriptions. The evident advantages of such an arrangement, whereby the physician was relieved of a burden and the patient provided with medicines prepared with greater skill, for a time made slow progress against the combined influence of tradition and prejudice. With the increasing demand for the services of com- Introduction 35 petent apothecaries, however, came the recognition of the necessity of more systematic instruction for those assuming such duties. The initiative was taken in 1816 by Dr. James Mease, who delivered the introductory to his lectures on pharmacy under the auspices of the University of Pennsylvania. Five years later, upon the recommendation of the Medical Faculty, the University resolved to establish the degree of master of pharmacy and at the com- mencement, April, 1821, this degree was conferred upon sixteen pharmacists, who, by reason of their qualifications, were regarded as worthy of the distinction. It was further stipulated, however, that future candidates for the degree must have attended at least two courses of lectures on chemistry, materia medica and pharmacy in the University. This effort to improve the conditions of pharmacy by system- atic scientific instruction was viewed by the druggists of this city with disfavor and as an attempt to regulate their affairs. It awakened, however, a determination to meet the urgent demand for closer supervision of their trade and better preparation of pharmacists, by providing the needed control and training under the immediate auspices of the druggists themselves. Accordingly, in February, 1825, a meeting was held in Carpen- ter's Hall and a committee was appointed. The latter recommended the formation of a college of apothecaries and, in connection there- with, a school of pharmacy. In March of the ensuing year, a charter was obtained which established the corporate existence of the Phila- delphia College of Pharmacy and thus added to the list of institu- tions of this city which have assumed national importance. Mr. Charles Marshall, long identified with the drug business of this city, was the first president of the college, a capacity in which he served, however, for less than three years, as advancing age led to his resignation. In December, 1823, he was succeeded by Mr. William Lehman. The instruction in the school began with a professional staff of two — Dr. Gerard Troost in chemistry and Dr. Samuel Jackson in materia medica. Dr. Troost held his chair for only one year and was succeeded by Dr. George B. Wood, who thus became identified with the College of Pharmacy as one of its earliest professors. The intimate relations between the College of Pharmacy and the medical profession of this city are indicated by the personnel 36 Founders' Week Memorial Volume of its past faculties. In addition to Drs. Jackson and Wood, Dr. Franklin Baehe and Dr. Joseph Carson, after serving the college, occupied with distinction, professorships in the leading medical schools. Then, too, for over half a century, members of its faculties have taken an active and important part in the revisions of the United States Pharmacopoeia, and to their efficient aid has been due, in no small measure, the continued and recognized excellence of this national work. At first located on Seventh Street above Chestnut, then on Filbert Street above Seventh, in 1867 the College of Pharmacy acquired its present situation on Tenth Street near Arch. Here its property has expanded, until at present the college possesses a group of buildings, containing lecture halls, thoroughly equipped laboratories and an extensive museum, commensurate with its wide activities. The latter have not been restricted to the preparation of students, for early in the history of the college steps were taken to promote the interests of pharmacy and to advance its scientific progress by the publication of a journal. In 1825 the American Journal of Pharmacy was established, under the direction of the faculty of the College of Pharmacy. This journal is not only the oldest periodical devoted to pharmacy, in the English language, but by reason of its high scientific character, is accorded merited recognition as an authority of international standing. Among the hundreds of graduates of the College of Pharmacy, the oldest institution of its kind in this countn^, many have taken foremost rank in their profession as members of faculties of other colleges throughout this country, while others have become identified with extensive interests as manufacturing pharmacists and chemists. Medicine being but a phase of biology, from time immemorial, physicians have found congenial study in the natural sciences. The rich and resplendent flora of our country attracted the early colonial practitioners, not only on account of its inherent botanical interest, but also for its possible importance to medicine. Although self-taught in materia medica and physic, the genius of John Bartram carried his fame as the first American botanist to such heights, that the great Linnaeus declared him to be "the greatest natural botanist in the world." Those of us who have wandered through the old gardens on the bank of the Schuylkill, and paused to read the inscription carved by Bartram's hand over Introduction 37 the quaint window, must have glimpsed the consecration of a life to the study of Nature. Another enthusiastic pioneer in exploring the treasures of flora and fauna of the western continent was Benjamin Barton, one of the early professors in the University Medical School. His contributions to botany and natural history won for him an inter- national reputation and an enduring place among America's early naturalists. The Academy of Natural Sciences, a Philadelphia institution of world-wide renown, recognizes as its founder, John Speakman, whose sincere but untutored taste for science led him to propose the formation of a society for mutual instruction in the subjects of natural history. When organized by the first election of officers, in 1812, the members of the society numbered eight ; so that after the necessary depletion of the ranks to supply a president, two vice-presidents, a treasurer, a controller, a conservator and a secretary — seven in all — only one member remained without official honors. The president, the secretary and the residuum were doctors of medicine, and thus emphasized the interest of physicians in the infant academy. From small beginnings — a limited collection of dried plants, a few stuffed birds, a few shells and insects and some mounted crystals and a dozen books — slowly, but surely, grew the museum and library. The members early determined to enlist the sympathy of the public by stimulating the innate interest in Nature, and, to that end, inaugurated a series of lectures under the auspices of the Academy, including the first popular course on botany given in this city. The collections increased so rapidly, that in 1815 they were removed to the remodelled church property at Twelfth and Locust Streets; while fourteen years later the pressing need for space led to the acquisition of the building at Broad and Sansom. This edifice and its subsequent additions served as the home of the academy for nearly forty years, during which period the museum was recognized as one of Philadelphia's notable attractions. Centennial year found the Academy once more migrating westward, this time to take possession of the newly erected wing of what has become its present extensive quarters. During these changes in domicile, the museum expanded enormously, and to-day the Academy points with pardonable pride 38 Founders' Week Memorial Volume to its great collections, which in not a few departments— notably birds, reptiles, insects and mollusks — are of foremost rank. Its library is one of the great storehouses of science and of priceless value to the investigator. When we recall that among the many prominent scientists identified with the Academy have been : Samuel G. Morton, Wood- house, Caspar Wistar, Horner, Isaac Lea, Say, Conrad, Euschen- berger, Harrison Allen, Edward D. Cope and Joseph Leidy, it is evident why the Academy of Natural Sciences acquired an inter- national importance. Other agents actively engaged in stimulating an interest in nature-study, and in awakening a desire to understand something of the great world of Life, are the Wagner Free Institute of Science, the Zoological Society, and the Biological School of the University. The growing appreciation of the desirability of such instruction, encourages the hope that the day is not far distant when, in all grades of our educational system, the natural sciences will find their place. Enough has been said, even in this incomplete review, to emphasize the traditions and character of the Medical Schools and Allied Institutions of this city, and to substantiate their claims to lasting recognition. True to the ideals of high purpose set by her founder, Phila- delphia has cherished her institutions of learning, and through them has afforded facilities for professional education of the highest excellence. The tens of thousands who have won the diplomas of her medical schools, and the thousands who have gone out from her dental colleges, have carried Philadelphia's fame to the remote corners of the earth. Their achievements are her glory ; and in the accorded recognition of their services to humanity she shares. Amidst the busy life of the practitioner come the recollection of the traditions of his alma mater and the realization of the debt which he owes to those early defenders of Truth and Freedom, who made possible the advantages which he has enjoyed. And with that recollection comes the grateful veneration of Philadelphia, not only as the Cradle of Liberty, but also as the Birth-place of American Medicine ! Introduction 39 THE DEVELOPMENT OF PRACTICAL MEDICINE IN PHILADELPHIA By JAMES M. ANDERS, M.D., LL.D. The courteous invitation to deliver an address on the develop- ment of practical medicine in Philadelphia, was wisely coupled with the request to omit any extended reference to the medical schools, since this aspect of the general subject has been, as this presence has been made aware, assigned to one of my predecessors on this occasion. In celebrating Pounders' Week, it seems meet that due recognition should be given the medical profession for it has always been to the fore in the progress of civilization. In attempting to unfold the history of practical medicine in Philadelphia, I can only chronicle the principal events and refer to certain men who have shaped its development and destiny. We of the present day and generation must, upon reflection, feel devoutly thankful to the founders of medical science in Philadelphia — to Kearsley, Cadwalader, the Bonds, the elder Shippen, Morgan, Jones, Rush, Gerhard and many others; their enterprise was not guided and assisted by well-equipped laboratories and overfilled hospital wards, yet these pioneers, and I should include a host of co-workers, who cannot be named for want of space, have rendered incalculable services to both their profession and the general public. The story of the rise and progress of medicine in Philadelphia possesses a distinct and lively interest of its own; and it is inti- mately associated with the developmental history of our city and our State, in fact, of the entire country. The relation of medicine to public health from the earliest colonial days will be recognized from the statement of the fact that the first medical publication in North America was entitled, "Brief Rule to Guide the Common People of New England ; how to order themselves and theirs in the Smallpox or Measles." This was pub- lished in 1667, and was written by Thomas Thatcher, a clergyman, who also practiced medicine in Boston. The earliest settlements in Pennsylvania were made by the Swedes and the Dutch, and the first representative of the medical profession, so far as is known, was Jan Petersen, a barber of Alfendolft, who was surgeon to one of the Swedish colonies on the Delaware at a salary of ten guilders a month, beginning July 10, 1638. 40 Founders' Week Memorial Volume The late Dr. Stille, of Philadelphia, at one time Provost of the University of Pennsylvania, was a descendant of Olaf Person Stille, who it is believed, was one of the colonists of 1638. Probably the first practicing physician in Pennsylvania was John Goodson, of London, who came over as surgeon to the Society of Free Traders shortly before Penn's visit. With the exception of John Goodson and Dr. Nicholas Moore, a member of the same body, the barber surgeon prevailed prior to the coming of Penn in 1682. The Swedes were a simple people, but the colony brought by Penn was made up of the best of British skill. To the standard set by the Welsh Quaker doctors who accompanied the colonists, is largely due the advanced professional position taken by Philadel- phia in its incipiency. So high was the medical profession in the esteem of the Quakers that it seemed natural that the members thereof should occupy prominent positions and become leaders in the early colonial government. In those days the public were less dependent on physicians in cases of ordinary illness, than they are to-day, their chief need being in surgical and difficult obstetrical cases. People were prone to self-medication to a great extent, not, however, in the modern sense, using plants and herbs, often wild, or cultivated, because of their medicinal properties. Even in a greater degree than is true of sparsely settled districts to-day, the people were familiar with common vegetation and its medicinal virtues. Much of this knowledge was acquired from the Indians. In Xorris's Garden, in Philadelphia, many of these plants were grown, and it was an annual custom of the ladies of the family to distribute them among the poor and needy. The first physician of real note in Pennsylvania was Griffith Owen, a Welshman, who, with Dr. Thomas Wynne, came over on the ''Welcome," with Penn. The first amputation performed in Pennsylvania of which any record exists, was done by Griffith Owen, the pioneer. Thomas Wynne never actively followed his profes- sion, but he later became judge of the principal Supreme Court, and also was elected president of the first assembly which was held in Philadelphia. The next physician of eminence to settle here was Dr. John Kearsley, who arrived in 1711 from London. He not only acquired an extensive practice, but was an extremely active rep- Introduction 41 resentative of Philadelphia in the House of Assembly, and served as preceptor for a number of youths, who were ambitious to study medicine. So important were his efforts in this direction that he has been said to have conducted the first American medical college, though, as is well-known, Lambert Wilson, in 1629, and Giles Firmin, in 1632, both acted as preceptors and taught medicine in Massachusetts. Kearsley was, besides, possessed of architectural ability, and two monuments, still standing, attest his skill in this direction: Independence Hall and Christ Church, though with the former of these, Andrew Hamilton had much to do and practically super- intended the building. Two other notable contemporaries were Dr. Thomas Graeme, the first man to occupy a position analogous to that of port physician, and John Bartram, the first American botanist, and founder of the Botanical Garden on the Schuylkill, now known as Bartram's Garden. Bartram built the first greenhouse in Philadelphia, founded the Linnsean Society and the Philadelphia Medical and Physical Journal, and he was the first to teach the natural sciences in America. In 1699, the city suffered an epidemic of yellow fever, and about 220 deaths occurred. In the following year, when Philadel- phia had about 700 houses in the neighborhood of the Delaware wharf, the first quarantine law was passed. It was as quarantine physician that Dr. Thomas Graeme served the city more or less constantly during forty years. During the next decade, a number of men destined to fame in the annals of Philadelphia medicine, rose slowly above the horizon. Some of these had been apprentices of John Kearsley, others occasional attendants at his lectures, and several, although later, went abroad to amplify their medical knowledge. Lloyd Zachary was one of the earliest of these. After three years of European study, he returned to Philadelphia, and later served as port physician with Dr. Graeme, but it is especially with Dr. Phineas Bond that he will be recalled, in that they made it possible, by volunteering gratuitous service, to bring into formation the plans suggested by Dr. Thomas Bond to Franklin, namely: The active establishment of the Pennsylvania Hospital. Con- temporary with the above was Dr. Thomas Cadwalader, the first native son of Pennsylvania to receive his medical education abroad, 42 Founders' Week Memorial Volume for Zachary was bom in Boston, though later identified with Philadelphia. Cadwalader returned to Philadelphia in 1730, when only 23 years of age, and rapidly made for himself a widespread reputation as a dissector and teacher of anatomy. He was one of the first in America to make a necropsy for scientific purposes, and published the earliest medical work in the province and one of the earliest in America, an article dealing with lead poisoning, due to the drink- ing of punch made from Jamaica rum, which had been distilled in leaden vessels. Influenced by Franklin's experiments in the study of elec- tricity, Cadwalader was the first American physician to employ electricity in the treatment of disease — a case of paralysis. He became a trustee and clinical lecturer in the first medical school and founded one of the earliest medical libraries (1763), and one of the earliest medical societies in the country (1765). He was made the first vice-president of the American Philosophical Society, an organization founded by Franklin at the suggestion of Dr. Cad- walader Colden, and the first acting president during the absence of Franklin in 1767. There was scarcely an important event in his day, medical or civic, in which he did not participate. Cadwalader was one of a brilliant coterie of Philadelphia physicians with Zachary, the elder Shippen and the Bonds, famous not alone for their medical and surgical skill and the part they took in the various activities of the growing city, but even more because they mark a distinct epoch. Prior to their time, their predecessors had worked individually and their knowledge and influence died with them, at least, in large part, but with the advent of these men, collective efforts were made with the result that a number of institutions begun by them, many being still in existence, made it possible for them to put medical teaching on a more secure basis through the aid of school, library and hospital. To Dr. Thomas Bond, credit is due for the first record of lithotomy in America. It was performed by him at the Pennsyl- vania Hospital in 1756. He was a fairly frequent contributor to various medical journals and was credited by Franklin as the originator of the idea of establishing a hospital, now known as the Pennsylvania Hospital. The elder Shippen, born in this city in 1712, was profoundly Introduction 43 influenced by the work and teaching of Thomas Bond under whom he studied anatomy, and appreciating his own lack of foreign training, decided to give his son every advantage. He was also a member of the Continental Congress, Trustee of the College of Philadelphia, Vice-President of the American Philosophical So- ciety, and one of the founders of Princeton College, then known as the College of New Jersey. Wm. Shippen, Jr., born in Philadelphia, October 21, 1736, was educated at the College of New Jersey, now Princeton Univer- sity, and subsequently took up medicine under his father. Three years later he went to London where he studied anatomy with the Hunters and Wm. Hewson, and obstetrics under McKenzie. From London he went to Edinburgh and fell under the influence of Cullen and the younger Munro. He then spent some time in Paris, and after five years abroad, returned to Philadelphia in May, 1762, when he began to teach anatomy and obstetrics; he was probably the first in America to teach obstetrics. Prior to 1790, midwifery was almost solely practiced by women, except in difficult cases. The most famous of the Philadelphia midwives was Lydia Darrach, a noted Revolutionary Whig, who occupied the celebrated Loxley House. Shippen was certainly the pioneer in advocating systematic medical school education, rather than the apprentice system then in vogue. Dr. Shippen experienced much trouble at first, owing to the objection on the part of the public, to his receiving human bodies for dissection, and many acts of violence were threatened, but no serious damage was done, though an attempt was made to destroy his house. Then too, it was not considered proper for men to conduct midwifery cases and it required some time to overcome prejudice and opposition in this direction. For a year he gave these courses to private students only, but in the spring of 1763, he offered to give a course under the auspices of the Pennsylvania Hospital, for which students paid a fee, for the benefit of the institution. It is meet that we should, with Dr. Shippen, consider the career of his most intimate contemporary, Dr. Morgan, also a Philadelphian, who was born in 1705. Morgan attended the same preparatory school as Shippen, but afterward entered the College of Philadelphia (later the University of Pennsylvania) and graduated with its first class. After spending five or six years with Dr. Redman, he became for one year the apothecary to the Pennsyl- 44 Founders' Week Memorial Volume vania Hospital. He then spent four years as a military surgeon, and was one of the first in the country to serve in this capacity. The next five years he spent in Europe, going first to London, where he studied anatomy with the Hunters and Hewson, and perfected himself in the art of making anatomical preparations by corrosion, which he later introduced on the continent. Dr. Morgan then went to Edinburgh, and there received his doctorate in medicine. His inaugural dissertation was on suppuration and in this he advanced the view that pus is a secretion from the vessels, thus anticipating Hunter. In Edinburgh he acquired much valuable knowledge relative to teaching and the establishment of medical schools, which later enabled him to leave his impress for all time on the system of medical education in America. From Edinburgh he went to France, Italy and Switzerland. His correspondence is replete with reference to'Cullen, the Monros, Voltaire, Morgagni, Senac and various members of the royal house- holds. On his return to London, he wrote to Cullen (for whom he seems to have formed a deep attachment), under date of November 10, 1764, mentioning his views relative to founding a teaching school in America, of which he promised more would be heard later. Truly prophetic, his confidence in the ultimate success of his plans, which were still indefinite, is shown by the fact that he prepared his inaugural address upon the subject while still abroad and took counsel of many men whose advice he considered valuable. On his return to America, early in 1765, he at once set about perfecting his plans, and submitted a petition to the Trustees of the College of Philadelphia. This board consisted of twenty-four members, five of whom were members of the staff of the Pennsyl- vania Hospital, viz., Drs. Thomas and Phineas Bond, Cadwalader, Eedman and the elder Shippen. On May 3d, Morgan was elected by them, Professor of the Theory and Practice of Physics. A member of the first class to graduate from the institution, he thus became the first professor in the first medical school to be estab- lished on the western continent. He had recognized the futility of the individual or preceptor- ship system, hitherto in vogue, and while Thomas Bond was the first to recognize the advantages of the institution method and the first to found a hospital in the modern sense, it was reserved for Morgan to advance an important step further and to found the first school in America devoted to the teaching of medicine. In his Introduction 45 opening address, he said among other things "that private schemes of propagating knowledge are unstable in their nature and that the cultivation of useful learning can only be effectually promoted under those who are patrons of science and under the authority and direction of men incorporated for the improvement of literature." Morgan at once took a firm stand relative to the division between medicine and surgery. He felt that they required entirely different types of men, and he said he would be strictly a physician, attempting neither the work of the surgeon nor the apothecary. In those days each physician had his own office pharmacy, and it was considered a radical innovation when Morgan insisted on sending his patients to an apothecary shop for their medicines. Moreover, it was due largely to his teaching and influence that America early recognized the special work of the surgeon and took an advanced position in surgery. As I have said, the earliest physicians were all foreigners, usually well educated and well trained men, but ere long, by an apprentice system, native sons were inducted into the mysteries of the healing art. During all this period, history presents a remark- able paucity of differences among the guild. As time went on, however, and need for more thorough training was recognized, cor- porate effort supplanted individualistic and with it, entered jealous- ies and strife. The first note of discord, though not a very strident one, was struck when Wm. Shippen, Jr., who, in accepting a professorship in the new school, mildly contended for priority in recommending the establishing of such an institution, and later became actively antagonistic to Morgan when he was director general of the army. The almost necessarily inchoate system prevailing in the early ranks of the continental army, the ignorant or possibly wilful abuse of money and power, the jealousy among those in less exalted positions than that of the director general, all these influences engendered bitter contentions between many of the army surgeons, increased the difficulties under which Washington labored, and in large measure, for a time at least, rendered nugatory the work of the medical service, and more than this, it jeopardized the lives of .thousands of men entrusted to their care. Dr. Benjamin Church was the first director general of the hospital department; he appointed four surgeons, but differences arose almost immediately and an investigation was about to be 46 Founders' Week Memorial Volume made, when Church was court-martialed for having carried on a cipher correspondence with the enemy. He was at first imprisoned and later dismissed. Church was succeeded by Dr. John Morgan, although some two months prior, Dr. Samuel Stringer, of Maryland, whose education had been received in Philadelphia, was created Director of the Hospital and Physician for the Northern Department under General Schuyler. He felt his position to be equal to that of Morgan's, and that engendered friction. As new departments were added, friction increased, which was accentuated by the appoint- ment of Dr. William Shippen, Jr., as Director of the Hospitals in Xew Jersey. The times were trying, not alone for the hospital service, but for the army as well, especially during the disastrous years of 1776 and 1777. Shippen's strictures and the attitude of Stringer, resulted in the dismissal from the service in January, 1777, of both Morgan and Stringer. Shortly after, Dr. Shippen became director general of the entire medical service and Dr. Benjamin Rush, Surgeon General of the Middle Army service. Control of the medical serv- ice of the army was almost solely in the hands of Philadelphia men ; hence the history of the Revolutionary period is actually concurrent with that of the history of practical medicine in Philadelphia. This was especially true during the period when sick soldiers were quartered in Philadelphia, some in the Pennsj^lvania Hospital (at the suggestion of Dr. Thomas Bond), and many more in the "Bettering House," and scattered private dwelling houses. The mortality was dreadful and bodies were literally piled into Potter's field, now Washington Square. Smallpox and so-called putrid fever, the result of filth and crowding (probably typhus fever) were responsible for most of these deaths. In the fall of 177 7, the British took possession of the city, and for some months quartered their sick in the Pennsylvania Hospital and the Almshouse ("Bettering House"). A list of Philadelphia physicians who rendered service at various times during this war, would, as stated, practically be an epitome of the profession in this city at that time. Whilst no detailed statement of the injuries and diseases treated is extant, so far as I know (owing doubtless to the lack of system and the strenuous character of the work), Dr. Benjamin Rush has left a record of some of the points of special interest. One Introduction 47 observation in particular is worthy of comment here as it has a present bearing and it was also noted by Murchison in his great work on the continued fevers of Great Britain, i.e., the frequent sudden deaths among those convalescing, or even apparently con- valescent, from continued fevers, when they arose from bed for any purpose. During the closing period of the war, the atmosphere of Philadelphia gradually became more peaceful, the college, hospitals, and new medical schools were reorganized, and younger men took the places of those earlier native sons who were now either dead or too old to resume work. There were at this time about fifty physicians to a population of approximately 40,000, situated between the Delaware river, and Sixth and Pine and Vine Streets. Of these, it will be well for us to consider more in detail those who in any way, served to make the history of Philadelphia medicine and some of whom were responsible for institutional and practical measures which are with us to-day. One of them who attracted attention early in his career was Samuel Powell Griffith, a Quaker, who was born in Philadel- phia in 1759. He was educated in the College of Philadelphia and its medical school, later spending three years in Europe. It was to him that Push suggested the founding of the College of Physicians along the lines of the Eoyal College of Physicians in London, and later Griffith became one of the founders and was vice-president at the time of his death in 1826. At the suggestion of Dr. Henry Moyer, Griffith aided in founding the Philadelphia Dispensary in 1786, the first institution of its kind in America, and now located at 125 South Fifth Street. Almost without a break, Griffith continued in daily attendance for over forty years. He was also one of the founders of the Friends' Asylum in Frankford, Philadelphia, and at the early age of thirty years, was appointed Professor of Materia Medica and Pharmacy in the Medical School. Griffith was one of sixteen members of the American Philosophical Society, and he likewise rendered valuable service during various epidemics of yellow fever in Philadelphia. The history of practical medicine would be incomplete without brief reference to the various yellow fever epidemics, which have occurred; for apart from the heroism displayed by the physicians in the performance of their duties, both the municipal hospital system and the health board administration then sprung into existence. 48 Founders' Week Memorial Volume The first great epidemic occurred in 1699, when about 220 persons died out of a total population of approximately 2,000. Outbreaks occurred also in 1741, 1747 and 1762, the latter having been described by Dr. John Eedman. It began at Front and Pine Streets in some tenement houses, supposedly from a case imported from Havana, and Eedman treated eighteen to twenty cases daily during the scourge. The next and most appalling epidemic occurred in 1793, the city being now nearly four times larger than in 1762, there being about 50,000 inhabitants and 56 doctors. The first case occurred early in August and by the third week of that month, 150 victims had been claimed. The populace took fright and an exodus from the city resulted, leaving it practically prostrate. On account of the large number of cases, the guardians of the poor rented a circus tent, the incipiency of our Municipal Hospital, but public clamor was so great that threats to burn it were openly made. More room being needed, the Wm. Hamilton Mansion on Bush Hill, in the old Fairmount district, was appropriated, but it was so dreaded that few entered until well-advanced in the disease, which explains in part, at least, the dreadful mortality there. In September, 1793, Stephen Girard and Peter Helm assumed the management of Bush Hill, and aided by Drs. Deveze and Benjamin Duffield, with three resident physicians, helped to restore confidence. Dr. Benjamin Push, in his account of the epidemic, says that at one period there were about 6,000 cases in the city, and only three physicians who were well enough to go out and attend the sick. Scarcely any of the doctors practicing in Phila- delphia escaped and within a few weeks, ten of their number and many students died of the disease. Push himself was among the stricken. In short, not less than 5,000, or ten per cent, of the entire population, died. Surely, contemplation of such fearful decimation should awake in us a sense of obligation for the com- parative immunity we enjoy to-day, the result of the labors of a few self-sacrificing physicians. Unfortunately, in the epidemic of 1793, considerable dissen- sion arose among the physicians as to the nature and treatment of the disease, and the newspapers commenting thereon, served to create a distrust among the people which tended to increase the distress. Push in his advocacy of bleeding and purging, divided the profession into two camps. He was so severely satirized by Introduction 49 Wm. Cobbett, who characterized him as "the modern Sangrado," that he brought and won a suit against Cobbett. The proceeds he divided among the poor. The opinions of Eush were widely accepted by the public, but by a minority of his fellow practitioners, and this led to his resignation from the College of Physicians, an institution which he had conceived and had helped to found. The latter body which probably had its inception in 1786, soon became a power in the community and by 1793, the year of publication of its first volume of transactions, it had done such splendid work and so specially had its members studied the cause and character of the epidemic, that it was appealed to by the Governor, in 1794, for suggestions as to the best method of safeguarding the public health. The formation of a body resulted, later known as the Board of Health. It had charge of the marine and city hospital service, the latter referring cases to Bush Hill, the former to the Lazaretto. In 1797, another considerable epidemic of yellow fever occurred, and a more extensive one in 1798, when about 4,000 persons died, while still another prevailed in 1799 with a loss of nearly 1,300 souls. Other outbreaks followed, although none as serious as those cited, but it is probable that they engendered a widespread fear, for so seriously was the trade of Philadelphia crippled, that the com- mercial supremacy, hitherto enjoyed, was lost and New York then took precedence. Benjamin Eush, born in Byberry, in 1745, is conceded to have been the greatest physician of his day, and one of the greatest this country has ever produced — the Sydenham of America as Lettsom styled him. He was descended from English stock, his great grand- father, John Eush, having been an officer in Cromwell's army. Benjamin's father died when the boy was six years old, and he was reared and educated by an uncle, Eev. Samuel Finlej r , who at that time was head of an academy in Nottingham, Maryland, and a minister in a local church, but later became the head of the College of New Jersey (now Princeton College). Eush obtained a splendid classical training, graduating from Princeton before he was sixteen, so that he was able later to trans- late the works of great medical writers, both Latin and Greek, with facility. After spending six years with Dr. John Eedman, he went abroad and two years later received the medical degree in Edinburgh, where he studied under Cullen. He continued his 50 Founders' Week Memorial Volume post-graduate studies for about two years in London and Paris, and then returned to Philadelphia, where he became Professor of Chemistry in the school founded by Morgan ( 1769) . About twenty- two years later, he became Professor of the Institute of Medicine and six years afterward, he succeeded Dr. Kuhn, as Professor of the Theory and Practice of Medicine. Dr. Push was an acknowledged leader in medicine at home, and membership in many foreign societies was conferred upon him ; also many degrees, and his advice was sought in Europe as well as by his own countrymen. He was one of the founders of Dickinson College, a friend and advocate of the black man, Treasurer of the Mint, an essayist, not only in medicine but in other lines, an investigator, orator, a scholar, statesman, philosopher, scientist, a teacher and a Christian gentleman. He was active in the political affairs of his day, and as is everywhere known, was one of the signers of the Declaration of Independence. While still a student in Scotland, Push prevailed upon Dr. Witherspoon of Paisley, a Scotch Presbyterian divine, to accept the post he had once declined, namely, the Presidency of Princeton College. After a life of almost unparalleled activity and usefulness, he died in 1813, aged 66 years. Among the pupils of Rush were many men who added lustre to the reputation of Philadelphia as a medical centre, notably, Dr. Thomas Woodhouse, who occupied the chair of Chemistry at the University of Pennsylvania for fourteen years, and Dr. Phillip Syng Physick, who has been called the Father of American Surgery. Mention should also be made of Dr. John Redman Coxe, the founder of Medical Journalism in America, and the first subject to be successfully vaccinated in Philadelphia, and whose son was in turn successfully vaccinated when two weeks old. It has been already noted that Shippen early taught obstetrics in Philadelphia, but the first man to place that subject on its proper plane was Dr. Thomas C. James, who was the first professor of obstetrics, and one of the founders of the Historical Society of Pennsylvania. To James belongs the credit of first opening lying- in wards in the Pennsylvania and Philadelphia Hospitals. A man of great prominence, just past his meridian, when Rush died, was Dr. Caspar Wistar. His anatomical specimens and models used in teaching, form the nucleus of the present Wistar museum of the University of Pennsylvania. He it was who Introduction 51 originated the now famous Saturday evening Wistar parties. In 1811, he published a work on anatomy, one of the first medical text-books in America. In the earliest history of medicine in Philadelphia, and throughout the country for over a century, it was only possible to study medicine under preceptors on the apprenticeship plan, unless one had the means to go abroad. This method continued to exist for many years after Morgan founded his school and from this originated our modern quizzing system, and the development of other schools. Dr. Nathaniel Chapman was the first to depart from this plan, and associated with him other teachers (e. g., Hodge, Jackson, Dewees, J. K. Mitchell) to form a so-called quiz associa- tion, each teaching the subject with which he was the most familiar. Dr. Chapman afterward became the successor of Eush in the chair of practice at the University, but it was the founding of his Institute, rather than his University connection, that brought him the distinction which he later enjoyed. In 1820 he founded the first permanent medical journal in America, the Philadelphia Journal of the Medical and Physical Sciences, now known as the American Journal of the Medical Sciences. Until the first quarter of the nineteenth century, there were numerous cuppers, bleeders and leeches in Philadelphia, many of them members of the barber's guild. With the advance of medical knowledge, their number proportionate to the increasing population, steadily diminished. After the demise of Eush, a group of men came to the front, some of them (already referred to), former pupils of Eush, and, as knowledge grew and the tendency toward specialism increased, the supreme dominance of the individual ceased for all time, and collective effort, which had its origin with Morgan and his asso- ciates, now became the rule. This must be borne in mind in considering the further history of practical medicine in Philadel- phia during the end of the eighteenth and the first half of the nineteenth century, for it explains the multiplication of schools and private institutions for the dissemination of medical knowledge. Then, too, factors prevailed not entirely foreign to our latter day institutions, although always most regrettable, viz., internal dissen- sions. These were at times the direct cause of fission, new bodies resulting. 52 Founders' Week Memorial Volume Among the men who were famous in the history of practical medicine in Philadelphia during the early part of the nineteenth century were: Dr. William P. Dewees, whose text-book on mid- wifery gave him world-wide recognition; Dr. William E. Horner, the noted anatomist and dissector, who published a text-book on anatomy and whose models now form part of the Wistar and Hor- ner collection at the University of Pennsylvania; Dr. William Gibson, who succeeded Physick in the chair of Surgery, performed two successful Cassarean sections on the same subject, wrote a surgi- cal treatise, and whose collection of morbid specimens used in teaching were famous; Dr. Eobert Hare, the inventor of the oxy- hydrogen blow-pipe, who made many discoveries and inventions in electricity and chemistry and Dr. George B. Wood, a graduate of the College and Medical School of the University of Pennsylvania, and later professor in that institution for 25 years. One of his greatest labors was, with Bache of the Jefferson faculty, the publication of the United States Dispensatory. It is worthy of note that his lec- tures on materia medica were illustrated whenever possible, by living specimens of plants grown in his own garden and conservatory, although a cabinet of mineral and crude specimens of drugs was also maintained for teaching purposes. He was an indefatigable worker and a prolific writer, and his works on practice of medicine and therapeutics and pharmacology enjoyed an extremely wide circula- tion. He succeeded Chapman in the chair of Practice in the University of Pennsylvania. Three additional names belong to this category, and first that of Dr. Hugh L. Hodge, a colleague of Wood's, who for a time taught anatomy and surgery, but was forced to give them up owing to increasingly poor vision. He then took up obstetrics and his book on that subject, as well as his forceps and pessary, brought him great prominence. Dr. Samuel Jackson is deserving of special mention, as he was the first to introduce the methods of the French School, particularly those of Laennec, Louis and Broussais, in this country. He was a graduate of both the College and Medical Departments of the University of Pennsylvania, and with Gibson and Horner had served in the war of 1812. Jackson was an active sanitarian, and became president of the Board of Health in 1820. He passed through an epidemic of yellow fever, and it is interesting to note that he taught that the disease was not contagious. Introduction 53 Jackson, with Gerhard and Pennoek, served as physicians of the Almshouse, where they introduced the (at that time) newer methods of physical diagnosis, namely, auscultation and percussion, and where they put into practice the newer methods of the French School. He may be said to have introduced the subject of path- ology into American medicine. His work published in 1832, "Principles of Medicine founded on the Structure and Functions of the Animal Organism," was the first of its kind published in America. Dr. William W. Gerhard, an assistant of Jackson's, was one of a coterie of men in Philadelphia who were advised by Jackson to go to Paris to study under the masters there, as were also Stille and Pennoek. As a result of his work with Louis, whose book on typhoid fever was published in 1826, he was later enabled to fortify the teachings of Louis as to the separate entity of typhoid and typhus fevers, and the first clearly to differentiate them. This was in 1836. Gerhard was the greatest exponent of scientific medicine of his time, especially of pathology, and in 1838 with Xorris, Pennoek, Stille, Goddard, Pepper, Mutter, Carson and others, he founded the first Pathological Society of Philadelphia. The present Pathological Society was organized in 1857, the first meeting being held in the old "picture house" of the Pennsylvania Hospital, where Dr. Wm. Osier delivered the address on the occasion of the fiftieth anniversary last year. In those days hospitals, which have contributed so much to the advancement of the practical side of medicine during the last half century, did not exist in connection with teaching schools, yet the necessity for some form of bedside instruction was clearly recognized. Here, reference should be made to other men, who left their impress upon the history of practical medicine in Philadelphia : to Dr. Geo. McClellan, the founder of Jefferson Medical College; to Revere, son of Paul Eevere, of Revolutionary fame; to Robley Dunglison, born in England, 1798, who, at 26 years of age, came to America, and was invited by Thomas Jefferson to enter the faculty of the University of Virginia, and who, in spite of the compre- hensive task of teaching six branches of medicine, published a work on human physiology, a medical dictionary, and after being called to the University of Maryland, a work on therapeutics, and was later (in 1856), called to the chair of Institutes of Medicine in 54 Founders' Week Memorial Volume Jefferson Medical College, which he occupied for 32 years; to Dr. Ann Preston (the first woman to occupy a chair in a Woman's Medical College), who reorganized the Woman's Medical College of Philadelphia, and to whom is mainly due the credit for the position which it soon took and has since maintained; and finally to Dr. George P. Oliver for his pioneer work in organizing the Medico- Chirurgical College. In addition, mushroom institutions of unsavory reputation had been permitted to spring into existence, and tended to check and restrain the progress and development of sound practical medicine. Unfortunately, the extremely loose and dangerous system then in vogue, was not confined to this city or State, but prevailed prac- tically all over the country. Nor was it solely to be met with in matters medical. Charles Dickens has immortalized this period in Martin Chuzzlewit, in portraying the experiences of Martin, Jr., and Mark Tapley during their visit to America. The rapid multiplication of medical schools, the low standard and the short course requisite for the degree, served to invite a measure of opprobrium that was only too apparent to those who were given to reflection, and these conditions were directly respon- sible for the origin of the American Medical Association, which was designed as a moral uplift to bring about a better state of medical ethics in the land. Originating with the State Medical Society of New York, in 1844, Dr. N. S. Davis urged a National Convention for the consideration of these problems. The first meeting was held in New York, in 1846, and the only Philadelphia School to join in the movement was the Medical Department of the Pennsylvania College, the more recent of the two schools founded by Dr. George McClellan. In the following year, representatives of 28 medical colleges and 40 medical societies assembled in Philadelphia. A report on medical ethics was submitted, and a plea for higher educational requirements was made to the Colleges. Dr. Nathaniel Chapman of the University of Pennsylvania was the first president, Dr. Alfred Stille one of the two secretaries, and Dr. Isaac Hays, treasurer. All of these men, be it observed, were Philadelphians. One of the results of this effort was to stimulate the local profession to better things, and another, the organization of the Philadelphia County Medical Society, an institution which has been a potent agency in forwarding both the theory and practice of Introduction 55 medicine in Philadelphia. Here should be pointed out the fact that the medical profession is indebted to a Philadelphia physician for having first proposed the branch idea (since adopted in other large cities), in connection with county medical societies, — I refer to Dr. A. M. Eaton. The University of Pennsylvania made an earnest attempt to increase the length of its term and raise its standard, but none of the other schools followed. Competition being keen, the added expense to the student as a result of a lengthened term made that institution fearful of a diminishing student body, and the old order of things was resumed. Prior to that period, the medical school of the University of Pennsylvania ranked equally with its prototype, the University of Edinburgh. And whilst the medical schools multiplied and irregular and private schools were organized, Philadelphia remained the centre of medical education, and took precedence also in issuing text-books, many of world-wide note, and in medical journalism, as well as in the formation of medical and scientific organizations. Among the men of prominence who helped to make the history of American Medicine, none were more famous than those who formed the faculty of Jefferson College during the fourth, fifth and sixth decades of the last century. The greatest of these was Dr. Joseph Pancoast, whose teaching of surgery was as brilliant as his operative work, and whose book, "Treatise on Operative Surgery," passed through many editions. Another surgeon of wide repute was Dr. Thomas D. Mutter, whose industry is only partly revealed by the splendid collection made by him, now in the Museum in the College of Physicians of this city. This remarkable group also included the following: Dr. John Kearsley Mitchell, father of S. Weir Mitchell, a southerner, who became one of the most famous chemists of his time. He it was who discovered the solvent for caoutchouc, and he was the first to solidify carbonic acid gas. He was a scholarly man, and unusually attractive as a lecturer. Dr. Mitchell was of a speculative type, and adumbrated many of the facts now well-known, as for instance, the particular causes of disease, the germ theory, in fact. He was a man of rare intuition and keen insight, possessed of a large measure of sympathy, and many stories are told about his relation to indigent students, and those who, for any reason, were in trouble. 56 Founders' Week Memorial Volume Dr. Charles D. Meigs, whose work on obstetrics and translation of Velpeau's work, brought him considerable recognition, was a linguist of marked ability, and in addition to the publication of many medical treatises, founded the North American Medical and Surgical Journal. Dr. Franklin Bache, great grandson of Benjamin Franklin, served as regimental surgeon in the War of 1812. Later he became professor in the College of Pharmacy, and later still was called to the chair of Chemistry in Jefferson. Though he wrote much, he will always be best remembered for his colossal work with George B. Wood, the United States Dispensatory and the National Phar- macopoeia with Hewson and Wood. Another writer still better known as an editor, was Dr. Isaac Hays, the founder of some of the most famous journals this country has produced. In 1826, he became associated with Dr. Chapman in editing the journal founded by Chapman in 1820, then known as the Philadelphia Journal of the Medical and Physical Sciences. Hays shortly after assumed sole charge and changed the name to the American Journal of the Medical Sciences, now edited by Dr. A. 0. J. Kelly. In 1843, he founded the Medical News and Library, a monthly, which later became a weekly publication, and a few years since, with the Philadelphia Medical Journal, was merged with the New York Medical Journal. It will be recalled that, with the opening of hostilities during the Civil War, all the regular medical schools ceased to exist, except two, the Medical Department of the University of Pennsylvania and Jefferson Medical College. These institutions were greatly depleted by the withdrawal of the large number of southern students, hitherto pursuing the study of medicine in Philadelphia. The Female Medical College, as it was then called, did not, however, suspend for long, and the contumely suffered by the noble and earnest women connected with the earlier career of this school, the attitude of the general profession toward the male members of its faculty, and the long, uphill battle for recognition, all serve to give a special interest to this institution. In the fall of 1858, the Philadelphia County Medical Society refused to recognize female physicians officially. During many years both county and State societies refused to admit women prac- titioners to membership, and but few men in Philadelphia would consult with them. Their ultimate victory in city, State and Introduction 57 national organizations, though hard fought, was deservedly suc- cessful, and the high character of their work, as medical practi- tioners, is too well-known to need further notice. Among the medical men of that period, and a little later, who brought about the principal practical advances, were the following : The Sogers, father and two sons, who were all eminent chemists. The father, Dr. Patrick K. Rogers, succeeded Dr. Hare in the William and Mary College of Virginia, when Hare was called to the University of Pennsylvania, and curiously enough, the two sons, some years later, successively succeeded to the chair of Dr. Hare at the University of Pennsylvania. One of them, James B., published an excellent text-book, and was one of the pioneers in teaching pathologic and physiologic chemistry. The brother, Eobert E., became a famous toxicologist, and his work on the method of refining silver at the United States Mint, led to practical reform. Dr. Joseph Leidy, the world-famous naturalist, needs no introduction for we affectionately claim him as of our generation, although as early as 1S53, he succeeded to the chair of anatomy in the University of Pennsylvania, made famous by Drs. Shippen, Wistar, Physick and Horner. He died in 1891 after an active career of 38 years with the University, and the city has recognized the great value of his many discoveries by erecting a statue to him on the City Hall plaza. From boyhood, he evinced an unusual fondness for the study of natural history, and later he developed a remarkable talent for drawing. After a year or two, as an apothe- cary's assistant, at seventeen he began the study of medicine with Dr. McClintock, but later entered the University of Pennsylvania, graduating in 1844. Drs. Horner and Wood on separate occasions, took him to Europe with them to assist in the preparation of models and the making of drawings, to be used for teaching purposes. His con- tributions to scientific literature were many, as he was at one time, an anatomist, a botanist, zoologist, geologist and comparative anatomist. He only practised medicine for a short time, and often referred to the fact humorously in his lectures, saying that he never considered himself cut out for a doctor. He served for three years as pathologist to the Satterlee Hospital during the Civil War. Probably his greatest work, certainly one fraught with the greatest possible good to humanity was his discovery, in 1847, of the intermediate host of the trichina, namely, the hog. 58 Founders' Week Memorial Volume Encapsulated trichina had been observed in human flesh, but it remained for Leidy to show that man became infected by eating flesh of infected hogs. Some years later, however, the disease was first recognized clinically by Zenker, a German. Leidy was called to various institutions, but he preferred to remain with his alma mater, teaching anatomy in the medical school, and as head of the biological department, though he became professor of natural history at Swarthmore College, and taught biology at the Wagner Free Institute of Science. Dr. D. Hayes Agnew's work is too well-known to the present generation to require more than passing mention. He was a great surgeon, a great teacher of anatomy, and later of surgery, a con- tributor to medical journals, and an author; during the Civil War, he served in several military hospitals as surgeon. He came prominently before the general public, when, in 1881, he was called to consult those in charge of President Garfield, after he had been shot by Guiteau. In 1868, he was one of the founders of the Orthopedic Hospital. Dr. Francis Gurney Smith, a student and disciple of the French School of Medicine, defeated Brown-Sequard for the chair of Physiology in the University of Pennsylvania. At the same time, he developed a large general practice, and served on the staff of a number of hospitals, and also at the military hospitals during the war. It is said of him that he introduced hypodermic medica- tion in Philadelphia. Dr. Alfred Stille, already spoken of as a descendant, on his father's side, of one of the first Swedish settlers, became a power in medical affairs in Philadelphia, was at the head of the University of Pennsylvania Medical School, and beside translating a work from the French, was a contributor to journals and an author of text- books of wide repute. He, too, became one of the staff of Satterlee Hospital during the war. Another name which looms large in the scroll of fame is that of Dr. S. D. Gross, unquestionably the greatest surgeon ever to serve his alma mater, Jefferson College, and one of the greatest this country has ever produced. Since his demise, he has been honored by the erection of a national statue, a unique distinction. He was a voluminous writer and translator, held teaching positions in several colleges in various states, before going to Jefferson College, and his splendid knowledge of pathology was of inestimable value, both in Introduction 59 his practical work and teaching. He founded and edited the North American Medico-Chirurgical Review, issued a work on military surgery, and later in life, another on general surgery ; he founded the Academy of Surgery of Philadelphia, in 1879, and the American Surgical Association in 1880. The old pathological society founded by Gerhard, has been referred to, and also a more recent one, and it was this latter that was organized in 1857 by Drs. S. D. Gross and J. M. DaCosta. In 1876, he was chosen president of the Inter- national Medical Congress, which met that year in Philadelphia. His son, Dr. S. W. Gross, who died prematurely, was also a surgeon of note, a capital teacher of surgery, and the author of a work on tumors of the breast. Another surgeon of note was Dr. Washington L. Atlee, whose early work as an ovariotomist was so frowned upon by many of his own profession that he was practically ostracized, and on the part of the laity, open threats of violence and public demonstrations were made against him. During the Civil War, Philadelphia as an army medical centre, was second only to that of Washington, D. C, throughout the States, and Satterlee, the largest of all military hospitals, was situated here, at about what is now Forty-fourth and Osage Avenue, West Philadelphia. It should be pointed out that the first organization of women as nurses for the military hospitals took place in Philadelphia in 1861, and was known as the Philadel- phia Nurses' Corps. The history of the development of practical medicine in Philadelphia should include some reference to those whose work has added lustre to our own day. To be sure, in stepping from the hallowed dimness of the past into the bright light of the present, our mental vision suffers, and try, as we will, we are unable to get the true perspective of the work of those who are, or have but recently been, with us. One of the strongest men in medicine in Philadelphia, was the late Dr. William Pepper. Of good birth, the son of a former professor at the University of Pennsylvania, of ample means and well educated, he employed to the full all these advantages. Possessed of tremendous energy, a truly remarkable capacity for work, splendid executive ability and an unusual knowledge of men, opportunity for the exercise of these qualities was given when he became Provost of the University of Pennsylvania, succeeding Dr. 60 Founders' Week Memorial Volume Stille. Probably his greatest claim to recognition lies in his untir- ing efforts for a higher standard in medicine in this country. As Provost of the University of Pennsylvania, he succeeded in raising large sums of money, and by deed and purchase, procured large tracts of land and erected many buildings. He still found time to attend to a large general and consultation practice, to teach medi- cine at the University, and to deliver public addresses, as well as to participate in many civic activities. Working well into the night, rising early each morning, he would literally catch his meals as opportunity presented, usually taking breakfast in his office, opening his mail, dictating to a stenographer, and seeing patients all at the same time. It is not at all surprising that such a man should have come to his death soon after passing the meridian of life, but it was not before he had left a permanent impression on medicine, not alone in his city, but by his many excellent published works, and through the school with which he had been so long connected, on the entire country. Another well-known and popular member of the local pro- fession, and one who enjoyed well merited distinctions was the late Dr. Wm. H. Pancoast, the son of Joseph Pancoast, whom he succeeded in the chair of Anatomy at Jefferson Medical College. He was well bred, cultured, a profound anatomist and a skilful surgeon. No man adhered more rigidly to a high ethical standard and none was better graced or more distinguished for kindness of heart and genuine hospitality than he. One of his chief claims to distinction was the leading role he so untiringly played in the reorganization and subsequent development of the Medico-Chi- rurgical College and Hospital, of which institution he was also the president for ten years. Mention should be made in this connection of Dr. J. M. Da Costa, who died in recent years (1900), at the age of 67 years, after a life full of various activities. He may be justly regarded as one of the pioneers in clinical medicine from our present stand- point, and certainly one of its greatest exponents in this country. He was a small man of kindly mien, unostentatious pertinacity, a great teacher, and one of the great men of Jefferson faculty during many years; a marvelously acute diagnostician with a tremendous experience in private and hospital work, a frequent contributor to medical journals, and an author of international repute. His con- tributions to our knowledge of cardiac derangements are classic, Introduction 61 and few books have enjoyed wider popularity than his work on diagnosis. Frederick Packard was another clinician of note. He died about five years ago, before reaching the apogee of his powers. He was a most lovable man, of fine presence, a thorough student and well trained, both in laboratory and clinical work. His wards at the Pennsylvania and Philadelphia Hospitals gave him a rich field upon which to draw, and he utilized his opportunities as few men do. Another man of promise was Dr. J. Dutton Steele, but recently removed from us. His death which came as a shock to all, was due to miliary tuberculosis. Though comparatively young in the ranks, he had worked assiduously, and to him is largely due the popular- ization of some of the newer German laboratory methods among our American confreres. It remains for us to speak of the work of a few men, happily still in the flesh, who have contributed mightily to the development of practical medicine, not only in Philadelphia, but throughout the world. Of these, I would make prominent mention of Drs. S. Weir Mitchell and Wm. Osier. Nor are they famed alone for their purely scientific work, since both are noted authors; Mitchell, as poet and novelist, upon whom has fallen the mantle of Oliver Wendell Holmes, and whose work, especially that dealing with the colonial period, borrows special interest at this time. Osier, on the other hand, may be justly compared with John Brown, his non- medical writing having been largely that of an essayist. Mitchell's work on snake venom was a splendid contribution, but it is his knowledge of practical nervous disorders and their treatment that has made him most famous. Who not only among the profession, but also among the laity, has not heard of the rest cure? As to Osier, there is scarcely a subject in the domain of internal medicine that has not been illumined by his masterly work; and not only was he remarkably fertile, but he succeeded, while a resident of Philadelphia and subsequently at Johns Hopkins, in gathering about him a coterie of young and earnest workers, who, feeling his stimulus, have greatly added to medical lore. Two additional names deserve a prominent place here, namely, that of Dr. Horatio C. Wood, the author of our modern system of rational, scientific therapeutics, and that of Dr. W. W. Keen who was one of the earliest and most brilliant workers in the line of brain surgery. Mention should also be made of the discovery of a new 62 Founders' Week Memorial Volume disease, adiposis dolorosa, by Dr. F. X. Dercum, the founding of the American Society of Tropical Medicine by Dr. T. H. Fenton, the advocacy, as long ago as 1SS6. of early operative interference in typhoid perforation by Dr. J. C. Wilson, the earliest recognition of typhoid cholecystitis as a pathologic basis of a relapse in typhoid fever by Dr. J. H. Zinsser, and the first description of vasomotor ataxia by Dr. S. Solis-Cohen. If we were asked to depict in a sketchy outline, the develop- ment of practical medicine in Philadelphia, it would not be possible to do so in epochs, so insensible have been the changes. So striking, however, are the extremes that in attempting a comparison, we are prone to regard out beginnings as an abstraction, and to dehumanize the great men of that period, and to regard them almost as demi- gods. A few men make opportunities, but an infinitely greater number are made as the result of opportunity, and we. of to-day, looking upon the collective efforts of those of the past, ascribe the results to a few. and feel that they were marvels, the like of whom we no longer have with us. The fact is that each is necessary to all, now as it ever has been, although we, of the present, in acting our part, fail to obtain a true sense of proportion. Philadelphia took front rank in American Medicine almost from her birth, and was the first to establish a hospital and medical school, which, with the exception of a brief period, was the only medical school on the continent for many years. At an early date, the physician was sharply delineated from the surgeon, after which, obstetrics became the first specialty. The value of hygiene and pre- ventive medicine was early recognized. A number of valuable methods of treatment took origin here, and many innovations in surgical treatment arose: For instance, the Bond splint for frac- tures of the lower end of the radius, devised by Dr. Thomas Bond. Phillip Syng Physiek invented many appliances and surgical instru- ments, such a? an instrument for urethrotomy, the seton for un- united fractures, ligatures for vessels and a tonsillotome. Dr. John Pihea Barton introduced wiring of fragments in fracture of the patella; Dr. Hugh L. Hodge invented a pessary and obstetrical forceps; Dr. S. D. Gross, a transfusion apparatus, foreign-body extractor, bullet probe, artery forceps, tourniquet and splints. Through Dr. Atlee, the attention of the world was directed to ovariotomy, as a justifiable procedure in given conditions. The stomach tube for gastric lavage is often ascribed to Dr. Physiek, and Introduction 63 was wrought out independently by him, although Dr. Alexander Monro, of Edinburgh, described its use in gastric lavage in 1797. Mention should also be made here of Montgomery's operation for retroversion, and that of Kodman, known as pylorectomy with subsequent jejunostomy. The conspicuous part played by Dr. John B. Deaver in urging immediate operation in appendicitis is too recent to need comment, and the same is equally true of the introduction of the use of normal salt solution in the treatment of lobar pneumonia by Dr. F. P. Henry and the brilliant pioneer labors on the oleates by Dr. John V. Shoemaker, and many other advances brought about by members of the medical profession of Philadelphia now living. It should be our pride that in the tuberculosis crusade, Phila- delphia leads all other cities of the union. The magnificent Phipps Institute, headed by Dr. Flick, in the past, aided recently by the Health Department of the State (under Dr. S. G. Dixon) and that of the city, as well as by the Pennsylvania Society for the Pre- vention of Tuberculosis, and other agencies, make unitedly a most impressive showing in humanity's fight against this dread disease. Moreover, there are signs of a public awakening to the possibility of a successful advance upon the great white plague, both in the direction of prevention and cure. In conclusion, while Philadelphia is venerable and her medical traditions are an inspiration to the present generation, while her scientific and practical developments have been happily blent with a sound spirit of conservatism, while we owe filial allegiance to the great masters of the past, we must concern ourselves chiefly with the present and the future ; and to this end, we must set high standards in the profession, putting aside rivalries of system and petty jealousies, and with sustained earnestness of purpose provide for the advance of theory and practical achievement in the days to come. Along this line, I would urge an interchange of professors in the various medical schools, both at home and abroad. An inno- vation, to be sure, but one that could be entered upon with advantage to professional amity, and would wield a beneficent influence upon the student body, the general profession and the public alike. 64 Founders' Week Memorial Volume FOUNDERS' WEEK REUNION OF THE MEMBERS AND EX- MEMBERS OF THE VISITING AND RESIDENT STAFFS OF THE PHILADELPHIA GENERAL HOSPITAL, OCTOBER 8, 1908 At a meeting of the Medical Board of the Philadelphia General Hospital, held April 1, 1908, a resolution was adopted to appoint a committee of five to arrange for a reunion during Founders' Week of the visiting, resident and former visiting and resident staffs of the hospital. This committee, appointed by the President of the Medical Board, was as follows : Dr. Herman B. Allyn, Chairman, and Doctors C. S. Potts, David Biesman, Louis W. Steinbach, and G. G. Davis. In accordance with this resolution the committee held several meetings, in conjunction with a committee of the Blockley ex-resi- dent and resident physicians, composed of the following members: Dr. J. H. McKee, Chairman; and Doctors D. Biesman, J. E. Tally, L. N". Boston, T. H. Weisenburg, G-. E. Shumway and Charles J. Swalm, with Dr. Boland G. Curtin, president of the society, ex- officio. It was arranged to have the celebration on October 8th, this being Medical Day of Pounders' Week. On the morning of this day a mass meeting of physicians and students was held in the Walnut Street theatre, at which addresses were delivered by Doctors George A. Piersol, S. Solis-Cohen, and James Anders, and other business connected with the medical program of Founders' Week was transacted. Dr. John V. Shoemaker, president of the com- mittee on scientific institutions, medical colleges, and hospitals of the Founders' Week celebration, presided. The detailed account of this meeting has been given on preceding pages. The program for the reunion of the former visiting and resi- dent staffs of the Philadelphia General Hospital was as follows : An inspection of the hospital by invited guests, followed by a meeting in the amphitheatre of the hospital at 5 p. m.. Dr. Eoland G. Curtin, president of the Association of Blockley ex-residents and residents to preside and make an address, to be followed with addresses by Dr. Joseph S. Neff, director of the Department of Health and Charities, by Dr. Charles K. Mills, on "Some Blockley Doctors and Some Personal Experiences," and by Dr. Alfred Sten- gel on "Clinical Teaching at the Philadelphia General Hospital." A luncheon to be served at the close of the meeting, and a Introduction 65 smoker at the Bellevue-Stratford to be held at nine o'clock in the evening. Abstracts of the addresses delivered at this meeting follow. The main body of the material included in the addresses of Doctors Curtin and Mills has been incorporated in their histories of the hospital, which appear in this volume. Dr. Eoland G. Curtin, before introducing the speakers, delivered some remarks, relating chiefly to the resident pupils, apothecaries, and physicians of the hospital. He addressed his audience as "My .dear Ex-Paupers." It was far better, he said, to begin life in Blockley than to end it there. He spoke from experience, as he had attended quite a number of medical graduates as ward patients. At one time he had two medical men in the ward devoted to cases of chronic alcoholism. They were graduates of two of our most prominent medical schools. Moral: Join the prohibitionists and by so doing end your days at home. Dr. Curtin referred to the fact that at almost all periods in the history of the institution it had had on its staff some of the most prominent medical men of Philadelphia. Such men as Cadwalader Evans, Thomas Bond, Eush, James, Physick, Gerhard, Pennock, Dorsey, Barton, Horner, Hodge, Penrose, the Pancoasts, Gross, Da Costa, Agnew, Stille, Pepper and Wood. Speaking of the resident physicians he said that thirteen hun- dred and fifty are known to have served, and more are lost to history. Dr. Curtin said that in looking up data for his part of the work he had collected much material relating to the resident students, or pupils, and resident physicians. The early records and histories, with the exception of the valuable history of Agnew, do not say much about the medical residents. The first resident apothecary was appointed on June 6, 1788, the second in 1789, and a third in 1802. At this time the terms senior and junior pupils were introduced, the oldest in service being called senior pupils, the next oldest juniors, the last appointed being the apothecary. The duties of the seniors, juniors and apothecaries were detailed by the speaker. The number of resident pupils was increased to four in 1811. In the early days fees were charged the pupils for the privilege of serving the hospital. The position of apothecary with a salary was created in 1816, abolished in 1817, resumed in 1818, and continued from that time until the present. At first the term "home pupils" was applied to those who would 66 Founders' Week Memorial Volume now be called resident physicians. In 1820, the title was changed to "house physician" and "house surgeon." In 1823, graduates were first appointed as house or resident physicians, in place of the pupils who had served up to this time. Dr. Curtin in his address gave the varied history of the service of resident pupils and physicians, down to the time when the present method of service was established. He also gave some interesting facts and incidents regarding this service : the library, for instance, was first catalogued in 1831 by Dr. Eivanus, one of the indoor physicians. As showing the great change which has taken place in the course of time, Dr. Curtin mentioned the fact that during the present year, 1908, the hospital was served by forty-one resident physicians, thirty-two in the hospital proper, seven in the Insane Department, and two dental residents. Dr. Curtin gave a history of the issuing of certificates to resi- dent pupils and physicians, the first in 1817, the second in 1832, and the third in 1860. The Philadelphia Hospital Eesident Physicians' Medical Society was first organized in 1867. In 1885, the residents organ- ized a new society called the Philadelphia Hospital Medical Society. In concluding his remarks Dr. Curtin referred to many of the former resident physicians who had become distinguished as practi- tioners, as medical teachers and writers, explorers, and members of the army, navy, and marine service. Dr. Joseph Neff, the Director of the Department of Public Health and Charities, after extending a welcome to the gentlemen present, alluded to the occasion of Pounders' Week, showing the great part played by Philadelphia in the history of the country, spoke of the absence of politics in its conception, of the arrangements and demonstration, laid stress upon its being a citizens' movement originating at a private dinner in the home of Mr. Eosengarten, and upon the fact that the demonstrations were not advertisements or aggrandizements of any individual or set of people or parties, but were intended to display the progress made by the city in her arts, sciences and business ; in a word, to bring home to every citizen her history. He went into some detail concerning the parade, on Mon- day, of military organizations, and the parade, on Tuesday, of city employees, and mentioned in particular the State Constabulary, which he claimed was the finest body of men in the world. Introduction 67 Although realizing that the majority of those present might hold allegiance to other cities, Dr. NefE expressed the thought that in a sense they must feel pride in the history of the city where they spent their college days and received their first practical instruction in medicine, and thus led up to the part that Blockley had played in this age of progress. He considered it an opportune time to turn back the pages of history and mark some of the important epochs. In tracing the history of Blockley, Dr. NefE spoke in effect as follows : The first active charity in Philadelphia was in the First Luth- eran Church, built in 1646. The first evidence of official charity is found in Penn's great law of 1682, in which Section 37 provides: "If any persons shall fall into decay or poverty and be unable to maintain themselves and their children with honest endeavor, or who shall die and leave poor orphans" complaint should be made to the justice until the next County Court could provide necessary care. In 1700 a law was passed for the "better provision for the poor." This did not work and was repealed in 1705, when a system of outdoor relief was created, under which two overseers of the poor were appointed to provide income for their support. The first building for the care and medical treatment of the poor was erected on a plot of ground given by John Martin, a tailor, on Walnut Street above Third. This was built by the Friends and was sectarian. About 1730-1732 an almshouse for the care and treatment of the sick poor was erected on a plot of ground surrounded by Third, Fourth, Spruce and Pine Streets, and paid for by money lent by the legislature. On account of the overcrowding of these buildings, twenty-six years later new buildings were erected on ground bounded by Spruce, Pine, Tenth and Eleventh Streets, the money being raised by private contribution. In 1758 we have the first mention of medical students practicing in the almshouse the foundation of the system which has played such an important part in the medical education of the city. An act of Assembly was passed at this time incorporating the overseers of the poor of the city and adjacent dis- tricts under the title of "Guardians of the Poor of the City of Phila- delphia." The cornerstone of the present buildings was laid here in 1830 on the property settled by the "first colonist west of the Schuyl- kill and called by him 'Blockley' in memory of his English home." The Guardians of the Poor remained in control of the management until, to correct some of the political abuses existing, a Board of 68 Founders' Week Memorial Volume Charities and Correction was organized, consisting of five men, who had charge of the institution until the passage of the Bullitt Bill in 1885. This created a number of executive departments with added responsibility and centralized power. Each department was pre- sided over by a director. The title -'Board of Charities and Cor- rection" was changed to "Department of Charities and Correction." In 1905 the Bureau of Health, which had been under the Depart- ment of Public Safety, changed places with the Bureau of Correc- tion, making the department as at present, "The Department of Public Health and Charities." Attention was then called by Dr. Neff to the evolution of the hospital proper, within the memory of those present : the origin of the training school for nurses ; the inauguration of laboratory work ; the introduction of hydrotherapy and the X-ray; the progress in knowledge of diseases (bacteriology) ; the many improvements in building construction and equipment. He concluded by mentioning the improvements that had been effected since the reunion of the ex- residents at Blockley last winter; a handsome tiled receiving ward replacing the old, worm-eaten, wooden rooms ; the modern lavatory and hygienic flooring ; the tiled drug-store, the remodeled and reno- vated men's nervous pavilions accommodating the tuberculous women and permitting their removal from the main wards; the rearrangement of the second floor of the main building, allowing the removal of the venereal patients from the old attics, which now will be permanently abandoned. "The changes have been rapid in the recent past," he said in conclusion, "and without egotism I can state that there is no hospital in Philadelphia to-day that has a better staff or can better care for the sick than dear old Blockley." Dr. Charles K. Mills, senior member and president of the medi- cal board of the hospital, delivered an address under the title of "Some Blockley Doctors and Some Personal Experiences." 1 Dr. Mills in opening his address said, it is well that this celebration should take the form of a reunion of the present and former mem- bers of both the visiting and resident staffs of this hospital. Many of those who lived within its walls as internes, in later years have held places of trust and responsibility on its visiting board. The list is a long one, and includes such names as Alfred Stille, S. W. i The material of this address will, in the main, be incorporated in the history of the Philadelphia General Hospital from 1854 to 190S in the Memorial Volume of Founders' Week, the remarks here given being an abstract of the address. Introduction 69 Gross, Harrison Allen, Horatio C. Wood, James Tyson, Louis A. Dnhring, J. W. White, Roland G. Curtin, John Guiteras, J. Chal- mers DaCosta and many others not members of its resident staff, men who have added lustre to the annals of American medicine, have also served with distinction on its medical board. This list includes such names as Thomas Bond, Thomas C. James, Philip Syng Physiek, William Gerhard, Joseph Carson, Samuel D. Gross, Jacob M. DaCosta, Eichard J. Levis, D. Hayes Agnew, William Pepper, E. 0. Shakespeare, John H. Brinton, W. Joseph Hearn and many more. Dr. Mills said that the hospital is the oldest in the country, although he knew that this statement has been and may be disputed. It is not the oldest hospital on the continent, as was stated by Dr. Agnew in his address delivered in 1862 on the "Medical History of the Philadelphia Almshouse." The Hotel Dieu in Montreal was founded in 1642 and still survives, and doubtless Mexico and Panama, conquered by the Spanish in 1519, and Peru, in 1533-34, had mission hospitals at even an earlier date. The Pennsylvania Hospital received its charter in 1751, its foundation being the outcome of a suggestion made by Dr. Thomas Bond. Even Dr. Prancis E. Packard, one of our most reliable medi- cal historians, in asserting that the Philadelphia Hospital is not entitled to be regarded as older than the Pennsylvania Hospital, acknowledges that while it was referred to in documents of the time preceding the foundation of the latter hospital, as the Poorhouse, "it possessed an infirmary for such of the poor as were insane or required more careful medical treatment than could be given them if in the same quarters with the other paupers." This is exactly what the Philadelphia General Hospital, located on what is left of the old Almshouse Farm at Blockley, is doing at the present time; having its buildings "for such of the poor as are insane or require more careful medical treatment than can be given them if in the same quarters with the other paupers," side by side with other buildings set apart for the reception and care of the poor who are not supposed to be sick. It is true that many changes in organiza- tion have been made, that much elaboration of machinery and methods has developed, and that the name hospital has come to be officially applied to a portion of the municipal almshouse plant, but to-day, as in the first half of the eighteenth century, almshouse, insane department, and infirmary or hospital work more or less 70 Founders' Week Memorial Volume together under the same general supervision. It is freely admitted that the Pennsylvania Hospital was "the first institution intended solely for the care of the sick and wounded within the limits of what is now the United States," and therefore, of course, the first in Pennsylvania and Philadelphia. Dr. NefE in his remarks has sketched for us some of the most interesting features in the history of the method of caring for the poor of our city, beginning as far back as 1646. He has given in succinct form an account of the changes which have taken place in the organization of the boards for the government of the almshouse and hospital, including the Board of Guardians, the Board of Chari- ties and Correction, the Department of Charities and Correction, and the present Department of Public Health and Charities. He has also called attention to the numerous and important improve- ments which have been made in recent times, and especially during the present administration — improvements which have been in evidence during the inspection made by those present, preceding the meeting. Dr. Curtin in his address has laid before us many inter- esting facts with regard to the resident pupils, apothecaries, and resident physicians, their number in early times, their gradual increase in number, and the fees which they were expected to pay (not receive) and the duties which they were called upon to perform. Dr. Mills said he would not trespass upon the ground which had been covered so admirably by the preceding speakers, nor would he especially speak of the development of clinical teaching, the history of which was to be presented by Dr. Stengel, but would confine him- self to some historical memoranda regarding Blockley physicians of the times preceding his own experience, in connection with the hospital, and to some of his personal experience which he believed might be of particular interest. Of the physicians who gave their time and attention to the sick and insane in the infirmary or hospital of the Philadelphia almshouse, and of the work done by them during the first thirty to forty years of its existence, little has been recorded. They doubtless included some of those best known in Philadelphia medical annals between 1730 and the Eevolution. The only chronological list of members of the Philadelphia Hospital visiting staff, of which Dr. Mills had knowledge, begins with the name of Dr. Cadwalader Evans under the date of 1768. In the period closing with 1800 or 1801 and beginning with Introduction 71 the appointment of this physician, we discover such names as Thomas Bond, suggester of the Pennsylvania Hospital, famous in our medical, surgical and social annals; Benjamin Eush, in some respects still the greatest figure in American medical history; Caspar Wistar, whose name and fame are commemorated in the Institute of Anatomy at the University of Pennsylvania; William Shippen, the first teacher of practical anatomy and of obstetrics in a separate chair. Philip Syng Physick, who has been called the father of American surgery, and who was the first of the long list of famous Philadelphia surgeons, in which are found the names of Gibson, Joseph Pancoast, Samuel D. Gross, Agnew and Keen, served in this hospital from 1801 to 1805. In the long period from 1800 to 1842, at which time Dr. Agnew began his personal recollections of this hospital, many of the names best known in this city both as teachers and practitioners of medicine and surgery are to be found in the list of members of the visiting staff of this hospital. It includes such names as James Hutchinson, John Syng Dorsey, Nathaniel Chapman, William E. Horner, Samuel Jackson, John K. Mitchell, William H. Gerhard, Joseph Pancoast, Meredith Clymer and John Khea Barton. After the consolidation of the city in 1854, a new order of things was established by placing the administration of this hos- pital under a chief resident physician and a board of clinical lec- turers. In this board appear the names of men familiar personally to the older members and ex-members of the staff who are gathered here— Ludlow, Carson, J. Aitkin Meigs, Henry H. Smith, D. Hayes Agnew, Eichard J. Levis, E. A. F. Penrose and others almost equally well known. Dr. Mills said that his remarks regarding the Blockley doctors would, however, chiefly refer to those who served during what might be termed the post-bellum period, from about 1865 to 1880. Gross, Agnew, Pancoast, Levis, DaCosta and Duer were among those who served during the eventful period of the Civil War, doing service also in the military hospitals of our city. The staff, owing to the exigencies of the war, was meagre in numbers, but not in merit. Dr. Mills said that he had attended the clinical lectures at the Philadelphia Hospital when he was a student, in 1867-68 and 1868- 69, and after his graduation, not infrequently, up to the time when he became a member of the medical board in 1877. Eecollections of the teaching methods of the men of the period mentioned (1865 72 Founders' Week Memorial Volume to 1880) were given. In the list of those referred to were such, names as Levis, W. H. Pancoast, Maury, Stille, Ludlow, Ehoads, Pepper, Tutt, Duer, Parry, Tyson, Brinton, Allen, H. C. Wood and S. W. Gross. He spoke of the brilliant galaxy of young men who were added to the staff in 1875 and near this time, including such men as Keating, Bruen, Wilson, Guiteras, Hatfield, White and Porter. Dr. Alfred Stengel made some remarks on "Clinical Teaching in the Philadelphia Hospital." In the evening, in connection with the reunion, a smoker was held at the Bellevue-Stratford. This was very largely attended by present and ex-members of the visiting and resident staffs. Dr. J. H. McKee presided and acted as toast-master. Governor Edwin S. Stuart was present, and made some remarks, in which he spoke of his own experience in connection with the Philadelphia Hospital when mayor of Philadelphia, of the excellent work done by the members of the medical staffs, and of the great interest which he always retained in the work of the hospital as one of the most important of the city's institutions. Mayor John E. Eeyburn was also present, and made some interesting remarks, in which he spoke of the great value of the various celebrations of Pounders' Week, of the good which they had done in an educational way, and in promoting the solid interests of the city. Brief addresses were made by a number of those present, including Dr. Poland G. Curtin, Dr. Charles K. Mills and Dr. John V. Shoemaker, formerly President of the Board of Charities and Correction, who spoke as follows : — "Mr. Toastmaster : — It is an honor to be here and a still greater honor to be invited to address this large assemblage of ex-resident physicians and members of the visiting staff of the Philadelphia Hospital. As I look around this table at so many well known and truly representative members of the local medical professsion, it seems to me to be demonstrated that one of the principal roads to professional success is that which leads the young graduate through the wards of the Philadelphia Hospital. This is certainly true of professional success in Philadelphia, but it is also true of success elsewhere, for in whatever part of the universe you may happen to be, you will be likely to meet American physicians who were for- merly internes at Blockley. There are also numerous officers of the medical corps of the United States army and navy and of the Introduction 73 marine hospital service who walked the wards of this great hospital and there acquired the most practical part of their medical educa- tion. "In thanking you, Mr. Chairman, for the honor you have con- ferred upon me this evening, I wish also to congratulate you upon the fact that you have enjoyed such exceptional opportunities for advancement. "The people of Philadelphia in general have just reason to be proud of the marvelous advances in science, art and manufactures which have been made in this city since its foundation, and the medical profession in particular, has no reason to be ashamed of its part in the work of progress. This is exemplified, but only in miniature, by the history of the Philadelphia Hospital. This institution has had on its staff, since its foundation in colonial times, the leaders of the medical profession whose self-imposed duties have never been limited to attendance upon the sick within its walls. Actuated by love of their profession and by the generous desire to share the benefits derived from their positions, they have always thrown open the hospital doors and given a cordial welcome to the students of the different medical schools of Philadelphia. The service thus rendered to scientific medicine in this country is incal- culable since the great departments of medicine and surgery and their various special subdivisions have always been represented by their most distinguished exponents. "I am certainly very proud of my own association with this great hospital and shall always consider the position which brought me into official relations with its distinguished staff as one of the greatest honors of my life." The following was the official program for each of the seven days of the celebration : — 74 Founders' Week Memorial Volume OFFICIAL PROGRAM Sunday, October 4, 1908 6.00 A. M. Formal Opening of the Celebration by the ringing of Inde- pendence Hall bell in unison with all the Church bells and chimes in the City. 9.00 A. M. Eeligious Services at Penn Treaty Monument. William Rowan, Chairman; Rev. C. H. Woolston, Orator. Music by combined choirs of the East Baptist Church and the Perseverance Cornet Band. Civic and Patriotic Societies of Kensington to attend in a body. 10.00 A. M. Official Municipal Service in Gloria Dei (Old Swedes) Church (oldest Church in Philadelphia), corner Swanson and Christian Streets. Rev. S. B. Simes, Rector. To be attended by the Mayor, City Officials, Presidents of Select and Common Councils and members of the Founders' Week Executive Committee, together with the City's invited guests. Military Observance. — Christ Church, Second Street above Market Street; attended by Washington during the Revolution. Rev. L. C. Washburn, Rector. To be attended by the Governor and Staff, and Army and Navy representatives in Philadelphia. Grand Army Observance. — St. George's Methodist Episcopal Church, Fourth Street above Vine, oldest Methodist Church in the United States. Rev. J. S. Hughes, Pastor. Sermon by Chaplain John W. Sayers. 10.30 A. M. Special Services, St. Joseph's Roman Catholic Church, Fourth Street and Willing's Alley. Rev. S. C. Cahill, Rector. Special Commemorative Services in Churches of all denomina- tions. 12.00 M. Distribution of cut flowers and plants by Church Organizations to the sick in the Hospitals and Homes, and to the sick or infirm members of the several Churches. Introduction 75 2.30 P.M. Third (old Pine Street) Presbyterian Church, Fourth and Pine Streets ; One Hundred and Fortieth Anniversary. To be attended by the Naval Officers. Sermon by the Eev. H. 0. Gibbons, Pastor. 2.45 P. M. Sunday-school Children throughout the City will sing simul- taneously : "My Country 'Tis of Thee." 3.00 P. M. Knights of Columbus unveil tablet at St. Joseph's Church. Prior to services 5,000 Knights of Columbus will parade from Broad Street and Girard Avenue to the Church to participate in the ceremony. Monsignor Falconio, Apostolic Delegate to the United States, will unveil and pronounce the Pontifical blessing. Various Church Organizations will hold special services in the Institutions. 4.30 P. M. Non-sectarian open air services in eight sections of the City, including the four original squares: Franklin Square, Sixth and Vine Streets ; Logan Square, Eighteenth and Pace Streets ; Kitten- house Square, Nineteenth and Walnut Streets ; Washington Square, Sixth and Walnut Streets, and Norris Square, Howard Street and Susquehanna Avenue; Vernon Square, German town; Memorial Hall, Forty-third Street and Parkside Avenue; East Fairmount Park, Strawberry Mansion Plateau. Meetings to be addressed by representatives of every denomination. At each meeting there will be a large chorus accompanied by an orchestra. The anthems will include Gounod's "Praise Ye the Father," "America," "My Country, 'Tis of Thee," "Fearer, My God, to Thee," Mozart's "Gloria" (Twelfth Mass), "Onward, Christian Soldiers." 8.00 P. M. Grace Baptist Temple, Broad and Berks Streets. Eev. Russell H. Conwell, Pastor. Sons of America, 2000 strong, in full dress uniform will attend services in a body. The Order will form at Broad and Spring Garden Streets 6.30 P. M. and march to the Church. Palatinate Eeformed Church, Fifty-sixth Street and Girard Avenue. Rev. Dr. A. H. Hibshman, Pastor. Knights of Pythias, 76 Founders' Week Memorial Volume Odd Fellows and Golden Eagles to attend service. Signor F. Cortez will render "Home, Sweet Home," on the harp, by request. Fraternal Organizations. Various Churches of their own selection. Special Services and Sermons in all Churches. Special Services in Germantown Churches to Commemorate the Founding of Germantown. Monday, October 5, 1908 MILITARY DAY 8.00 A. M. Salute to the City by the guns of the United States war vessels and foreign war vessels in the Delaware and at the Philadelphia Navy Yard. 8.30 A. M. Proclamation by eight Heralds in mediaeval costume at the four entrances to City Hall. 9.00 A.M. Striking of the first impression of new City Seal, in effect this day, by Mayor John E. Eeyburn, in the presence of City Officials and the City's invited guests, Mayor's office. 9.30 A. M. 9.30 to 10.30, Public Eeception by the Mayor. 10.00 A. M. Unveiling of bronze Tablets on Old City Hall, Fifth and Chestnut Streets and Old Congress Hall, Sixth and Chestnut Streets, by the Pennsylvania Society, Daughters of the Eevolution. 10.30 A- M. Second Annual Convention of the Illuminating Engineering Society — Hotel Walton. Delegates to attend from Canada and all the States of the Union. Address of Welcome — Hon. John E. Reyburn, Mayor of Philadelphia. Presidential Address — Dr. Louis Bell, Boston, Mass. Report Committee on Nomenclature and Standards — Dr. A. C. Hum- phreys, President Stevens Institute. 11.00 A. M. Reception to Visiting Ladies, first floor, Hotel Walton. Introduction 77 Unveiling of Tablet by the French Ambassador to the United States in City Hall Court Yard, by the Pennsylvania Society of the Order of the Founders and Patriots of America, to commemorate the Camp of Comte de Kochambeau, Commander-in-Chief of the French Army in America, with 6000 patriots in September, 1781, while on their way to the final battle of the Eevolution at Yorktown, where they assisted Washington in capturing Cornwallis. Music — The Star Spangled Banner. Presentation of the Tablet to the City of Philadelphia, Rev. Charles Wadsworth, Jr., D.D., Governor of the Pennsylvania Society of the Order of the Founders and Patriots of America. Acceptance of the Tablet, Hon. John E. Keyburn, Mayor of Philadel- phia. Unveiling of the Tablet, Ambassador Jusserand, Representing the French Republic. Music — The Marseillaise. Singing — America. 12.30 P. M. Luncheon to Delegates at Hotel Walton. 1.00 P. M. Military Parade. FORMATION OF PARADE Platoon of Mounted Police Grand Marshal, General Edward Morrell, Accompanied by Major-Gen. Fred D. Grant, U. S. A. Chief of Staff, Major-Gen. James W. Latta, N. G. P. Chief Aide — Lewis E. Beitler. Staff — Representatives of the Regular Army, Governor's Staff, Divi- sion Staff, the three Brigade Staffs, and the Staff of the Grand Marshal of the Third Division — Guard of Honor to Major General Fred. D. Grant, U. S. A., First Troop Philadelphia City Cavalry, Captain John C. Groome. First Division M&rshal — Col. W. H. C. Bowen, 12th Infantry, U. S. A. — Captain and Adjutant James P. Harbeson, U. S. A. — Mounted Band and Companies E, F, G and H, 12th Infantry from Fort Jay— Fifth Band, and 51st, 84th, 98th and 123d Companies, Coast Artillery Corps, from Fort Hamilton, N. Y.— Twelfth Band, and 54th, 82d, 87th, 101st, 114th, 135th, 165th and 167th Companies, Coast Artillery Corps, from Fort Totten, N. Y — Thir- teenth Band, and 4th, 45th, 112th and 139th Companies, Coast Artillery Corps, from Fort DuPont, Delaware — Band, and Troops E, F, G and H, 78 Founders' Week Memorial Volume 13th Cavalry, from Fort Meyer, Va. — Band, and 11th, 18th and 81st Com- panies, Coast Artillery Corps, from Fort Schuyler, N. Y. — Band, and 30th, 53d, 56th, 86th and 157th Companies, Coast Artillery Corps, from Fort Wadsworth, N. Y — Band, and 48th, 55th, 95th, 113th, 136th and 137th Companies, Coast Artillery Corps, from Fort Hancock, N. J. — Band, and 42d, 119th and 138th Companies, Coast Artillery Corps, from Fort Mott, N. J. — Band, and 21st, 40th, 103d and 140th Companies, Coast Artillery Corps, from Fort Howard, Md. — Band, and 128th, 141st and 142d Com- panies, Coast Artillery Corps, from Fort McHenry, Md. — Band, and 17th, 44th, 104th and 143d Companies, Coast Artillery Corps, from Fort Wash- ington, Md. — Band, and 47th Company, Coast Artillery Corps, from Fort Hunt, Va. — aggregating 3500 men. Marshal — Capt. Alfred Reynolds, of the Cruiser "Montana" — Sailors from the Third Squadron, North Atlantic Fleet, and from the Philadelphia JMavy Yard — aggregating 1600 men. Marshal — Lieut. W. H. Allen, Personal Aide ef Rear-Admiral Arnold — Marines from Third Squadron, North Atlantic Fleet, and from the Phila- delphia Navy Yard — aggregating 500 men. Second Division National Guard of Pennsylvania Marshal — Gov. Edwin S. Stuart, Commander-in-Chief — Chief of Staff, Brig. Gen. Thos. J. Stewart. Staff — Col. Ezra Ripple, Col. Frank G. Sweeney, Col. Thomas Potter, Col. Daniel B. Shepp, Col. Albert J. Logan, Lieut.-Col. Horace L. Haldeman, Col. Joseph K. Weaver, Col. Frank K. Patterson, Col. Sheldon Potter — Aides — Lieut-Cols. James Elverson, Jr., Harry C. Trexler, James M. Reid, Ned Arden Flood, Lewis T. Brown, Walter T. Bradley, James Archbald, Jr., Lewis E. Beitler, Fred. Taylor Pusey, Charles A. Rook, J. Warner Hutehins, John R. Wiggins and Oliver S. Hershman — Major-Gen. John A. Wiley, National Guard of Pennsylvania — Staff: Lieut.-Col. Chess Lamber- ton, Lieut.-Col. John P. Penney, Lieut.-Col. Wm. J. Elliott, Lieut.-Col. Wm. F. Richardson, Lieut.-Col. Wm. S. McLain, Lieut.-Col. Andrew S. Stayer, Lieut.-Col. Samuel W. Jefferis, Sr., Lieut.-Col. Frank G. Darte, Major Thos. J. Dolan, Major Fred. R. Drake, Major Marshall Phipps. Third Brigade, National Guard of Pennsylvania: Brig.-Gen. Charles Bowman Dougherty, Commanding. Staff — Major William Sharpe, Major William P. Clarke, Major David J. Davis, Major Frank M. Vandling, Major Gordon Scott, Major Carleton C. Jones, Major George H. Halberstadt, Capt. Edmund N. Carpenter, Capt. Charles H. Bernheisel — Fourth Regiment, Col. Christopher T. O'Neill, Allentown — Eighth Regiment, Col. Joseph B. Hutchinson, Harrisburg — Ninth Regiment, Col. Asher Miner, Wilkes-Barre — Twelfth Regiment, Col. Charles M. Clement, Sunbury — Thirteenth Regiment, Col. Frederick W. Stillwell, Scranton. Second Brigade, National Guard of Pennsylvania: Brig.-Gen. Willis J. Hulings, Commanding. Introduction 79 Staff — Major John M. Reed, Major Harry D. Fowler, Major William 0. McNary, Major William H. Corrin, Major John H. Martin, Major C. G. Wiley, Major Blaine Aiken— Fifth Regiment, Col. Hugh Stuart Taylor, Bellefonte — Tenth Regiment, Col. Richard Coulter, Jr., Greensburg— Four- teenth Regiment, Col. William E. Thompson, Pittsburgh— Sixteenth Regi- ment, Col. George C. Rickards, Oil City — Eighteenth Regiment, Col. Frank 1. Rutledge, Pittsburgh. First Brigade, National Guard of Pennsylvania: Brig-Gen. Wendell P. Bowman, Commanding. Staff — Major J. Campbell Gilmore, Major Charles H. Worman, Major Howard A. Davis, Major Frank L. Mueller, Major W. J. Ashenfelter, Major E. Claude Goddard, Capt. Thomas S. Martin, Capt. W. Preston Tyler- First Regiment, Col. J. Lewis Good, Philadelphia/ — Second Regiment, Col. Hamilton D. Turner, Philadelphia — Third Regiment, Col. William G. Price, Jr., Philadelphia — Sixth Regiment, Col. James B. Coryell, Philadelphia — Third Regiment, N. G. N. J., Col. John A. Mather. Regiment of Cavalry, Capt. Frederick M. Ott Commanding— Second Troop, Philadelphia City Cavalry, Capt. Frank Earle Schermerhorn — Troop "A," Philadelphia, Capt. Norman MacLeod — Governor's Troop, Harrisburg, First Lieut. Charles P. Meek — Sheridan Troop, Tyrone, Capt. Luther F. Crawford — Troop "F," New Castle, Capt. Joseph V. Cunningham. Artillery: Battery "B," Pittsburgh, Capt. William T. Rees — Battery "C," Phoenixville, Capt. Howard S. Williams. Naval Reserves — Naval Battalion of Pennsylvania, C. W. Ruschenber- ger, Commanding — Naval Reserves of New Jersey. Third Division Marshal — Col. J. R. C. Ward, Commanding — Capt. and Adjutant Joseph L. Bailey — Cooper Battalion — United Spanish War Veterans — American Veterans of Foreign Service — Pennsylvania Division Sons of Veterans — First Regiment, Pennsylvania Division, Boys' Brigade of America —Third Regiment, New Jersey Division, Boys' Brigade of America— Boys' Battalion, Olivet M. E. Church— St. Joseph's Cadets— Battalion, Gray Invincibles — Atlantic City Troop. 5.00 P. M. Organ Eecitals in leading Churches. 6.00 P. M. Luncheon to City's invited guests. Bellevue-Stratford. 7.00 P. M. Beception, Horticultural Hall. 7.30 P. M. Illumination of the City Hall and general illuminations of the City. 80 Founders' Week Memorial Volume 8.00 P. M. Municipal Celebration, Academy of Music. Addresses by Hon. John E. Keyburn, Mayor of Philadelphia; Hon. Edwin S. Stuart, Governor of Pennsylvania; Eev. Eussell H. Conwell and Hon. J. Hampton Moore, Member of Congress. Evening Session, Convention of Illuminating Engineering Society — Hotel Walton. Modern Gas-Lighting Conveniences. By Mr. T. J. Litle, Jr. Illuminating Value of Petroleum Oils. By Dr. A. H. Elliott. Street-Lighting Fixtures — Gas and Electric. By Mr. H. Thurston Owens. Structural Difficulties in Installation Work. By Mr. James R. Strong. Architecture and Illumination. By Mr. Emile G. Perrot. Musical-Historical Drama, "Philadelphia" — Franklin Field, University of Pennsylvania. Depicting in music, tableau and action the history and growth of the municipality — Army and Navy Night. Midnight. Illuminations extinguished. Tuesday, October 6, 1908 MUNICIPAL DAY Morning. Devoted to general business, sightseeing and shopping tours. 9.30 A. M. Second Day's Session, Convention of the Illuminating Engi- neering Society — Hotel Walton. Intensity of Natural Illumination Throughout the Day. By Mr. Leonard J. Lewinson. The Integrating Sphere in Industrial Photometry. By Dr. Clayton H. Sharp and Mr. Preston S. Millar. The Ives Colorimeter in Illuminating Engineering. By Dr. Herbert E. Ives. Calculating and Comparing Lights from Various Sources. By Mr. Carl Hering. The Calculation of Illumination by the Flux of Light Method. By Mr. J. R. Cravath and Mr. V. R. Lansingh. Parade of the German Societies. Route: Form at Broad Street and Erie Avenue; North on Broad Street to Germantown Avenue, to Vernon Park. A. H. Ladner, Chief Marshal. In the Parade there will be repre- Introduction 81 sentatives of the different branches of the German-American League, repre- senting forty-two States: Singers, Turners, Riflemen, Volksfest and Mili- tary Societies, the United Workmen, Children of all the German Sunday- schools, including numerous floats and hundreds of banners of the different societies not only from Philadelphia, but also from Pittsburgh, Altoona, Johnstown, Lancaster, Reading, Washington, Baltimore, Wilmington, New- ark, Trenton, Camden and Atlantic City. At Wayne Junction the Parade from the city will meet the Parade of the Germantown citizens, of which General Louis Wagner is Chief Marshal, and then proceeding to Vernon Park. 10.00 A. M. Ceremonies incident to the laying of the Cornerstone of the Pastorius Monument in Germantown by the United German Soci- eties to Commemorate the Settlement of Germantown by Pastorius, in 1683. Vernon Park. Celebration in Vernon Park, Germantown Selection Orchestra Song — "Der Tag des Herrn" Kreutzer The United Singers of Philadelphia — Over 1000 Voices Mr. Herman G. Kumme, Leader German Oration Rev. Georg von Bosse Laying of the Cornerstone of the Pastorius Monument by Dr. C. J. Hexamer and presentation to the City Acceptance for the City By His Honor, Mayor J. E. Reyburn Children's Chorus— "Unser Vaterland" Specially Composed for this Occasion by J. Stumpf Sung by the Children's Choruses of the various German Sunday-schools of Philadelphia Mr. J. Stumpf, Leader English Oration Hon. A. J. Barchfeld, Member of Congress Grand Chorus— "Dankgebet" Kremser The United Singers of Philadelphia "America" Sung by all present 10.00 A. M. Special Joint Convention of the Pennsylvania Osteopathic Association and the Philadelphia Osteopathic Society. Walnut Street Theatre. Address on The Obligations of the State in Matters of Health. By O. J. Snyder, A.C., M.S., D.O., President Pennsylvania Osteopathic Asso- ciation. 82 Founders' Week Memorial Volume Report on The A. T. Still Research Institute. By D. S. Brown Pen- noek, D.O., M.D., Vice-President Philadelphia College of Osteopathy; E. M. Downing, CO., Secretary to Committee on Osteopathic Research. Report on Osteopathic Journalism. By E. S. Willard, CO., Editor Philadelphia Journal of Osteopathy ; Virgil A. Hook, CO., ex-President Atlantic College of Osteopathy. Report on Osteopathic Dispensary, Hospitals and Sanitariums. By W. B. Keene, M.D., D.O., late President Philadelphia Alumni Association; C. T. Bryan, D.O., Chairman of Board of Philadelphia Dispensary. Report on Osteopathic Legislation. By Frank R. Heine, B.S.D., D.O., Chairman National Committee on Legislation. Report on 1908 A. 0. A. Convention. By J. C. Howell, D.O., Treasurer Philadelphia College of Osteopathy. Address on Osteopathic Education in Philadelphia. By C. J. Muttart, D.O.. Dean Philadelphia College of Osteopathy. Address on Osteopathy in Preventive Medicine. By Wm. Rohacek, D.O., Treasurer Pennsylvania Osteopathic Association. 1.00 P. M. Parade of the Police and Fire Departments of Philadelphia. Eodte of Parade : South on Broad Street, from Montgomery Avenue to Snyder Avenue and there dismiss. The column will pass around the west side of the City Hall, and will be reviewed on Broad Street, south of Arch Street. FORMATION OF PARADE Grand Marshal, Hon. Henry Clay, Director of Public Safety Assistant Grand Marshal, Hon. William B. Smith Marshals' Aides— James B. Sheehan, James F. McLaughlin, Capt. Wm. C. Zane, John M. Lukens, Wm. A. Patterson, Gen. St. Clair A. Mul- holland, Gen. Jas. Stewart, Jr., Timothy O'Leary. Alfred S. Eisenhower, Edwin Clark, John Lattimer, Hubley R. Owen, M.D., John Lamon, Frank Feeney, Samuel W. Roop. First Division: State Police and visiting Police Officials, on west side of Broad Street, heading south, with the right resting on Diamond Street. Major Thomas S. Martin, Marshal. Second Division: Superintendent of Police John B. Taylor and Staff and two battalions of the Philadelphia Police, on Diamond Street, west of Broad Street, right resting on Broad Street. Third Division: Two battalions of Philadelphia Police, Motorcycle squad, Harbor Police and Fairmount Park Guards, on Diamond Street, east of Broad Street; right resting on Broad Street. Captain William T. Little, Marshal. Introduction 83 Fourth Division: Traffic Squad, Mounted Officers, Fire Marshals, Police Patrol Service and Vans, on Norris Street, west of Broad Street; right resting on Broad Street. Captain William L. Dungan, Marshal. Fifth Division: Motor Fire Chiefs' Wagons, Combination Chemical and Motor Fire-fighting Apparatus, on Norris Street, east of Broad Street; right resting on Broad Street. George S. Biker, Marshal. Sixth Division: Old Guard State Fencibles and Infantry Battalion State Fencibles, escorting the Veterans of the Seventy-second Regiment, Pennsylvania Volunteers (Philadelphia Fire Zouaves), on Berks Street, west of Broad Street; right resting on Broad Street. Major Thurber T. Brazer, Marshal. Seventh Division: Chief of Bureau of Fire James C. Baxter, Jr., and detail of Philadelphia Fire Department, with apparatus, on Berks Street, east of Broad Street (continued south on Park Avenue), with right resting on Broad Street. Eighth Division: Keystone Fire Chiefs' Association, visiting Fire Officials, and visiting Volunteer Fire Companies, on Montgomery Avenue, west of Broad Street; right resting on Broad Street. William F. Totten, Marshal. Ninth Division: Visiting Volunteer Fire Companies, on Montgomery Avenue, east of Broad Street; right resting on Broad Street. William Allmendinger, Marshal. Tenth Division: United States Government Employees, Post Office Department, etc., on Park Avenue, south of Montgomery Avenue; right resting on Montgomery Avenue. Captain George W. Durang, Marshal. 2.00 P. M. Afternoon Session, Convention of the Illuminating Engineer- ing Society — Hotel Walton. Street Lighting with Gas in Europe. By Mr. E. N. Wrightington. Design of the Illumination of the New York City Carnegie Libraries. By Mr. L. B. Marks. Engineering Problems in Illumination. By Mr. Alfred A. Wohlauer. Intrinsic Brightness of Lighting Sources. By Mr. J. E. Woodwell. Some Experiments on Reflection from Ceiling, Walls and Floor. By Mr. V. R. Lansingh and Mr. T. W. Rolph. The Relation Between Candle-Power and Voltage of Different Types of Incandescent Lamps. By Mr. Francis E.. Cady. Sightseeing automobile trip for visiting ladies. 3.00 P. M. Clinics at the Philadelphia College of Osteopathy, 1715 North Broad Street; J. Ivan Dufur, D.O., Chief of Clinics, in charge. Clinics at the Philadelphia Dispensary, 1617 Fairmount Avenue; E. D. Burleigh, D.O., in charge. 84 Founders' Week Memorial Volume 7.30 P. M. General illumination of the City. German Celebration, Academy of Music. Overture — "Der Freischuetz'' von Weber Orchestra, Mr. Louis Koemmenich, Leader "Das Deutschenlied" Specially composed for this occasion by Louis Koemmenich The United Singers of Philadelphia, Mr. Herman G. Kumme, Leader Opening Address by the President of the National German- American Alliance, Dr. C. J. Hexamer 8.00 P. M. Annual Meeting of the Philadelphia Osteopathic Society, 1414 Arch Street. President's Address, The Physician of To-morrow. Chas. W. Mc- Curdy, Ph.D., D.O. Address by the Governor of the Commonwealth Hon. Edwin S. Stuart Address by the Eepresentative of His Majesty the German Emperor German Oration Prof. Dr. Adolph Spaeth Songs ( a ) "Die Auswanderer" Gevaert Junger Mannerchor, Mr. Louis Koemmenich, Leader ( 6 ) "Waldweben" Weler "Harmonie," Mr. Eugen Klee, Leader (c) "Hoch Empor" Gurti Philadelphia Quartet Club, Mr. E. F. Ulrich, Leader Selections from "Meistersingers of Nuremberg" Wagner Introduction to the Third Act; Dance of the Apprentices; entrance of the Meistersingers and Welcome to Hans Sachs. Orchestra, Mr. Louis Koemmenich, Leader English Oration — Hon. Herman Ridder, President "New York Staatszeitung" "Gothenzug" Kriegeskotten Mixed Chorus of 800 Voices and Orchestra, with various mixed Choruses of the City Mr. Eugen Klee, Leader "The Star Spangled Banner" Sung by all present 8.00 P. M. Assemblage of fifteen hundred clergymen, of all denominations, in Friends' Meeting House, Fifteenth and Pace Streets, for dis- cussion of William Penn as a Statesman and First Champion of Introduction 85 Eeligious Liberty. The speakers, and the various denominations and faiths winch they represent, will include the following: Baptist—Rev. Dr. Russell H. Conwell. Roman Catholic— Archbishop P. J. Ryan. Episcopal— Rev. Floyd W. Tomkins, S.T.D. Hebrew— Rabbi Krauskopf. Friends (Race Street)— Henry W. Wilbur. Friends ( Orthodox ) —George A. Barton. Congregational — Rev. Edward Rice. Disciples — Rev. L. Batman. Mennonites — N. B. Grubb. Methodist Episcopal— Bishop Luther W. Wilson. Presbyterian— Dr. W. H. Roberts. African Churches — Bishop Levi J. Coppin. Reformed — Rev. C. J. Messer. Unitarian — Dr. Chas. St. John. Universalist — Rev. E. C. Sweetser. Musical-Historical Drama "Philadelphia," Franklin Field, Municipal Night. Midnight. Illuminations extinguished. Wednesday, October 7, 1908 INDUSTRIAL DAY Morning. Devoted to general business, sightseeing and shopping tours. 10.00 A. M. Annual Meeting National Board of Steam Navigation. Meeting of Insurance Men at Philadelphia Bourse. 12.00 M. Industrial Parade, Showing the Birth and Development of Philadelphia's Industries. Eoute of Parade: Broad Street, from Diamond Street to Snyder Avenue. Chief Marshal, William Vollmer Aides to Chief Marshal — H. P. Austin, H. DeR. Bright, Samuel Bullock, R. M. Campbell, Wm. DeKrafft, E. C. Donaghy, H. H. Davis, B. E. Foster, R. G. Hare, Briee Ewing, J. E. Jeffords, Samuel Limmeriek, S. MeNaughton, William W. Matos, Granville G. Miller, Robert Morris, C. J. Milne, J. Pollock, Harry Pearce, Robt. Radford, Joseph Raub, H. W. Shel- mire, Godfrey Smith, L. W. Williams, J. R. Wilson. 86 Founders' Week Memorial Volume First Division — Allied Building Trades Floats Floats Leutin Brick Company 1 C. B. Coles Company 2 S. Faith & Co 2 Fleck Bros. Company 2 Philip Beeler & Co 2 Lupton Sons' Company 1 Abram Cox Stove Company 1 Builders' Exchange 1 The H. B. Smith Company 1 Armstrong & Latta Company. ... 1 Cyrus Borgner Company 2 J. S. Thorn Company 1 Second Division — Brewers, Distillers, and Allied Trades Philadelphia Lager Beer Brewers' Association 7 Floats Third Division — Book Trade William Sehlipf, Jr 1 Float Fourth Division — Drugs, Chemicals and Paints Paint Manufacturers 6 Floats Manufacturing Chemists 3 Floats Fifth Division — Leather and Leather Goods Floats Float Boot and Shoe Trade 3 Boyer & Co 1 George H. McNeely 2 Sixth Division — Electricity Floats Floats Philadelphia Electric Company . . 6 Keystone Telephone Company .... 1 Bell Telephone Company 3 City Electrical Bureau 1 Seventh Division — Food Products Floats Floats Louis Burk 3 Freihofer Vienna Baking Corn- Thomas Bradley 1 pany 3 John J. Felin & Co 1 Hutchison Baking Company 1 Swift & Co 1 August Bauersehmidt 1 G. F. Pfund & Son 2 Fleishmann Company 1 Chas. Roesch & Sons Co 2 Finley Acker Company 1 Philadelphia Jobbing Conf ec- American Ice Company 2 tioners 1 Millbourne Mills Company 1 Eighth Division — Furniture and House Decorations Floats Floats J. R. Bunting & Co 1 Lincoln Manufacturing Company . 1 Bernstein Manufacturing Com- James Bellak & Sons 1 pany 1 J. B. Van Sciver & Co 2 Estey Piano Company 1 George Kelly's Department Store 4 Ninth Division — Machinery and Metal Products Floats Floats Machinery Committee 3 Otto Gas Engine Works 1 Henry Disston & Sons 5 Bement-Miles Works 1 Baldwin Locomotive Works 2 3 Introduction 87 Tenth Division— Merchandise Floats Floats Lit Brothers ! Theo bald & Oppenheimer Com- Otto Eisenlohr Brother*, l pa ny , Singer Sewing Machine Company 1 Automatic Carpet Cleaning Co " 2 Young Soap Company i Eleventh Division— Textiles and Allied Trades „ A Floats Floats R. A. Blyte 2 Folwell Bros. & Co Sanquoit Silk Manuiacturing Cu . Brown- Alberle Company 1 S. B. & B. W. Fleisher 2 Southwark Mills . 3 ivins, Dietz & Magee 2 Charles H. Wittz & Co ...' 1 Park Mills 1 Schwarzwaelder & Co \\ \ William Scholes & Co 1 Theodore C. Search l Joseph Bromley 2 Walter E. Knipe Company 1 Twelfth Division — Transportation Floats Floats J. G. Brill Company 2 Rech-Marbaker Company 1 Finnesey-Kobler Company 1 Transportation Committee 7 Fulton & Walker 1 Thirteenth Division — Wearing Apparel Charles B. Morris 3 Floats Fourteenth Division — Rubber Goods Floats Floats H. B. Hanford Company 2 India Rubber Companies 5 James L. Gibney & Bros 1 Fifteenth Division — Miscellaneous unclassified Floats Floats Derr-Haney Company 1 Forbes & Co Blanck & Sons I Henry F. Michell Joseph Fischer & Co 1 Williamson Bros. Company Evening Times 1 Clark's Iron Foundry National Cash Register Company 1 Thomas Hamilton Sons Company. Hoffman-Corr Company 1 Fels & Company 5.00 P. M. Organ Eecitals in principal Churches. 7.30 P. M. Illumination of the City. 8.00 P. M. Parade of Labor Organizations, with Descriptive Floats. Route — Broad Street, from Diamond Street to Snyder Avenue. 88 Founders' Week Memorial Volume Festival of Music, First Presbyterian Church, Washington Square, Seventh and Locust Streets. Musical-Historical Drama, "Philadelphia" — Franklin Field. University Night. Midnight Illuminations extinguished. Thursday, October 8, 1908 MEDICAL DAY CHILDREN'S AND NAVAL DAY Morning Devoted to general business, sightseeing and shopping tours. 9.00 A. M. School Children hold Special Patriotic Exercises in the Schools and visit historic points of interest, and then proceed to Independ- ence Hall. 9.30 A. M. Medical Convention — Walnut Street Theatre, Ninth and Wal- nut Streets, the oldest theatre in America. John V. Shoemaker, M.D., Chairman Frank Woodbury, M.D., Secretary Report of the Committee on Scientific Institutions, Colleges and Hos- pitals. By John V. Shoemaker, M.D. Report of the Committee on and Editor of the Volume of Scientific Institutions, Colleges and Hospitals. By Charles K. Mills, M.D., and Frederick P. Henry, M.D. Report of the Committee on Historical Exhibit. By Joseph P. Rem- ington, Ph.M. Report of the Committee on Medical Day. By L. Webster Fox, M.D. Address on the Medical Colleges and Allied Institutions of Philadel- phia. By Professor George A. Piersol, University of Pennsylvania. Address on the Great Hospitals of Philadelphia. By Professor John C. Da Costa, Jefferson Medical College. Address on the Development of Practical Medicine in Philadelphia. By Professor James M. Anders, Medico- Chirurgical College of Philadelphia. Other eminent scientists are expected to be present and address the meeting in commemoration of the Two Hundred and Twenty-fifth Anniver- sary of the Founding of the City of Philadelphia, and in celebration of the growth and development of the scientific institutions, colleges and hospitals of Philadelphia. Introduction 89 The medical profession and members of all other scientific bodies, and the public are invited to attend the meeting. Visitors are invited to see the Historical Exhibit of relics from the scientific institutions, colleges and hospitals of the city. 11.00 A. M. Patriotic Exercises by School Children, in Independence Square. Addresses to be made by distinguished speakers. 1.00 P. M. Beview of United States and Foreign War Vessels in the Har- bor — North Atlantic Squadron, Eear Admiral Conway H. Arnold, Commanding. Third Squadron, North Atlantic Fleet IT. S. S. "Dolphin," flying the flag of Eear Admiral Conway H. Arnold, Commander of the Third Squadron of the United States Atlantic Fleet. Battleships and Cruisers Submarines New Hampshire Plunger North Carolina Octopus Montana Cuttlefish Idaho Viper Mississippi Tarantula Yankee (Parent Ship) Torpedo Boats Submarine Tenders Stringham Hist Barney Nina DeLong Thornton Tingey 1.00 P. M. Eiver Pageant— Start from Fort Mifflin. Proceed up the West side of Eiver to and around City Ice Boat No. 1, at Allegheny Avenue; down the East side to City Ice Boat No. 2, opposite Gloucester City, N. J. First Division: U. S. S. "Sunflower" as Flagship, with Admiral Marix and Staff; Steamer "Samuel H. Ashbridge," with Hon. John E. Eeyburn, Mayor of Philadelphia, and Staff; followed by the official steamers. Second Division: City Ice Boat "John Weaver" and large Passenger Steamers. Third Division: Patrol Boat and Passenger Steamers. Fourth Division: Patrol Boat and Passenger Steamers. 90 Founders' Week Memorial Volume Fifth Division: Yachts. Sixth Division: Tow Boats. Seventh Division: Motor Boats and Power Launches. 5.00 P. M. Organ Eecitals in leading Churches. Philadelphia General Hospital Eeception to Past-President and Staff and Besident Physicians and Staff. 6.00 P. M. Naval Dinner at the Union League. 7.30 P. M. Illumination of the City. Street Demonstration of Improved Order of Eed Men. Eoute: Start from South side of Diamond Street; down Broad Street to Snyder Avenue, and dismiss. FORMATION OF PARADE Chief Mishinewa — Frank Weideman, Osage Tribe, No. 113. Aides to Chief Mishinewa — Wm. Eiler, No. 79; Albert A. Redifer, No. 3; R. J. Lamb, No. 379; Frank Ryan, No. 325; Samuel W. Meredith, Mo. 31; Geo. A. Willie, No. 356; John Ullmann, No. 137; Chas. E. Bell, Mo. 304; Samuel R. Kerlin, No. 138; William Goddard, No. 135; Joseph B. Remaily, No. 30; Samuel Williams, Jr., No. 434. Float — Representation of a, Council of Chiefs seated around a. Council-fire. DIVISION MISHINEWAS AND FORMATION First Division: Worth New Jersey, with Trenton as the basis. Float — Treaty with William Penn. Mishinewa — Harry J. Rathbone, No. 93, New Jersey. Aides— P. W. Mellick, No. 170; John C. Rabatie, No. 102; D. J. Mur- phy. No. 115; T. A. Quinn, No. 108; Walter Irons, No. 86; John Carlile, Mo. 5. Second Division: Reservation of Delaware Tribes. Float — Prophet rescuing a Paleface; Freedom. Mishinewa— William F. Schell, No. 1, Delaware. Aides — Frank A. Gradawohl, No. 1; James T. Semmerteen, No. 4; William J. Hunter, No. 9; Eli S. Bane, No. 42; William J. Buckley. No. 3; Irvine E. Dickerson. Mo. 8; George R. Young, No. 17; Stephen A. Barcus, Mo. 39. Third Division: Lansdale, Ambler, South Perkasie, Hellertown, Bethlehem, Allentown. Catasauqua, Seranton and Altoona. Float — An Indian extending a welcome to a Paleface; Friendship. Mishinewa— Grant Jenkins, No. 191. Introduction 91 Aides— D. D. Swartz, No. 261; M. S. Cummings, No. 191- W Penny- packer, No. 279; George W. Donahue, No. 223; Allen H. Focht, No. 55. Fourth Division: Chester Tribes and vicinity. Float— The Rainmaker. Mishinewa — John McKnight, No. 80. Aides— Charles Martin, No. 149; Lewis Schupp, No. 266; Harry Pye- well, No. 29; George Hewes, No. 80. Fifth Division: Bryn Mawr, West Chester, Ardmore, Berwyn and Tanguey. Float — Landing of Columbus. Mishinewa— William S. Ristine, No. 306. Aides— William S. Baird, No. 47 ; W. A. Bean, No. 231 ; G. S. Hughes, No. 395; John Smith, No. 192; G. Gane, No. 306; H. L. Peoples, No. 4?! Sixth Division: Reading, and Berks and Schuylkill Counties. Float — Indian from an elevation gazing at White Men representing the Advance of Civilization. Mishinewa — Charles T. Davis, No. 330. Aides — George Sassaman, No. 74; John Luft, No. 186; David Etter, No. 330; William Sperry, No. 122; Harry Manger, No. 301; Louis Beard, No. 351; William Tindle, No. 416. Seventh Division: South New Jersey, with Camden as the basis. Float — Boston Tea-party. Mishinewa — Robert Lutton, No. 134, New Jersey. Eighth Division: Norristown, Conshohocken, Pottstown, Phoenixville, Royersford and Boyertown. Float — Rescue of Captain John Smith by Pocahontas. Mishinewa — J. Dyson Redfern, No. 1. Aides — I. J. Moyer, No. 53; Hammond S. Boyer, No. 213; Frank P. Matson, No. 478; James Frat, No. 198; James Lynagh, No. 1. Ninth Division: Tribes Nos. 7, 23, 73, 87, 31, 51. 113, 328, 25, 139, 278, 423, 8, 137, 251, 325. Float — Unity represented by the Sachem, Senior Sagamore, Junior Sagamore, Prophet and a Paleface bearing torches, joining them together. Mishinewa — John O'Donnell, No. 325. Aides — William F. MeCaffery, No. 7; Charles J. Redfern, No. 73; Charles J. Farley, No. 328; John C. Bruder, No. 23; John J. Devine, No. 251; John F. Coward, No. 139. Tenth Division: Tribes Nos. 19, 48, 381, 391, 36, 49, 69, 447, 21, 304, 396, 483. Float — An Empty Camp, with Scouts making an Examination. Mishinewa — Robt. J. Boucher, No. 21. 92 Founders' Week Memorial Volume Aides— William M. Gilbert, No. 48; Harry Kobler, No. 391 ; Joseph L. Moore, No. 447; John H. Cornelius, No. 304; James Parks, No. 381; H. F. Seiler, No. 69. Eleventh Division: Tribes Nos. 6, 17, 45, 79, 144, 150, 409, 20, 27, 32, 309. Float — The Peacemaker: an Indian maiden stopping a quarrel between two Indians with uplifted tomahawks. Mishinewa — A. Salaman, No. 17. Aides — Wm. Bueke, No. 6; Geo. C. Bowers, No. 27; Richard Moon, No. 79; Chas. Siddons, No. 17; Jos. Naylor, No. 32; Geo. Stone, No. 144. Twelfth Division: Tribes Nos. 44, 50, 124, 133, 63, 118, 238, 300, 303, 397. Float — Delivering of Wampum Belt by Tamina to William Penn. Mishinewa — J. Frank Redfern, No. 44. Aides— Chief of Staff, William M. Davis, No. 44; William Wells, No. 50; William J. Snyder, No. 238 ; Samuel Henry, No. 124; William Thomp- son, No. 133; Charles Coppes, No. 44. Thirteenth Division: Tribes Nos. 16, 24, 220, 14, 38, 58, 236, 322. Float — Charity, represented by the Prophet showing mercy to a sup- plicant who is surrounded by fierce Warriors. Mishinewa — Frank A. Barth, No. 220. Aides— William Wills, No. 322 ; Joseph Sanders, No. 14; Geo. Kirch- ner, No. 220; T. Dautrechy, No. 236; John Gresser, No. 58; W. W. Stattler, No. 16. Fourteenth Division: Tribes Nos. 9, 72, 26, 377, 105, 135, 152, 202, 76, 176, 217, 333. Float — Scalp-danee, represented by Indians dancing around a stake to which is tied an effigy of a Paleface. Mishinewa — Charles Shane, No. 377. Aides— Charles Dinan, No. 217; Jos. Mariner, No. 176; D. H. Heil- man, No. 333; Edw. N. Manning, No. 105; D. McFadden, No. 26; G. W. Hennington, No. 9. Fifteenth Division: Tribes Nos. 3, 12, 18, 70, 126, 281, 368. Float — The Totemic Bond as formed in the Warrior's Degree. Mishinewa — Alfred H. Pierson, No. 18. Aides— Wm. Naylor, No. IS; J. A. Bubeck, No. 3; Nelson O'Connor, No. 281; J. Ross Pinkerton, No. 70; Wm. Mills, No. 126; Wm. Curry, No. 12. Sixteenth Division: Tribes Nos. 30, 54, 181, 239, 404, 111, 210, 295, 355. Float — Tableaux, Acceptance into the Covenant of Faith. Mishinewa— F. S. Schnell, No. 54. Introduction 93 Aides— Jacob Unselt, No. 30; Chas. Letzing, No. Ill; Samuel Gentle, No. 239; John A. MeMaster, No. 54; Harry Wagner, No. 181; L. J. Leving, No. 295; Samuel Hancock, No. 404. Seventeenth Division: Tribes Nos. 33, 121, 138, 115, 307, 379, 200, 321, 371. Float— Tradition, when Sachem exhibits the American Flag, repre- senting Patriotism. Mishinewa— William Hamill, No. 379. Aides— Theo. Kirmse, No. 33; Wm. E. Lafferty, No. 121; R. Strieker, No. 307; Wm. H. Eppley, No. 115; H. W. Hiller, No. 200; Dr. Fred. Mor- rison, No. 371. Eighteenth Division: Tribes Nos. 81, 157, 187, 34, 184, 227, 358, 104, 451, 468, 470, 479. Mishinewa — George W. Price, No. 184. Aides— T. R. Frankenfield, No. 34; Wm. J. Shedwick, No. 157; W. J. Brookmyre, No. 451; Warden C. Mead, No. 81; Geo. F. Baier, Jr., No. 227; Robert S. Brown, No. 470. Nineteenth Division: Tribes Nos. 161, 271, 282, 455, 495, 4, 209, 343, 346. Mishinewa — James Warner, No. 209. Aides — Harry Dillmore, No. 209 ; John Fisher, No. 343 ; George Carr, No. 282; C. H. Mayberry, No. 161; Jos. H. Chandler, No. 495; George Richey, No. 455; Leonard Lockyer, No. 271; Longfellow, No. 4. 8.00 P. M. Musical-Historical Drama, "Philadelphia" — Franklin Field. Elaborate Display of Fireworks on the Delaware Kiver, opposite Eeed Street, Chestnut Street and Penn Treaty Park. Vaudeville Entertainment, ballroom Hotel Walton, for dele- gates and ladies attending the Engineering Society's Convention. 9.00 P. M. Naval Ball at the Philadelphia Navy Yard in honor of Kear- Admiral Arnold, Commander of the North Atlantic Squadron ordered to take part in the Founders' Week Celebration. Music by the Band of the dispatch boat "Dolphin." Smoker for Visiting Physicians at the Hotel Walton. Midnight. Illuminations extinguished. 94 Founders' Week Memorial Volume Friday, October 9, 1908 HISTORICAL DAY Morning. Devoted to general business, sightseeing and shopping tours. 10.00 A. M. Municipal Congress. Eepresentatives of Leading Cities to be present — City Hall. 1.00 P. M. Historical Pageant. Description of the History of Philadelphia from the time of the first Swedish and Dutch Settlements to the present. [This Historical Pageant, the first to be given in the United States, is designed to be a moving picture of the two and a quarter centuries of Philadelphia's history. In arranging the pageant care was taken to divide it into what was deemed natural sections. These may be held to comprise, in a general way, epochs of the city's history. The nine sections are divided into scenes which have to do with a, certain event or time or cus- tom in the same story. Work on the pageant, under the direction of Dr. Ellis Paxson Oberholtzer, covered many months, although the actual prac- tical work of manufacture was completed in the almost unprecedented time of ten weeks. There are nine main divisions of the pageant: First, Indians and Early Settlers; second, William Penn and the Quakers; third. Colonial Philadelphia; fourth, The Revolution; fifth, Under the Constitution; sixth, The City from 1800 to 1860; seventh, The Civil War; eighth, The Centennial; ninth, The City Beautiful.] Eoute : Porm at Broad Street and Columbia Avenue ; proceed down Broad Street to a point near the Southern Manual Training School, and dismiss. Director of the Pageant, Dr. Ellis Paxson Oberholtzer The pageant is under the artistic direction of Miss Violet Oakley. Costumes, banners, heraldic signs and accessories in charge of Guernsey Moore. Director of Music, Hugh A. Clarke. Builders of historic cars, J. J. Habermehl's Sons, under the practical supervision of Henry Habierske. Costumer, Joseph C. Fisher. Introduction 95 FORMATION DIVISION A: Exploration and Early Settlement 1— "Onrust," First Ship to enter 4— Early Swedish Settlers. Delaware River, 1616. 5— Dutch Recapture Delaware 2 — Lenni Lenape Indians. Forts, 1655. 3— Early Dutch Settlers. DIVISION B: Penn and the Quakers 6 — Penn Under Arrest, 1668. 7 — Charles II Signing the Charter, 1681. 8 — Arrival of Penn, 1682. 9 — Welsh who followed Penn. 10' — Founders of Germantown, 1683. 11 — German Mystics and Pietists. 12— The Scotch-Irish. 13 — Penn's Treaty with the Indians. 14 — Penn, his Wife and Daughter, 1700. 15 — Penn's Barge on the Delaware, 1700. '23. the DIVISION C: 16 — Proclaiming George I, 1714 17 — Constable and Town Watch. 18— Arrest of Pirates, 1718. 19 — Franklin Coming to Town, 1 20— Street Fair, 1740. 21— Palatines Going to Take Oath, 1740. DIVISION D: 28 — Resisting the Stamp Act. 29 — Virginians Coming to Congress, 1775. 30 — New Englanders Coming to Con- gress, 1775. 31 — John Paul Jones, 1775. 32 — Declaration of Independence, 1776. 33 — New State of Pennsylvania, 1776. 34 — Making the Flag. 35— The Liberty Bell. 36 — Washington, Wayne and Lafay- Colonial Philadelphia 22— First Fire Company, 1740. 23 — Old London Coffee House. 24 — Printing and Other Industries. 25— Franklin and His Kite, 1752. 26 — University of Pennsylvania. 27— Prince of Parthia, 1767. The Revolution 37 — Entrance of British, October, 1777. 38 — Lydia Darrach. 39 — The Meschianza, 1778. 40 — Franklin at the Court of Louis XVI. 41 — Robert Morris's Ox Train. 42 — Americans on the Way to York- town, 1781. 43 — Rochambeau and the French Allies. 44 — Flags Captured at Yorktown, 1781. ette, 1777. DIVISION E: Under the Constitution 48 — Sympathy for the French Revo- 45 — Adoption of the Constitution, 1787. 46 — Washington's Inauguration, 1793. 47 — Lady Washington's Reception, 1794. lution. 49 — Commerce with the Orient. 50— John Fitch's Steamboat, 1790. 51 — Commodore Barry, 1798. 52— Hail Columbia, 1798. 96 Founders' Week Memorial Volume DIVISION F: The City from 1800 to 1860 53 — The War of 1812. First Steam Train to the West, 54— Stephen Girard. 1834. 55— Lafayette's Visit, 1824. 57 — Old Ironsides, Built by Bald- 56 — Pennsylvania Railroad Presents win, 1832. Early Transportation. 58 — The Pocket, a Reading Engine, Conestoga Wagon. 1838. Canal Boat on Pittsburgh Line. 59 — Volunteer Fire Companies. Early Railway Car, 1836. 60 — Consolidation of the City, 1854. DIVISION G: The Civil War 61 — The Underground Railroad. 65 — Lincoln in Philadelphia, 1864. 62— Wide-awakes, 1860. 66 — Return of the Soldiers. 63— Departure of the Troops, 1861. 67— The Centennial, 1876. 64— Selling the War Loans. 6S— The City Beautiful. 7.30 P. M. Illumination of the City. 8.00 P. M. Parade of Patriotic Order Sons of America. In the column will be all the Camps of Philadelphia, a large number from New Jersey and the counties of Pennsylvania contiguous to the City, in full uniform. Eoute : From Broad and Diamond Streets, down Broad Street to Snyder Avenue, and dismiss. FORMATION Platoon of Police Chief Marshal, Captain Louis F. Stees Officers of the Pennsylvania State Camp President — James W. Thompson, Ashland, Pa. Vice-President — J. Calvin Strayer, York, Pa. Master of Forms — Dr. D. L. Burlington, Johnstown, Pa. Treasurer — Irwin S. Smith, Reading, Pa. Secretary — William Weand, Philadelphia. First District: Emmet B. Berger, Marshal. Second District: John R. Wright, Marshal. Third District: Henri E. Jones, Marshal. Fourth District: Walter E. Roop, Marshal. Fifth District: Charles L. Packer, Marshal. Sixth District: J. H. Cumberland, Marshal. Seventh District: John William Settle, Marshal. Eighth District: Harry T. Lukcns, Marshal. Ninth District: Herbert Haines, Marshal. Tenth District: George W. Webster, Marshal. Introduction 97 Eleventh District: William J. Albright, Marshal. Twelfth District: Hiram L. Wynne, Marshal. Thirteenth District: James E. Sanborn, Marshal. 8.00 P. M. Musical-Historical Drama, "Philadelphia"— Franklin Field. Midnight. Illuminations extinguished. Saturday, October 10, 1908 ATHLETIC AND KNIGHTS TEMPLAR DAY Morning Devoted to general business, sightseeing and shopping tours. 6.00 A. M. to 10.00 A. M. International Chassis Automobile Bace, 200-mile contest over roads of Fairmount Park, under auspices of Quaker City Motor Club, for a valuable trophy. Twenty automobiles of national and international reputation as racers will compete for first honors. Among the men who will handle the cars will be some of the most daring and capable racing drivers in the world. This will be one of the greatest spectacles the country has ever seen. Officials for the Contest Referee — Dr. J. R. Overpeck Patrol Judge — Chas. J. Swain Assistant Patrol Judge — Richard Sellers Honorary Judges Manager of Grand Stand Hon. John E. Reyburn Geo. W. Daley George W. B. Hicks Chairman Press Committee Col. L. E. Beitler H. U. Sharp Col. A. Louden Snowden Chief Timer Jesse T. Vogdes R E Rosg Judges Chief Scorer P. D. Folwell M. J. O'Mara George H. Smith clerk 0I the Course A. T. James A. B. Cumner Starter Asst. Clerks of the Course W. Wayne Davis joe Keir Marshal C. E. Bartlett F. M. Johnson Surgeons Chief of Umpires Dr. H. R. Owen John H. Hickman Dr. John F. Sinclair 98 Founders' Week Memorial Volume Official Cars — White Steamers Secretary — H. C. Harbach. Treasurer — A. T. Stewart To be held "under the rules and with the sanction of the Racing Board of the American Automobile Association." Contest Committee Richard Sellers, Chairman Chas. J. Swain F. M. Johnson Edwin H. Lewis W. Wayne Davis G. Hilton Gantert A. B. Cumner J. R. Overpeck M. E. Brigham Irving J. Morse P. D. Folwell C. Edwin Bartlett EL C. Harbach Racing Board Arthur B. Cumner, Chairman Richard Sellers P. D. Folwell F. M. Johnson J. R. Overpeck H. C. Harbach, Secretary to Committees. 12.00 M. Parade of Horsemen, under the auspices of the Eoad Drivers' Association of Pennsylvania. Eoute: Form at Broad and Pine Streets; North on Broad Street to Oxford Street, to Thirty-third Street, to Dauphin Street entrance of the Park ; thence over Trolley Bridge via Ford Drive to head of Speedway, and over Speedway to Chamounix end, and there dismiss. FORMATION Chief Marshal and Staff First Division: Single Horse to One-man Wagon. Second Division: Double Teams to One-man Wagon. Third Division: Single Horse to Wagon, seating two. Fourth Division: Double-team Wagons, seating two. Fifth Division: Single and Double Teams to Wagons seating four; four-in-hands and miscellaneous teams. Following the Parade there will be a series of Paces held on the Speedway for which the City of Philadelphia has awarded Hand- some Silver Cups as first prizes. In addition the Eoad Drivers' Association will award four ribbons in each class. These races are Introduction 99 open to all, amateur or professional drivers, no one barred. The classes will be : Class A— Free-for-all, Trotting. Class D— Pacing. Class B— Free-for-all, Pacing. Class E— Trotting. Class C— Trotting. Class F-Running. The Trotting and Pacing Paces will be best 2 in 3, half mile heats, to wagons. The Running Races will be in half mile and repeat. General Road Drivers' Committee Joshua Evans, Belmont and Gentlemen's Driving Club Joseph A. Wenderoth, Philadelphia Turf Club Hugh McAnany, Philadelphia Driving Park, Point Breeze John J. Winkler, North Penn Trotting Association James Bell, Tioga Driving Club Lewis McDowell, Kensington Driving Club Charles Schofield, Roxborough Driving Club Charles Chipman, Cedar Park Driving Club Ash S. Pennington William Laycock Channing Eastburn Paul Connelly J. C. Swisher George W. Cook J. Dobson Hagy. 1.00 P. M. Founders' Week Athletic Celebration. Philadelphia Ball Grounds, Broad and Huntingdon Streets. Dr. J. K. Shell, in charge. EVENTS Open to All Registered Amateur Athletes 100-yard Boys' (17 years) Eace, 120-yard Dash, Handicap. Seatch. 440-yard Dash, Handicap. 220-yard Novice, Scratch. 880-yard Run, Handicap. One-mile Novice, Scratch. Running High Jump, Handicap. Two-mile Steeplechase, Handicap. Running Broad Jump, Handicap. Pole Vault, Handicap. Relay Races Handicap 880-yard Midget Race, 5 feet or under. 880-yard Grammar and Boys' Race, 17 years and under. One-mile School and Academy. Medley Relay Race— 220, 400, 660 and 880 yards. Frizes Emblematic Solid Gold, Silver and Bronze Medals to 1st, 2d and 3d. Special Cups for Relay Races, 1st, 2d and 3d. 100 Founders' Week Memorial Volume 1.00 P. M. Knights Templar Parade on Broad Street, followed by Field Day Exercises at Belmont, West Fairmount Park. Koute : Form at Masonic Temple, Broad and Filbert Streets. March South to Spruce Street and countermarch on Broad Street to Poplar Street, where special cars will be taken to convey the Sir Knights to Belmont. FORMATION Platoon of Police Chief Marshal, P. E. Sir McCIuney Radcliffe Aides — E. Sir Samuel Laughlin, E. Sir John 0. Taylor, E. Sir Joseph L. Mann, E. Sir Harry H. Heist. Staff— E. Sir George B. Wells, No. 2, Chief of Staff; E. Sir A. Howard Thomas, No. 2, Herald; E. Sir Wm, H. Sivel, No. 53, Standard Bearer; E. Sir John A. Bolard, No. 4; E. Sir George W. Loudenslager, No. 29; E. Sir David W. Stewart, No. 36; E. Sir A. G. Criswell Smith, No. 47; E. Sir S. Curtis Ingalls, No. 53; E. Sir Lewis T. Matlack, No. 54; E. Sir Robert P. Mercer, No. 66; E. Sir Charles H. Brelsford, No. 70; E. Sir Burd P. Evans, No. 82. Commanderies Participating Philadelphia Commandery, No. 2, K. 1. E. Sir William C. Ash, Eminent Commander. Sir Joseph W. Kenworthy, Generalissimo. Sir Bertram D. Bearick, Captain-General. St. John's Comma'ndery, No. 4, K. T. E. Sir Charles T. Baker, Eminent Commander. Sir Henry F. Mitchell, Generalissimo. Sir Hayes H. Duncan, Captain-General. Eadosh Commandery, No. 29, K. T. E. Sir Thomas Biddle Ellis, Eminent Commander. Sir William B. Chalfant, Generalissimo. Sir Thomas R. Patton, Jr., Captain-General. Mary Commandery, No. 36, K. T. E. Sir James W. Baird, Eminent Commander. Sir Paul J. Pontius, Generalissimo. Sir Charles T. Gilden, Captain-General. St. Alban Commandery, No. 47, X. T. E. Sir Charles S. Wood, Eminent Commander. Sir Thomas J. Beatty, Generalissimo. Sir Ellis M. Harvey, Captain-General. Introduction 101 Corinthian "Chasseur" Commandery, Ho. 53, K. T. E. Sir I. Roberts Newkirk, Eminent Commander. Sir August P. Kunzig, Generalissimo. Sir Wesley R. Roe, Captain-General. Kensington Commandery, Ho. 54, K. T. E. Sir Norbert Whitley, Eminent Commander. Sir Joseph B. Quigley, Generalissimo. Sir William B. Marshall, Captain-General. Chester Commandery, Ho. 66, K. T. E. Sir A. Lincoln Castle, Eminent Commander. Sir William H. Irving, Generalissimo. Sir Wesley R. Morgan, Captain-General. Pennsylvania Commandery, Ho. 70, K. T. E. Sir Linnaeus E. Marter, Eminent Commander. Sir Ernest P. Appledorn, Generalissimo. Sir Louis J. Gerson, Captain-General. Germantown Commandery, Ho. 82, K. T. E. Sir Walter B. Staton, Eminent Commander. Sir Thomas R. Wiggins, Generalissimo. Sir William Wilkie, Captain-General. 12.00 M. Boating Carnival and National Eegatta on the Schuylkill Kiver, over the National Course. Parade of all the boats of the Schuylkill Navy from Boat Clubs to the lower end of the course. EACIHG EVENTS One-Mile Course Single Sculls. Quadruple Sculls. Double Sculls. Four-oared Shells. Eight-oared Shells. 3.00 P. M. Belmont, West Fairmount Park. Commanderies form for Field Day Parade and Beview. They will be reviewed by the Grand Commander of Pennsylvania, E. E. Sir William J. Milligan and Staff. Following the review there will be Exhibition Drills by the various Commanderies. 6.45 P. M. Knights Templar Commanderies depart from Belmont and pro- ceed to Franklin Field, University of Pennsylvania. 8.00 P. M. Fireworks Display, West Fairmount Park. 102 Founders' Week Memorial Volume Introduction — The beginning of the display will be announced by the discharge of three mammoth report shells. Illumination — Magical illumination of the entire surroundings by the use of eighteen one-pound patent prismatic illuminators in crimson and green, burning with intense brilliancy. Beautiful and lasting. Aerial Bouquet — Thirty-six one-pound rockets fired simultaneously form a beautiful bouquet of mammoth proportions, in all the colors of the rainbow. Grand Device — Cross and Crown. Bombshell Display — Two eighteen-ineh shells in floating star effect, displaying numerous stars of mammoth proportions, floating away in the heavens. Aerial Festoons — One mammoth thirty-inch shell in Japanese festoon effect, suspending in the sky immense festoons or crescents of diamond lights, changing constantly and disappearing in a golden rain. Weeping Willow — Two eighteen-inch shells in weeping willow effect, displaying grand burst of golden hanging spurs representing the graceful branches of the willow. One mammoth thirty-inch shell in golden meteor effect. Triple Bombshell Display — One eighteen-inch three-break shell which, on reaching its altitude, gives three separate and distinct breaks, each in different colors and effects. Grand Device — William Penn — A reproduction of our famous William Penn Statue on City Hall, in fire. Rocket Display — Six four-pound rockets in golden wreath effect, dis- playing numerous wreaths of liquid fire intermingling in their descent. Silver Clouds — Four six-pound rockets in silver cloud effect, six four- pound rockets in Japanese festoon effect. The Spider and the Fly — Four six-pound rockets in spider and fly effect which, on reaching their altitude, develop into monster spider shapes surrounded by flies of various hues. Old Glory — Four six-pound rockets in red, white and blue effect, dis- playing the national colors. Miscellaneous — "Flight of Whistling Jacks" darting and hissing through the air in a comical manner. Golden Canopies or Umbrellas of Fire — Eight mammoth Yellowstone geysers whirling upwards in grand columns and developing into canopies of gold. Exceptionally beautiful. Polychromatic Canopy — Four thirteen-inch shells fired in rapid suc- cession, forming an immense many-colored canopy in richest tints at a great altitude. Grand Device — Niagara Falls — Monster waterfall illustrating a cata- ract in the most realistic manner and covering a fire frontage of fifty feet. Introduction 103 Special Shell and Rocket Display— Two eighteen-ineh shells in golden duration star effect. One mammoth thirty-inch shell in silver duration star effect. The Banner in the Sky— Six four-pound rockets in red, white and blue effect. Aerial Searchlights— Four six-pound rockets in searchlight effect- developing into radiant silver lights of intense brightness. Two eighteen- inch shells in beautiful sapphire effect. One mammoth thirty-inch shell in liquid fire effect. Six four-pound rockets in liberty effect. Four six-pound rockets in golden meteor effects. One mammoth thirty-inch two-break shell, showing all the latest and newest tints, colorings and effects. Aerial Parachntes — Four six-pound rockets in parachute effect, releas- ing at a great altitude floating stars in changing colors. Six four-pound rockets in liquid gold effect. Electric Cascade Shells — Two eighteen-ineh shells in cascade effect, bursting into magnificent cascades of electric hues intermingled with emerald stars. Two eighteen-ineh shells in three breaks, which on reaching their altitude, give three distinct and separate breaks each in different colors and effects. The Plumes of the Peacock — One mammoth thirty-inch shell in pea- cock plume effect, which on reaching its altitude, with loud detonations, releases gorgeous canopies of feathery plumes in richest colorings. Grand Device — American Beauty Rose. Grand Finale — Bombardment — As a conclusion of this great display there will be a bombardment which will embrace in one grand pyrotechnical effect every device known to the firework art, all fired simultaneously. Grand Flight of seventy-two one-pound rockets. 8.00 P. M. Musical-Historical Drama, "Philadelphia" — Franklin Field. Knights Templar Night. 10.00 P. M. to 11.00 P. M. Sacred Concert by Combined Choirs at Broad and Arch Streets. The Seven Chorus Choirs, numbering 300 each, which were organized to sing at the Sunday Afternoon Meetings on October 4th, in the City Squares and in Fairmount Park, will be combined, and render a Sacred Concert. In addition to the Anthems and Hymns sung by the Choruses at the Squares and Parks on the pre- vious Sunday, there will be sung many popular hymns. On the approach and massing of the Knights Templar at the North front of the City Hall, at 11.00 o'clock, the Chorus will sing, "Onward, Christian Soldiers." 104 Founders' Week Memorial Volume 10.15 P.M. Knights Templar leave Franklin Field for City Hall. Boute: East over Walnut Street Bridge to Twenty-second Street, to Locust Street, to Broad Street and thence to City Hall. After passing around the East side of City Hall will mass to the North of the Building, where the Knights Templar will officially close the Two Hundred and Twenty-fifth Anniversary Celebration of the Founding of the City. Closing Exercises 11.15 P.M. Knights Templar mass in front of the City Hall. Selection by Band — "My Country, 'Tis of Thee.' Address by R. E. Sir William J. Milligan, Grand Commander of Penn- sylvania. Prayer. Address — His Honor, John E. Reyburn, Mayor of Philadelphia. Proclamation, by Grand Marshal, accompanied by the Grand Herald, that the 225th Anniversary Celebration is at an end. The proclamation is made to the East, to the West, to the North and to the South. As the Herald sounds the final note to the South, every light on the City Hall will be simultaneously extinguished. Benediction. Selection by Band — "Star Spangled Banner." Scientific Institutions The American Philosophical Society By J. G. ROSENGARTEN, LL.D. FBANKLIN, in his Autobiography, says that in the year 1727 or 1728, when he was but twenty-two years of age, "I united the majority of well-informed persons of my acquaintance into a club which was called the Junto, the object of which was to improve our understandings. We met every Friday evening." The American Philosophical Society is the direct lineal successor of that Junto, and still maintains the Friday evening meetings. As the population grew larger and the colonies became more densely settled, Franklin saw the need of a society of larger scope and usefulness than the Junto, and in 1743 he issued his well- known circular, entitled "A Proposal for Promoting Useful Knowl- edge Among the British Plantations in America," in which he urged "That one society be formed of virtuosi, or ingenious men, residing in the several colonies, to be called the American Philo- sophical Society, who are to maintain a constant correspondence. That Philadelphia, being the city nearest the center of the conti- nent colonies, communicating with all of them northward and southward by post, and with all the islands by sea, and having the advantage of a good growing library [The Philadelphia Library, founded in 1731], be the center of the Society." The proposition was favorably received, and Dr. Franklin, when in Few York in the spring of the following year, wrote to Governor Cadwallader Colden of that Province: "I can now acquaint you that the Society, as far as relates to Philadelphia, is actually formed and has had several meetings to mutual satis- faction The members are Dr. Thomas Bond as Phy- sician, Mr. John Bartram as Botanist, Mr. Thomas Godfrey as Mathematician, Mr. Samuel Ehodes as Mechanician, Mr. William Parsons as Geographer, Dr. Phineas Bond as General Nat. Philosopher, Mr. Thomas Hopkinson, President; Mr. William Cole- man, Treasurer; B[enjamin] F[ranklin], Secretary. To whom the following members have since been added, viz.: Mr. Alex- (105) 106 Scientific Institutions ander, of New York; Mr. Morris, Ch. Justice of the Jerseys; Mr. Home, Secretary of Do.; Mr. Jno. Coxe, of Trenton, and Mr. Martyn, of the same place. Mr. Nicholls tells me of several other Gentlemen of this City that incline to encourage the thing — And there are a number of others in Virginia, Maryland, Carolina and the New England Colonies who we expect to join us as soon as they are acquainted that the Society has begun to form itself." Thus was launched the first scientific society in the New World. It led a struggling life, the details of which we do not fully know, as the early records appear not to have been preserved, but from indirect evidence there is reason to believe that in the later fifties the Society passed into a condition of suspended ani- mation, to revive and flourish at a later period with greater vigor than it had previously possessed. For the original Junto Franklin still retained the warmest affec- tion. From England he wrote, in 1765, to his friend, Hugh Eoberts : "I wish you would continue to meet the Junto, notwith- standing that some effects of our public political Misunderstandings may sometimes appear there. 'Tis now perhaps one of the oldest Clubs, as I think it was formerly one of the lest in the King's Dominions. It wants but about two years of Forty since it was establish'd." The political dissensions between the Proprietary Party, led by James Hamilton, and the Popular Party, led by Franklin, resulted in the concentration of the energies of the friends of the former, on the American Philosophical Society, and this in turn inspired Franklin's friends to reorganize the Junto, and in Decem- ber, 1766, it determined to extend its scope, to admit non-residents, and to change the name for the more ambitious title of "The American Society held at Philadelphia for Promoting Useful Knowledge." It elected Dr. Franklin, President, Charles Thom- son, Secretary, and added to its old Philadelphia members of the original Junto, many men of note from the other provinces. The American Philosophical Society of 1743 was thus stimu- lated into renewed activity in the later sixties by the expansion of its now vigorous rival. Governor John Penn became its Patron, and it enjoyed the special countenance and protection of the Proprie- tary Party, which probably accounts for the more active interest of Franklin and his friends in the American Society. The year 1768 opened with the American Society and the Philosophical Society side by side in the same city, zealously BENJAMIN FRANKLIN PAINTED BY DAVID MARTIN ABOUT 1766 FROM THE COPY BY CHARLES WILLSON PEALE IN THE POSSESSION OF THE AMERICAN PHILOSOPHICAL SOCIETY The American Philosophical Society 107 engaged in the same pursuits, with a considerable proportion of their members belonging to both societies. It was inevitable that the advisability of union should strongly commend itself to the good sense of the members of each. It took the whole year to elaborate the details, which was done with much formality and necessitated considerable diplomacy; but finally, on December 20, the terms were mutually agreed upon by both societies in session at the same time. i On the evening of the 2d of January, 1769, the conjoined Society, under the title by which it is still known, "The American Philosophical Society held at Philadelphia for Promoting Useful Knowledge," held its first meeting and its first election of officers. The candidacy for President led to an active contest. The names presented were those of Dr. Franklin, the President of the American Society, who was, and had been for some time, abroad on public business and who was identified with the Popular Party in politics, and of ex-Governor James Hamilton, President of the Philosophical Society and a leader of the Proprietary Party. The deepest interest was taken in the balloting. Eighty-nine votes— a very large number for those days, or even, indeed, for the present day — were cast. Franklin, the philosopher and founder of one of the constituent societies, was properly chosen the first Presi- dent of the conjoined Society, and he held the office by successive re-election until his death in 1790. The Governor of the Province, the Honorable John Penn, was then formally invited to become the Patron of the Society, but he declined, and Bishop White tells us that the language he used on the occasion was: "No, gentlemen, I cannot be the Patron of a Society whose first President is the greatest enemy of my family." Two years later, however, his successor, Gover- nor Eichard Penn, showed a better feeling, and in accepting the office of Patron, in the most courteous terms begged to assure the Society that he should "not consider the patronage of the Philosophical Society, begun and flourishing in this province, as the least honourable appendage to my present appointment." The Vice-Presidents of the Society elected at the same time were Dr. Thomas Cadwalader, Dr. Thomas Bond and Joseph Galloway, and the Secretaries were Charles Thomson, Eev. Wil- liam Smith, Thomas Mifflin and Eev. John Ewing — a remarkably brilliant galaxy of men. Drs. Cadwalader and Bond were the 108 Scientific Institutions leading physicians in the province, and Joseph Galloway was a highly influential citizen, Speaker of the Assembly from 1766 to 1774, a member of the Continental Congress of 1774 and 1775; he finally, however, sided with the Tories and removed to England never to return. Charles Thomson, the "man of truth," as the Indians called him, was the patriot Secretary of the Continental Con- gress, the memory of whose faithful and devoted services the lapse of over a century and a quarter has not dimmed. Eev. William Smith was the energetic and learned Provost of the College, whose zeal for education even prison walls could not restrain, for when arrested by the Assembly for alleged libel of the Quakers, he lectured to his classes behind the bars. Eev. John Ewing, an eminent mathe- matician and scientist, was his successor in the office of Provost, and Thomas Mifflin became a member of the Continental Con- gress, a major-general in the Continental Army, a member of the convention that framed the Constitution of the United States, and also of the convention that framed the Constitution of the State of Pennsylvania. He was the first governor of the State elected under the new constitution, and served for three successive terms. The Society, in its laws, ideals and methods of work, took for its model the Eoyal Society of London, and arranged for the publication of its "Transactions" in quarto form, the first volume appearing in 1771, and passing through two editions. The Society at once entered upon arrangements to success- fully carry out a notable scientific undertaking of great magni- tude for those days with its limited resources, viz.: to make careful observations on June 3, 1769, of the expected transit of Venus, a very rare phenomenon which would not recur again for 105 years, and accurate observations of which were very important for determining the distance of the earth from the sun. The Assembly was petitioned for aid, and it gave a grant of money and leave to the Society to erect an observatory in the State House yard for the purpose of observing the eclipse. Three temporary observatories were built, one in the State House yard (from the balcony of which the Declaration of Inde- pendence was subsequently proclaimed in 1776), one at David Eittenhouse's place at Norriton, about twenty miles northwest of Philadelphia, in Montgomery County, and one at Cape Henlopen. Committees were appointed by the Society to conduct the obser- vations at the three different stations. A telescope with a The American Philosophical Society 109 Dollond micrometer was purchased, by order of the Society, by Dr. Franklin in London, and another was sent by Hon. Thomas Penn, one of the proprietors, with a request that after it had been used for the observation of the transit, it should be given to the College, and other instruments of sufficient number and of good quality were supplied. David Rittenhouse constructed a clock for the time observations, which still stands on the west wall of the hall of the Society, and so well was it made that, although it has been running for 140 years, it is still a good timekeeper. The day for which astronomers all over the world had made most elaborate preparation, and whose coming had been most anxiously awaited, at length arrived. In Northern Europe cloudy weather disappointed the hopes of the astronomers, but at Phila- delphia, after several days of stormy weather, it finally cleared on the morning of the transit, and Provost Smith, who was one of the observers, tells us that "there was such a state of serenity, splendour of sunshine and purity of atmosphere that not the least appearance of cloud was to be seen." The observations at the Society's three observatories were successfully made, and in no part of the world were they more perfect or more important. Of them a high authority has said: "The first approximately accurate results in the measurement of the spheres were given to the world, not by the schooled and salaried astronomers who watched from the magnificent Eoyal observatories of Europe, but by unpaid amateurs and devotees to the science in the youthful province of Pennsylvania." These observations were subsequently published in full detail in the first volume of the Society's Trans- actions. A copy of this volume was sent to each member of the Assembly as an acknowledgment of the grateful sense which the Society entertained of the public patronage and encouragement which it had received from the Assembly of Pennsylvania, and the address, which accompanied the volume, concluded with the fol- lowing paragraph: "As the various societies which have of late years been instituted in Europe have confessedly contributed much to the more general propagation of knowledge and useful arts, it is hoped that it will give satisfaction to the members of the honour- able House to find that the province which they represent can boast of the first Society and the first volume of 'Transactions' 110 Scientific Institutions for the advancement of useful knowledge on this side of the Atlantic; a volume which is wholly American in composition, printing and paper, and which, we natter ourselves, may not be thought altogether unworthy of the attention of men of letters in the most improved part of the world." The Society continued the active prosecution of the objects for which it was founded up to March 4, 1774, when there began a series of interruptions to its regular meetings which continued for five years, due to the political complications with the mother country which occupied the thoughts and engrossed the energies of its members, and before which the quiet pursuits of science perforce had to give way. Before the minutes of the meeting of December 17, 1774, appears the following note in the handwriting of Dr. Benjamin Bush, one of the Secretaries : "The Acts of the British Parliament for shutting up the port of Boston, for altering the charters, and for the more impartial administration of justice in the province of Massachusetts Bay, together with the bill for establishing popery and arbitrary power in Quebec, having alarmed the whole of the American Colonies, the members of the Philosophical Society partaking with their countrymen in the distress and labours brought upon their country, were obliged to discontinue their meetings for some months, until a mode of opposition to the said Acts of Parliament was established, which they hope will restore the former harmony, and maintain a perpetual union, between Great Britain and the American Colonies." In little more than eighteen months after this hope of har- mony and perpetual union was expressed, the writer of the above note became a signer of that memorable document which declared the independence of the American Colonies and their eternal separation from the mother country. All minds were deeply absorbed in the stirring political events which were crowding upon the Colony with startling rapidity. In April, 1775, the first bat- tle was waged at Lexington; in May, the second Continental Congress convened at Philadelphia ; and in June the battle of Bunker Hill was fought. Dr. Patterson, in his discourse at the celebration of the one hundredth anniversary of the founding of this Society, said: "During such times as these a Philosophical Society bearing and meriting the name of American, could not he expected to go forward. There were accordingly very few The American Philosophical Society 111 meetings in 1775." An event, however, of great importance to the Society in this year was the return to America of Dr. Franklin on the 5th of May, and he presided for the first time over the Society at its meeting on the 27th of September following. On taking the chair he said: "The great honour done me by this Society, in choosing me so many years successively their Presi- dent, notwithstanding my absence in Europe, and the very kind welcome they are pleased to give me on my return, demand my most grateful acknowledgments." In the Autumn of the following year he was sent to Europe on the public service, and did not again occupy the Chair until after his return from France in 1785. From 1776 to 1778 the work of the Society was almost totally interrupted by the occupation of Philadelphia by the enemy and the operations of the war in the surrounding country, but on the 5th of March, 1779, the Society reassembled, never again to be interrupted in its scientific pursuits. In 1780, before the adoption of the Constitution of the United States, and when Pennsylvania was still an independent State at war with Great Britain, the General Assembly granted a most liberal charter to the Society, which contains the follow- ing unique provisions: "That it shall and may be lawful for the said Society by their proper officers, at all times, whether in peace or war, to correspond with learned societies, as well as individual learned men, of any nation or country, upon matters merely belonging to the business of the said Society, such as the mutual communication of their discoveries and proceedings in philosophy and science; the procuring books, apparatus, natural curiosities, and such other articles and intelligence as are usually exchanged between learned bodies for furthering their common pursuits; provided always, That such correspondence of the said Society be at all times open to the inspection of the Supreme Executive Council of this Commonwealth." This Society always maintained a deep and patriotic interest in the political events of the day. After the surrender of Corn- wallis at Yorktown it adopted, on December 27, 1781, the fol- lowing address to General Washington : "The American Philosophical Society held at Philadelphia for Promoting Useful Knowledge beg leave to welcome your Excellency's return from your late expedition. "Sensible of the influence of civil liberty and the purposes 112 Scientific Institutions of their institution, they have always conceived their interests as a society to be dependent on the great cause of their country; indebted to the former successes of the American army under your Excellency's command for the revival of their labour, they have considered this as one motive, among many, of affection for your person; the additional security in the pursuits of science derived from the late capture of the British army forms a con- siderable part of their joy at that happy event, and will heighten the lustre of your Excellency's character in the eyes of your coun- try, of the world and of posterity. "The Society embrace this opportunity of joining in the gen- eral testimony of gratitude for the services rendered in the late campaign by the fleet and army of our great ally; it is with pleasure they reflect that this tribute is due to a nation who have long excelled in arts as well as in arms and with whose literary characters it has been their ambition, from the time of their institution, to cultivate a correspondence. "We think ourselves peculiarly happy in this opportunity of assuring your Excellency that we not only feel the warmest affection and respect for your private virtues and public services, but that we consider it as one of the chief honours of our Society that we have your Excellency's name in the list of our members." In 1785, the State desiring to aid the objects for which the Philosophical Society was instituted, but recognizing that it was contrary to the spirit of republican institutions to make annual grants to the Society, as is customary in similar cases in the monarchical governments of Europe, granted to the Society a lot in the State House Square for the erection thereon of a hall, which should always be. free from taxation, and it further provided that the Society might obtain income by renting out such rooms in the hall as it did not require for its own uses, provided that the income so derived should be expended for the purposes for which the Society was organized. The present hall was built and com- pleted in 1789, and the income derived from the rental of the rooms has furnished the Society with its publication fund. The "Transactions" of the Society are published in quarto and comprise six volumes, running from 1771 to 1809, and a new series still current beginning in 1818, of which twenty-one volumes have been published. The "Proceedings" are in octavo form, and were begun in 1838, and volume xlviii is now in course of publication. The American Philosophical Society 113 In the closing years of the eighteenth century Philadelphia was the seat of the National Government, and those highest in authority believed that the Government should exert its influence to advance education and learning. The meetings of the Society were then attended by Franklin, Washington, Jefferson, Hopkin- son, Charles Thomson, Gallatin, Madison, Robert Morris, John Quincy Adams, and others prominent in the political life of the country. Franklin, on his death in 1790, was succeeded in the Presi- dency by David Eittenhouse, the patriot astronomer and Vice- President of the Council of Safety of the Province of Pennsyl- vania, who held the office until his death, five and a half years later. After the death of each, eulogies were delivered, by appointment, before the Society, by Provost Smith and Dr. Push, respectively, and on each occasion the President and the Senate and the House of Eepresentatives of the United States, the foreign Ministers and Judges of the Courts, and other high public functionaries attended in their official capacity in evidence of their sympathy in the losses which science had sustained. Thomas Jefferson was the third President of this Society, and held the office for eighteen years. In his letter accepting the office he said: "The suffrage of a body which comprehends whatever the American world has of distinction in philosophy and science in general, is the most flattering incident of my life, and that to which I am the most sensible." As Vice-President of the United States under Mr. Adams he took but little part in the affairs of the Administration, and was at liberty to cultivate the sciences. When he came to Philadelphia to be inaugurated Vice- President, in the year following his election to the Presidency of this Society, he brought with him a number of the fossilized bones of some large quadruped of the sloth family and the manuscript of a memoir upon them, which he read before the Society. "The spectacle of an American statesman coming to take part as a central figure in the greatest political ceremony of our country and bringing with him an original contribution to science is certainly," as a recent writer has well said, "one we shall not soon see repeated." During the eight years that Jefferson was President of the United States, he was also President of the American Philosophical Society, and was in touch with all the intellectual activities of 114 Scientific Institutions the period. He wrote to one correspondent: "Nature intended me for the tranquil pursuits of science by rendering them my extreme delight," and to another he said : "Your first letter gives me information in the line of natural history, and the second promises political news; the first is my passion, the last is my duty.'' The most exciting political duties could never withdraw him from the pleasurable pursuits of science. "Thus,"' as Browne Goode has well said, "during those exciting weeks in February, 1801, when Congress was vainly trying to untangle the difficulties arising from the tie vote between Jefferson and Burr, when every politician at the Capital was busy with schemes and counter- schemes, this man, whose political fate was balanced on a razor's edge, was corresponding with Dr. Wistar in regard to some bones from Shawangunk, in New York. Again, in 1808, when the excitement over the embargo was highest, and when every day brought fresh denunciations of him and his policy, he was carry- ing on his geological studies in the White House itself. Under his direction upwards of 300 specimens of fossil bones had been brought from the famous Big Bone Lick and spread in one of the large unfinished rooms of the Presidential mansion. Dr. Wistar was asked to come from Philadelphia to select such as were needed to complete the collection of the Philosophical Society." Jefferson's devotion to science led to much acrimonious criticism, of which the lines of William Cullen Bryant, in "The Embargo," afford a mild example: "Go, wretch, resign the Presidential Chair; Disclose thy secret measures, foul or fair. Go, search with curious eyes for horned frogs 'Mid the wild waste of Louisianian bogs, Or where the Ohio rolls his turbid stream Dig for huge bones, thy glory and thy theme." President Jefferson maintained his deep interest in this Society to the day of his death, and to his influence it is indebted for many valuable contributions to its publications, as well as to its library and cabinet. He was succeeded in the Presidency by Dr. Caspar Wistar, and the subsequent incumbents were Dr. Robert Pat- terson, Chief Justice Tilghman, Peter S. Du Ponceau, Eobert M. Patterson, Dr. Nathaniel Chapman, Dr. Franklin Bache, Professor Alexander Dallas Bache, Judge John K. Kane, Dr. George B. Wood, Mr. Frederick Fraley, General Isaac Wistar, Dr. Edgar F. Smith and Dr. W. W. Keen. The American Philosophical Society 115 Such, in brief, is the history of the Society down to the begin- ning of the 19th century, covering the most interesting period of its existence, even though it be not that of its greatest activity in scientific pursuits. From it we learn that the leaders of intel- lectual thought and activity in the provinces, when the liberties of the people became endangered, were the first to sound the note of warning and to organize resistance to the encroachments of the mother country. When separation became inevitable, it was they who framed and launched the new "Ship of State," and took their places at the helm and guided her through the tempestuous sea of revolution, and finally brought her into the harbor of peace with the recognition of her independent sovereignty. It was they who laid so well the foundations of self-government by a free people, that its success has been assured in spite of the severe strains to which it has since been subjected. The Society has a library of 45,000 volumes, rich in the "Trans- actions" of learned societies. Franklin left to it nearly a hundred volumes of the publications of the great French scientific societies, and these are represented on its shelves by exchanges with the five Academies that now constitute the famous Institut de France. The American Philosophical Society is the custodian of the greater part of the Franklin papers and correspondence in exist- ence. After a long period in the ownership of William Temple Franklin, the grandson of Franklin, and the editor of the first collected edition of his writings in six volumes, they came through Charles Fox and his family to the Society. They con- tain forty-four volumes of letters to him from 1735 to 1790; the forty-fifth volume contains copies of his own letters; the forty- sixth, his correspondence with his wife; the forty-seventh and forty-eighth, his own letters from 1733 to 1789; the forty-ninth, his scientific and political papers; the fiftieth, his other writings, notably his famous Bagatelles, clever squibs printed on his own press at Passy, near Paris, during his long service as the repre- sentative of the United States to France at the time of the Eevolution ; the fifty-first, poetry and verse ; the fifty-second, the "Georgia Papers," — he was agent for that Colony; the remaining twenty volumes, all his multifarious correspondence with men of all nationalities who wrote to him for help and advice on every conceivable subject. The Society has also in its library, eight volumes of letters, from 1775 to 1790, to Temple Franklin, his grandson and secretary. 116 Scientific Institutions From the Historical and Literary Committee of the Philo- sophical Society, with its publication of valuable volumes in 1819, sprang the Historical Society of Pennsylvania, now strong with its splendid collections. From its members, too, went forth those who founded the Academy of Natural Sciences of Philadelphia, now one of the most important institutions of its kind in this country. The Philosophical Society's collections of natural history were deposited with the Academy of Natural Sciences; its collec- tion of coins with the Numismatic Society; its archaeological col- lection in the Archaeological Museum of the University of Penn- sylvania. In early days it rented quarters in its building on Fifth Street below Chestnut, on land given by the State in Colonial times, successively to the College of Philadelphia, the University of Pennsylvania, the College of Physicians, the Historical Society, the Athenasum and Peale's Museum. Founded in honest imitation of the Eoyal Society, of which, in 1756, Franklin was elected a member, in the first years of his scientific publications, it has kept in touch with the parent society by an exchange of publications and by selecting and electing members on the basis of the system that has worked so well with that venerable body, limiting the number annually to fifteen American and five foreign members. Under the inspiration of Franklin the early foreign members were mainly Englishmen of note in science; the earliest, Maskelyne and Banks, and the other leaders of his and their day. From those whom he met during his long residence in France and from the distinguished Frenchmen who came to this country during the war for American independence, the Philosophical Society elected many men of note, among them Lafayette, Bochambeau, Chastellux, Barbe-Marbois, Vergennes, Buffon, Condorcet, Talleyrand. When the French Eevolution forced many noted men to seek in Philadelphia a harbor of refuge, the Philosophical Society elected, among others of these exiles, Volney, Brissot de Warville, Eochefoucauld, and found them active and useful members. Another notable Frenchman, Du Ponceau, came to Philadelphia at the time of the War of Independence, and after serving with Steuben, became a leader of the Bar and was elected President of this Society and contributed many valuable papers to its proceedings. Through all its history the Society has elected leaders of The American Philosophical Society 117 science and of letters, both American and foreign, and its rolls contain the names of representative men down to our own day. The Philosophical Society has a wealth of rare manuscripts in its library, notably: the Field Notes of Lewis and Clark's expedition, deposited by Colonel Clark at the request of Presi- dent Jefferson; a collection of Penn papers, arranged by Joshua Francis Fisher, with much interesting material in reference to the Penn-Baltimore boundary controversy; the original copy of Penn's Charter of Privileges, dated 1701, the one retained by Penn; a volume of original papers relating to the claims of Connecticut in the Wyoming Valley, so long a subject of legal con- troversy and actual warfare; a manuscript volume of the Laws of Pennsylvania prior to 1700, with the only known copy of some of the earliest- laws ; much valuable manuscript correspond- ence of the men of the American Eevolution, described in the "Calendar of the correspondence, relating to the American Revo- lution, of Brigadier-General George Weedon, Hon. Eichard Henry Lee, Hon. Arthur Lee and Major-General Nathaniel Greene," printed by the Society in 1900. From its manuscript treasures many interesting volumes have been printed, and authors have found valuable material for the latest editions of the writings of Washington, Franklin, Jefferson and other great men. Note- worthy among these manuscripts are the Minutes of the Com- missioners to determine the boundary line between Pennsylvania and Maryland, the so-called Mason and Dixon line of 1760-68; General Weedon's Valley Forge orderly book (published by Dodd, Mead & Co., New York, 1902); original broadside of the Declaration of Independence, an extremely rare example; manu- script of William Dunbar's Exploration of the Red River, etc., 1804-05 (published by Houghton, Mifflin & Co., Boston, 1904) ; John Vaughan's account of the American Philosophical Society written in his eighty-fifth year, in 1841 ; and Peter S. Du Pon- ceau's manuscript account of the American Philosophical Society, 1840 and 1841, which deals especially with the question of the Society being the lineal successor of Franklin's Junto, decided by him affirmatively, largely on the recollections of Bishop White and others who knew Franklin. Mr. Du Ponceau read two papers on the history of the Society, one on June 19, 1840, the other on October 15, 1841 — both still in manuscript in the library. He traces the origin of 118 Scientific Institutions the Society past the union of the "American Society held at Phila- delphia for Promoting Useful Knowledge," with the "American Philosophical Society," in 1769, to the celebrated Junto founded by Franklin in 1727, and described in his Autobiography. The Junto, united to the Philosophical Society, only changed its name, extended its views and increased its membership, but continued its original association. He quotes in support of this view, the testimony of Bishop White and Franklin's frequent and affectionate mention. As early as 1736 the Junto, which was limited to twelve members, at Franklin's suggestion, formed a number of similar clubs, called the Vine, the Union, the Band, etc. Dr. William Smith, Provost of the College, in his eulogium of Franklin, spoke of the Philosophical Society as the outcome of Franklin's Junto. Franklin's correspondents (in letters to be found in the recently issued Calendar of Franklin Papers) affirm this view. Franklin himself, in his account of the Junto, writes that its debates were to be conducted in the sincere spirit of inquiry after truth, without fondness for dispute or desire for victory. The Minutes of the Junto are only partially preserved among the records of the Philosophical Society. It would be interesting if they had been preserved for the forty years of its existence. Mr. Du Ponceau writes : "The province of Pennsylvania was then divided into two great parties. The one was the party of the proprietaries, who were struggling to preserve their feudal sovereignty which they were in danger of losing. They had governed with too high a hand and the King had been petitioned to make Pennsylvania a royal government. The other was the popu- lar party opposed to their government and to this the greatest num- ber, if not all, the members of the Junto, now called the "American Society," belonged. To the proprietary's party belonged the wealthiest and most influential men, such as the Aliens, the Shippens, the Francises and all that were considered as the aristocracy of the country. The officers of the government, of course, belonged to it. At the head of this party was James Ham- ilton, who had been twice governor of the province and was then president of the Provincial Council. The leader of the opposite party was Benjamin Franklin, who was then in England, but had great influence in the province, whose agent he was at the British court. "These parties had been much exasperated against each other, The American Philosophical Society 119 but the encroachments of the British Parliament on the liberties of the country, had, in a degree, softened those asperities and brought the citizens nearer to each other for the purpose of legal resistance. Yet the storm of party rancor was not extinguished, particularly in the higher ranks of society. "In that state of things the high aristocratic party could not see with unconcern that an obscure club, which till then had been unknown, should assume to form themselves into a learned society like those which in Europe bore royal titles and were under the pat- ronage of the king, the fountain of all honors, and that they should do so independently of the government which represented the King in the Province. It was carrying the spirit of liberty too far, and they determined to counteract it, as they had not the power directly to forbid it. For that purpose they could think of nothing better than restoring to life the Society which had been established in 1743 with the participation of the men in power and they took immediate steps to effect it. "The few members that remained of that abortive association were easily collected and their design was made known, but whether they thought that would be sufficient to check their antagonists, or from some other cause, they did nothing until the month of Novem- ber, 1767, when they added to their list three new members, and offered membership to a fourth, who refused it. "The American Society, on their part, took no decisive meas- ure during that year, but went on in their usual way ; they talked of enlarging their Society, as they expressed it, but did nothing to effect that purpose, except electing a new member. The two parties seemed to lie on their oars, watching each other's motions ; it was not until the year 1768 that the contest truly began and assumed a formidable aspect." In the autumn of the year 1768 the two societies took active steps looking toward their union and on December 20th of that year a treaty was concluded beginning as follows : "Wheheas, two societies subsist in this city, whose views and ends are the same, viz., the advancement of useful knowledge, and it being judged that their union would be of public advantage, it was agreed that such a union should take place, on terms of perfect equality, and for that purpose, it was thought reasonable "That a new name, made out of the former names of both, should be fixed for the united society, and the following was accord- 120 Scientific Institutions ingly agreed to, viz. : The American Philosophical Society, held at Philadelphia for promoting useful knowledge." Mr. Du Ponceau's views were contested by Mr. Joshua Francis Fisher, one of the secretaries of the Society, and his report on the subject of the original date of the Society is preserved in the volume of manuscripts with Mr. Du Ponceau's paper, together with the early minutes of the Junto — it would be well if these could all be printed for the use of students of this interesting phase of local history. Other valuable and interesting manuscripts in the Philosophical Society's large collection, are: Andre Michaux (the elder's) "Botanical Journal of North America," 1787 to 1796, 8 volumes (Charles Sprague Sargent described it in the Proceedings of the Society, vol. xxvi, 1889) ; G. H. E. Muhlenberg's manuscripts on "Botany of Pennsylvania," 1784; "Agricultural Journal," 1786 to 1804; Priestley's manuscript relating to Phlogiston, 1783; manu- script relating to North American Indian vocabularies, deposited at the request of Mr. Jefferson in 1805 ; manuscript of Zeisberger on the language of the Lenni Lenape, or Delaware Indians, 1816, and other manuscripts by him on kindred subjects. Among its most valued possessions are: Gilbert Stuart's por- trait of Washington, painted for the Society. It is of great interest, because it is the only Stuart's Washington in the pos- session of the original owner; Sully's portrait of President Jefferson, painted from life for the Society; portraits of all its Presidents and of many of its leading members — a collection that increases in interest every year. It has a large collection of busts of its members. Notable among them are: Houdon's Franklin and one of Condorcet, pre- sented in 1830 by William Short. The latter is described in a letter from him to Jefferson (printed in the Massachusetts Historical Society's Collections, seventh series, vol. i, p. 288, 1900) as that which stood in the salon of the Hotel de Eochefoucauld until, during the French Revolution, it was thought unwise to keep it there. It was then presented to Mr. Short, who was Secretary to Jefferson while he was American Minister in Paris, who, in turn, sent it to Mr. Jefferson for presentation to the Philosophical Society. Among other busts are those of Jefferson, Turgot, La Fayette, Alexander Hamilton, Dr. Caspar Wistar, Nicholas Bid- die, Nathaniel Bowditch, Cuvier, the Abbe Correa — all members of the Society. The American Philosophical Society 121 Among the portraits on its walls are those of Priestley, by Rembrandt Peale; of Rittenhouse, by Charles Wilson Peale; of Heckewelder, Joseph Henry, Andre Miehaux, Benjamin Rush, Samuel Vaughan, Caspar Wistar, Robert Patterson, Chief Justice Tilghman, P. S. Du Ponceau, Robert M. Patterson, Dr. Nathaniel Chapman, Dr. Franklin Bache, Prof. Alexander Dallas Bache, Hon. John K. Kane, Dr. George B. Wood, Frederick Fraley, General Isaac Wistar, Baron von Humboldt, E. D. Cope, Daniel G. Brinton and William Pepper. Among the relics piously preserved is the chair used by Franklin when the Society met, owing to Franklin's health, at his house, presented by his son-in-law, Richard Bache, shortly after Franklin's death and which is now used as the President's chair. The Philosophical Society has in its care, for awards in recognition of scientific discoveries and as prizes for essays, the funds given by Magellan, by Miss Emily Phillips, and by Miehaux ; for the library, the bequests of Chief Justice Tilghman, one of its Presidents, and of Henry Phillips, Jr., one of its Librarians, and of Auguste Carlier, of Paris, elected in 1869. From these sources, few, indeed, and small, considering the long and useful life of the Society, it continues to add to its library and to en- courage scientific research. The Miehaux fund supplied the splendid collection of oaks planted in Fairmount Park. The General Meetings of the Society, held annually in the spring, bring together a large number of members and others from the United States and abroad, and the papers read at these meetings give a general view of the state of science up to our own time. The regular fortnightly meetings of the Society are marked by the reading of papers submitted by the members and others, fol- lowed by discussions, always of interest and often of great value. These papers constitute the bulk of the material of the long and growing series of the publications of the Society, and by a system of exchanges numbering upward of 1,000, with -similar bodies at home and abroad it is kept in touch with the whole scientific world. In close touch with scientific and other learned societies in this country and abroad, the Philosophical Society is often invited to send representatives to recurring anniversaries and other im- portant meetings. At the recent celebration in memory of Linnasus at the University of Upsala, this Society, by invitation, 122 Scientific Institutions was represented by the President, Dr. W. W. Keen, who received its academic honors. The Franklin bi-centennial celebration, by the American Philosophical Society in 1906, brought together a large body of distinguished men, to join with the members of the Society and the representatives of all the institutions founded by Franklin in Philadelphia, in paying due tribute to that great man, whose life is indeed one of the notable chapters of American history. The American Philosophical Society is proud of its long record of usefulness, and still maintains its activity, quickened by the recollection of its debt to Franklin and to that long line of men who, following his example, have enabled it to maintain its purpose and to continue its labors "for promoting useful knowl- edge." The most important and interesting publication of the Philo- sophical Society of late years is its record of the Franklin bi- centennial celebration, 1906, in six volumes. The first volume is the record of the two hundredth anniversary of the birth of Benjamin Franklin. To that anniversary both the United States and the State of Pennsylvania made generous contributions in acknowledg- ment of the debt due to Franklin's great services. This volume records the gift by Earl Grey to the United States of the portrait of Franklin, taken from his house in Philadelphia by Major Andre and presented to his commanding officer, General Sir Charles Grey, whose descendant, Earl Grey, on this bi-centennial, gave it to the President of the United States to be placed in the White House. The portrait was painted by Wilson, in London, in 1759. The volume also contains reproductions of the miniature of Franklin by Duplessis, painted in Passy in 1782, and of the por- trait of Franklin by Martin, painted in London in 1766, of which there is a copy by Charles Wilson Peale in the hall of the Society; and of the Franklin Medal, designed by Louis and Augustus St. Gaudens and struck at the United States Mint, in accordance with the Act of Congress of April 27, 1904. The volume contains the list of Delegates at the Franklin bi-centennial, including Eepre- sentatives of both branches of Congress, of the State of Pennsyl- vania, of France and Italy, of the Universities of Oxford and Cam- bridge, Pavia, St. Andrew's, Glasgow, Edinburgh, Padua, Eome, Harvard, the Eoyal Society of England, and the leading universities and scientific societies of the United States and other countries. The American Philosophical Society 123 The most important memorial of this bi-centennial was the publication of the "Calendar of the Papers of Benjamin Franklin in the Library of the American Philosophical Society." 1 Dr. Hays has rendered a great service to American history in his careful labor in the preparation of this calendar. In his preface he shows that of Franklin's papers, the Philosophical Society has 13,800 pieces (78 per cent.) ; the Library of Congress, 2,938 pieces (16.6 per cent.) ; the University of Pennsylvania, 840 pieces (4.8 per cent.) ; Dr. T. Hewson Bache, 100 pieces (.6 per cent.), making a total of 17,678 pieces. He also records the destruction of many of Franklin's papers during the British occupation of Philadelphia in 1777. Dr. Hays has provided a chronology of Franklin, from his birth in 1706 to his death in 1790, with the dates of each impor- tant event in his long and busy life. The Calendar now puts in the hands of students ready access to the vast collection of papers that illustrate the life of Franklin, showing the close touch in which he stood with men and affairs during his career, as man of business and as man of letters, as philosopher and discoverer, as statesman and diplomatist, as sage and adviser. The Philosophical Society, by this publication, has paid the best tribute to its great Founder, and thus attests its zeal in continuing the work begun by him for promoting useful knowledge. The Philosophical Society has, during its whole life, paid tribute to Franklin as its Founder in his youth, when he gathered his friends together in the Junto, and as its acknowledged leader, when, later on, it elected him its President, in recognition of his service to the City, the State and the Nation. It has ever striven to secure the well-merited honors due to his long career of varied usefulness, and to its efforts during his life and after his death, may well be attributed the general recognition of his extraordinary merit, so universally recognized now in the tributes paid to his memory. At every recurring anniversary, eloquent tribute is paid to his many-sided genius, by those best fitted to describe his achievements. His spirit still inspires all the members of this Society, and it is represented in the long and growing series of papers read at its meetings. l Calendar of the Papers of Benjamin Franklin in the Library of the American Philosophical Society, edited by I. Minis Hays; in five octavo volumes, respectively: vol. i, pp. 573; vol. ii, pp. 526; vol. iii, pp. 560; vol. iv, pp. 510; vol v, pp. 322, with an exhaustive index. The College of Physicians of Philadelphia By J. NORMAN HENRY, M.D. THE College of Physicians of Philadelphia was founded about the year 1787, though unfortunately the exact date is unknown. This confusion arises from the absence of any dates in the copy of the first address of the President, and in that of the first Constitution. The earliest record of a meeting is that of Jan- uary 2, 1787, and though there is much evidence to support the view that the College was in existence prior to this time, we are compelled to consider that day as its official birthday. The minutes of that meeting show that nine senior and four junior fellows were present, and the first Tuesday of every month was chosen for the regular monthly meetings. A committee was appointed consisting of Drs. Push, Duffield, and Griffitts to prepare a certificate of mem- bership and a seal, and it was directed that the Constitution should be published in the newspapers. It subsequently appeared in the Pennsylvania Packet and Daily Advertiser, February 1, 1787. The Officers and Fellows at the time of this first recorded meeting were as follows: President. — John Eedman. Vice-President. — John Jones. Treasurer. — Gerardus Clarkson. Secretary. — James Hutchinson. Censors: William Shippen, Jr.; Benjamin Rush, John Mor- gan, Adam Kuhn. Senior Fellows. — John Eedman, John Jones, William Ship- pen, Jr.; Benjamin Push, Samuel Duffield, James Hutchinson, Abraham Chovet, John Morgan, Adam Kuhn, Gerardus Clark- son, Thomas Parke, George Glentworth. Junior Fellows. — Robert Harris, Benjamin Duffield, John Foulke, James Hall, Andrew Ross, William Currie, John Carson, William W. Smith, Samuel P. Griffitts, John Morris, William Clarkson, Benjamin Say, John Lynn. 1 l John Lynn, the last name under "Junior Fellows," was dropped from the list of members, probably because he did not sign the Constitu- tion or pay the entrance fee. He was present at only one meeting, October, 1787. He is not included in the list of the "Founders." (124) JOHN REDMAN. The College of Physicians 125 The number of Senior Fellows was limited to twelve, while the junior membership had no limitation as to its numbers. The Senior Fellows alone had the right to hold office. ; At the meeting of January 2d, the first address of the first President of the College, Dr. John Redman, was delivered; the Constitution was signed by the Fellows and an order issued "that the institution of the new society should be proclaimed to the world, and that all who were friendly to the progress of medical science should be invited to join in its promotion." A certificate of membership, by-laws, and a design for a seal for the College were adopted at a meeting held on February 6, 1787, at which were present seven Senior and eight Junior Fellows. The seal con- sisted of a broad ribbon with buckle, encircling an altar on which burns the lamp of science. On the ribbon is the legend Sigillum Collegii Medicorum Philadelphia Institut. A.D. MDCCLXXXVII, and beneath the altar the motto "non sibi sed toti." At this meeting also, the first scientific paper was read by Dr. Rush, "On the Means of Promoting Medical Knowledge," and on March 6th of the same year the first standing committee, that on Meteorology and Epidemics, which has continued in active service for a period of ninety-five years, was appointed. At the regular meeting held on April 3d, the first election of Fellows was held, and committees were appointed to consider the building of hot and cold baths, and to establish a botanic garden in the city. On July 3d the Officers of the Society were re-elected, this being the first election of Officers that is recorded in the min- utes. On August 7th "a member submitted a new form of Con- stitution, which was made the order of business this day three months" and was adopted November 6th. In September of this year, 1787, the College memorialized the Legislature, "Setting forth the pernicious effects of spirituous liquors upon the human body and praying that such a law may be passed as shall tend to diminish their consumption." During this first year, one special and twelve regular meetings were held. The total mem- bership was twenty-nine. The entrance fee was three pounds (Pennsylvania currency) and the annual dues fifteen shillings. Two Founders were dropped from the rolls because of failure to pay their dues. The College held its meetings at Fourth and Arch Streets in the building of the Academy of Philadelphia. 126 Scientific Institutions The College was modeled upon the lines of the Eoyal Col- lege of Physicians of London, and consisted of a body of men of the highest professional standing who met at stated intervals to read and discuss scientific papers and to consider questions of public health. The necessity of a library at once became apparent and, on the year following its birth, the College took the first step in founding what is now one of the greatest medical libraries of the world. On June 3, 1788, committees were ap- pointed "to form a Pharmacopoeia for the uses of the College" and to outline a plan for the formation of a library. Following a request to contribute books, Dr. John Morgan, in December, 1788, presented twenty-four volumes to the library, and in 1789 made a further donation. This was the germ of the present magnificent collection. The library at this time was under the direction of the Secretary and Censors, and its growth was fostered by appro- priating for its use some portion of the surplus funds that might remain over at the end of each year. In 1789, several events occurred of importance in the his- tory of the College. The first of these was the incorporation of the College by act of Legislature dated March 26, 1789, and the second the enlisting of the efforts of physicians all over the country to aid the College in preparing a Pharmacopoeia. On April 16, 1789, the College presented a protest to the authorities against a general illumination of the streets which was proposed on the occasion of President Washington's progress through Philadelphia on his way to his inauguration in New York. An epidemic of influenza was then prevalent and the framers of the protest were evidently of the opinion that the safety and comfort of their patients might be imperiled by undue ebullitions of patriotism. They certainly put their case strongly when they informed the Council that "a general illumination of the city might be productive of fatal consequences." During this year also (1789) the Legislature requested the College to supply it with information concerning the prevention of the spread of infectious diseases. On October 15, 1789, Dr. John Morgan, a Censor of the College, founder of the Medical School of the University of Pennsylvania and ex-Director-General of Hospitals during the War of the Eevolution, died after a brief illness. JOHN MORGAN. College of Physicians. The College of Physicians 127 On April 21, 1790, twenty Fellows representing the College, attended the funeral of Benjamin Franklin. The by-laws were first printed during this year, and two of the Founders, Dr. Gerardus Clarkson and Dr. Abraham Chovet, died. In 1791, the dues of the College were increased to make it possible to hire a room of sufficient size in which to hold meetings and house the library. The initiation fee was raised to $26.66, and the annual dues to four dollars. The College was then moved to the build- ing of the American Philosophical Society in which a room had been rented for three years and a half, viz., from December 10, 1791, until June 10, 1794. In 1792 Dr. Waters volunteered his services as Librarian, but resigned and was succeeded by Dr. Leib. In 1793, the College addressed the Mayor on the subject of a "malignant and contagious" fever which was then present in the city, and the following recommendations were made: "First. — That all unnecessary intercourse should be avoided with such persons as are infected by it. "Second. — To place a mark upon the door or windows of such houses as have any infected persons therein. "Third. — To place the persons infected in the center of large and airy rooms, in beds without curtains, and to pay the strictest regard to cleanliness by frequently changing their body and bed linen; also by removing as speedily as possible all offensive mat- ters from their rooms. "Fourth. — To provide a large and airy hospital in the neigh- borhood of the city for the reception of such poor persons as cannot be accommodated with the above advantages in private houses. "Fifth. — To put a stop to the tolling of the bells. "Sixth. — To bury such people as die of this fever in carriages and in as private a manner as possible. "Seventh. — To keep the streets and wharves of this city as clean as possible. As the contagion of the disease may be taken into the body, and pass out of it without producing the fever, unless it be rendered active by some occasional cause, the follow- ing means should be attended to to prevent the contagion being excited into action in the body. "Eighth. — To avoid all fatigue of body and mind. "Ninth. — To avoid standing or sitting in the sun, also in a current of air, or in the evening air. 128 Scientific Institutions "Tenth. — To accommodate the dress to the weather and to exceed rather in warm than in cool clothing. "Eleventh. — To avoid intemperance, but to use fermented liquors, such as wine, beer, and cider with moderation. "The College conceives fires to be a very ineffectual, if not dangerous, means of checking the progress of the fever. They have reason to place more dependence on the burning of gun- powder. The benefits of vinegar and camphor are confined chiefly to infected rooms, and they cannot be used too frequently upon handkerchiefs or in smelling bottles by persons whose duty calls them to visit or attend the sick." On September 6th there is a note of a letter from Dr. Bush warmly advocating mercury in the treatment of yellow fever, "particularly in the first stage." This letter immediately brings up the story of the controversy in regard to the treatment of yellow fever which, in all probability, was the cause of Dr. Rush's resignation from the College. In a lecture delivered before the University of Pennsylvania students, Dr. Eush complained bit- terly of the attacks made upon him by Fellows of the College, because of his copious blood-letting and large dosage of calomel and jalap in the treatment of yellow fever. On account of the epidemic of yellow fever there was no meeting of the College between September 17, 1793, and November 5th of the same year. On that date the President submitted a letter from Governor Mifflin asking for information in regard to the then prevalent epidemic of yellow fever, and particularly requesting an opinion as to its origin, cause, and the best methods to stamp it out. A committee was appointed to prepare a reply to the Governor's questions. The Col- lege, on November 26th adopted the report of the committee and replied to the Governor that the disease was brought to the city by vessels after the middle of July. "Cleanliness of the streets, the use of gunpowder as a disinfectant, and of unslaked lime in privy wells were recommended." In 1793, Dr. James Hutchinson, a Pounder and the first Secretary of the College, died of yellow fever, which was believed to have been contracted from visiting a poor woman suffering from that malady. Dr. John Morris, also a Founder, died of the same disease very nearly at the same time. In 1794, the College took a very active part in dealing with broad questions concerning "the regulation of the practice of WILLIAM SHIPPEN, JR. College ol Physicians. The College of Physicians 129 Physic within the State"; the establishment of a quarantine, and of a hospital for contagious diseases. These matters were taken up at the request of the various authorities concerned; in one instance the Governor, in another the Legislature of the State, and in another the local Board of Health asked for aid in dealing with their several duties. Throughout the epidemics of '93, '97, and '98, the College aided the authorities in every way possible. Meetings were held almost daily, and bulletins were issued setting forth the means necessary to maintain health and avoid infection. In 1798, the Proceedings of the College were published "relative to the pre- vention of the introduction and spreading of contagious diseases." Subsequently, in the same year, "Facts and observations relative to the nature and origin of the pestilential fever which prevailed in this city in 1793, 1797, and 1798," were published and dis- tributed to the members of the Legislature, City Corporation, Board of Health, and corresponding medical societies. In the year 1799, there were various interchanges of communications between the Governor and the College concerning the subject of epidemic diseases. On February 2, 1802, Dr. Glentworth proposed Dr. Jenner for Associate Fellowship in the College. Dr. Jenner was not elected. On July 2, 1805, William Shippen, Jr., was elected President in place of Dr. Kedman, who had requested that his own resigna- tion be accepted after eighteen years of service. In 1808, Dr. Shippen died, and Dr. Adam Kuhn was elected President. For several years following this period the College passed through a time of more or less inactivity due, perhaps, as sug- gested by Dr. Euschenberger, to the variety of interests claim- ing the time and attention of the Fellows, several of the most prominent among them belonging to other Societies, such as the Academy of Medicine, the Chemical Society, the Medical Lyceum, and the American Philosophical Society. In 1817, Dr. Kuhn died, and in July, 1818, Dr. Thomas Parke was elected to succeed him in the office of President. It is recorded, as a matter of interest and comparison, that in 1818 the entrance fee was $15, and the annual dues $3, making a yearly income of $54; in other words, in 1818 there were but eighteen Fellows. 9 130 Scientific Institutions In 1820, we again find the municipal authorities addressing the College and asking for information and guidance in dealing with an epidemic of "a malignant or pestilential disease." A committee composed of Drs. Hewson, Griffitts, and Emlen was appointed to prepare the necessary answers, and among their recommendations was "the prosecution of the plan now in con- templation for removing the whole of the buildings" (on Water Street) "from the east side of Front Street, inclusive, to the river, beginning at Vine and ending at South Street, according to the original plan of William Penn, the wise and intelligent founder of our city." On December 5th of this year (1820), the entrance fee was reduced to ten dollars. In 1821, the College had failed to pay rent for its quarters for four years, and money had to be borrowed and a note given in order to raise the sum necessary to pay the arrears. In 1823, after other accounts such as the bills for fuel, etc., had been paid, the College was in debt to the Treasurer to the extent of $18.62. On November 9, 1824, the College held a special meeting to consider the staying of the execution of one John Zimmerman, of Orwigsburg, Schuylkill County, who was then under sentence of death for the murder of his daughter. Dr. Joseph Parrish had reported to the College that, so far as he could judge by hearsay, the prisoner was insane and irresponsible at the time the act was committed. The College, at this special meeting, addressed a communication to the Governor of the State, asking that the execution of Zimmerman be stayed until all reasonable doubt of his mental condition should be settled. On January 22, 1825, the Governor replied that, upon receipt of the letter from the College, the execution had been postponed until March 30th, and asked that the College appoint certain of its members to visit and examine the prisoner and acquaint him with his true mental condition. Drs. Parke, Parrish, and Moore journeyed to Orwigsburg and spent two days examining the prisoner. They found him to be insane and irresponsible as regards his act and, on so notifying the Governor, had the satisfaction of securing his release from the death penalty. The College was put to the expense of $50.25 incurred by this commission — a very severe drain upon its scanty resources. The College of Physicians 131 ' In May, 1827, a resolution was adopted, making it compul- sory for each Fellow in turn to read at each stated meeting an original paper, or pay a fine of $1. The College at this date could not afford to publish Transactions and permission was accorded the Fellows to publish their papers in the North American Med- ical and Surgical Journal. During this year (1827) the meeting hour was changed from the afternoon to the evening, the time adopted for the future being 7 p.m. from October to March, and 8 p.m. from April to September. In January, 1832, the College, through a committee com- posed of Drs. Otto, Bache, and Wood, conferred with one from the Philadelphia College of Pharmacy, upon the important matter of introducing the Pharmacopoeia into general use, and recom- mended the adoption of the one prepared by the National Med- ical Convention of 1820. This important subject, the establish- ment of a Pharmacopoeia, was first discussed in the College on June 3, 1788, and had occupied its attention more or less con- tinuously until the decision above mentioned, was reached. On April 12th of this year, the Board of Health asked for informa- tion from the College in regard to an epidemic of cholera which was then present in the city. The College, through a report of a committee, replied in due time. On November 26, 1833, the Treasurer reported a balance on hand of $308.42, which was or- dered to be invested. Dr. Buschenberger, in his history, calls atten- tion to the fact of this being the first instance of financial ease in the College for a period of forty-six years. In 1833, a committee was appointed to investigate the by-laws and determine whether or no any changes were necessary. Alterations of considerable im- portance were effected. The number of Associate Fellows was lim- ited to forty, ten of whom should be foreign. Candidates for fellow- ship were, for the future, to be proposed by three Fellows, and the entrance fee was made $10 and the annual dues $3. The by-laws provided for the following committees : Library, Theory and Prac- tice of Medicine, Surgery, Midwifery, Diseases of Children, Materia Medica and Pharmacy, Meteorology and Epidemics, and Public Hygiene. These committees were to submit annual reports. A special committee existed for inspecting and passing judgment on papers written for publication in the Transactions. On January 9, 1835, Dr. Thomas Parke, the President and last of the Founders, died in his eighty-sixth year. Dr. James 132 Scientific Institutions was elected President March 3, 1835, and died in July of the same year. He was succeeded by Dr. Thomas T. Hewson. ' On September 6, 1836, a committee of the trustees of the Preston Eetreat and Lying-in Charity Hospital asked information from the College as to the best plan for a building for its par- ticular purpose. The College submitted this request to the Com- mittee on Midwifery which, in turn, reported to the College, and the report was then sent to the trustees of the Preston Eetreat. On January 1, 1839, the College advised the Legislature to place public squares with fountains in every district of the city. The College this year was again able to invest some surplus funds ($222.23). In 1841, a committee on publication of the Transac- tions was appointed, and it was determined to publish them quar- terly. On November 7, 1843, the College advised the purchase by the city of Lemon Hill, now in Fairmount Park, to protect from contamination the Schuylkill Eiver, which then supplied, as it still does, much of the drinking water of the city. In No- vember of this year the College received a request from the New York State Medical Society to appoint delegates to a National Medical Convention of all the medical institutions of the United States. After due consideration on the part of a committee appointed for the purpose, the invitation was declined. At this period the quarters of the College became too small for the increasing number of members and the need for space of the growing library. Committees were appointed to consider the questions of building a hall, joining with other societies to procure a hall which could be used by each of the contributing associations, or renting more commodious rooms. On July 1, 1845, the College moved into the building of the Mercantile Library Company at the southeast corner of Fifth and Library Streets. The committee in charge had succeeded in renting on the third floor of this building, a large room of sufficient size to accommodate the meetings and give ample space for the library. The rental of this apartment added greatly to the expenses of the College, and the furnishing and moving of the College prop- erty were provided for by liberal private subscriptions from the Fellows. Dr. Euschenberger notes that "for the first time the record of Proceedings was headed, 'Hall of the College.' " "In 1846, the College set the seal of its disapprobation upon the attempt to get a patent for anaesthetic ether under the name The College of Physicians 133 of 'Letheon.' In the following year it condemned as an offense, which was sometimes a crime, the prescription of medicines by apothecaries. In 1848, it encouraged and aided the formation of the Medical Society of Pennsylvania, and sent delegates to the Convention that organized it." 2 In 1848, the College adopted a fee-bill, but later on, when it was found that it did not meet the requirements of the times, it was abolished. In 1849, the museum of the College was begun and a building fund started. In 1851, all committees were abolished, with the exception of that on meteorology and epidemics. In April of the same year, the meeting night was changed from the first Tuesday to the first Wednesday of every month. In July, 1854, the "picture house" of the Pennsylvania Hospital was leased, and the furniture and library transferred from the Mercantile Library Company building. In 1849, as previously stated, the patholog- ical museum, which now bears the name of Dr. Thomas Dent Mutter was begun. Its foundations were of very modest propor- tions. A Curator and Museum Committee were appointed, and $50 annually was ordered to be expended on building cases and preparing and arranging specimens. Dr. John Neill was the first Curator and Drs. Moreton Stille, Edward Hallowell, and Isaac Parrish constituted the first Museum Committee. Dr. B. H. Coates presented a microscope and the museum was further in- creased by the addition of a number of specimens from the late Dr. Parrish's collection. In June, 1856, a special meeting of the College was convened to receive a communication from Dr. Mut- ter. Dr. S. Weir Mitchell announced that Dr. Mutter was willing to present his collection of pathological specimens to the College, together with the sum of $30,000 to pay for the services of a lecturer and to add to the specimens in the museum, providing the College on its part would place the valuable collection in a fireproof building. Dr. Mutter stated that his collection had been assembled after twenty-four years of work, and that he had been offered a sum of $20,000 for it. He suggested that the Curator of the College Museum should be appointed Curator of his collection also, thus showing that he desired the two to remain separate. The offer was one which the College could little afford to refuse 2 Stille, "Reminiscences of the College." 134 Scientific Institutions and yet, with its accompanying condition, a difficult situation was created. A committee was appointed which reported to the Col- lege their opinion of the great value of this collection both to the College and to the profession at large, but were, of course, unable at the time to advise final proceedings in view of the absence of funds for a suitable fireproof building. Dr. Mutter expressed considerable disappointment at the failure to reach a satisfactory conclusion in the matter of accepting his gift and went abroad, after stating that he was too ill and too busy to give the proper time and care to the arrangement between the College and himself. Thus the question hung fire until October, 1858, when Dr. Mutter again expressed himself as willing to renew negotiations with a view to effecting the transfer of his museum. The next step was the statement of Dr. Mutter that he wished an agreement to be made to finish a fireproof building within three years, and, on the committee expressing their belief in the impracticability of doing this, he agreed to the period being prolonged to five years. Dr. Mutter signed the agreement on December 11, 1858, and the officers of the College on January 8, 1859. Dr. Mutter then placed his collection in the hands of three trustees and left for Europe, where he died in March, 1859. Four years later, in March, 1863, the building at Thirteenth and Locust Streets was finished and ready for occupation. The trus- tees thereupon, after being satisfied by expert opinion of the fireproof quality of the new home for the collection, announced their intention of paying to the chairman of the Mutter Museum Committee, the income of the deed of trust executed by Dr. Mutter. This deed provided for the payment annually of $300 to a curator and $200 to a lecturer, "and the remainder of said income to the preparing, fitting up, keeping in order, increasing and insuring of pathological and anatomical preparations and specimens," etc. The specimens already belonging to the College Museum were then combined with those of the Mutter Museum and placed under the care of the Curator and the Mutter Museum Committee. The Museum grew steadily for many years through the acquisition of many new specimens by purchase and gifts. The income of the fund, however, was by no means expended, and surplusage arose which, from time to time, was partly in- vested, and in part disbursed to secure valuable new collections. In 1876, the new building became inadequate for the large HALL OF THE COLLEGE AT THIRTEENTH AND LOCUST STREETS. College of Physicians. The College of Physicians 135 and steady increase in size of these two valuable branches of the institution, the library, and the museum. Further addition of specimens was curtailed, and the income of the Mutter fund was allowed to accumulate until, in 1883, the balance reached $7000. The College proposed to borrow from this accumulated income of the Mutter fund in order to enlarge the building and provide suitable accommodation for the specimens. This, however, could not be done until a legal opinion had been obtained to determine if this expenditure would fall properly within the deed of trust which, by any misappropriation of the funds, would be forfeited by the College. An amicable suit was arranged which was heard before a master and finally reported to the court, when the judge directed that the accumulated income, or some part of it, might be borrowed by the College. Articles of covenant were then drawn up which gave leave to the Mutter Museum Committee to lend the College a sum of $5000 for the specific purpose of en- larging the space for the Mutter Museum and, at the same time, contained a clause indemnifying the museum committee from any liability in the future. The enlargement of the building was then undertaken and a large, well-lighted third story was added to the Hall, and the College and Mutter collections were placed therein and included under the name of the latter. Dr. Mutter's gift provided, as already stated, a sum of money for the payment of a lecturer on surgical pathology to be ap- pointed once in three years, and to deliver annually a course of lectures. The terms of the legacy state that such courses should consist of not less than ten lectures annually. In spite of every reasonable effort this requirement of the legacy has not been lived up to. At the present time one lecture is delivered an- nually on some point of interest in surgical pathology, and usu- ally a large audience of Fellows and other physicians is attracted. This departure from the original provision of the legacy has been sanctioned by the College on request of the Mutter Museum Committee. The Mutter lectures have in successive years been delivered by Drs. John H. Packard, Harrison Allen, John H. Brinton, J. Solis-Cohen, Samuel W. Gross, Edward O. Shakes- peare, Henry F. Formad, Oscar H. Allis, Koswell Park, De Forest Willard, John B. Koberts, H. W. Cushing, George H. Monks, John Bogers, and George W. Crile, whose names alone suffice to prove the value of their discourses. 136 Scientific Institutions For several years past valuable courses of instruction have been given in the Museum to the students of the different med- ical schools. The specimens, illustrating gross pathological anat- omy and especially the diseases of bones, are probably unrivaled by any similar collection in this country. In 1867, the College had memorialized the Legislature to legalize dissection, and the efficient law of 1883, which now gov- erns the practice of this essential part of medical education, and with which the name of Dr. William S. Forbes is indelibly asso- ciated, took its origin in this proceeding. In January, 1883, Dr. Alfred Stille was elected President, and in February, Dr. S. Weir Mitchell established an entertain- ment fund by a generous gift of $5000. During this month also the College memorialized Congress concerning the National Board of Health, and recommended an increased appropriation. Between 1875 and 1883, the College, either alone or in con- junction with other medical societies, petitioned Congress against reducing the appropriation for the Army Medical Museum Library, and in favor of publishing the subject catalogue of the "National Medical Library" (Library of the Surgeon-General's Office). The College also petitioned the Legislature for a law protecting professional communications between physicians and patients. In April, 1883, a committee was appointed to confer with the College of Pharmacy on the question of amending the present laws governing the sale of poisons, and in October the Council was constituted. In November, 1883, Dr. Joseph Leidy was exempted from the payment of dues as a mark of appreciation of his scientific achievements. Dr. Samuel Lewis was elected President in Jan- uary, 1884, and resigned the same year, and Dr. J. M. DaCosta was elected to complete his unexpired term. Dr. J. G. Hunt and Dr. Henry F. Formad were exempted from the payment of dues in recognition of their scientific attainments. In June, 1884, the Samuel D. Gross Library was received from the Philadelphia Academy of Surgery as a special deposit, and in July, a bust of Dr. Gross, by Obermeyer, was presented by A. Haller Gross, Esq., executor of Dr. Gross's estate. In September, 1884, a reception was held in honor of the members of the American and British Associations for the advancement of Science, the first under the The College of Physicians 137 provisions of the S. Weir Mitchell Entertainment Fund. A sum of $2153.23 was received from the estate of Dr. George B Wood on account of the legacy of $10,000 and an annuity of $500, left by him to the College. The meetings in July, August, and Septem- ber were omitted by a vote amending the by-laws governing stated monthly meetings. In November, 1884, a committee of five was appointed to consider the union of the library of the Pennsylva- nia Hospital with that of the College of Physicians. This propo- sition was indefinitely postponed. A committee to arrange a cele- bration of the one hundredth anniversary of the College was appointed. A committee was also appointed to address Select and Common Council on the question of the precautions to be taken to avert the threatened invasion of Asiatic cholera during the coming year. A communication on this subject from the National Board of Health was read and referred to this com- mittee. In February, 1885, the College sent to the Legislature a remonstrance against a bill to prevent physiological experi- ments upon living animals, declaring, as its opinion, "that scien- tific experimentation upon the lower animals is essential to the progress of medical science." A copy of Eembrandt's School of Anatomy was presented to the College by Mrs. Small and Mrs. S. Weir Mitchell. In 1885, the Publication Committee was in debt to the extent of $822.33, and a proposition was made to publish the Transactions in the Medical Times. By the gener- osity of Dr. DaCosta this debt was paid in great part, and the method of publishing the Transactions was continued. In No- vember, 1885, Mrs. Helen C. Jenks established, in memory of her husband, the William F. Jenks Fund by presenting $5000, the income of which was to be awarded every three years to the author of the best essay on. a subject connected with obstetrics and the diseases of women and children. This sum, which had accumulated until it amounted to $7000, was, in 1900, with the approval of Mrs. Jenks, converted into a library fund for the pur- chase of literature relating to obstetrics and the diseases of women and children. In January, 1886, Dr. S. Weir Mitchell was elected Presi- dent. In June, 1886, 512 volumes, principally on ophthalmolog- ical subjects, were presented by Mrs. J. F. Weigh tman. The College accepted the Parry Library and the library of the Obstet- rical Society as permanent deposits. The celebration of the cen- 138 Scientific Institutions tennial of the foundation of the College was held on January 3 and 4, 1887. The program on this occasion was as follows: A commemorative address by the President, Dr. S. Weir Mitchell, was delivered at Association Hall, Fifteenth and Chestnut Streets, at 7.30 p.m. ; a reception in the Hall of the College, at 9.30 p.m., followed. On January 4th, a special meeting was held at which Dr. Alfred Stille delivered an address. This was followed by the introduction of newly-elected Associate Fellows, who were wel- comed in an address by Dr. J. M. DaCosta. Luncheon was served in the museum room, and a dinner on the same evening was held in the ball room of the Union League. Dr. Mitchell was re- elected President. In April, 1887, a portrait of Dr. John Morgan was hung in the Hall of the College, with the understanding that the owner, Dr. Collins, of Louisville, Ky., might remove it at any time he desired. The Alvarenga legacy of $4140.38 was received in April, 1888. A portrait of Dr. Benjamin Eush was presented by the Misses Eush in November, 1888. In January, 1889, Dr. D. Hayes Agnew was elected President. In May, 1891, the death of Dr. Joseph Leidy was announced. A special meeting was held March 24, 1892, to take action on the death of Dr. Agnew. In accordance with a resolution of the College on January 4, 1893, a committee of five, consisting of Drs. J. M. DaCosta, J. C. Wilson, E. 0. Shakespeare, H. C. Wood, and Morris J. Lewis, was appointed by the President, Dr. S. Weir Mitchell, to report at the next meeting of the College a plan of action in regard to the threatened epidemic of cholera. The Committee made an elaborate report on February 1, 1893, dividing the subject into three heads: National, State, and Municipal Quarantine. Their most important recommendations came under the first head and consisted (1) in the recommenda- tion that "quarantine at all frontiers of the country should be immediately taken and kept under the exclusive regulation and control of the National Government; (2) that steerage passengers should be absolutely prohibited from landing in this country dur- ing the year 1893, and (3) that a Department of Health in the United States Government, "presided over by Special Cabinet Officer," should be established or, failing this, a "National Com- mission similar to those now existing in England, Germany, France, and other countries, the scope of whose functions and The College of Physicians 139 authority shall cover quarantine and other subjects connected with public health." The resolutions were unanimously adopted. At the meeting of April 5th, in pursuance of a -resolution introduced by Dr. Morris J. Lewis on March 1st, a permanent Committee on Cholera, consisting of E. 0. Shakespeare, J. M. DaCosta, H. C. Wood, J. C. Wilson, F. P. Henry, Morris J. Lewis, and J. K. Mitchell, was appointed. On May 3d Dr. J. H. Musser was appointed in place of Dr. Lewis, who declined to serve. Thanks to the vigorous measures adopted at our seaports, especially New York, the threatened visitation of cholera was averted. In March, 1893, Dr. Osier proposed that The College of Phy- sicians take the initiative in causing to be erected in England a hospital in memory of Dr. Edward Jenner who, ninety-one years before, had been denied the honor of being elected an Associate Fellow. In June, 1893, a photograph of the famous painting of Dr. John Morgan, by Angelica Kauffman, was pre- sented by D. T. Watson, Esq., of Pittsburgh. In 1893 a resolu- tion was adopted congratulating the Chairman of the Committee on the Eevision of the Pharmacopoeia on the successful conclusion of his labors. In April, 1894, Clement A. Griseom, Esq., pre- sented $5000 to establish the John D. Griseom Book Fund. Dur- ing January, 1895, a further effort was made to take steps to secure a Department of Public Health and Preventive Medicine in the United States Government. In April, 1896, the College again urged upon City Councils the importance of establishing filtration of the drinking water. In April, 1897, the College memorialized Congress, protesting against the removal of books and philosophical apparatus from the duty-free list when im- ported for scientific societies. In January, 1898, Dr. John Ash- hurst, Jr., was elected President. A gift of $5000, to which another $1000 was subsequently added, was made to the College by H. E. Hatfield, Esq., and Walter Hatfield, Esq., the interest of which was to be devoted to the giving of a prize for original research in medicine every three years. In the event of no essay being deemed of sufficient merit to gain the prize, the trustees were empowered to appoint some one to pursue a line of investigation and to appropriate a sum of money toward the expenses. In October, 1898, announcement of the death of Dr. William Pepper was made. The Oliver A. Judson Prize was established by the 140 Scientific Institutions deposit of $1000, the prize to be awarded when the interest should amount to $100, and the subject of the competing essays to be the practical prevention of disease. This bequest was sub- sequently converted by Mrs. Judson into a fund for the purchase of books on preventive medicine. The Henrietta Bush. Fales Baker Fund was established by the gift of $5000 by Dr. George Fales Baker, the income to be used for the purchase of books. A gift of $5000 to the Library Endowment Fund was secured upon condition that $50,000 be raised. In January, 1900, Dr. W. W. Keen was elected President. The W. W. Keen Library Fund of $5000 was started by a gift of $1000 by Dr. Keen. In May, 1900, the Library Endowment Fund reached the sum of $50,000. Dur- ing this year the College suffered heavily in the loss by death of three of its most distinguished members, Drs. John Ashhurst, Jr., J. M. DaCosta, and Alfred Stille. Dr. DaCosta, in a legacy, pre- sented to the College a sum of $5000 for the endowment of the Publication Fund. Mrs. S. Weir Mitchell presented a portrait of Dr. Mitchell. In December, 1900, Dr. Mitchell pointed out the need of more space for the library, and advised abandoning the museum. The matter was referred to the Council. In January, 1901, the portrait of Dr. Joseph Leidy was pre- sented by Mrs. Joseph Leidy, Jr. Dr. W. W. Keen was elected President. In May, 1901, a committee of seven was appointed to consider the present condition and the future needs of the College. On December 8, 1901, the death of Dr. William F. Norris was announced. In January, 1902, Dr. H. C. Wood was elected President. A portrait of Dr. W. W. Keen was presented by a committee of the Fellows. In December, 1902, a committee of five was appointed to confer with committees appointed by other organizations upon the advisability of moving the City Alms- house, the Insane Hospital, and the Municipal Hospital from their present location. In January, 1903, Dr. Mitchell announced that he had secured from Mr. Andrew Carnegie the promise of a gift to the College of $50,000 conditional upon the College rais- ing an equal amount. This fund was to be used to furnish in- creased accommodation for the Library. A resolution was adopted and sent to the President of the United States, advising the bestowal of the "amplest powers upon the medical officers in charge of the sanitation of the Panama Canal.'' "And that to attain this end a medical officer should be a member of the com- The College of Physicians 141 mission which the President of the United States is authorized to appoint to conduct the affairs of the proposed canal." A reso- lution was adopted favoring the passage of a bill to give a pen- sion of $4000 a year to Mrs. Reed, the widow of Dr. Walter Reed, who died a martyr to his researches on yellow fever. On January 21, 1903, a special meeting was held. The President in an ad- dress referred to the growing needs of the library for increased space, and exhibited a plan for alterations to the building. A committee of seven was appointed to collect a sum of $50,000 to comply with the conditions attached to the gift of Mr. Car- negie. A committee was also appointed to consider plans. In March, 1903, Dr. Mitchell announced that the subscriptions to the building fund had reached the sum of $53,000, and on April 1, 1903, the subscriptions amounted to $105,000. The names of Andrew Carnegie, Clement A. Griscom, and Frederick W. Van- derbilt, were ordered to be placed on a tablet containing the names of eminent benefactors of the College. The committee to consider plans reported and was discharged. A committee was then appointed to consider the question of either moving to a new building or altering the present one. This committee was given power to secure options on one or more properties, and was ordered to report at a special meeting not later than No- vember 1, 1903. On May 29, 1903, at a special meeting, the pur- chase of a lot at Twenty-second and Ludlow Streets was author- ized by the College for a sum of $80,000. In June, 1903, the death of Dr. Thomas G. Morton was announced. A committee of five was appointed to report at the next meeting of the Cellege on the municipal control of contagious diseases. In November, 1903, a committee on plans for the new building was appointed. In January, 1904, Dr. A. V. Meigs was elected President. In March, 1904, resolutions were adopted containing "desirable regulations for the prevention of infectious diseases in Phila- delphia" (fifteen paragraphs). At a special meeting March 30th, the College voted to move to Twenty-second and Ludlow Streets. A building committee of six was appointed and directed to select an architect and secure plans, specifications, and bids, so that the cost of building might be known. This committee was ordered to report in the Autumn, and was authorized to spend $3000 in its investigations. In May, 1904, a minority committee was ap- pointed to report to the College in November an alternative 142 Scientific Institutions proposition to that of moving from its location. Following the report of this committee in November, the sale of the lot at Twenty-second and Ludlow Streets was directed, and an option ordered to be taken on a lot at Eighteenth and Eittenhouse Streets. This option, however, was not assumed because of building restrictions on the property. At a special meeting, De- cember 13, 1904, a resolution to remain at Thirteenth and Locust Streets was laid on the table; a resolution to buy 1233 and 1235 Locust Street was laid on the table. The minority committee was discharged and a new committee of five was appointed to report at the next meeting a desirable site. In January, 1905, the committee on site recommended the purchase from the city of a property at Seventeenth and Pine Streets, occupied as a schoolhouse, for $50,000, and asked for power to secure the pas- sage of an ordinance in Councils legalizing the transfer. This proposition was referred back to the committee. In February, 1905, the Officers of the College were authorized to enter into an agreement with the city to purchase the property within three years and, one month later, Councils gave the necessary authority. The President of the College appointed three delegates to repre- sent the College at the installation of Edmund Jones James, Ph.D., LL.D., as President of the University of Illinois. The death of Dr. William S. Forbes was announced in January, 1906. In February, 1906, an invitation was received from the American Philosophical Society to send representatives of the College to the celebration of the two hundredth anniversay of the birth of Benjamin Franklin. In May, 1906, the Board of Education stated that they could not vacate the Grant School, situated at Seven- teenth and Pine Streets, in the time mentioned in the resolution of Councils. The Fellows of the College were requested to co- operate with the Philadelphia County Medical Society in its efforts to raise funds for the immediate and permanent relief of the physicians of San Francisco who had suffered so greatly in the recent earthquake. At this meeting also the College reaffirmed its intention of erecting a building on the lot at Twenty-second and Ludlow Streets. The old building committee, constituted in April, 1904, was directed to proceed with the duty assigned to it in the matter of plans and estimates, and to present its findings at the October meeting. In June, 1906, the library committee was authorized, at its discretion, to present duplicate books to The College of Physicians 143 the medical libraries of San Francisco. In December, 1906, Messrs. C. C. Harrison and W. W. Frazier each presented $10,000 to the Building Fund, and one of the Fellows promised $5,000 if five more subscriptions of the same amount could be obtained. In January, 1907, Dr. James Tyson was elected President, and a subscription of $1000 to the Building Fund was received from Mrs. *S. Weir Mitchell. The building committee reported that architects had been selected and submitted plans. Mr. Clement B. Newbold contributed $10,000 to the Building Fund, and Dr. John K. Mitchell also gave $1,000. In April, 1907, the Officers of the College were authorized to sign a contract for the erection of the new building, and the report of the building committee was accepted. The new building was to be erected at a cost not to exceed $250,000, and in accordance with the plans submitted by the committee and adopted by the College. The death of Dr. John H. Packard was announced in June, 1907, and in Octo- ber, 1907, that of Dr. William Thomson. The Elizabeth K. New- comet Fund of $1000 was established for the purchase of books. The College authorized the annual appointment of a committee on scientific business. In November, 1907, announcement was made of the death of Dr. Charles S. Wurts, former Treasurer of the College. In January, 1908, the William F. Norris Book Fund, founded by a bequest of John Lambert, Esq., was an- nounced. In February, the College approved the order placing naval surgeons in command of United States Hospital ships. In March, 1908, a gift of $50,000 was received from Mrs. Frederick Penfield in memory of her father, the late William Weightman, Esq., the income alone from this sum to be devoted to whatever purpose the College might elect. A committee was appointed to dispose of the College real estate at Thirteenth and Locust Streets by sale. On April 29th the cornerstone of the new College build- ing was laid by Dr. S. Weir Mitchell, and appropriate ceremonies were held in the presence of a large number of Fellows and in- vited guests. To meet the estimated increase in the cost of main- tenance the annual dues were raised to $30, and the initiation fee made $35. DIRECTORY FOR NURSES On February 1, 1882, Dr. S. Weir Mitchell suggested the project of establishing a registration of nurses and, on his mo- tion, a committee was appointed to organize a Directory for 144 Scientific Institutions Nurses. On March 1st, the committee reported that more than $1,000 had been subscribed, largely by ladies who had become inter- ested in the enterprise. On May 15th, the office of the Directory was opened on the ground floor of the College building, with Miss Emily Thomas as Secretary. The Directory is under the direct control of three Fellows of the College, annually elected, assisted by a committee of ladies appointed by them. The number of these ladies, at first four, was subsequently reduced to three. The income of the Directory, derived, in part, from the registration fees of the nurses, but chiefly from the fees paid by those who obtain nurses through its agency, usually exceeds its expenses, and the surplus is appropriated to the use of the library. THE LIBRARY Very early in the history of the College the necessity of a library "became apparent, and on June 3, 1788, a committee was appointed to formulate a plan for its establishment. In conse- quence of its report a resolution was adopted "that the several members of the College be requested to send to the Secretary such books as they mean to present to the College." In Decem- ber, 1789, Dr. John Morgan presented twenty-four volumes and added a further gift in the following month, thus forming the nucleus of the present library. The following report of the commit- tee for the formation of a library was submitted and adopted on March 3, 1789 : "First, that the business of collecting books from the mem- bers by way of donation to the library, of procuring a suitable place for keeping them, and a person to attend at stated times for lending them to the members, be committed to the Censors and Secretary, who shall consult the College respecting the time and manner of lending them. "Second, that on the first Tuesday of July of every year, as soon as the Treasurer has made his annual report of the balance remaining in his hands, the College do grant such sums as they may think proper for the service of the library for the ensuing year." In October, 1789, Drs. William Shippen, Jr., John Morris, and John Jones presented volumes to the library. In November, the President was authorized to expend fifty pounds for the purchase of books. In 1790, some volumes were imported, and in 1793, Dr. The College of Physicians 145 Push presented Sydenham's works. In 1795, Dr. Parke sent thirty-five pounds to purchase books and reported the receipt of twelve volumes from London. From that date until 1818 fre- quent additions to the library were made by gifts, and by pur- chase at home and abroad. On the report of the Censors that some volumes from the library were missing, a committee was appointed to make a catalogue. Drs. William Currie, Samuel P. Griffitts, and Thomas T. Hewson completed the catalogue in January, 1819. On June 7, 1836, the Library Committee reported that the library contained 291 volumes and some unbound pam- phlets. From that time until 1843 very few volumes were added, and the library was "rarely, if ever, used." In May, 1844, the medical library of Dr. Otto was purchased for $200, and, as there was no space for this collection in the College apartments, it was placed in a room over the office of Dr. Hodge at the northwest corner of Ninth and Walnut Streets. The Library Committee advised that a librarian be present for one hour, twice monthly, to deliver hooks. In June, 1845, the committee reported that the library was hut seldom used. On August 5th it was resolved that the library should be kept open from 11 a.m. until 2 p.m. Most of the medical periodicals of the United States and one from Canada were received in exchange for the Transactions of the College. The Philadelphia Medical Society deposited its library in the College December 1, 1846. On June 6, 1855, the library, then installed in the "picture house" of the Pennsylvania Hospital, had been rearranged and catalogued, and 350 volumes had been added during the past year. On November 4th, 900 volumes were received from Dr. Thomas F. Betton, including some rare and important works. The library then contained 3560 volumes. On May 4, 1859, because of increased interest, the library was kept open one evening in each week. On December 3, 1862, the State Medical Society presented a complete set of its Transactions and 192 volumes of French theses were presented by Fellows of the College. The most important event in the history of the library was the gift of 2500 volumes by Dr. Sam- uel F. Lewis in 1864. These books, which were the origin of the "Lewis Library," had been carefully selected by Dr. Lewis, who was an accomplished scholar and an ardent lover of books. For about twenty-five years he devoted the greater portion of his time to his library which, at the date of his death in 1890, contained 10 146 Scientific Institutions more than 11,000 volumes. The choicest treasures of the library of the College of Physicians are to be found in the Lewis col- lection. On April 4, 1866, Dr. George B. Wood agreed to give $500 annually for the salary of a librarian in order that the library might be kept open daily. The library was then in charge of the Standing Committee on the Library, and the first librarian was elected January 3, 1855. In March, 1871, a Journal Asso- ciation was formed, and subscriptions were made to a few of the best English, French, and German journals. On November 5, 1880, Dr. S. Weir Mitchell presented $1000, and subsequently increased this sum to a total of $5000, the money being invested under the title of the Weir Mitchell Library Fund, and the in- come therefrom devoted to the purchase of books and journals. On February 20, 1881, a card catalogue was commenced. In 1882, by amendment of the ordinances and by-laws, the office of Hon- orary Librarian was created. During this year the libraries of four deceased Fellows were received, namely, those of Drs. Charles D. Meigs, John Forsyth Meigs, E. M. Bertolet, and William F. Jenks. On January 3, 1883, Dr. James H. Hutchinson was elected the first Honorary Librarian, and the Library Com- mittee was empowered to appoint an assistant librarian on a salary. In 1884, the Samuel D. Gross Library of the Philadelphia Academy of Surgery, consisting of 5128 volumes, was presented as a permanent deposit. The library of Dr. H. Lenox Hodge was deposited in the library of the College during the same year, and subsequently was presented to the College by Dr. Hodge's son. 901 volumes were presented by Dr. I. Minis Hays during this year. In 1886, Mrs. Weightman presented the library of her hus- band, Dr. John F. Weightman, and the sum of $1000, the income therefrom to be devoted to purchase of books on ophthalmology. The library of the Obstetrical Society was presented as a permanent deposit during the same year. The College library was now begin- ning to exceed its accommodations, and the Library Committee reported that some 1500 volumes were packed on top of the cases. In 1888, book cases were placed in the lower west reading room, and in 1889, a gallery was erected and filled with book cases and a spiral stairway was built from this room to the second-story reading room. In 1890, Dr. Frederick P. Henry was elected Honorary Librarian to succeed the late Dr. James H. Hutchinson. In 1891, Mrs. Deborah The College of Physicians 147 K. Rodman presented the College with $5000, the income to be used for the purchase of books. The gift was in memory of her hus- band, Dr. Lewis Eodman, and the fund bears his name. In 1892, iron book stacks were erected in the lower east room. In 1894, Mr. Clement A. Griscom presented $5000 in memory of his father, Dr. John D. Griscom, the income from this fund to be used for the purchase of books. During this year the Library Committee procured 796 French and German dissertations, 377 volumes of foreign journals, and began the completion of the files of thirty-three of the most valuable French and German periodicals; this latter event was accomplished in the following year, and 294 additional volumes of foreign journals were pur- chased. During 1896 and 1897 Dr. DaCosta presented 293 vol- umes to complete the files of several important foreign period- icals. In 1899, Dr. Baker presented $5000 to establish a fund to be known as the Henrietta Rush Fales Baker Library Fund, the income to be used for the purchase of books. In 1896, the College passed a resolution proposed by Dr. F. P. Henry "To obtain subscriptions from the general public toward a fund for the endowment of the Library." During 1899, many subscriptions to the Library endowment fund, both from Fellows and from the public, were obtained, and by July 1, 1900, the sum had reached $50,000. During this year also the Library Committee was directed to obtain by exchange the French theses and German dissertations. In 1900, the Library received 6963 theses and inaugural dis- sertations, and exchanged publications with six foreign univer- sities. These were mainly effected through the efforts of the President of the College, Dr. W. W. Keen. In the same year the valuable library of the late J. M. DaCosta, 2466 volumes, was presented to the College. During this year the Librarian called the attention of the Library Committee to the condition of the card catalogue, with the result that a committee was ap- pointed by the College to obtain by subscription the sum of $2500 for the purpose of bringing it up to the standard of modern library equipment. The sum of $1900 was collected by this committee. In 1901, by legacy of Dr. John Ashhurst, Jr., 1500 volumes from his library were presented to the College. This bequest contained many valuable works. 148 Scientific Institutions In April, 1901, the Library Committee purchased the valu- able collection of books of the late Dr. J. Stockton Hough. They were enabled to accomplish this largely by the aid of generous subscriptions from Drs. George Pales Baker, S. Weir Mitchell, and John K. Mitchell. Duplicate copies and non-medical books of the collection were sold to the Library of the University of Pennsylvania for $1500. The Hough collection was from the standard of the bibliophile, the most important addition that has ever been made to the library, and the opportunity of securing it was chiefly due to the energy of Dr. W. W. Keen, who visited New York on behalf of the College and negotiated the terms of its purchase. In 1902, the library of Dr. William P. Ebrris, containing 1177 volumes on Ophthalmology, was presented by his family. In October, 1903, Dr. George W. Nbrris presented to the library three volumes containing the colored plates of eye grounds, made from the original drawings and notes of Prof. Edward Jaeger, of Vienna. These volumes also contained ophthalmological drawings from cases seen in Dr. Norris's practice. In 1904, there were received 958 volumes from the library of the late Dr. Thomas M. Drysdale. In 1905, gifts of 1982 volumes and 548 volumes were made by the Board of Managers of the Epis- copal Hospital and by Dr. James V. Ingham, respectively. In 1906, the Library contained 82,305 volumes, 56,116 pamphlets, 20,978 dissertations. In 1908, 33 rare and very valuable books were obtained through the efforts of Dr. W. W. Keen, 21 of these being of the Fifteenth Century. In 1908, the Library contained 86,718 volumes, 67,122 pam- phlets, and 22,681 dissertations. During this year exchanges with the Paculte de Medecine de Paris were effected through the efforts of Drs. Keen and Osier, and Drs. A. J. Magnin and Louis Landouzy, Dean of the Medical Faculty of the University of Paris. "The importance of completing our files of the Theses de Paris was so great that an appeal was made to certain Fellows of the College for subscriptions; this was generously responded to, and $1415 were collected for the purpose. Of this amount Dr. Keen obtained $315, and the Librarian the remainder. This money has been most judiciously expended by Dr. Keen while in The College of Physicians 149 Paris, and his purchases will complete our files from 1882 to 1907 — more than 850 bound volumes." 3 It is impossible in this space to enter into further details concerning this valuable collection of medical books. As remarked by Mr. Charles Perry Fisher in his interesting Account of the Library of the College of Physicians : "The Library of the Col- lege of Physicians contains treasures enough to fill a good sized printed volume." THE BUILDING FUNDS In November, 1849, a committee was appointed to inquire into the cost of purchasing a lot of ground and constructing a building suitable to meet the expanding conditions of the College. This committee subsequently reported that at least $20,000 would be required for the purpose, and that the best means of raising such a sum was to take the invested securities of the College, amounting to $945, as a nucleus, and to add to that sum such contributions as might be received from time to time. In 1850, a committee was appointed to solicit subscriptions. In 1859, after nearly ten years of patient work, the trustees of the fund announced to the College that they had in their possession securi- ties to the value of $21,545. In receiving this report the College continued the Building Fund Trustees in office for another five years, and a committee was appointed to obtain a building site. On January 4, 1860, this committee announced that the north- east corner of Thirteenth and Locust Streets had been purchased for $10,867.93. Subsequently an adjoining lot 18 by 118 feet, on the eastern side of the property was purchased for a sum of $3540.67, thus making the total expenditure for the site of the building $14,408.60. On December 18, 1861, the College deter- mined to begin the construction of its new building at Thirteenth and Locust Streets, which was completed and occupied for the first time in March, 1863. At that time the Trustees of the Building Fund announced a debt of $5000 in the shape of a mortgage on the building of which, however, the College was soon relieved by a generous provision in the will of Dr. George B. Wood. On February 3, 1864, the following statement appears in the report of the Building Committee : "It must be manifest that we have reason to be proud of what the profession of our 3AimUal Report of the Library Committee of the College of Phy- sicians of Philadelphia for the year 1908. 150 Scientific Institutions city has done for the promotion of our science, the improvement of the healing art and the relief of suffering. And this has nearly all been accomplished by the contributions from our hard-worked and inadequately-compensated profession, the whole sum fur- nished from other sources amounting to only about $2500." In a very few years a second building fund was started to meet the necessity of larger accommodation. In 1883, Dr. J. M. Da Costa presented $1000 to serve as a nucleus for this fund. Two years later it had increased to a sum of $14,581, and the committee was authorized to add a third story to the Hall. This was finally accomplished without incurring debt, the last $2500 being gen- erously contributed by Mr. George W. Childs. Again, in a few years, the tremendous growth of the College, or, more particularly of the Library, necessitated larger quarters. The walls of the old building were pronounced inadequate to sus- tain the weight of more book shelves or books, and for the third time in the history of the College a building fund was instituted and so generously supported as to make possible the construc- tion of the splendid new home of the College at Twenty-second and Ludlow Streets. The story of this fund is so closely inter- woven with the intimate history of the College that no detailed account of it will here be given. It is not possible in a history of these necessarily narrow limits to give in any detail accounts of the individual benefactors of the College throughout its long and honorable career. In all its financial crises strong men have arisen among its Fellows either to help with money from their own pockets, or by raising interest in others, to aid in the development of their valuable In- stitution. Without making any invidious comparisons, we may mention some names among the Fellowship which stand forth as those of conspicuous benefactors: John Eedman, the first Presi- dent, who served for eighteen years ; John Morgan, a Founder of the College, who presented the first volumes to form a library; George B. Wood, who served the College as President for thirty years and gave liberally to its needs; Thomas D. Mutter, who presented his museum and endowed a lectureship which bears his name; Samuel F. Lewis, who presented his large and valuable library; Drs. Gross, Ashhurst, DaCosta, Stille, and many others who left their libraries after their death to the College; William W. Keen, who has aided in collecting large sums of money for the The College of Physicians 151 new home of the College, established exchanges with many for- eign universities, and given most liberally to its various needs; S. Weir Mitchell, who for a period of fifty years has been most active in every advance. To him, more than any one, is due the collection of the great sums that were necessary to build the new home of the College. It is difficult to mention any of its activi- ties without recording the fact that Dr. Mitchell was in the fore- front not only with valuable counsel and advice, but also with generous gifts of money and unflagging zeal in interesting others to give of their plenty to a great cause. In conclusion the name of Andrew Carnegie should never be omitted from a history of the College of Physicians. His gen- erous gifts of two sums of §50.000 each have laid upon it a debt of honor to live up to the record of great achievement and public utility that has been handed down by the great Fellows of the past. Memorable dates in the history of the College of Phvsieians of Philadelphia: Institution of the College, January 2. 1?8?. Institution of the Library, March 3, 1?8S. Incorporation of the College, March 26. 1789. Institution of the Pathological Museum. June 5. 1849. Institution of the first building fund, Xovember 2, 1S4P. Institution of the Mutter Museum, December 11, 1S5S. Institution of the second building fund, April ?, IS? 5. The College first occupied its own premises in MaTch, 1S63. Completion of a third story for accommodation of the Mu- seum. May 31, 1SS6. Celebration of the Centennial anniversary, January 3, 158?. Institution of a third building fund, January 21, 1903. Purchase of lot at Twenty-second and Ludlow Streets, May 29, 1903. Laying of cornerstone of new building at Twenty-second and Ludlow Streets. April 29. 1908. Presidents. — John Eedman, 1TS6 : William Shippen, Jr., 1805 : Adam Kuhn, 1808; Thomas Parte, 1818; Thomas C. James, 1835; Thomas T. Hewson, 1835; George B. Wood, 1848: W. S. W. Euschenberger, 18?9: Alfred Stifle, 1883: Samuel Lewis, 1884: J. M. DaCosta. 1884; S. Weir Mitchell, 1SS6; D. Hayes Agnew, 1889; S. Weir Mitchell, 1892; J. M. DaCosta, 1895: 152 Scientific Institutions John Ashhurst, Jr., 1898; W. W. Keen, 1900; H. C. Wood, 1902; A. V. Meigs, 1904; James Tyson, 1907. Vice-Presidents. — John Jones, 1786; William Shippen, Jr., 1791; Adam Kuhn, 1805 ; Samuel Duffield, 1808 ; Thomas Parke, 1813 ; Samuel P. Griffitts, 1818 ; Thomas C. James, 1826 ; Thomas T. Hewson, 1835 ; Joseph Parrish, 1835 ; John C. Otto, 1840 ; Henry jSTeill, 1844; George B. Wood, 1845; Charles D. Meigs, 1848; Franklin Bache, 1855; George W. Norris, 1864; W. S. W. Eusch- enberger, 1875; Alfred Stille, 1879; J. M. DaCosta, 1883; S. Weir Mitchell, 1884; John H. Packard, 1886; James H. Hutch- inson, 1889; S. Weir Mitchell, 1890; J. M. DaCosta, 1892; John Ashhurst, Jr., 1895; W. W. Keen, 1898; H. C. Wood, 1900; Arthur V. Meigs, 1902; James Tyson, 1904; George E. De Schweinitz, 1907. Secretaries. — James Hutchinson, 1786; Samuel P. Griffitts, 1788; Thomas C. James, 1796; Thomas T. Hewson, 1802; Joseph Parrish, 1812; J. Wilson Moore, 1819; Samuel Emlen, 1820; Charles D. Meigs, 1828; Henry Bond, 1833; D. Francis Condie, 1843; Francis West, 1854; W. S. W. Buschenberger, 1854; Alfred Stille, 1854; Edward Hartshorne, 1858; John H. Packard, 1862; William G. Porter, 1877; Eichard A. Cleemann, 1879; Isaac Norris, Jr., 1885; Charles W. Dulles, 1891; Thomas B. Neilson, 1896. Treasurers. — Gerardus Clarkson, 1786 ; Samuel Duffield, 1790; Benjamin Say, 1791; Thomas C. James, 1809; J. Wilson Moore, 1825; J. Eodman Paul, 1839; Charles S. Wurts, 1877; Henry M. Fisher, 1894; Eichard H. Harte, 1899. Honorary Librarians. — James H. Hutchinson, 1883; Fred- erick P. Henry, 1890. Librarians. — T. Hewson Bache, 1855; C. S. Boker, 1864; J. H. Slack, 1865; Eobert Bridges, 1868; Frank Woodbury, 1881; Charles P. Fisher, 4 1882. 4 Mr. Fisher was engaged as Assistant Librarian, subsequently appointed Librarian, and at present has also the title and function of Superintendent of the building. The Academy of Natural Sciences of Philadelphia By EDWARD J. NOLAN. M.D. As for the Corruptions and Moths of History, which are Epitomes, the use of them deserveth to be banished as all men of sound judgment have confessed. — Bacon, "Advancement of Learning." ALTHOUGH at the beginning of the nineteenth century Phila- delphia was acknowledged to be the center of scientific, if not of literary culture in America, there were not many societies in the city devoted to scientific research. The American Philosoph- ical Society had, indeed, established for itself an honorable position in the learned world, but membership was scarcely aspired to by those who had no right in any sense to consider themselves philos- ophers. The "Botanical Society, held at Philadelphia," had been founded in 1806, the name being changed the following year to the "Philadelphia Linnaean Society." It had a brief and uneventful existence and is at present remembered from the publication of an essay by Benjamin Smith Barton, entitled "Discourse on some Principal Desiderata in Natural History." There were but few who cared anything about the natural sciences, and these had to contend with many difficulties. Neither cabinets to awaken curiosity nor libraries to satisfy it were in exist- ence. There were two or three collections of minerals belong- ing to gentlemen who had brought them from Europe, but they were not accessible to the public. A few young men in the city were, however, interested in the study of nature. They were all engaged during the day in making a living, and they must have found that occasional gossip in places of resort available to those of their social condition would not help them much in the search for exact knowledge. After one of these accidental meetings early in 1812, John Speakman suggested to his friend Jacob Gilliams that if their associates could come together at stated times where they would be free from interruption and could compare notes as to what they supposed they knew, they would secure more pleasure and profit than by desultory talk. Gilliams agreed with him, and before they separated it was decided to invite such friends as might be favorable (153) 154 Scientific Institutions to the formation of a society to meet at Speakman's house the fol- lowing Saturday night. In accordance with this agreement Doctors Gerard Troost and Camillus Macmahon Mann, with Jacob Gilliams, John Shinn, Jr., and Nicholas S. Parmentier, met at the house of Mr. Speakman, on the northwest corner of Market and Second Streets, on Saturday evening, January 25, 1812. Mr. Speakman acted as chairman, and Dr. Mann as secretary. The minutes are described as those of "a meeting of gentlemen, friends of science and of rational disposure of leisure moments," and it was agreed that the exclusive object of the society should be the cultivation of the natural sciences. This was the humble origin of The Academy of Natural Sciences of Philadelphia. Although there is abundant evidence in the records and in tradition that the founders took themselves seriously and were conscious of the dignity of their undertaking, it is scarcely conceivable that they could have anticipated the future development of their society into one of the most active and influential scientific associations of the world. 1 In order not to be a burden on Mr. Speakman's hospitality, the next two or three meetings were held at a public house on Market, or High Street, near the corner of Franklin Place, known as Mercer's Cake Shop. The title, Academy of Natural Sciences, was employed for the first time in the minutes of March 21, 1812, and was sug- gested opportunely by Dr. Samuel Jackson, of the University of Pennsylvania. He had not joined the society because, it is said, he feared that in the estimation of the public all its members would be considered, however unjustly, as lacking in proper respect for religion, a supposition which might be detrimental to a physician at the outset of his career. It was decided that the origin of the Academy should date from that session and that in subsequent years the anniversary should be observed on that day. At this meeting Thomas Say was chosen a member, and it was determined that, although he had not attended the initial meetings, his name should be enrolled as one of the founders, who are, there- fore, recorded as being John Speakman, 2 Jacob Gilliams, 2 John Shinn, Jr., Nicholas Parmentier, Dr. Gerard Troost, 2 Dr. Camillus Macmahon Mann and Thomas Say. 2 It was John Speakman and 1 In the preparation of the first part of this article the Notices of the Academy, by Dr. W. 8. W. Euschenberger, have been freely drawn upon. 2 Portraits of these are hung in the library. The Academy of Natural Sciences 155 Jacob Gilliams, however, who had issued the invitation for the preliminary meeting and the conclusion is a just one that the foundation of the Academy is ascribable to these two men. John Speakman was born in Bucks County, Pennsylvania, and belonged to the religious order of Friends. His apothecary shop at the northwest corner of Second and Market Streets was one of the centers of literary and scientific gossip. He was for a time in disastrous partnership with Say and was ever ready to do all the work of the shop so as to enable his friend to devote almost his entire time to the service of science. Through the endorsement of friends the firm of Speakman and Say came to an unfortunate end, the partners retaining scarcely anything for themselves. As late as 1839 Mr. Speakman, at a considerable sacrifice of his private interests, visited Mr. Maclure in Mexico, where he spent several months for the benefit of the Academy. Mr. Jacob Gilliams was a native of Philadelphia and a leading dentist of the day. He was an intimate associate of Thomas Say and Alexander Wilson, and when the latter was engaged on his American Ornithology the three friends were frequent visitors to Mr. William Bartram at his house attached to the garden which has now become classic ground. Mr. John Shinn, Jr., was a native of New Jersey. He was employed as a manufacturing chemist. Soon after the Academy was established in the new hall in Gilliam's Court he delivered a course of lectures on chemistry, the first given under the auspices of the society. Mr. Nicholas S. Parmentier was born in France. He was a distiller and manufacturer of spermaceti oil. He removed to Florida. Gerard Troost 3 was the first President of the Academy and served efficiently until 1817. He was born in Bois-le-Duc in Hol- land and educated as a pharmacist and chemist. After an eventful career in Europe he settled in Philadelphia in 1810. In 1815 and 1816 he engaged in the manufacture of alum on the Magothy Eiver in Maryland. On his return to the city he delivered lectures on mineralogy in the Philadelphia Museum and the College of Phar- macy. After spending two years with his friend Maclure at New Harmony, Ind., he was elected, in 1828, Professor of Chemistry, 3 University of Tennessee, Bulletin of Information, v., 6, Jan., 1907. 156 Scientific Institutions Geology and Mineralogy in the University of Nashville, retaining the position until his death August 17, 1850. During his incum- bency he served as State Geologist of Tennessee until the office was abolished in 1849. The first Recording Secretary, Dr. Camillus Macmahon Mann, was born in Ireland. He was "out" in the rebellion of 1798. After a stay in France he sought refuge in the United States, living for a time in Philadelphia, and later edited a paper in Baltimore. The date of his death is uncertain. The presence of Thomas Say at a meeting is first recorded on Thursday, April 16, 1812. Henceforth, except when away from the city, he was rarely absent from a session of the society. It may be claimed that the continued existence of the Academy was in great measure due to his devotion and the dignity he was able to give the proceedings by the high character of his scientific work. After the failure of the firm of Speakman and Say he resided for a time in the hair of the Academy, accommodating himself heroically to his ex- ceedingly cramped means. In 1825 he accompanied Mr. Maclure to New Harmony. The communistic experiment in which they were engaged having proved a failure he accompanied Mr. Maclure to Mexico. He remained there for twelve months and was then compelled by business engagements to return to New Harmony where he died October 10, 1834, in his forty-seventh year. Much the greater part of his work was completed before he left Phila- delphia for the West. In his new home, however, his business engagements evidently did not take lip all his time for he issued there six numbers of the American Gonchology and several papers, including two in the Annals of the Maclurean Lyceum. Say was a born naturalist. He troubled himself but little about relationships and classification, confining himself almost entirely to the determination of specific distinctions of which he had an unusually acute perception. His reports of original re- searches were the first to replace the reading of extracts from encyclopaedias or journals, which formed the attraction at the earlier meetings. 4 About the first of April a small room on the second floor of a 4 An appreciative biography of Say, by George Ord, is published in connection with The Complete Writings of Thomas Say on the Entomology of North America, edited by John L. Le Conte, M.D. Another by Benjamin Horner Coates was issued under the auspices of the Academy in 1835. The Academy of Natural Sciences 157 house on the east side of Second Street, then No. 121, near Eace Street, was rented. Here the nucleus of the present library and museum was formed. Each member gave something, and although the "display of objects of science was calculated rather to excite merriment than to procure respect" the result formed the germ of the superb library and museum which have given the Academy dis- tinction among scientific societies. On the fifteenth of August, 1812, a collection of minerals con- taining about 2000 specimens, previously purchased from Dr. Sey- bert for $750 by Mr. Speakman, was acquired by the society, and soon after Dr. Troost delivered a course of lectures on mineralogy to the members and others. It is a tradition that the necessity of dis- charging the indebtedness incurred by the purchase of the Seybert minerals, was a bond of union during the first year or two of struggle and discouragement. The collections, meager as they were, soon required more room and in September of the same year they were removed to apart- ments in the upper part of a house on the west side of Second Street, then No. 78, north of Arch. These quarters were called the Hall of the Academy. So little interest had the new society enlisted that at the close of its first year it consisted of but fourteen members and thirty-three correspondents. During the following two years the museum and library in- creased more rapidly. Lectures on entomology were delivered by Mr. Say and on botany by Drs. Waterhouse and Barnes. At the beginning of 1815 increased accommodation was again necessary and Mr. Gilliams built a hall on a vacant lot in the rear of his father's house on the north side of Arch Street east of Second. The collections were removed to it in July. The first period of the Academy's existence extended from its foundation to this, the first exclusive occupancy of a building. As far as regards the permanency and prosperity of the society the most important event of these years was the election to member- ship in June, 1812, of William Maclure without whose help it would probably not have been possible to prolong its existence. In 1816, a constitution was adopted and the society was legally incorporated the following year. At the instance mainly of Mr. Maclure the Academy decided on the publication of a Journal, the first number of which was placed before the meeting held May 20, 1817. The first volume was issued 158 Scientific Institutions under great discouragement and the publication was suspended until 1821 when, owing to the industry and zeal of Dr. Isaac Hays, it was continued without incurring further indebtedness. In November, 1817, Standing Committees on Zoology, Botany, Mineralogy and Geology were appointed for the first time. Progress was not very rapid, yet at the close of 1820 the ques- tion of enlarged accommodation once more presented itself for con- sideration. At that time there were one hundred members and one hundred and ninety correspondents on the roll. A committee was appointed in 1823 to consider the best means of obtaining additional room. It was not, however, until 1826 that a lot of ground and a building at the southeast corner of Twelfth and Sansom Streets (then George's Street) were purchased for $4,300. The building had been used for several years as a place of worship by a society of Swedenborgians, and to fit it for the purposes of the Academy an expenditure of $1,700 was required. A debt of $3,000 was created and up to August, 1837, only $300 of the amount had been paid off. Mr. Maclure then gave $5,000, the debt was liquidated and $2,300 were placed at interest for the current needs of the institution, the first time in its history that it was in possession of such a surplus. A first meeting was held in the new hall on May 9, 1826. In 1828, the, museum was open to the public. Since that time admission to the collections under varying conditions, has been an important factor in the educational resources of the city. For the next fourteen years the prosperity of the Academy was uninterrupted, although its resources remained extremely meager compared with the amount and character of the work accomplished. William Maclure, because of his active interest in the society, richly deserved the compliment of an annual re-election as President, although his prolonged and frequent absence from the city made it impossible for him to discharge the duties of the office. George Ord, as Vice-President, acted as his zealous and efficient substitute until 1834 when he was succeeded by John Price Wetherill. The other Vice-President, William Hembel, was too deaf to act as presiding officer. Among the successors of Dr. Mann, the first Eecording Secre- tary, William Hippolyte Keating is distinguished for his faithfulness and efficiency. He served from January, 1822, to December, 1825, and has left two annual reports which are of interest as indicating specifically the value of the work the Academy was then doing. He a s R < The Academy of Natural Sciences 159 relinquished the office because of removal from the city and was succeeded by Dr. Samuel George Morton who served until 1829. The necessity for increased room becoming yearly more press- ing, a lot at the northwest corner of Broad and Sansom Streets was bought on the twenty-second of April, 1839, for $13,333. On Saturday the twentieth of May, the corner-stone of a new building was laid with the usual ceremonies by Vice-Presidents William Hernbel and John Price Wetherill. An eloquent address was made on the occasion by Walter K. Johnson 5 who had been one of the most active members of the society since his election in 1827. He had been a Curator in 1836 and 1837 and subsequently served as Corres- ponding Secretary from 1841 to 1848. The building was forty-five feet front on Broad Street by eighty-five feet deep on Sansom with an elevation of fifty-five feet. It at first consisted of a single saloon with two ranges of galleries, beneath which, in the basement, was a lecture room to accommodate five hundred people. The value of the premises at the corner of Twelfth and Sansom Streets had appre- ciated and the property was sold to William B. Hanson for $10,950. The means for the erection of the new hall were, however, chiefly derived from William Maclure who subscribed toward the object $20,000. The building fund was largely augmented by liberal sub- scriptions from members and others interested in science. The transfer of the collections and library was made at a cost of $34, several of the members giving their time and strength to the service so as to lower the expense and save time. One of the most active in this work and in the accumulation of the building fund was William S. Vaux who had been elected a member in 1834. During the rest of his life he gave devoted attention to the economic interests of the Academy, serving continuously as Curator from 1838, and as Vice-President from 1860, with a brief interval, until his death in 1882. He also rendered indispensable service as a member of the Publication Committee from 1840 and as treasurer of the Board of Trustees of the Building Fund from its organization in January, 1867. The books and specimens were placed in the saloon on the second floor and here the first meeting was held on the 18th of February, 1840. 5 Nat. Encycl. of Am. Biogr., xii, 260. Barnard's Am. Journ. Educa- tion, Dec, 1858. 160 Scientific Institutions The death of William Maclure 6 on the 23d of March, 1840, inflicted on the society the greatest loss it had yet sustained. In addition to his large pecuniary contributions, he had given in 1835 a selection from his library in New Harmony. The transfer of the collection, amounting to 2,259 volumes and an extensive series of maps and charts, had been safely accomplished by Charles Pickering, the distinguished author of the Chronological History of Plants, who was Librarian of the Academy from 1829 to 1833. He had also con- ducted the transfer and arrangement of a great number of plants bequeathed by the Eev. Lewis David von Schweinitz, who died in 1831. Mr. Maclure was succeeded in the Presidency by William Hembel 7 who had been elected a member in 1825. He held the office from December, 1840, until December, 1849. His adminis- tration was uneventful. In the hope of being able to remedy impaired hearing resulting from an attack of scarlet fever he had studied medicine in the University of Pennsylvania but did not graduate. Dr. Morton announced to the meeting held June 16, 1840, that a bill for the perpetual exemption of the property of the Academy from taxation had passed both houses of the Legislature. The first annual election in the new building at Broad and San- som Streets resulted as follows: President, William Hembel; Vice-Presidents, John Price Wetherill, Samuel Geo. Morton, M.D. ; Corresponding Secretary, Eobert Bridges, M.D. ; Recording Secre- tary, A. Denman Chaloner, M.D. ; Librarian, A. L. Elwyn, M.D. ; Curators, William S. Vaux, John S. Phillips, Eobert Pearsall, George C. Leib, M.D. In March, 1841, tbe publication of the Proceedings was com- menced. The sessions of the Academy were then and until May, 1903, held every Tuesday evening throughout the year. A most important event in the history of the society was the election to membership on July 29, 1845, of Dr. Joseph Leidy. He published the first of a brilliant series of contributions to natural history in the Proceedings a couple of months later and for the succeeding forty-six years he exerted a most active influence on the well-being of the institution in every department of its administra- 6 A Memoir of William Maclure, by Samuel George Morton, M.D. Published by the Academy, 1841. 7 Simpson's Lives of Eminent Philadelphians, 1859, p. 515. WILLIAM MACLURB, 1763-1840. Academy of Natural Sciences. The Academy of Natural Sciences 161 tion until, to the community at large, the names of Leidy and the Academy were inseparably associated. At the stated meeting of June 30, 1846, Dr. Morton announced that Dr. Thomas B. Wilson, having purchased the famous collection of birds of the Due de Eivoli, embracing 10,000 specimens mounted and named, was desirous of arranging them in the museum. In furtherance of Dr. Wilson's wishes the building was extended thirty feet westward covering all the ground then at the disposal of the society. The library was moved from the second floor to the new room at the west end of the basement and the first meeting was held in it May 4, 1847. Vice-President Morton made a brief address of welcome and congratulation on taking the chair. He alluded feel- ingly to the services of those who had sustained the burden during the days of struggle and uncertainty and gave credit to those who were then devoted to the interests of the Academy, alluding especially to Dr. Wilson who had paid the entire cost of the extension to the building but, in deference to his modesty, without mentioning his name. Dr. Wilson's entire collection of birds, amounting to 26,000 mounted specimens and 2,000 skins, until then on deposit, was presented outright in 1860. The ornithological collection formed the most attractive feature of the museum, and for years gave it distinction in the appreciation of the public. While the collection of birds was Dr. Wilson's most striking gift, every department of the museum and library received important additions from him. No other benefactor of the Academy has demonstrated his interest in its welfare with such active personal exertion or with such self-sacrificing labor. His name, therefore, should be among the first of those who deserve the gratitude of the society. 8 A second series of the Journal in quarto was begun in Decem- ber, 1847, mainly through the influence and on the urging of Dr. Wilson who subsequently contributed liberally to the expenses of illustration, especially of the fine colored plates of Cassin's descrip- tions of new species of birds. In 1848, there were on the lists of the society 245 members and 520 correspondents. The most active workers were Samuel George Morton, John Cassin, Joseph Leidy, William S. Vaux, Eobert 8 A Memoir of Thomas Bellerby Wilson, M.D. Proo. Ent. Soc. of PHU,, v., 1865. 11 162 Scientific Institutions Bridges, John Phillips, William Gambel, Timothy Abbott Conrad, and Samuel Stehman Haldeman. At the close of 1849, Mr. Hembel declined a renomination for the Presidency. He was succeeded by Dr. Morton who had, with few exceptions, presided at the meetings during the entire incum- bency of his predecessor. Dr. Morton's position as Vice-President was filled by the election of Dr. R. Egglesfield Griffith, the accom- plished author of the Medical Botany. He died in 1850. The election of Dr. Morton to the Presidency was a fitting recognition, not only of more than a quarter of a century's devoted service, but also of his distinguished rank as one of the world's most accomplished ethnologists. He was to enjoy the well-merited honor, which was the ultimate expression of the Academy's appreciation of his work, for less than eighteen months. He presided at a meeting for the last time on May 6, 1851, and died on the 15th of that month in his fiftieth year, after an illness of four days. His first work was in geology but his magnum opus, the Crania Americana, was published in 1839 and has been properly described as a lasting monument to his learning, energy and ability. His last paper was on the size of the brain in various races of man and in support of his belief in the plurality of origin of mankind, a doctrine to which he gave unfaltering support. 9 Dr. Morton was succeeded in the Presidency by George Ord. He had served as Vice-President from 1816 to 1834 and as Curator during 1816 and 1817. He belonged to the old fashioned type of naturalist which has now almost entirely disappeared. His favorite subjects of study were birds and mammals although he did not confine his attention entirely to them. He acted as the literary executor of his friend Alexander Wilson. His contribution to Guthrie's Geography is regarded as the first systematic work on the zoology of North America by an American. His biographies of Wilson and Say are specimens of elegant English and prove him to have had what his friend Charles Waterton called "a polished mind." Although he had declared as far back as 1841 that he was compelled by the encroaching infirmities of age to abandon his nature studies and devote himself to more sedentary occupations, he served the society faithfully as presiding officer until December, 1858, when, 9 A Memoir of Samuel George Morton, by Charles D. Meigs, M.D. Read November 6, 1851, and published by direction of the Academy, Phila- delphia, 1851. The Academy of Natural Sciences 163 declining a renomination, he was succeeded by Isaac Lea. Mr. Ord died January 23, 1866. 10 The anniversary of the founding of the Academy was cele- brated in 1854. On the evening of March 20th, William Parker Foulke delivered an appropriate address in the Hall of the Univer- sity of Pennsylvania, and the following evening more than one hundred members and correspondents, with a few distinguished guests, dined in the hall of the Musical Fund Society, the occasion being long remembered as an unusually pleasant one. In 1855, the building was again enlarged by the erection of an additional story of twenty-four feet in height at a cost of $12,263, the entire amount being secured in subscriptions by a committee of which Mr. William S. Vaux was the energetic and efficient chairman. The specimens in the apartment fronting on Broad Street, at first designed as a lecture room, were now removed upstairs and the growing library was extended into the room thus vacated which was used subsequently as the place of meeting. The western room in which the meetings had been held was later divided by a galleried partition, thus affording additional space for shelving. In 1858, the recently formed Biological Society became the Biological Department of the Academy, Dr. Leidy being the first Director. Valuable contributions were made for the next three years to the separately paged Proceedings by S. Weir Mitchell, Henry Hartshorne, J. Cheston Morris, William A. Hammond, Isaac I. Hayes, J. J. Woodward and the Director. More pressing matters engaged the attention of many of the members on the breaking out of the war, so that the meetings were suspended and not resumed until 1868, when renewed life was acquired by union with the recently organized Microscopical Society of Philadelphia, the com- bination being known as the Biological and Microscopical Section of the Academy. As a presiding officer Dr. Lea was dignified and genial, greatly enjoying the exchange of opinions with those brought together each succeeding Tuesday evening. He imparted to the meetings more than ever the character of conversazioni, frequently dropping the gavel long after the appointed time. He died December 8, 1886. 11 In 1860, the children of the late Augustus E. Jessup, in fulfil- 10 George Ord, by Samuel N. Rhoads. Cassinia, No. 12, 1908. 11 The Published Writings of Isaac Lea, LL.D. By Newton Pratt Scudder. Bulletin of the U. 8. National Museum, No. 23. 164 Scientific Institutions merit of his intention, announced that they would pay $120 per annum toward the expenses of publication and $480 per a^num for the assistance of poor young men desiring to study natural history. The sums named were regularly paid until February, 1872, when the sum of $10,000 in bonds was transferred to the Academy. Mrs. Clara J. Moore, in 1888, added $5,000 to the fund and, in 1893, gave $5,000 to be applied to the assistance of young women similarly inclined. Sixty-nine men and four women have been assisted by the endowment, some of them attaining dignified positions as teachers, geologists, biologists and authors. The same year the Academy lost the services of the Treasurer, George W. Carpenter, who had served in that capacity most dis- creetly for thirty-four years. He was ever generous in his encouragement of young naturalists, Mr. Thomas Meehan, for example, being always warm in his acknowledgement of indebtedness to him. The Academy entered on its second half century under the brightest prospects and with a most gratifying record of honor- able achievements. The year 1862 was made notable by the work of illustrious veterans who were still active, and by what there was reason to expect from their successors. But few of the great collec- tions which have since come into prominence were in existence. The Smithsonian Institution was then rather a distributing agency than a storehouse of scientific material. The United States Government had not become, through the Agricultural Department, the National Museum, the Pish Commission and the Geological Surveys, one of the largest publishing concerns in the world, and a formidable rival in the publication of scientific matter, so that the work of Gill, Meek, Hayden, Coues, Stimpson, Kennicott, Yarrow and others in Washington and elsewhere, was issued promptly and accurately in the pages of the Proceedings and Journal. Leidy had suspended for a time his delightful field and lab- oratory notes and was pursuing his paleontological studies in a little dark and dusty room on the first floor of the museum. These he continued until driven out of the field by the wrangling of Cope and Marsh, when his microscopic studies were carried on more comfortably at home. John Cassin 12 had held for years such undisputed sway over the 12 John Cassin, by Witmer Stone. Cassinia I, pp. 1-7. The Academy of Natural Sciences 165 collection of birds as to be somewhat jealous of his authority as Ornithological Curator. Daniel Giraud Elliot and others desiring access to the specimens for purposes of study found him ready with most generous assistance, but interference in the administration of the department, as was once attempted by Dr. Heerman, the cata- loguer of the oological collection, was sternly and effectively resented. The western room of the library was filled with trays of mounted birds and scores of volumes which no one dared to touch. Books and specimens, although somewhat the worse for dust, were made good use of by the autocrat, especially on Sundays, for the exigencies of breadwinning left him but little time for his favorite studies during the week. The genial old Frenchman, Elias Durand, 13 had charge of the herbarium and was just then much perturbed by the blunders of S. B. Buckley in his papers on the plants of Texas. These were later unsparingly criticised by Gray. Lea was reading at the meetings the prodromi of the papers to be afterwards printed in extenso in the Journal and, it must be confessed, not contributing greatly thereby to the interest of the sessions. The sound of the fierce battle between him and Conrad had died away and the latter, as efficiently as his dyspepsia would allow, was describing fossil shells and making autograph drawings on stone of his new species, his activity being greatly stimulated by the facilities for publication supplied by the newly started American Journal of Gonchology. George W. Tryon, Jr., 14 the devoted editor and proprietor of the new journal, was an indefatigable worker and gave up his interest in a lucrative business to devote himself to science. Before doing so he devoted every spare moment to his conchological work and on meeting nights and holidays would be found at his preempted post in the library with trays of shells and piles of books preparing his lists and monographs. He started the American Journal of Gonchology in 1865 and carried it successfully through seven volumes. In 1879 he published the first number of the Manual of Conchology, a work to which his future scientific labors were almost entirely confined. The series has been continued by the 13 Obituary Notice of Elias Durand, by Thomas Meehan, Proceedings A. N. 8. P., 1873, pp. 355-359. 14 A Biographical Notice of George W. Tryon, Jr., by W. S. W. Ruschenberger, M.D. Proceedings A. N. S. P. 1888, pp. 399-418. 166 Scientific Institutions Academy since Tryon's death in 1888, under the able editorship of Dr. Henry A. Pilsbry, the value of whose conchological work has received the most cordial recognition. Mr. Tryon's business train- ing enabled him to actually secure a revenue from his two unpromis- ing ventures, which, with much more, he bequeathed to his favorite department. In quite a special sense, therefore, his work con- tinues. Much the greater part of Cope's time was, at this period, devoted to the study of herpetology, his work being done in a small room in the northeast corner of the first gallery. Cope's contribu- tions to science, his paleontological work especially, lent brilliancy to the Proceedings and Journal and as time progressed entitled him to be regarded as the greatest naturalist born on American soil. In his relations to the administrative affairs of the Academy, he was ever a storm center, absolutely a law unto himself, and so divergent were his theories and methods from those entertained by Dr. Leidy and his other associates, that for years before his death in 1897, he had no official connection with the society, although his interest in the meetings was maintained and the provisions of his will give evidence that through all the disagreements and in spite of them, he retained confidence in its usefulness and was, perhaps, after all not entirely opposed to its methods. He bequeathed to the Academy about 8,000 valuable specimens of mammals, birds, reptiles and fishes and the fund arising from the sale of his paleontological collections after the payment of certain legacies. Dr. James Aitken Meigs had taken up the work of Samuel George Morton and was giving all the time he could spare from a rapidly growing practice to the study of ethnology, with the fine results recorded in the Proceedings. John Hamilton Slack, a man of extraordinary versatility, in a little room directly under Cope's, was studying the mammals and laying ambitious plans for a monograph of the monkeys, which, it is to be regretted, resulted in nothing more than a sixteen page con- tribution to the Proceedings. He was a frequent visitor to the library and by his accomplishments gave brightness and variety to the dullest days. William M. Gabb, during his term as one of the Jessup Fund students, had fitted himself for the work accomplished later in connection with the Geological Survey of California and as Director of the survey of San Domingo. The Academy of Natural Sciences 167 The first recipient of benefits from the Jessup endowment was Charles Conrad Abbott, then engaged in the study of ichthyology, but later recognized as an authority on the Stone Age in America and as the author of graceful contributions to the literature of nature study. Harrison Allen 15 had begun his fine work on the bats and had contributed his first papers to the Proceedings for 1861. They were, in common with those prepared by him in later years, characterized by painstaking accuracy and remain of permanent value, conscientiousness being the keynote of the author's character and work. John L. Le Conte 10 was adding to his reputation as one of the most accomplished of American naturalists by a series of papers on the coleoptera. From him his friend and protege, George H. Horn, 17 was drawing the inspiration that enabled him to secure a distinguished position in the same department of science. Thomas Meehan 18 had been elected a member ten years before and was contributing to the Proceedings the results of his observa- tions on the physiology of plants, continued until his death in 1901. He was indefatigable as Conservator of the Botanical Sec- tion, and gave much time and labor, even when suffering from the illness which proved fatal, to the increase and care of the herb- arium. He was an acute observer and graceful recorder of the life histories of plants, and it is far from being to his discredit that he never, as far as known, thought it worth while to describe a new species. John Warner's communications on the mathematics of organic morphology gave a novel interest to several of the meetings, 15 Proceedings of a meeting of the Academy held in commemoration of Harrison Allen, M.D., and George H. Horn, M.D., Proceedings of the Academy, 1897, pp. 505-535. Harrison Allen, 1841-1897, by Burt 6. Wilder. Association of American Anatomists, December 28, 1897. 16 Biographical Sketch of John Lawrence Le Conte, by S. H. Scudder. Trans. Am. Ent. Soc, xi, 1883-84, pp. 1-27. Sketch of John L. Le Conte, by Jos. P. Lesley, and Memoir, by George H. Horn, M.D. Proc. Am. Philos. 8oc, xxi, 1883, pp. 291-299. 17 Proceedings of memorial meeting, Proc. A. N. 8., 1897, pp. 505-535; A Biographical Notice of George Henry Horn, by Philip P. Calvert. Trams- actions Amer. Ent. Soc, xxv, 1898. 18 "The Botanists of Philadelphia and Their Work," by John H. Harshberger, Ph.D., 1899, pp. 249-256. 168 Scientific Institutions delivered as they were with a quaint earnestness which held the attention even of those unable to follow his abstract deductions. These were the men who were actually engaged in original scientific work on and about the fiftieth birthday of the Academy, in connection with its library and museum. Their contributions to knowledge were published in the Proceedings and Journal, which were additionally reinforced by contributions from most of the leading naturalists of America. Dr. Lea declined a re-election in 1863, and Dr. Wilson very reluctantly and on the persistent urging of nearly every one he met during his visits to the premises, allowed himself to be placed in nomination, and was, of course, unanimously elected at the annual meeting of that year. His term of office was the briefest in the history of the Academy. He was not altogether satisfied with the conduct of the entomological department, and had, with characteristic zeal, allied himself with the American Entomol- ogical Society, which had been founded in 1859 and incorporated in 1863. His sympathies during the war were distinctly South- ern and therefore not in harmony with the rather aggressive patriotism of the majority of his fellow-members. Moreover, his desire to remain in retirement and to avoid any expression of gratitude for his enormous benefits to the society made his posi- tion as President distasteful to him. As a matter of fact he had not presided at a single meeting when, on June 28, 1864, he sent in his resignation. Dr. Wilson was succeeded by Dr. Robert Bridges, 19 who had been elected to membership in 1835. There probably has never been one among those devoted unobtrusively to the interests of the society who rendered more efficient service than Dr. Bridges. He had served at various times as Librarian, Recording Secretary, Corresponding Secretary, Auditor and Vice-President, and did effective work on numerous standing and special committees, including those on the Library, Publications, Finance, Botany, Entomology, Herpetology and Ichthyology, Physics and Chemis- try. His unassuming modesty was like that of his predecessor, and after one year in office he declined a re-election, and was 19 Biographical Notice of Dr. Robert Bridges, by W. S. W. Rusehen- berger, M.D. Proceedings Am. Phil. Soc, xxi, 1884, pp. 427-447. Proceed- ings of the Academy, 1882, pp. 226-230. a Oh (J H n < o « The committee appointed in December, 1779, to reorganize the Medical School seems to have found its task especially difficult, and the Board of Trustees itself when it took up the work made slow progress. Dr. Shippen accepted at once the invitation to retain his old position, but partly from personal jealousies, partly from other causes, the other Medical Professors declined re-elec- tion. Even Dr. Shippen was slow to begin his instruction. In November, 1780, a petition was presented to the Board by a num- ber of the medical students complaining of the lack of anatomical lectures, and asking that the course in that subject should be resumed. The President of the Board therefore wrote to Dr. Shippen, trying to obtain from him a definite agreement as to when he would begin his work. Several others to whom the various chairs were offered declined, and instruction was only given by temporary and irregular expedients until 1783, when the old Professors finally accepted their re-election, and more regular courses were given. In the newspapers of September, 1784, there is an advertisement that "The Lectures upon Anatomy, Chemistry, Materia Medica and Practice of Physic will begin in this city on Monday, November 1." There were from four to ten graduates, either as Bachelors or Doctors of Medicine each year, and a much larger number attending such courses as were given. The old Board of Trustees had never acknowledged the legality of the action by which they were legislated out of control 232 Medical, Pharmaceutical and Dental Colleges of the property and trusts of the old College, and they kept up a continuous agitation for the repeal of that action. For a con- siderable time no success was attained, but by the end of ten years the old radical Eevolutionary element had lost its control of the State Legislature, and given place to a more conservative body. Under these circumstances, in 1789, a partial repeal of the law of 1779 took place, which enabled the old Trustees of the College of Philadelphia to re-establish that institution and regain its old property, while it enabled the new Trustees of the Univer- sity of the State of Pennsylvania to continue its existence, retain its recent endowments, and carry out its recently granted powers. The result was that if both bodies were obstinate — or conscien- tious — there was a possibility of the existence of two separate institutions, each with its own Trustees and Faculty. This was what actually occurred. On the ninth of March, 1789, three days after the passage of the Act of reinstatement, a meeting of the Trustees of the old College was held at the home of Franklin, who was now spending the last few years of his long life in great honor and such rest as his busy nature would allow to him. He was the oldest member of the Board in years, and the onlv sur- vivor of the original twenty-four. All of the fourteen living Trustees were present. At a subsequent meeting, held April 28, 1789, the ten vacancies in the old Board were filled, the Faculty reorganized, and steps were taken to rehabilitate their restored estates. The old buildings were immediately handed over to them, the new University removing its classes to "the Lodge in Lodge Alley," which had been temporarily rented for the purpose. The Medical School was treated separately. Of its Profes- sors, Drs. Shippen, Kuhn and Rush were living and accepted their old positions, though Dr. Kuhn soon resigned from the College to take .a higher position in the University. Dr. Push, on the other hand, gave up his position at the University to become Professor of the Theory and Practice of Medicine in the College. Dr. Shippen retained his position as Professor of Anatomy in both institutions. Dr. Morgan was still living, though not in Penn- sylvania at the time, and he died later in the same year. Several new men were then added. Dr. Caspar Wistar began his con- spicuous professional career by being elected to the chair of Chem- istry and the Institute of Physic. Dr. Samuel P. Griffitts was elected Professor of Materia Medica and Pharmacy, and Dr. ]. -FIRST BUILDINC FOURTH AND ARCH STREETS, 1740. 2.-LOGAN HALL. 3. -THE WILLIAM PEPPER CLINICAL LABORA- TORY. University of Pennsylvania. I. -LABORATORY OF HY- GIENE. W1STAR INSTITUTE OF ANATOMY. fi -ROBERT HARE LABOR- ATORY OF CHEMISTRY BUILDING OF THE MEDICAL SCHOOL OX NINTH STREET, 1829-1872. ADAM Kl'H.V PHILIP SYNC, PHYSICK. it 1 *. 'Ski University of Pennsylvania IH'ILDING OF THE MEDICAL SCHOOL. 17tM-lSH2. University of Pennsylvania 233 Benjamin Smith Barton of Natural History and Botany. Per- haps the most important action in this reorganization of the Medical School was the abandonment of the degree of Bachelor of Medicine. It was declared that to confer that degree gave encouragement to those who had taken it to enter immediately into practice, to call themselves Doctors of Medicine, and thus to impose upon the public, and never return for the further study and maturity necessary to obtain the degree of Doctor of Medi- cine. It -was therefore determined to confer the Doctor's degree only, and to insist that in order to obtain it all candidates should be at least twenty-one years old, should spend at least two years at the College, attended all principal courses of lectures, pass exami- nations, and prepare and print a thesis. On the eighth of June, 1790, the first Medical Commence- ment of the re-established institution took place in the old College Hall at the same hour at which the Commencement of the Uni- versity took place in the new quarters which they had rented in the Philosophical Society's hall on Fifth Street below Chestnut. On the seventeenth of July the regular College Commencement was held. A Commencement was held June 22, 1791, to confer the degree of Doctor of Medicine on five students, but none was held for the College classes. It had no doubt already come to be realized before the usual time for Commencement that the con- tinuance of the two institutions, the College and the Universitv, in perpetual duplication and rivalry, was impracticable. The Provost and Trustees of the College had obtained their vindica- tion, and now both institutions alike were straitened in finances and poorly attended by students; the old rivalries were dimin- ished, the old pride somewhat humbled. There was but little popular interest in either institution, although the University was subjected, in the summer of 1790, to a searching investigation by a committee of the State Legislature. Franklin was a member of the Board of Trustees of each institution, though he had never taken the oaths qualifying him for service in the University, and had not attended any of the meetings. One of the Medical Pro- fessors was serving on both Faculties, and at least one other, Dr. Wistar, was deeply interested in both. Under these circumstances the question of a union of the College and University could hardly fail to come up. ' After long negotiations during the year 1791 this was sue- 234 Medical, Pharmaceutical and Dental Colleges cessfully accomplished. The main features of the plan of union were the adoption of the name of "University of Pennsylvania;" the creation of a new Board of Trustees by the choice from each Board then existing of twelve of its members, and the addition of the Governor of the State; the creation of a new Faculty by choosing from each of the existing Faculties one-half the number of Professors it should be determined to have in the new institu- tion, and the election of a Provost and Vice-Provost from among these Professors; that the Board should be perpetuated by filling its own vacancies, and the Faculty by election of the Board; that all the property of the two institutions should be united, and that an annual statement of the condition of their funds be laid before a representative of the State government. A petition for union was submitted to the Assembly by the two institutions jointly, and an Act was thereupon passed on the thirtieth of September, 1791, embodying these proposals and incorporating a new institu- tion, the "University of Pennsylvania." The property of both institutions came into the possession of the new one, and all the old duties, including the keeping up of a Charity School, were still incumbent upon it. The two Boards of Trustees proceeded to select each one-half of its members to form the new Board, and elected the following Professors to their respective chairs: Dr. Ewing, Professor of Xatural Philosophy; Dr. Andrews, of Moral Philosophy; James Davidson, of Greek and Latin; Robert Patterson, of Mathematics; Rev. Dr. William Rogers, of English and Belles-Lettres, and Rev. Dr. J. H. C. Helmuth, of German and the Oriental Languages. As Medical Professors, Dr. Shippen was elected Professor of Anatomy, Surgery and Midwifery; Dr. Caspar Wistar, Adjunct Professor of the same branches; Dr. Adam Kuhn, Professor of the Practice of Physic; Dr. Rush, of the Institutes of Medicine and of Clinical Medicine; Dr. James Hutchinson, of Chemistry; Dr. S. P. Grifntts, of Materia Medica and Botany; Dr. Benjamin S. Barton, of Xatural History and Botany. The adoption of a new location followed close upon the reor- ganization of 1791. The available buildings were at this time only the old Hall and the adjoining building at Fourth and Arch Streets and the "Anatomical Hall" on Fifth Street. These were inadequate and inconveniently located. The center of population of the city had moved westward and southward. Moreover, University of Pennsylvania 235 within the next five years an unusually good opportunity for a new location presented itself. Between the years 1792 and 1797 a large and handsome huilding had heen erected by the State Legislature on the west side of Ninth Street where the Post Office now stands, to serve as a "White House" for the occupancy of the President of the United States. When it was completed, how- ever, President Adams declined to live in it; the capital was soon afterward removed, and it remained in the hands of the State authorities. In 1800 it was ordered to be sold, and was afterward offered to the Trustees of the University at a relatively small price. It was purchased, altered, and in 1802 became the home of the College department. In 1806 it was enlarged to accommo- date the medical classes also, and added to from time to time, till in 1829 it was removed and two similar buildings erected on the same site, one for the College, the other for the Medical School. Thus was established the second location of the University, that which it retained during its whole ''middle ages," down to the removal to West Philadelphia in 1871. \ This period of about three-quarters of a century was one in which the College was less conspicuous than the Medical Depart- ment, and in which experiments and advances were mainly along non-collegiate lines. One of the most persevering efforts was for the establishment of a Department of Law. This was a project of long standing. A plan had been made and a temporary organi- zation effected as early as 1790. The circumstances were some- what analogous to those of the formation of the Medical School twenty-five years before. Philadelphia was already famous for the talent of its lawyers, and students preparing themselves for the bar were numerous and ambitious. The only instruction avail- able to them was that obtained in the offices of the practicing lawyers with whom they were entered. Additional opportunities of learning were an evident desideratum. At one of the meetings of the Board therefore, soon after the Eevolution, on March 16, 1789, a request came from a group of young law students for the use of one of the rooms of the College for the meetings of a society which they had formed. The request was granted. A year or more later, July 10, 1790, a communication was sent to the Board by a prominent lawyer, Charles Smith, Esq., suggesting the institution of a law lectureship and offering to read a course of lectures each winter, if he should be appointed to do so, under 236 Medical, Pharmaceutical and Dental Colleges such regulations as the authorities of the College might deem proper. The suggestion of giving instruction and degrees in law attracted attention, and was discussed at several successive meet- ings, though no formal notice was taken of Mr. Smith's personal proposal. Finally, in August a plan of such a Professorship was reported to the Board by a committee, of which the Chairman was James Wilson, formerly a tutor in the College, but now one of the Trustees, and an eminent statesman and lawyer. He had, moreover, been recently appointed by President Washington one of the Justices of the Supreme Court. This plan, which provided for a course of twenty-four lectures each year, was immediately adopted, and Judge Wilson himself was appointed Professor of Law. To accept this position he resigned from the Board of Trustees. An announcement was made of a course of lectures to be delivered on three afternoons of the week at six o'clock, with law exercises on Saturday. The introductory lecture, given on the fifteenth of December, 1790, was a notable affair. Since Phila- delphia was at that time the Capital of the United States, there was no lack of public officials to compliment Judge Wilson by their presence. President Washington and the members of the Cabinet, the members of the Senate and House of Representa- tives, of the Supreme Executive Council and of the Assembly of the State, the Mayor and members of City Councils, judges of the courts and a great array of prominent citizens and well-known ladies made a very striking gathering. The course of lectures then inaugurated was given during the winter of 1790-1791. But a second series, although begun during the next winter and carried part way through the year, was interrupted and never completed. Nor were the law lectures continued thereafter. The plan fell into desuetude, to be temporarily revived twenty- five years later, but not to attain any real importance or to become an actual law school until the middle of the next century. The lectureship was only an experiment, interesting in itself, from the personality of the lecturer, and from being the first law lec- tureship established in America, but it had no permanent signifi- cance. It was only the old College courses and the medical courses that were fully established at this time. In 1817, however, the revival of such a course was determined upon, and Charles Willing Hare, Esq., was elected Professor of University of Pennsylvania 237 Law and delivered his introductory lecture a month later. He announced a series of three successive courses; the first, on Natural Jurisprudence, or the science of right and wrong, as dis- covered by human reason, compared with, illustrated by, and embodied in law; the second, on International Jurisprudence, or the laws which regulate the intercourse of nations, the elements of sovereignty, the different forms of government, and partic- ularly the theory and practice of the Constitutions of the United States and of the State of Pennsylvania; and the third, on the Jurisprudence of the United States and Pennsylvania as distin- guished from the common law of England. The first of these courses only was given, the lectures being delivered during the season of 1817-18. Shortly afterward Mr. Hare lost his reason, and died in 1828. The lectureship remained vacant. In 1832 a vigorous petition for the appointment of a Professor of Law was submitted to the Trustees by a committee of the Philadelphia Law Academy, expressing regret that the facilities provided for law students at Harvard, Yale and the University of Virginia were not furnished in Philadelphia, famous for her judges and lawyers and rich in courts of justice. No action, however, seems to have been taken with reference to this petition. It was not until after the middle of the century that this department was permanently established. On April 22, 1850, the old Professorship of Law was again revived, and the Hon. George Sharswood, Judge of the Philadelphia District Court, was elected to fill it. The course was begun the thirtieth of September, 1850, and for some reason, to be discovered probably in the change of times, as well as in the personality of the Professor, it succeeded where the two former efforts had failed. An appreciable number of students, undergraduates and some who were already practicing at the bar, attended the lectures and study classes. From this time forward the growth and development of the Law School has been continuous, until now it is one of the most securely estab- lished, successful, and useful departments of the University. An interesting attempt was made early in the century to establish a Department of Natural Sciences, with a botanical and experimental garden. An interest in matters of natural science was an old inheritance of the University. In Franklin's "Pro- posals" he had suggested the studying of "some of the best histories of nature, which would not only be delightful to youth 238 Medical, Pharmaceutical and Dental Colleges and furnish them with matters for their letters, as well as other history, but would afterwards be of great use to them, whether they are merchants, handicrafts, or divines; enabling the first the better to understand many commodities and drugs, the second to improve his trade or handicraft by new mixtures and materials, and the last to adorn his discourses by beautiful comparisons or strengthen them by new proofs of Divine Providence. While they are reading natural history might not a little gardening, planting, grafting and inoculating be taught and practiced, and now and then excursions made to the neighboring plantations of the best farmers, their methods observed and reasoned upon for the infor- mation of youth; the improvement of agriculture being useful to all, and skill in it no disparagement to any?" As a matter of fact nothing of the kind was taught in the Academy or College, education being carried along on much more conventional lines. Yet even thus the prominence of "Natural Philosophy," or Physics, was a marked characteristic in the whole history of the institution, and among the medical courses there was almost always a course of lectures in Botany. In the mean- time Philadelphia had become a center of botanical knowledge and interest. Three generations of Bartrams, Adam Kuhn, Benjamin S. Barton, Pursh, Nuttall, W. P. C. Barton, Darlington, Baldwin and Horsefield were all Philadelphians of the period before or shortly after the beginning of this century, and foreign botanists, such as Kalm and Michaux, made repeated visits here. In 1807 there was promise of a tangible establishment for educa- tion in the field of natural history. The last instalment of the money owed by the University to the State in payment for the building on Ninth Street was still due, and the Legislature was induced to remit it in the form of a nominal appropriation of $3000 for the creation of a botanical garden, "for the improve- ment of the science of botany, and for instituting a series of experiments to ascertain the cheapest food for plants, and their medical properties and virtues." This was, however, merely the remission of a debt, not a grant of actual money, so, although the interest in the project was still kept up, nothing was done for some years. In 1815, however, a committee was appointed to pre- pare a plan, and in the spring of 181G it was determined to buy a plot of land in or near the city, and to appoint a Faculty of Natural History. Subscriptions were asked for from the pub- University of Pennsylvania 239 lie to enable the Trustees to carry out these plans. In December William P. C. Barton was elected Professor of Botany; Charles Caldwell, Professor of Natural History, including Geology and Zoology; Thomas Cooper, Professor of Mineralogy and Chemistry as applied to Agriculture and the Arts ; Thomas T. Hewson, Pro- fessor of Comparative Anatomy. These professorships brought no salaries, but it was appar- ently anticipated that there would be fees from students, and as the courses given by the first two gentlemen would be taken by many medical students, since their professorships had been de- tached from that department, the fees in their cases at least might be expected to be of an appreciable amount. Early in 1817 the University bought forty-two acres of land in Penn Township, near the Canal Road, for the purposes of the botanical garden, and enough for immediate uses was fenced off. With this amount of preparation, however, the progress of the new school seems to have stopped. The Professors petitioned for rooms and apparatus for lectures, but these could not be given them. There was no money to improve the garden, and the Professor of Botany had to be allowed the use of a part of the College yard for the cultiva- tion of plants "at his own expense." A green-house was proposed, but not built. The courses of lectures were very irregularly given, and the Professors from time to time resigned and were replaced by others, though always after considerable intermission. Finally, in 1827 a committee investigated the whole question of the Depart- ment of Natural Science, and the plan seeming to be hopeless, early in 1828 the Faculty was abolished. An additional reason for the dissolution of the department was found in the recent establishment of the Franklin Institute, which seemed, to a cer- tain degree, to make its existence unnecessary. The chair of Botany was re-established the next year as a part of the Medical Department, and an effort was made, though unsuccessfully, to do the same for the chair of Comparative Anatomy. Nevertheless, the idea of teaching science was not entirely given up, though its later development was along somewhat more utilitarian lines. In the middle of the century the national interest in the development of mining, of chemical processes, of engineering in its various branches, of more scientific agriculture, and of the exploitation of the natural resources of the country generally was extremely strong. One response to this was the establishment in 240 Medical, Pharmaceutical and Dental Colleges the University of a department of "Chemistry as Applied to the Arts." In October, 1850, a professorship of that subject was created, and James C. Booth was elected to fill it. The number of students was restricted to ten, the intention being that they should work in the laboratory at actual experimental investigation under the immediate personal supervision of the professor, who would also give informal lectures on ''Mineralogy, Geology, Theoretic and Applied Chemistry." Professor Booth seems to have served without salary from the University authorities. Within the narrow limits of the plan it was successful, and was continued, the number of students at one time rising to thirteen, till the death of Professor Booth in February, 1856, brought this special line of work to an end. The real germ of all the perma- nent technical scientific instruction given in the University was the adoption, in June, 1852, of a scheme for the establishment of a "School of Mines, Arts and Manufactures." An extensive plan for the teaching of Chemistry, Metallurgy, Civil Engineering, Mining Engineering, Geology, Mineralogy, Paleontology, Pure Mathematics, Mechanics, Mathematical Drawing and other allied subjects was drawn up, and certain of the Professorships nom- inally filled. But the actual establishment of the school and the initiation of instruction dragged on for one year after another, until a new access of vigor on the part of the authorities brought the Scientific Department ultimately into life in the fall of 1855. The first instruction was given by Professor Fairman Rogers, in the form of a course of twenty-eight lectures upon Civil Engi- neering, given to a class of five students between November, 1855, and February, 1856. It was for the partial endowment of this department that the first considerable gift from anv private per- son to the University, since the Revolution, was made. This was the bequest in the will of Mr. Elliott Cresson of $5000, "to be applied toward founding a school of mines for developing the mineral treasures of my native State." Before the opening of the next College year a still more strenuous effort had been made to provide technical instruction in the Scientific Department, so that in 1856-1857 Professor John F. Frazer gave instruction in Theoretical and Applied Chemistry, Professor Kendall lectured on Pure Mathematics and its connection with Practical Science, Professor Rogers gave fifty lectures on Civil Engineering and Sur- veying, and Professor Trego on Geology and Mineralogy. There University of Pennsylvania 241 were twenty-two students for the year, and this course might be considered to be fairly launched. Three years later Professor John Peter Lesley was elected to the chair of Mining, in addi- tion to the four professors already giving courses. In 1864, great hopes were entertained by the University authorities of obtaining a sufficient endowment for this depart- ment in a grant of land from the United States Government. In 1862, the Government granted to each State from the public domain an amount of land equal to thirty thousand acres for each Senator or Eepresentative to which the State was entitled in Con- gress. This made the share of Pennsylvania seven hundred and eighty thousand acres. It was required that the land should be used by the State governments to endow colleges or schools where instruction was given in Agriculture and the Mechanical Arts. In 1863, the University decided to apply to the State Legislature of Pennsylvania to become the beneficiary of this grant. The title of the Scientific Department was therefore changed to the "College of Agriculture, Mines, Arts, and the Mechanical Arts," and provision was made for the election of a Professor of Agricul- tural Chemistry and Scientific Agriculture, a Professor of Botany, and a Professor of Military Tactics, to give instruction in mili- tary drill. The Government land-grant, however, was ultimately given to another institution, the University having failed entirely in its application to the Legislature. So the extension of equip- ment could not be made, and even on its old basis the Scientific Department was extremely hampered for funds, and for a num- ber of years attracted no great number of students. During almost the whole of this early nineteenth century period of the University's history, however, it was the Medical School that was the most prominent and successful of its depart- ments. At the very beginning of the century it forged distinctly ahead of the College, at least in numbers and national reputation. Previous to 1800 its graduates had averaged about eight a year, and had never been above seventeen in any one year. After 1802 the numbers began to rise. In the winter of 1803-1804, the total number of medical students was one hundred and fifty; three years afterwards it was two hundred and seventy. The average annual number of graduates for a half century was more than one hundred, and several times the number was as many as one hun- dred and sixty. Moreover, these students were drawn from many 16 242 Medical, Pharmaceutical and Dental Colleges different lands and distant parts of our own. There were fre- quently more students from Virginia than from Pennsylvania. The reputation of the school constantly spread; its professor- ships were lucrative and honorable, and both attracted the ablest physicians, and induced the most careful preparation and delivery of medical lectures by them. The old connection between the Medical School and the hos- pitals of the city was during this period drawn still closer. Dr. Bond, one of the Trustees, had voluntarily given clinical instruc- tion in the Pennsylvania Hospital to the very earliest medical students of the College. Drs. Shippen, Morgan, Kuhn, Eush, Hutchinson, Wistar, Physick and Barton had all been physicians of the Pennsylvania Hospital, as well as professors in the Medical School before the beginning of the century, and the next gen- eration of professors had the same connection. The instruction at the actual bedsides of patients, which was the early custom, was superseded about 1834 by the later method of having the patients brought to the amphitheatre of the hospital, and here lectured about, prescribed for, and operated upon in the presence of the class. i The connection of the students with the Almshouse Hospital had hardly been as close, nor the freedom of their admission so early established nor so continuously allowed. Nevertheless, the professors of the Medical School had frequently served at the Almshouse, and from time to time, varying with the differing opinions of those in the management of it, medical students had been more or less freely admitted. From 1803 onwards, however, the barriers were gradually removed, the physicians allowed to give instruction there to the students, and in 1807 a special lec- ture room was fitted up for the purpose. This concession on the part of the authorities of the city was partly in return for a fee of $8 charged to each student attending clinical instruction. When the Almshouse was removed to the new buildings in West Philadelphia in 1832, the authorities of the Medical School and the Board of Guardians of the Poor of the City both placed so high a valuation on the advantages to the students of visiting the Almshouse Hospital that in 1834 a system of omnibuses was intro- duced by the latter to carry two hundred and twenty medical students twice a week from the center of the city to the hospital at Blockley. New hospitals also were growing up in Philadel- University of Pennsylvania 243 phia, and these opportunities, along with the fame of its phy- sicians and the central location of the city, helped to keep up and extend the prosperity of the Medical School of the University. Something will be said later of the internal development of the school. It is to be noted here that separate meetings of its Faculty and the election of a dean, with the keeping of minutes seem to have occurred for the first time in 1800, and only became regular by 1804. < More general in character was a petition sent in 1806 by the Medical Faculty to the Legislature of Pennsylvania, calling atten- tion to the evils of medical practice by persons quite unqualified, and soliciting the passage of a law by which no person should be allowed to practice in the State who had not a diploma from a regular medical school or the approval of a government board. This effort, like many later ones for the same purpose emanating from various sources, was unsuccessful. Somewhat later steps were taken to encourage the more scientific study of Pharmacy. In 1816, and again in 1817, the use of the College building was granted to Dr. James Mease to deliver the inaugural of a course of private lectures on the subject. In 1825 the University itself took the matter up, on the recommendation of the Medical Faculty, and declared its intention of conferring the degree of Master of Pharmacy on such persons exercising the profession of apothecary as they should consider qualified. The degree was then conferred upon sixteen men at that time practicing in the city, but it was announced that in future it would only be given to those who had served three years as apprentices to some regular druggist and taken two courses of lectures on Chemistry and on Materia Medica and Pharmacy in the University. In 1841, the Medical School opened its first dispensary clinic. This custom had been adopted before by the Jefferson Medical College at the time of its organization in 1824, but probably because of the close connection of the University School with the hospitals the plan had not been used by it. It was first carried on under the auspices of the University by Drs. Gerhard and Johnson, in the building of the Medical Institute on Locust Street above Eleventh. At the opening of the medical courses of 1843 it was transferred to the Universitj'' building, and carried on under the immediate supervision of the Medical Professors. Closely attached to the Medical School was another new creation of this 244 Medical, Pharmaceutical and Dental Colleges period. This was the Auxiliary Department of Medicine. The medical lectures ended at that time with the month of March. They were also necessarily somewhat narrow and technical, four short terms of instruction being quite insufficient to give anything like a comprehensive view of the various branches of medical science and those subjects most closely correlative to it. These facts were realized quite clearly by the Faculty and by the Trus- tees, but it was not then thought practicable to make the term longer or to increase the whole course beyond two years. At the suggestion, therefore, of Dr. George B. Wood, who had been a Professor in the Medical Department for thirty-eight years, and after his resignation had been elected a Trustee, and on his promise of individual pecuniary support, the Board, in April, 1865, instituted a faculty of five professors in connection with the Medical Department, but which should be separately organized with a dean of its own. Instruction was to be given during the months of April, May and June, after the regular course had been closed for the year. Certificates of proficiency were to be bestowed, and encouragement was given to medical students to take the course by providing that these certificates given to med- ical graduates should be of a more formal character than those given to others, having the seal of the University and the signa- ture of the Provost, and forming a sort of secondary diploma. In the fall of 1865 Dr. Harrison Allen was elected Professor of Zoology and Comparative Anatomy in the new Faculty; Dr. Horatio C. Wood, Professor of Botany; Dr. P. V. Hayden, Pro- fessor of Geology and Mineralogy; Dr. Henry Hartshorne, Professor of Hygiene; and Dr. John J. Keese, Professor of Medical Jurisprudence. The professors received salaries of $500 apiece and such fees as should be paid by the students, these last being restricted by statute to $10 from each student to each professor. Dr. Wood supported this department during his life- time, and at his death left a bequest for the same purpose. The first courses were given in the spring of 1866, and success seemed assured by the attendance of about one hundred students. After thirty-three years of existence, and after the general level of medical instruction had risen so as to include most of the objects for which it had been founded, the Faculty of Sciences Auxiliary to Medicine was merged into the general Medical Faculty. As will he seen from the description just given, when the WILLIAM PEPPER. University of Pennsylvania. University of Pennsylvania 245 second half of the nineteenth century began there were four dif- ferent branches of the University's work— the old College or Department of Arts, the Medical School and the Auxiliary Medi- cal Course, the Law School, and the Scientific School. It soon became evident, however, that the Ninth Street location was as unsuited to the further development of these rising schools as the Fourth and Fifth Street sites had been at the beginning of the century. Ninth Street was now in the heart of the city, sur- rounded on all sides by a closely built up district, and prevented thereby from increasing the number or size of its buildings. There was known to be a tract in West Philadelphia surrounding the Almshouse and belonging to the city. It was hoped that this could be acquired on favorable terms and room to spread thus obtained. Dr. Stille became Provost in 1868, and with a new infusion of life in many forms, earnest efforts succeeded in obtaining, in 1870, ten acres of this land, the nucleus of the extensive domain in West Philadelphia that the University now possesses. Almost forty years have elapsed since this site was obtained, and it has long been abundantly evident that this third location has been, and is destined to be, the scene of a develop- ment far more extended and far more varied than that character- izing either of the two former stages of the University's existence. The main lines of this development will now be traced and the present condition of the University described: First, in out- line, so far as the University in general is concerned; then, in more detail as regards the Medical and allied departments, to which this article is especially devoted. The first group of build- ings, constructed between 1870 and 1879, consisted of College Hall, the "Old" Medical Building, the Hospital and the "Old" Dental Building. These were and are all built of the same green serpentine stone, then so much in fashion; all are of the same style of architecture, and all in one close group. In 1874 and 1882 the city extended the tract belonging to the University to twenty-seven acres, the University giving in return fifty free scholarships to boys from the Philadelphia public schools. By successive grants, purchases and bequests since that time, the extent of territory has been increased to some sixty acres, includ- ing most of the land lying for several squares south of Woodland Avenue, extending from Thirty-second Street to Thirty-ninth Street. On this tract have been successively erected the "Old" 246 Medical, Pharmaceutical and Dental Colleges and "New" Veterinary Buildings, the Biological Building, the Library, the Laboratory of Hygiene, the Chemical Laboratory, the "Old" and "New" Engineering Buildings, the Wistar Institute Building, various additions to the Hospital, Houston Hall, the Museums, the extensive system of Dormitory Buildings, the Laboratory of Physics, the Gymnasium and other buildings con- nected with Franklin Field, and the great new buildings for the Dental and Medical Schools. The erection of a graduate build- ing, in conformity with the bequest of Mr. Bennett, is about to be undertaken. (When the Law School finally removed to West Philadelphia in 1900, a building for its accommodation was erected on land somewhat detached from that of the other buildings of the Uni- versity ; the Astronomical Observatory and its accompanying buildings were necessarily placed outside of the city; and a third detached portion of University territory is the Marine Laboratory, situated at Sea Isle City, on the New Jersey coast. Closely dependent upon the University, though not, of course, officially connected with it, are some twenty buildings belonging to various Greek Letter Fraternities, the University boathouse on the river, the Young Men's Christian Association Settlement house, and the Mask and Wig Club house. But these buildings are, after all, only the shell in which the University lives. The University is the group of instructors, officers and students which inhabits them. This group has in- creased in number since the location was changed to West Phila- delphia with ever-increasing rapidity. In 1870 the total number of students in the University was 623, in 1881, at the commence- ment of Dr. Pepper's Provostship, the number was 2180, in 1904 it was just over 3000, and in the year 1908 it was almost exactly 4500. At the same periods the numbers in the Faculty have been 37, 88, 268, 325 and 454. A notable change in the character of the students has been the increasing number who have come from outside of Philadel- phia, and even from outside of the State, while in just the last few years an even more striking feature has been the number who have come from foreign countries. During the year 1908 some- thing like 3000 are recorded as from Pennsylvania, something over 1000 from the United States outside of Pennsylvania, and about 260 from foreign countries, including 40 from China and University of Pennsylvania 247 Japan, and 60 from Central and South America. Equally marked, at least for the College department, has been a rise in the average age of students at entrance from 16 years 8 months in 1880 to 17 years 1 month in 1890, 18 years in 1900, and 18 years 4 months in 1906. Statistics from the Medical and other departments in this respect are not forthcoming. Among leading characteristics common to the whole life of the University during recent years may be chosen for special men- tion dormitory life and the increasing use of the Library, the last being in turn closely connected with changes in methods of teach- ing. From the early days on Fourth Street down to the latter part of the nineteenth century the College and University, like other similar institutions situated in large cities, made no pro- vision for the daily life of the students outside of the hours of instruction. The desirability of provision of living accommoda- tions for the students by the University was however much discussed; it aroused the hearty interest of the present Provost, Mr. Harrison, and shortly after his accession to office, that is to say, in the years 1895 and 1896, the first group of buildings was erected. Additions were made from time to time, including the War Memorial Tower in 1898, and now scarcely a year passes without the addition of one or two "houses 5 ' to the group of dormitory buildings. Altogether this year the group includes 26 buildings and gives accommodation to 700 students. But it not only gives healthy and cheerful living accommodations to the students, but creates or encourages a spirit of devotion to the University and interest in its affairs through bringing students of all departments together and leading them to spend practically all their life during term time within University surroundings. The same statement is true in a large degree of the existence of Houston Hall, built in 1908, and dedicated to recreation and to a varied group of students' interests, and used by one or two thou- sand students every day. The use of the main University Library is indicated by the following statistics. There are registered as users of the Library, 2810. Of these, members of the Faculty make up some 234, students of the College 1500, and students of the Medical and allied schools 427. About 300 books are used on the average daily in the Library and about 200 daily taken out of the Library Build- ing during the busy time of the year. During last year 55,048 248 Medical, Pharmaceutical and Dental Colleges books were used in the Library and 29,795 taken out. In addi- tion to these figures it must be noted that a great number of students and others use the Law Library daily, and that there are a large number of departmental or seminar branch libraries in the Library and other buildings, which are constantly in use, but the statistics of which are seldom preserved. This extensive and constant use of the University equipment of books reflects not only the increasing number of students in the University, but the increasing habit of requiring the use of books by students in con- nection with dogmatic or text-book teaching, and the attraction of the collections of the University Library for scholars engaged in investigation. Under these circumstances it is no wonder that the Librarian feels deeply the strain on Library facilities and the need of better equipment, and that a movement has been recently inaugurated for the endowment of the Library with $500,000 for administrative expenses and the same sum for the purchase of books. A matter of importance in the administrative history and present condition of the University is the changed position and present influence and authority of the Provost. In the original plan of the institution no individual administrative head had been contemplated. The whole control in small things and in great was to be exercised by the Board of Trustees and its officers and committees. In the main, this condition continued to exist till after the University was transferred to West Philadelphia. The position of the Provost in the Department of Arts was scarcely more than the Deanship in the Medical or Law School. During Dr. Stille's term of office, however, from 1868 to 1881, a number of causes, such as the need for a more centralized government, the closer relations arising between the departments, and the mere increasing extent of the University were demanding a general official administrative head. In 1871, a committee of the Board, at Dr. Stille's suggestion, recommended a change in the rules by which the Provost's position should be made one of much greater power and responsibility. This proposition met with opposition because it would have made him head of all the Faculties, includ- ing that of Medicine, which had always maintained a quasi-inde- pendent position. The plan was finally defeated in the Board. In 1874 he brought the matter up again, but it led to nothing except that the Provost was given the privilege of attending meet- University of Pennsylvania 249 ings of the Board of Trustees in order to give information to its members. He had no vote or official voice or influence, and was looked upon in this position as simply an organ of communication between the Faculties and the Board. As a matter of fact, he seldom attended the meetings, and the growing influence and importance of his office arose simply from the natural require- ments of the position. Although the members of the Board were extremely able and even eminent men, they had neither time, knowledge, patience nor judgment to attend to the details of administration of an institution constantly growing in extent and diversification of parts. The lack of official powers acted simply as an obstacle to the Provost in the performance of his work and placed the University at a distinct disadvantage in comparison with other American colleges with a more centralized and efficient organization. < When Dr. Pepper was elected Provost in 1881 his election was accompanied with a decision to endow the Provostship with all the added power that had been proposed for it. The Provost was not to be a member of the Board, but he presided, appointed committees, and represented the Board in financial and legal as well as in academic affairs. It has since that time, moreover, been understood that the Provost is to act in every organization which draws its authority from the University, and that no considerable action of any kind shall be taken without his knowledge and approval. The fact that Dr. Pepper was not a Professor in the College Department, as all his predecessors had been, made a still more distinct change from the Provostship of the past. The teaching side of the office disappeared altogether, as did also the disciplinary, except in grave cases; while the administrative side was broadened and strengthened, and raised above all the other elements in the government of the institution, except in case of last resort, when of course ultimate power and authority resides in the Board of Trustees. The individuality of the Provost has,- therefore, counted for vastly more during the last two periods than ever before, and no account of the history of the University since 1881, which did not take into account the vigor and versa- tility of Dr. Pepper and the equally well-marked characteristics of his successor, would recognize the true forces at work in its development. This successor of Provost Pepper was Mr. Charles C. Harri- 250 Medical, Pharmaceutical and Dental Colleges son, a graduate of the University of the class of 1862, and long connected with its government as a member of the Board of Trustees and Chairman of the Committee of Ways and Means. His Provostship has continued from 1894 to the present time, with a success and an influence for good which has deeply impressed itself upon the whole institution and set a standard of complete devotion to duty that has spread far and wide, and which all connected with the University hope may long continue in its ever-increasing beneficence. < Many sides of the University's life; the more technical mat- ters of its educational system, its elective studies, separation of courses, introduction of new professional and cultural lines of studies, its archaeological researches, its competitions in debate, its renewal of old or foreign plays, Greek, English, French and German, its athletics, its dramatic and musical clubs, its learned publications and its student's periodicals, and a dozen other inter- ests among the four or five thousand of the "University family" must be omitted, and the remaining pages of this article devoted to a somewhat fuller statement of the recent development and present condition of the Medical and allied departments, and the more strictly scientific sides of the University. The Medical School came out to West Philadelphia with reluctance. So many of the clinical opportunities for the stu- dents and so close a relation on the part of the Professors were connected with the old Pennsylvania Hospital at Ninth and Spruce Streets, that a removal of the School was a most serious matter; and there was a transition period in which the medical courses were given for two years after the sale of the Ninth Street build- ing, either there or in the building provided for them jointly with those of the Law School on Ninth Street below Locust. During this time, however, the building was being put up especially for the Medical School in West Philadelphia, to which it was moved in the fall of 1874. The Almshouse Hospital was, of course, closely adjacent, but the use of the old Pennsylvania Hospital was sorely missed. The recognition of the desirability of keeping all departments of the University together and at the same time providing ample facili- ties for clinical study had already suggested the establishment of a new hospital in the immediate vicinity of the University. There was abundant need for such an institution. In this respect, as University of Pennsylvania 251 in so many others, Philadelphia had early attained a pre-eminence which she had allowed to slip from her during the middle years of the century. There had been a time when the Pennsylvania Hospital had been perhaps the best equipped in the world; cer- tainly the best conducted and most liberal in its provisions for patients of any hospital in any community in America. But in 1872, while New York City, with its population of about a million, had six thousand three hundred and twenty-five free beds in hos- pitals, Philadelphia, with some seven hundred thousand popula- tion, had only one thousand one hundred; that is, with almost three-quarters of the population, it had much less than one-quar- ter as many free hospital opportunities. Since the middle of the century the city and the State had been growing rapidly, their wealth even more rapidly than their population. Pennsylvania's manufactures, its internal commerce, the products of its mines had increased many fold, but the accommodations of Philadelphia hospitals had not quite doubled. Moreover, the railroad service, manufacturing and other dangerous occupations brought a daily harvest of accidents, happening for the most part to those who were least able to afford good medical treatment at their homes. Therefore when Dr. William Pepper, Dr. Horatio C. Wood, Dr. William P. Norris and others proposed the founding of a new hospital there was abundance of argument to be brought forward for its propriety; argument that might appeal to men interested in the advancement of the University, patriotic citizens of Phila- delphia, or of Pennsylvania, and to those actuated merely by humane sympathies. The movement was initiated by the calling of a mass meeting of alumni of the Medical School for June 12, 1871. At this meeting it was decided to recommend the project to the Medical Faculty and to the Board of Trustees. The Faculty took up the matter with enthusiasm, and appointed a committee to act with the committee of the alumni. The Trus- tees, led by the personal enthusiasm and activity of Dr. George B. Wood, gave immediate approval and appropriated ground for the purpose. The joint committee, which had been formed by the Alumni and Faculty, asked a number of prominent citizens to join with them in the effort to obtain funds for the projected hospital. Within the year 1872 three forms of appeal were made by them, and responded to with unexampled liberality. To the 252 Medical, Pharmaceutical and Dental Colleges government of the State they appealed, partly on the ground that accident and other cases would come to the hospital from all over the State, partly on the ground that the University was a State organization, and so should be aided by State appropriations in carrying out its various forms of usefulness. As a result of this appeal the Legislature, in April, 1872, granted to the University for the purpose of building a hospital a sum of $100,000 on con- dition that $25,000 in addition should be collected from other sources, and that at least 200 free beds for injured persons should be maintained forever. To the government of the city they appealed, on the ground of the direct need of the city for more hospital facilities and the insufficiency of the land which could be afforded from the tract already in the possession of the Univer- sity. City Councils therefore, in May 1872, granted five and a half acres adjoining the existing site, on condition of the hospital furnishing fifty free beds for indigent sick. To the charitable public generally similar appeals were made. Subscriptions were asked for, payable in four annual instalments. Three thousand dol- lars or multiples of that sum, it was arranged, should give the donor the right to send one or more free patients to the hospital. Smaller sums than $3000 were also asked. Liberal gifts were made, and no ultimate difficulty was found in obtaining from private sources the $250,000 necessary to make the gift of the State operative. At the session of the Legislature in the next year, 1873, a request for an additional $100,000 for the Hospital Fund was made in the name of the University by the Judges of the Supreme Court and of the city courts, and by prominent citi- zens who had been interested in the movement. This sum was appropriated in April, 1873, on condition of the collection of a further sum of $100,000. In these various ways, within a period of three years, $532,042 had been collected and land acquired sufficient for any probable extension of the hospital. The erection of the building was begun in the spring of 1873, it was dedicated in June and opened for patients in July, 1874. In 1875, its first calendar year, the hospital received six hundred and forty-two patients, and its seven dispensaries treated four thousand five hundred and sixty-nine cases. A Board of Managers of the Hospital was created, composed of five Trustees of the Uni- versity, seven members of the Medical Faculty, three persons elected by the general contributors and three elected by the Med- University of Pennsylvania 253 ical Alumni. Dr. Wood was its first President, Dr. Alfred Stille its Secretary, and Saunders Lewis its Treasurer. Three Profes- sors of the Medical School, and nine clinical Professors and Lecturers not on the Faculty, made up the Medical staff; there were two resident physicians chosen from the Medical Alumni for a service of six months, and seven chiefs of the respective dis- pensaries, with assistants. In 1875, a Board of Women Visitors was created, whose services in overseeing the various parts of the Hospital, in collecting money for various minor purposes and in creating a general interest in the institution, have been inesti- mable. All these officers served without pay. In 1874, an unsuc- cessful request for a third appropriation of $125,000 was made to the State Legislature. Thus within a period of five years a veritable new department, though not of a scholastic character, was added to the University; and one whose good work, whose good name, and whose continually expanding field of service has been of the greatest advantage to the University, as it has been to the community. The Hospital has been much extended, both in size and func- tion, since 1874. Some of the most important of these extensions are the following: In 1883, the Gibson Wing for Chronic Diseases, especially those of the heart and lungs, was erected, which now accommodates sixty-two patients; in 1897, the D. Hayes Agnew Memorial Pavilion, largely devoted to provision for high-grade clinical instruction, in the form of wards and amphitheatres, was opened; the Maternity Pavilion has been gradually extended till it comprises a group of wards, delivery, and lecture rooms fur- nishing accommodations for fifty patients and opportunities for individual and class instruction; the William Pepper Clinical Laboratory, erected by the late Provost as a memorial to his father, a still earlier professor in the Medical School, is intended to provide facilities for more minute and extended clinical studies and original research, and to publish the results of these investiga- tions. Post-graduate instruction only, and this only in selected cases, is carried on at the Pepper Laboratory, its great function being investigation and publication. A Training School for Nurses was attached to the Hospital in 1885 and a residence build- ing erected. This has been extended until a home and training are now furnished for some eighty-five pupil nurses and for a num- ber of others on probation. The X-ray Laboratory is an active 254 Medical, Pharmaceutical and Dental Colleges and valuable branch of the Hospital. The most recent addition, just completed, is a new Dispensary building, which forms the center of the twelve dispensaries which carry on the out-patient side of the Hospital and teaching work. The various wards and departments of the Hospital have a staff of some sixty physicians. An equal number, many of them the same physicians, fulfill the duties of the various dispensaries. Twenty-four physicians are in constant residence at the Hospital. There are accommodations for 300 patients; 4342 patients were admitted in the year 1908, and 12,640 treated at the dispensaries. A pleasant characteristic of the Hospital is the large number of philanthropic persons, most of them women, who regularly visit its different branches, provide additional funds, make many kindly donations to the patients, and do much to increase the comfort and happiness of needy or dependent patients. A new foundation of this early West Philadelphia period was the Department of Dentistry. A School of Dentistry had been established in Philadelphia as early as 1850, known as the Phila- delphia College of Dental Surgery. After four years it was reorganized as the Pennsylvania College of Dental Surgery. At a later time the Philadelphia Dental College was also established. The growth of dental science, the rise of its practice to a higher plane, and the development of dental associations and of inde- pendent dental schools attracted much attention in the two decades just before and just after the middle of the century. It seems to have been felt that the subject should of right be con- nected with the teaching of medicine as one of its subordinate branches. In 1877, the Faculty of the Medical Department of the University made propositions looking toward a union of the Penn- sylvania College of Dental Surgery with the University as one of its Departments. The offer was declined, although the two prin- cipal Professors in that institution, Drs. E. T. Darby and C. J. Essig, accepted the invitation for themselves personally. On March 6, 1878, the Trustees passed resolutions that there should be a Dental Department of the University with a separately organized Faculty. Two professors were chosen, one for the chair of Mechanical Dentistry and Metallurgy, and one for that of Operative Dentistry and Dental Histology. There were five other professors, but they were the same as those who taught the respective subjects to medical students. A corps of twelve or life- • -i , : • University of Pennsylvania 255 more instructors and demonstrators was also chosen. A lab- oratory building, already referred to, was built during the winter of 1878-1879 for the use of the Medical and Dental Departments jointly. The new Faculty thereupon proceeded to the work of organizing the department. The course was to be of two years, and involved examinations in all the subjects given before obtain- ing the degree of Doctor of Dental Surgery. A preliminary spring session was held in 1878, and it is of interest to note that the first matriculate was Edward C. Kirk, who is now, and has long been, the active Dean of the Department. Since that time more than 2000 graduates in Dentistry have passed out from the school. The new building long needed by the Dental School was completed in the fall of 1897 at a cost of $180,000 and equipped with admirable apparatus and fittings at an additional cost of $26,000. The length of the course was extended to three years in 1891, and additional preparation for entrance was required in that year. Proposals were made by the Faculty for the admission of women in 1881, and again in 1887, but they were not approved by the Trustees. At the present time there are 385 students in the School. The Faculty consists of fourteen professors and assistant professors, with some thirty-six lecturers and demonstrators. The Dental Department has the interesting distinction of being that Department of the University which draws the largest proportion of its students from outside of the United States, about one-fourth of its students this year being natives of some twenty countries outside of the United States. Corresponding to this is the further fact that in a num- ber of foreign countries enthusiastic bodies of Dental alumni exist, or they form an especially active element in general University alumni societies. The clinical work of this department is nat- urally an important part of its activity, about 28,000 operations being performed yearly for some 12,000 patients. Much interest is taken in the special exhibitions of difficult operations per- formed at the Dental Building every year during Commencement Week. In 1884, still another department was established which was to draw part of its instructors from the Medical Faculty. Like many other educational movements, this had been anticipated in a much earlier period of the University's history. The introduc- tory lecture to the regular course on the Institutes and Practice 256 Medical, Pharmaceutical and Dental Colleges of Medicine, given by Dr. Benjamin Bush, November 2, 1807, was "Upon the Duty and Advantages of Studying the Diseases of Domestic Animals and the Eemedies Proper to Eemove Them." In his conclusion Dr. Eush says : "I have lived to see the Medical School of Philadelphia emerge from small beginnings and grad- ually advance to its present nourishing condition, but I am not yet satisfied with its prosperity and fame, nor shall I be so until I see the Veterinary Science taught in our University." He pro- posed the establishment of a chair of Veterinary Medicine in the Medical Department of the University. A period much longer than that which had then elapsed from the beginning of the Medical School was destined to pass before Dr. Eush's anticipa- tions were to be fulfilled at the University, or elsewhere in America, for that matter, and when "Veterinary Science" did come to be taught it was not under the auspices of the Medical School, but independently. The time did finally come, and in the fall of 1882 and the spring of 1883 two contributions of $20,000 and $10,000 were made by J. B. Lippincott and J. E. Gillingham, respectively, for the purpose of establishing a Veterinary School. The Trustees formulated plans for the organization of a Faculty, providing that most of the teaching should be done by Professors in the Medical School and the College, but that, in addition to these, there should be distinctive teachers of certain branches peculiar to veterinary medicine. Dr. Eush Shippen Huidekoper, who had studied at various European veterinary schools, was elected Professor of Veterinary Anatomy and Internal Pathology. Later Dr. William Zuill was elected Professor of Surgical Pathol- ogy and Obstetrics. The remainder of the instruction, except purely mechanical parts, was furnished by the Professors of the Medical Department. A three years' course was provided for, giving to students a general course in medicine and special train- ing in the medical and surgical knowledge involved in the treat- ment of domestic animals. Land was set apart for the uses of the new school from the tract lately given by the city. During the year 1883 further funds were collected and buildings erected, and on October 2, 1884, the school was opened for its first session with an enrollment of twenty students. The need for a hospital for animals was felt to be as great as in teaching medicine in its application to human beings, and the erection of hospital stables was soon begun. In 1887, an appropriation of $25,000 was University of Pennsylvania 257 secured from the State Legislature for this purpose, conditioned upon the establishment of twelve free scholarships to be held by students nominated by the Governor of the State. As in the University Hospital, the administration of the Veterinary Hos- pital was put in the hands of a Board of Managers, consisting of five Trustees, two members of the Faculty and seven citizens. On the death of J. B. Lippincott, who was in a sense the founder of the School, and had been the most liberal contributor to its sup- port, his interest was continued by his family, and one of his sons has since been continuously Secretary and Treasurer of the Board of Managers, Mr. Gillingham, the other founder, being its President. In 1891 and 1893, some additional buildings were constructed, but the site originally chosen seemed to the Trustees so desirable as a location for the new medical laboratories that, in 1900, the old Veterinary buildings were razed and a new site secured on the other side of Woodland Avenue. Here, after a period of uncom- fortable life in a group of old-fashioned and ill-adapted structures, the new group of Veterinary School buildings is approaching com- pletion. They form structures facing on two main streets and including stables, kennels, operating rooms, bath-rooms for ani- mals, blacksmith shops, lecture rooms, and every possible provision for attention to some fifty-five horses and cows at one time, and a much larger number of dogs, cats and birds. Free clinics are held for these animals, and many thousand cases are treated each year. The State Government has made additional appropriations, other private gifts and bequests have been made, and altogether the buildings, when complete, will represent an expenditure of about $300,000, with $100,000 more for endowment. The State Live Stock Board has its offices in this building, and Professor Leonard Pearson, the active and influential Dean of this School, is also State Veterinarian. There are at present about one hun- dred students in the School, and some thirty are graduated every year. The Biological School also dates from 1884. Some of the early efforts to introduce natural history courses into the Univer- sity have already been mentioned. Except as an adjunct to the technical study of medicine these had obtained no permanent foothold. Even as represented in the courses auxiliary to medi- cine and in a course preparatory to medicine introduced into the 17 258 Medical, Pharmaceutical and Dental Colleges College in 1882, they were still looked upon from a purely utilitarian point of view and treated as merely preliminary to medical study. In the year 1884, however, a school was projected in which the biological sciences should he studied, not only for this purpose, but for their own sake. This department was largely the creation of Dr. Horace Jayne, who was a graduate of the Col- lege of the class of 1879 and of the Medical School of the class of 1882. He had studied abroad and at Johns Hopkins Univer- sity, and, in 1884, took up the work of placing the teaching of the natural sciences at the University on a more independent and worthy footing. The result of the efforts then made and of the liberal money contributions made by Dr. Jayne himself was the foundation of a School of Biology, the assignment of a tract of land at the extreme western end of the University's property for its building and for a botanical garden, the erection upon this of the Biological Hall, the organization of a Faculty and the com- mencement of instruction on December 4, 1884. Dr. Joseph Leidy was Director of the School, in addition to his work in the Medical Department. The School immediately obtained a certain clientage, partly of those who anticipated taking a medical course later, partly of those who were engaged in preparing to teach similar subjects, some who simply choose these subjects as parts of their college course of study, and a few advanced students engaged in independent investigation. The School is officially a part of the College, not an independent department. An offshoot from this, or rather, a part of its equipment, was the Laboratory of Marine Biology established in 1891 at Sea Isle City, New Jersey. Some five acres of ground on Ludlam's Bay were given to the University by Charles K. Landis, the principal landowner of Sea Isle, and an industrious collection of funds by some of those interested in the School made possible the building of a laboratory with aquaria, and other necessary furniture, boats, dredges, etc. The object was to give facilities for investigators and students gathered, especially during the summer months, and some good work was done, especially in testing the possibility of artificial propagation of oysters on the New Jersey coast. No sufficient support, however, was obtained, the location being some- what remote, and the principal promoters of the plan either lost their interest in it or were forced to devote their time to other things. The seashore laboratory, therefore, gradually sank into University of Pennsylvania 259 a condition of disuse from which only occasional and temporary revivals have roused it. Still more closely connected with medical study is the Depart- ment of Hygiene. This Department was established in a build- ing, the gift of Mr. Henry C. Lea, and on an endowment given by the family of Mr. H. C. Gibson. The Laboratory of Hygiene was formally opened February 22, 1892, Dr. John S. Billings then being Director, and instruction to medical and other students immediately began. Since that time various changes have taken place, Dr. Alexander C. Abbott becoming Director and Dr. D. H. Bergey Assistant Professor of Bacteriology. Instruction is given to all students in the Medical Department, and to a large number of those in Architecture and the College. In this department, as in that of Veterinary Medicine, there is a close connection with the public service, courses in public health being given especially intended to prepare men for service in the health departments of States and cities. Professor Abbott has also served for some years as Chief of the Bureau of Health of the City of Philadelphia. In the early part of the nineteenth century a Medical Museum was established by Dr. Caspar Wistar in connection with the Medical School, and continued by his successor in the chair of Anatomy, Dr. Horner. The formation of such collections was necessary in those days, when there was so much difficulty in obtaining material for dissection, and the collection in Philadel- phia was modeled on that of Dr. John Hunter in London, with whom Dr. Wistar, like his predecessors, Dr. Shippen and Dr. Morgan, had studied. The addition to this collection of specimens from time to time had gone on ever since its foundation. A fire which occurred in the Medical Building on the morning of May 31, 1888, inflict- ing some injury upon the contents of the Museum and upon the Stille Medical Library, called attention to the danger its valuable contents were subjected to in being placed in an ordinary build- ing. At the same time anatomy and comparative anatomy were being placed on a far higher plane of knowledge and research by men like Allen and Leidy, and needed a center of support. These facts were suggested to General Isaac J. Wistar, the grandson of the founder and a man of wealth and influence, and the establish- ment of a special institution, of which the old Museum should be the center, was proposed to him. In response to this request he 260 Medical, Pharmaceutical and Dental Colleges offered to the Board of Trustees to provide, and suitably endow, at his own expense, a fire-proof building, with facilities for the storage and display of the specimens already belonging to the Wistar Museum, for the collection of specimens of general and human anatomy, and for advanced study and investigation on anatomical lines. The conditions of the gift were the foundation of a separate corporation, to be known as the "Wistar Institute of Anatomy and Biology," in which, however, the Board of Trus- tees of the University should have a controlling power; the transference to the Institute of a suitable piece of land, and the restriction of the building to the uses of its trust forever. These conditions were accepted, permission for the transfer of land obtained from the city, and the fine lot on the west side of Thirty- sixth Street given to the new Institute. A handsome building was erected during the year 1893, and formally opened May 21, 1894. Up to that time General Wistar had expended about $265,000 on the building, its equipment and accompanying ex- penses, and he afterward continued to make liberal expenditures in bringing the Institute gradually into a position of maximum usefulness and interest as an educational and scientific center of influence, and eventually left the bulk of his fortune for its sup- port and extension. The Institute now has an endowment of something over $1,000,000, bringing in an income of some $45,- 000 a year. The Institute was placed under a Director and a Board of Managers; but in the furtherance of its scientific interests an Advisory Board of ten members was created in 1903. This Board is composed of representative scientists from various institutions and parts of the country, and meets for two days in April of every year. A Director of Kesearch has also been appointed, with sev- eral assistants, and a Chief of the Department of Publication. Little by little the character of the Museum has been changed from an institution primarily for the maintenance of a museum to one primarily for research. This research for the present has been directed especially into the field of neurology. In that field investigations of the utmost care, extent and interest have been taken up. For this purpose a variety of rats are bred at the Institute, opossums are secured by breeding in connection with the work of another investigation in Ohio, and frogs are obtained from certain marshes located near Delaware Water Gap. NEW CLINICAL LABORATORY. University of Pennsylvania 261 A still more valuable body of material is provided by the connection of the Institute with the School for Feeble-minded Children at Vineland, N. J. A trained psychologist there keeps a record of the characteristics of many of these children, whose brains are after their death removed and sent to the Institute for further study in the light of their past history. The Institute has also, since 1906, been appointed the center for brain research in America, rep- resenting the International Brain Commission. Many human embryos are also being preserved after careful study by a correspond- ing investigator connected with the Institute. The most extensive cooperative undertaking of the Institute, however, has been its taking over for purpose of publication the five national journals most closely connected with its field, the Journal of Morphology, the Journal of Comparative Neurology and Psy- chology, the American Journal of Anatomy, the Anatomical Record, and the Journal of Experimental Zoology. Each of these journals retains its own group of editors, but the expenses and labor and responsibilities of publication are borne by the Wistar Institute, this department being under the charge and partly at the expense of Dr. Horace Jayne. The work of the Wistar Institute is thus one of great activity and usefulness and it is especially strong on the side of cooperation with other institutions. Turning now in conclusion, to a short account of the recent development and present condition of the medical department proper, it soon became evident that it would ultimately outgrow the building originally erected for it in 1874, and plans were carefully formulated for a building which might include all the laboratories and rooms for instruction and administration except such as must necessarily be closely connected with the hospital wards. These plans were largely carried out by the completion of the new Medical Laboratories in 1904, although so rapid has been the growth and development that even yet some of the laboratories have been forced to utilize portions of the old Medical and Dental buildings. The new laboratories form an impressive building two stories in height and covering a space approximately 350 by 200 feet. Laboratories for practical instruction, for general and special research, for preparation and testing of materials, rooms for museums, for libraries, for demonstrations, and for general lectures, and private offices and provision for the general comfort of professors and students give every possible facility for excellence of work in the 262 Medical, Pharmaceutical and Dental Colleges lines to which this building is especially devoted. These lines are physiology, pharmacodynamics, pathology, including pathological histology, pathological bacteriology and experimental pathology, neural and surgical pathology, and physiological chemistry. Many well thought out arrangements, ingenious provisions for an abundant supply of daylight, and other more artificial accessories, make the equipment of this building a fair measure of modern adaptation of physical surroundings to scientific work in the fields to which it is devoted. The instruction given by the Medical School is largely in this building, and in the laboratories of histology, embryology, osteo- syndesmology, anatomy, and chemistry, still situated in the old buildings; but a large portion of the instruction is also given in the Department of Hygiene, in the Wistar Institute, and in the University and other hospitals. The course was extended from two years to three years in 1877 and from three to four in 1893. Entrance examinations were introduced in 1880 and made practically the same as for entrance to the College Department. Later it was required that as a part of this entrance preparation a certain amount of chemistry, biology and physics should have been studied. For the year 1908-9 these requirements were so far extended as to include the ordinary work of Freshman year in College, and it is announced that for 1910-11 they shall include the ordinary amount of study completed by the end of Sophomore year. Apart from these requirements, there has been an increase in the proportion of students who have completed a college course before entering the Medical School ; somewhat more than 30 per cent, of the students holding college degrees last year and 5 per cent, more having been college students to the close of the Junior year. The superiority of students with such preliminary training was shown by the much larger proportion of those who held out to the end of the medical course. The subjects of teaching in the course have become so diver- sified, the distribution of the students' time between didactic lectures, laboratory and dissection work, and clinic and bedside practice has been carried so far as almost to defy brief descrip- tion. It may be said that the first two years of the course now are in the main devoted to the fundamental medical sciences, Chemistry, Anatomy, Physiology and Pathology; the remaining two years to the clinical subjects, Medicine, Surgery, Obstetrics University of Pennsylvania 263 and the specialties. In the first of these periods instruction is more largely practical, a large part of the students' time being spent in the laboratories; in the second, the work is more obser- vational, time being more largely spent in clinics and hospital wards. The work is closely correlated, and forms an absorptive occupation through the whole four years of the course. The earlier efforts of the Medical School were devoted to the one object of producing physicians. To this function two others have, in the course of time, been added, the training of teachers in the various fields connected with medicine, and service as a center of medical research. The earlier function is fulfilled, not only by the didactic lectures, but by the considerable amount of laboratory work, and a still larger expenditure of time at clinics, clinical conferences, ward classes, and other forms of meeting with the practical problems of the physician and surgeon, under the guidance of professors or trained instructors, as alluded to above. The second object, while less definitely planned or arranged for, is reached unconsciously by the creation among the students of a scientific curiosity and an ambition to teach, in some one of the many fields connected with medical study, the special matters of their interests. The possibilities of research in these fields are of boundless extent and almost limitless usefulness, and such investigation is becoming more and more an integral part of the activity of the Medical School. The well-equipped laboratories lend themselves to such research, the many unsolved problems connected with the human body in health and disease are a con- stant incitement to effort and ingenuity, and opportunity for advanced students and instructors to carry on such investigations is so attractive that there is a constantly increasing body of research in progress and a constantly increasing pressure on the University to furnish the facilities for it. The policy of the Medical School has been to discourage this in its undergraduate students, the ambition of the School being rather to offer the student a well-graded, well-proportioned and comprehensive gen- eral course, fitted to prepare him to practice medicine, than to make him a specialist at the expense of his general medical training. On the other hand, among its advanced students, its numerous instructors, those who come to it in search of special opportunities, many lines of investigations of the most intense interest and greatest promise are in progress, and are given every 264 Medical, Pharmaceutical and Dental Colleges possible encouragement and facility. During the last four years some fifty or sixty distinct lines of research have been, or are being, carried on in the eight laboratories most closely connected with the Medical School. In addition to these should be consid- ered, if an adequate view of the work of the University in research in this field is to be obtained, the many investigations in progress in the Wistar Institute, the Laboratory of Hygiene and the Dental Laboratory. Just as this article is being written, in February, 1909, an endowment is announced of $200,000 for the support of advanced medical research in this department of the University. It is impossible to write a conclusion to such a story of prog- ress. Like the processes of Nature, it is a continuous develop- ment, and little more can be done than to describe present condi- tions and indicate the apparent direction of advance. The Jefferson Medical College of Philadelphia By J. W. HOLLAND, A.M.. M.D. IN the first quarter of the last century certain physicians, ambitious to teach medicine, made unsuccessful attempts to secure from the Legislature a charter for a second medical school in Philadel- phia. So much reproach was cast upon any graduate of the existing school who would endeavor to set up a rival to his alma mater that few had the audacity to try it. Social influence proved strong enough either to nip such enterprises in the bud or to Wight them before the Legislature. Dr. George McClellan, a man of restless energy, fertile in expedi- ents, determined if possible to organize a medical school under the authority of some literary college already chartered by the State. On June 2, 1824, in company with Drs. John Eberle, Joseph Klapp and Jacob Green, he sent a communication to the Trustees of Jefferson College, an institution founded in 1802 and situated at Canonsburg, Washington County, Pennsylvania, proposing a plan for a medical department at Philadelphia, in which these four should be part of the faculty. The Trustees adopted the suggestion and established a medical faculty of six chairs in the city of Philadelphia, as a constituent part of Jefferson College, under the name of the "Jefferson Medical College." In the winter of 1825-26 an enlargement of their charter was obtained, which authorized them to appoint ten additional Trustees in the city of Philadelphia. Eev. Ashbel Green, D.D., who was possessed both of influence and learning, wise in council, and of great decision of character, at one time President of Princeton College, was appointed Chairman of the additional Trustees, and held office until his death in May ; 1848. In 1826, an Act of the Legislature enlarged the charter, giving the right to grant the medical degree. Two years after, the Philadelphia Board was authorized to have almost entire man- agement of the affairs of the Medical College, the parent Board retaining the right to reverse the proceedings when in their judg- (265) 266 Medical, Pharmaceutical and Dental Colleges ment the interests of the College required this action. This relationship survived until the winter of 1837-38, when it termi- nated by the Medical College obtaining a separate charter. In organizing the first faculty Dr. Joseph Klapp resigned, and, in 1825, the chairs were filled as follows : John Bberle, M.D., Theory and Practice of Medicine; B. Kush Rhees, M.D., Materia Medica and Institutes; Jacob Green, Chemistry; Nathan R. Smith, M.D., Anatomy; Francis S. Beattie, M.D., Midwifery; George McClellan, M.D., Surgery. Having no endowment where- with to build, they rented the old "Tivoli Theatre," now 518 Locust Street, altered its interior to suit their purpose and announced a course of lectures for the winter of 1825-26. The first class numbered one hundred and seven, and the degree was conferred upon twenty in May by a writ of mandamus obtained from court, as the charter of the College at Canonsburg had not yet been amended so as to enable it to confer the medical degree. In the summer of 1826 Dr. W. P. C. Barton was appointed to a new chair of Materia Medica. Litigation and discord be- tween two of the Professors affected unfavorably the class of 1826-27. The old theatre building proving entirely inadequate, a member of the Board of Trustees, Rev. Ezra Styles Ely, D.D., offered to advance the money to erect a suitable building, the Col- lege to take a lease upon it for five years. This building was constructed upon a lot situated on Tenth Street, between what are now called Sansom and Moravian Streets. By August, 1828, it was ready for the tenant, which as renter or owner has been in continuous possession ever since. The Chair of Midwifery having been declared vacant, Dr. John Barnes was appointed lecturer pro tempore for one session, and in April, 1827, he was elected Professor. At the opening of the session of 1827-28, Dr. N. R. Smith resigned the chair of Anatomy. The juncture was critical, but Dr. George McClellan undertook the course on anatomy as well as his own on surgery. The Trustees being dissatisfied with the teaching in midwifery, on June 19, 1828, all the chairs were vacated, and on the 26th of the same month the faculty was reconstructed as follows: Sur- gery, George McClellan, M.D. ; Medicine, John Eberle, M.D. ; Materia Medica, W. P. C. Barton, M.D.; Institutes, B. Rush Rhees, M.D. ; Chemistry, Jacob Green, M.D. As the chairs of Midwifery and Anatomy were vacant, Dr. Eberle took the extra Jefferson Medical College 267 work in midwifery, and anatomy was taught by Dr. George Mc- Clellan, assisted by the Demonstrator, Dr. Samuel McClellan. In January, 1830, Dr. George McClellan was relieved of anatomical teaching by the appointment of his brother, Dr. Samuel McClellan, to the chair. In the hope of securing a more satis- factory assignment of labors in 1830, Dr. Barton having resigned, Dr. Eberle was transferred to the chair of Materia Medica, while undertaking to teach midwifery, and Dr. Daniel Drake, of Cin- cinnati, was appointed to the chair of Practice of Medicine. The session of 1830-31 opened with every professorship occupied by a man of proved ability as a writer and teacher. At the end of the session a disaster was experienced in the resignation of two of the most eminent professors, Daniel Drake and John Eberle. This loss and other changes made in the personnel from various causes had an unfortunate influence upon the prosperity of the institu- tion. For the session of 1831-32 Dr. Usher Parsons, of Provi- dence, E. I., held the chair of Midwifery, Dr. Granville Sharp Pattison, of Anatomy, vice Dr. Samuel McClellan resigned. At the end of the session Dr. Parsons resigned and Dr. Samuel McClellan was appointed Professor of Midwifery, Medical Juris- prudence and Diseases of Women and Children. By 1834, Dr. John Revere had been appointed Professor of Medicine and a mutually acceptable organization was effected, which persisted for six prosperous years. The teaching corps was much strengthened by the election of Dr. Robley Dunglison to the chair of Institutes in June, 1836. In 1838, the larger classes called for more .commodious quar- ters, and it was decided that the old building must be altered and enlarged. To do this it was desirable that the title to the prop- erty, hitherto vested in Eev. E. S. Ely, should be transferred to the Board of Trustees. As these Trustees in Philadelphia were subordinate to the parent Board and could hold property in their name only, a necessity arose for a distinct charter, which would enable the Philadelphia Trustees to hold and modify the Medical College property as a separate institution. At the session of the Legislature held in the spring of 1838, a charter was obtained creating "The Jefferson Medical College of Philadelphia," an independent corporation "with the same powers and restrictions as the University of Pennsylvania," and the Trustees then holding office were reappointed with "power 268 Medical, Pharmaceutical and Dental Colleges to increase their number to fifteen," and to be self-elective. At the meeting which accepted the new charter the Board of Trus- tees closed the old connection very gracefully by passing unani- mously the following resolution : "Besolved, That the President be directed to communicate to the mother Board at Canonsburg, that in accepting the charter which separates them from the Jefferson College at Canonsburg, the additional Trustees are influenced by the conviction that such a separation is for the mutual benefit and convenience of both bodies, and desired it for no other reason; and that this Board will retain a grateful sense of the kind and fostering care ever exhibited towards them by the parent institution, and will in their new capacity be always ready to acknowledge their past obligations and to exchange, in every way in their power, kind offices with Jefferson College at Canonsburg." The Trustees executed a lease on the College premises for twenty years, which gave them the privilege of paying off the principal at any time before the lease expired. In time they came into full ownership of the property, having made from time to time the alterations called for by the growth of the school. The happy outlook was soon beclouded by the personal difficulties of the faculty. These dissensions became so urgent that on the tenth of June, 1839, the Trustees dissolved the faculty, and organized another out of the more congenial members of the previous body, with some new appointments. The name of Dr. George McClellan does not appear in the reorganized faculty. In his place was Dr. Joseph Pancoast, and Dr. B. M. Huston replaced Dr. Samuel McClellan. Dr. George McClellan is conceded to have been the master spirit in founding the school. He had shown a marked aptitude for surgery before he studied medicine. In ten years after beginning practice he was among the foremost surgeons of the world, show- ing in his operations consummate skill joined to an alertness of mind which made him ready for the most trying emergency. His lectures evinced enthusiasm, clearness and thoroughness. His methods were characterized by brilliancy and dash rather than by cool calculation. It was very hard for him to submit to authority or to control the impulses of his ardent temperament. In 1841, new difficulties came to a crisis, and on the second of Jefferson Medical College 269 April, all the chairs were again vacated, and the faculty recon- stituted as follows: Robley Dunglison, M.D., Institutes; J. K. Mitchell, M.D., Practice of Medicine; Joseph Pancoast, M.D., Anatomy; R. M. Huston, M.D., Materia Medica; T. D. Mutter, M.D., Surgery; Charles D. Meigs, M.D., Obstetrics; Franklin Bache, M.D., Chemistry, succeeding to the chair on the death of Dr. Jacob Green. At last was brought together a group of teachers of approved merit who would work in harmony. Under their regime the College throve apace. During the first seventeen years there had been many disagreements ending in withdrawals, some of them involuntary. In that time there had been eight incumbents to the chair of Midwifery. At different times vacan- cies had been filled for short periods by men of unusual ability. Their stay was so short as to prefigure the early decline which seemed to be the fate of an institution whose history was marked by such extraordinary vicissitudes, due in the main to internal discords. Having lived through bitter opposition, poverty and domestic contention, like a child that has been delivered painfully and survived dentition, the eruptive fevers and the dangers of puberty, the school had reached the maturity of its powers. With the faculty of 1841 came the reign of peace, order, and good fortune. There were no changes in the faculty for fifteen years. The confidence of the public and of the profession was given in full measure to the friendly body of talented men, and as a result the school was prosperous to a degree surpassing any other med- ical school of its time. I Prominent among the features contributing to its usefulness and popularity, must be ranked its clinic. The virtual founder of the College, Dr. McClellan, whose name is intimately associated with every phase of its early history, was also the chief agent in creating its clinic. Having cultivated a charity practice at his office, he easily supplied the infirmary at the College building, and on May 9, 1825, before the first session, he performed the first operation in its amphitheatre. When the new building was erected in 1828, a small room in front, with an entrance under the staircase, was used by him as a dispensary for his patients. He would draw upon these for illustrating his lectures. Prom such small beginnings the clinic grew, under the new faculty, to such dimensions that in a single year, 1856, no less than 802 medical and 813 surgical eases were treated, and capital operations of the 270 Medical, Pharmaceutical and Dental Colleges rarest kind were performed before the class by such adroit opera- tors as Pancoast and Mutter. The accommodations at the College had been so poor that as late as 1841 even those who had under- gone serious operations were sent to their homes in carriages. In 1844, two rooms were rented over a shop at the southwest corner of Tenth and Sansom Streets, and grave cases were treated here after operations. The anaesthetic power of ether was first exhibited in Philadelphia by Dr. Mutter at the clinic, December 23, 1846. About 1849, the surgical clinic used two floors of a building adjoining the College on the north. Later this was remodeled to accommodate fifteen patients. In these narrow quarters the clinic was maintained until the Hospital was built in 1877. To accommodate the larger classes, in 1846 more ground on the north side was purchased for a new entrance and stairway, the lecture rooms were enlarged and the old gable front altered by the erection of a classic portico and pediment. On the death of the President, Eev. Ashbel Green, in 1848, the Eev. C. C. Cuyler served for one year and then was succeeded by Hon. Edward King, LL.D., who officiated until 1873. The failing health of Professor Mutter in 1856 caused him to resign. He was elected professw emeritus. He had been assistant to Dupuytren in the Paris hospitals, and while abroad had worked for months under other surgeons of equal celebrity. He has the credit of having been the first to introduce into this country the Edinburgh "quizzing" system. He was elected Pro- fessor of Surgery at twenty-nine years of age, and at once dis- played extraordinary talent as a teacher, eloquent, polished and much beloved by his classes. He was equally successful as a clinical lecturer and operator. The surgical clinic, by the asso- ciated zeal and efficiency of Mutter and Pancoast, became so famous that the amphitheatre was crowded with practitioners from all parts of the country. Always lacking in physical vigor, though abounding in nervous energy, Dr. Mutter was forced by increasing infirmities to bring his labors to a close. His death ensued within a year at the early age of forty-eight. The exten- sive Mutter Museum and its liberal endowment under the admin- istration of the College of Physicians, serve to keep his name in the grateful minds of the new generations. His place was taken by S. D. Gross, M.D., recently Professor Jefferson Medical College 271 in the University of Louisville, a graduate of the Jefferson Med- ical College of the class of 1828, who had made a great reputation as a surgeon, writer and lecturer. The following year Dr. Huston resigned, was made professor emeritus, and was succeeded by T. D. Mitchell, M.D., Professor in the Medical School of Transylvania University, Lexington, Ky. In 1858, the faculty was bereft of one of its most valued mem- bers by the death, in harness, of Dr. J. K. Mitchell. [Beginning his scientific career as Professor of Chemistry in the Franklin Institute, he published original researches on osmosis, the solvents for india rubber and the tests for arsenic. Later he was the author of important papers on medical topics, such as the spinal origin of rheumatism. His most notable contribution was his persistent advocacy of the view then entirely new, but which is now universally accepted, that malarial fevers, yellow fever and cholera are produced by the presence of low vegetable organisms in the body. On his death the professorship of Practice of Medi- cine was conferred on Samuel H. Dickson, M.D., recently of the University of South Carolina. When the Civil War broke out, as two-fifths of the class usually came from the Southern States, it is not surprising that in two years the roll of students shrank from 630 (the largest class which up to that time had attended any medical college in this country), to only 275. The last course of lectures delivered by Dr. C. D. Meigs was in the session of 1861-62. As professor emeritus for that year he took the place of the new appointeei, Professor Keating, whose health would not permit him to take the chair. In the following year the chair of Obstetrics was permanently filled by Dr. Ellerslie Wallace, some time Demonstrator of Anatomy. For twenty years Dr. Meigs had been eminent among the associates who had given so much lustre to the history of the College. Famous as a scholar, eloquent lecturer and writer on obstetrical subjects, he was at home in the arts of painting and modeling, which he used with great dexterity to illustrate his lectures. At his resignation the faculty made a minute which said, in part, that they "parted from him with intense and enduring regret. Never could anyone have more closely applied himself to the execution of the responsible duties that have devolved upon him." In 1864, the Chair of Chemistry lost its occupant, Dr. Frank- lin Bache, the great-grandson of Benjamin Franklin, best-known 272 Medical, Pharmaceutical and Dental Colleges as one of the authors of Wood and Bache's "United States Dis- pensatory." His eulogist, Dr. George B. Wood, considered him an extraordinary man, who worked diligently and thus did much for the public good — "presenting to the young men an example of all that is morally excellent, lovely and of good report in man- kind." He was succeeded by B. Howard Band, M.D., a practiced lecturer on chemistry in different medical institutions. After eight years of his connection with the College Dr. Thomas D. Mitchell died in 1865. In his endeavors for the well- being and the instruction of the students he acted conscientiously and harmoniously with his colleagues, who held him in high esteem. His successor in the chair of Materia Medica was John B. Biddle, M.D., an accomplished lecturer, who had won popularity as professor of that branch in the Pennsylvania Medical College. In the session of 1866-67 the. clinical opportunities were much enlarged by the establishment of a daily clinic, the medical cases being allotted to the skilful consideration of Dr. J. M. Da Costa as lecturer on clinical medicine. In the same year more extended facilities for learning the specialties of medicine and surgery were provided in a "summer course." The work of the faculty was sup- plemented by Drs. W. H. Pancoast, S. W. Gross, J. Aitken Meigs, B. J. Levis and F. F. Maury. In the following year this list was aug- mented by the names of Drs. J. H. Brinton and W. W. Keen. After filling for twenty-five years the chair of Institutes of Medicine and for fourteen the office of dean, in 1868, Dr. Eobley Dunglison was compelled to resign by the ill-health which in the next year caused his death. The Trustees accepted his resignation with expressions of regret and elected him emeritus professor. In him was a rare combination of varied culture and vast erudition, made useful by an industry which produced the best medical dictionary of its day, copious contributions to journalism and text- books on physiology, hygiene, materia medica and the practice of medicine. The honors awarded him at home and abroad gave him a prestige that lent impressiveness to the easy flow and grace of his discourses. In his thirty years of medical teaching this "Father of American Physiology" signed his name to at least five thousand medical diplomas. The chair of Institutes was next occupied by J. Aitken Meigs, M.D., a physician and anthropologist of repute. In 1870, the alumni formed an association to promote the interests of the College and medical education. Jefferson Medical College 273 In 1872, Hon. J. E. Burden became President and Dr. J. M. Da Costa received the appointment of Professor of Theory and Prac- tice of Medicine, made vacant by the demise of Dr. Samuel Henry Dickson. During the fourteen years of Dr. Dickson's connection with the college his courtesy and refinement had made him agreeable to all, while his students reaped the advantage of his wisdom and ripe experience. At this time the Hospital and Dispensary of the College were treating annually about six thousand free patients, with one thousand surgical operations, in quarters wholly inadequate. At the session of the Legislature of Pennsylvania in 1873, April 9, an act was passed for the endowment of a new college hospital, by which the sum of one hundred thousand dollars was appropriated to the Trustees of the Jefferson Medical College. To the same purpose large private subscriptions were made by the alumni and others. There was much anxious deliberation on the proposition of removal to a more roomy neighborhood. The present central location was considered most convenient to the patients who were the material for the clinics. A spacious lot near by was pur- chased for the new hospital. At the same time measures were taken to enlarge and improve the college buildings, to add a new front and to equip new laboratories. The Hospital was formally opened Sep- tember 17, 1877. It was found that more money was needed from the State, and after petition, an act appropriating an additional one hundred thousand dollars was passed and approved by the Governor, June 17, 1878. To encourage contributions to the endowment fund, the Trustees offered to establish and support one free bed on the dona- tion of five thousand dollars, or the annual payment of three hundred dollars. By this authority a perpetual charity became the memorial of various donors, such as I. V. Williamson, Henry C. Lea, Thomas A. Scott, Asa Packer, A. Whitney and A. J. Drexel. On the 27th of November, 1878, provision was made for the creation of a pathological museum in connection with the Hospital. A collection of wet preparations, casts and wax models was soon made and arranged under the direction of the curator, Dr. Morris Longstreth. After a service of more than a third of century, full of years and honors, in 1874, Dr. Joseph Pancoast resigned the chair of anatomy and was made professor emeritus. The vacant appoint- ment was given to his son, Dr. William Pancoast, who as his demon- 18 274 Medical, Pharmaceutical and Dental Colleges strator and adjunct had enjoyed his tutelage, acted as his substitute and carried the prestige of his name. Dr. Joseph Pancoast s greatest distinction was won as surgical clinician. His anatomical lectures were made rich in practical information by his faculties of looking at the dry bones and other anatomical details as things highly interesting to the surgeon, from their relation to various surgical maladies. Among the great surgeons who played their parts in the history of the institution he had been a most con- spicuous figure. On the death of President J. E. Burden, in 1877, the Board of Trustees elected E. B. Gardette as his successor. The failing health of Dr. Eand (who was a man of marked character though not brilliant) having necessitated his resignation, Dr. Eobert E. Rogers, the new appointee, brought to the vacant chair an accession of strength by his twenty-five years' of experience and reputation as Professor of Chemistry in the University of Penns}'lvania. In this year the new Hospital was completed and in operation. Fronting on Sansom Street, it was bounded on three sides by streets and on the fourth side by a wide passageway. It was 107 feet square, five stories in height and could easily accommodate 125 patients. Much valuable material for clinical instruction was obtained from the outdoor department. The amphitheatre, provided for operations and lectures, seated more than 600 spectators. The most approved appliances for heating and ventilation were provided, and in fact the construction represented the best knowledge of the time. The clinical lectures were delivered daily, in the fall and and winter by the faculty, in the summer by the hospital staff. As the successor of the suave and sagacious Biddle, whose lectures were refined to the last degree, but whose personality was even finer than his work and who died in 1878, begins the connec- tion of Eoberts Bartholow, M.D., Professor of Materia Medica and General Therapeutics. He was widely known as a medical author and in the Ohio Medical College had made his mark as a forcible and popular teacher. In the session of 1879-80, Dr. J. Aitken Meigs being in his last illness, Dr. H. C. Chapman was called upon as Demonstrator of Physiology to deliver the course of lectures in that branch. In the following summer Dr. Chapman, equally successful as investigator and teacher, was promoted to the chair vacated by the death of Dr. Meigs. The lectures of Dr. Meio-g had Jefferson Medical College 275 been notable for their learning and literary finish, resembling in these qualities the style of his predecessor, Dunglison. As a method of teaching physiology it has given place to the superior course of experiment with instruments of precision. The new laboratory building adjoining the medical hall was opened this same session. It provided a room for section teaching in operative and minor surgery and spacious laboratories for prac- tical chemistry, microscopy and physiology. The equipment for the uses of the student was thought at the time to be adequate, but year by year new and better apparatus was added until in the physio- logical laboratory the liberal expenditures of Professor Chapman provided a most extensive outfit for study and research. In this year Dr. Morris Longstreth was appointed Demonstrator of Patho- logical Anatomy. He obtained material from the autopsies of the Pennsylvania and the Jefferson Hospitals and gave instruction in pathological anatomy and histology. The laboratory of materia medica and pharmacy in the medical hall was equipped in the following year. Besides the necessary appliances for a practical course in pharmacy, a room was fitted up with instruments for special researches in the physiological action of remedies. These laboratories were put in charge of demonstrators under the super- vision of the professors of each branch. The lectureship on ophthal- mology held by Dr. William Thomson was made a professorship without seat in the faculty. At this time the statutes of Pennsylvania, like those of most American States, contained laws against the desecration of cemeteries, which if enforced would have made dissections next to impossible. Those in authority recognized that an educated physician must know his anatomy well or run the risk of liability to the law for malpractice, and this knowledge could be acquired only by dissection of the human body. But at intervals a person connected with a medical college would be caught in some overt act by officers sharing the vulgar prejudice and the law would be invoked to punish him. At the instance of Dr. W. S. Forbes, in 1866, a law had been enacted which partially obviated this by allowing dissections upon the unclaimed bodies in Philadelphia County. In 1882, urged on by the clamor of the sensational news- papers, a trial for desecration was brought against Dr. Forbes, while demonstrator of anatomy in the Jefferson Medical College. He was triumphantly vindicated, but not without a publicity which 276 Medical, Pharmaceutical and Dental Colleges was intensely annoying and for a time injurious to his professional practice. It was some compensation for this disagreeable experience that his prosecution brought him the sympathy of his professional brethren and excited an agitation in the ranks of the medical profession, which was communicated to other enlightened citizens and thus Dr. Forbes became the instrument which caused the enactment of a perfected anatomical bill, not only legalizing dissec- tions, but providing for the compulsory distribution to the medical colleges of all unclaimed dead bodies in the interest of the science which devotes itself to prolonging human life. A desire to take repose after a lifetime of ceaseless mental toil caused Professor Gross, in 1882, to resign the chair of Surgery, which he had made illustrious for twenty-six years. He received the honor of being named professor emeritus. After two years of retirement he died in his seventy-ninth year. Samuel D. Gross, M.D., LL.D. Edin., D.C.L. Oxon., LL.D. Cantab., was born near Easton, Pa. At the age of twenty-three he was graduated doctor of medicine in the third class that went forth from Jefferson Medical College. After five years of practice he be- came Demonstrator of Anatomy in the Medical College of Ohio, and with this office began his career of medical teacher, which lasted for forty-nine years. After seven years of hard work, in which he pro- duced a treatise on the "Bones and Joints," and another on "Pathological Anatomy," he was elected Professor of Surgery in the University of Louisville. He held this position for sixteen years, in the meantime growing to be the chief surgeon of the Southwest and helping to make the school the leading medical center west of the Alleghenies. In 1856, he succeeded Mutter in the faculty of his alma mater, dedicating to her the remainder of his life. In the years of his connection with Jefferson Medical College he delivered twenty-six annual courses of lectures, published his great "System of Surgery," edited for some years the "North American Medico-Chi- rurgical Eeview," wrote many articles for the journals and addresses notable for eloquence and lucidity. He was a skillful operator, careful in diagnosis and profoundly versed in pathology. His lectures were made acceptable in a high degree by his imposing presence, animated gestures, sonorous voice and earnest manner. Consecrated to a work in which he excelled, he was honored in life and in death is destined to a lasting fame. In their endeavor to make good the loss entailed by the with- JEFFERSON MEDICAL COLLEGE BUILDING. WALNUT STREET FRONT. PHYSIOLOGICAL LABORATORY. Jefferson Medical College 277 drawal of Dr. Gross, the Trustees provided that surgical instruction should be given by two professors, and elected his son, S. W. Gross, M.D., Professor of the Principles of Surgery and Clinical Surgery, and J. H. Brinton, M.D., Professor of Practice of Surgery and Clinical Surgery, the last named a teacher of many years' experi- ence, who had achieved distinction as a surgeon in the late war. The declining health of Dr. Wallace compelled him in 1883 to resign the chair of Obstetrics, which he had adorned for many years. His was a strong personality, shown in his power of impressing per- manently upon the minds of his pupils his clean-cut ideas. The vacancy was filled by the election of Theophilus Parvin, M.D., L.L.D., of Indianapolis, widely known as a writer and as a professor in several medical colleges. The long and distinguished service of Dr. E. E. Rogers as teacher of chemistry came to a close by his decease in 1885. Excelling in the art of illustration by striking experiments, the exposition of his difficult science lacked nothing for clearness of speech, while his delivery was always agreeable. For the session of 1884-5 the lectures were delivered by Professor J. W. Mallet, M.D., LL.D., E.E.S., who at the end of the session returned to his former position in the University of Virginia. The chair was filled by the appointment of J. W. Holland, M.D., who had thirteen years' ex- perience as professor in the University of Louisville. In the ensuing session a maternity department was organized in the Hospital, and practical instruction was given to members of the graduating class in the use of the laryngoscope and the ophthal- moscope. By the resignation of Dr. W. H. Pancoast in 1886 a vacancy was made in the chair of Anatomy, which was filled by the promo- tion of Dr. W. S. Forbes, who for seven years had performed satisfactorily the duties of demonstrator. Dr. Bartholow laid -aside the cares of the deanship in 1887-88 and the faculty chose Dr. Holland for this duty. In the next year provision was made for a better use of the hospital facilities by the creation of five clinical lectureships, which were first administered as follows: Orthopsedic Surgery, 0. H. Allis, M.D. ; Laryngology, C. E. Sajous, M.D. ; Children's Diseases, 0. P. Eex, M.D. ; Dermatology, A. Van Harlingen, M.D. ; Eenal Diseases, J. C. Wilson, M.D. The death of President Gardette was followed by the election of 278 Medical, Pharmaceutical and Dental Colleges Hon. James Campbell in the year 1889. The untimely death of Dr. S. W. Gross occurred in the spring of that year. Profoundly versed in surgical pathology, he was a warm advocate of the anti- septic system in surgerj', just then coming into vogue, and did much to establish it as the ruling method at the Hospital. In his lectures he was clear and emphatic, his discourse sweeping on in a river of words all bearing directly towards his definite aim. In his stead was appointed W. W. Keen, M.D., who had made a name equally distinguished in medical letters, medical teaching and as an operator. With the session of 1890-91 a chair known as the Honorary Professorship of Laryngology was created for Dr. J. Solis-Cohen, whose standing in this department was of the highest. The rules now required that all matriculates who could not show a certificate from an academy or college of a suitable preliminary education should pass an entrance examination in English and in Elementary Physics. A graded curriculum extending over three years was also required. At the close of the session 1890-91, Dr. J. M. Da Costa, having taught clinical medicine and practice of medicine to loving and admiring classes for twenty-four years in this institution, resigned his chair, accepting the title of professor emeritus. His successor, J. C. Wilson, M.D., had made his mark in medical letters and medical teaching while engrossed with the cares of a large pro- fessional practice. Owing to the poor health of Professor Bartholow in this session the course on Materia Medica and Therapeutics was con- ducted partly by Professor Holland and partly by Dr. A. P. Brubaker. In place of Dr. Bartholow, made professor emeritus, who was a forcible teacher, with a rare gift of clear and succinct statement, the Trustees elected Hobart A. Hare, M.D., who had made a name by his researches in physiological therapeutics and as a lecturer on the diseases of children. Dr. Morris Longstreth was promoted from the lectureship to the professorship of General Pathology and Pathological Anatomy. In 1882, Hon. Joseph Allison, LL.D., was elected president and E. E. Montgomery, M.D., recently professor in the Medico-Chi- rurgical College, was appointed Professor of Clinical Gynecology with a seat in the faculty. The next five years form a period of active evolution, with many additions to the teaching corps. The Jefferson Medical College 279 faculty chair of Ophthalmology, the first incumbent of which was Dr. William Thomson, after his resignation was occupied by George E. de Schweinitz, M.D., late professor in the Polyclinic College, while W. M. L. Coplin, M.D., recently professor in Vanderbilt University, became the successor of Dr. Longstreth in the chair of Pathology and Bacteriology. The three-years' course was now in operation and successful to a surprising degree, the matriculation list reaching 711 in the session of 1894-95. The additional time gave opportunity for the introduction into the curriculum of various special branches of practice as required studies. A body of "clinical professors" was instituted and the appointees chosen were men of recognized ability and experience. Though without a voice at the faculty meetings, each was put at the head of a clinic with a staff of assistants serving as instructors to the third-year class, which for this work was divided into sections of convenient size. The list of newly appointed clinical professors was as follows : Henry W. Stelwagon, M.D., Dermatology; H. Augustus Wilson, M.D., Orthopaedic Surgery ; Edwin E. Graham, M.D., Dis- eases of Children; F. X. Dereum, M.D., Diseases of the Nervous System; Orville Horwitz, M.D., Genito-Urinary Diseases; Edward P. Davis, M.D., Obstetrics; S. MacCuen Smith, M.D., Otology; W. Joseph Hearn, M.D., Surgery ; Howard P. Hansell, M.D., Ophthal- mology; Wm. S. Jones, M.D., Laryngology ; D. Braden Kyle, M.D., Laryngology ; J. Chalmers Da Costa, M.D., Surgery ; J. M. Barton, M.D., Surgery. A great many changes were made in the curriculum which, though small in themselves, in the aggregate transformed the course, making it more varied, more thorough and more practical. Although the course had been extended to three years and each term lengthened six weeks, the demands of a rapidly growing science created a need for more time. A compulsory four-years' course was announced to go into effect June 1, 1895. As this step was taken antecedent to a like action on the part of rival colleges, it was in full view of the fact that it would entail for a few years diminished revenues, to balance which no guarantee fund had been raised. The wisdom of this step has been shown by the fact that the graduating class of 1898, made up of students who have taken the four-years' graded course, was much larger than was expected. This was a long stride in advance; how long may be best appre- ciated by a retrospect. 280 Medical, Pharmaceutical and Dental Colleges The science, which five years before had been represented by seven chairs, now called for twenty chairs, didactic and clinical, each standing for a distinct branch of medical teaching. To direct the students' work it required nine demonstrators, twenty assistants and ten instructors. In the olden time there was but one laboratory — the dissecting-room. Now not only had suitable buildings been provided for the new laboratories, but these were furnished with expensive apparatus to which yearly additions were made. Where once there had been no clinical instruction except in the two general clinics on medicine and surgery, there were now not only these lectures, but instruction was given to each student at the side of the patient in twelve separate clinical rooms and wards. The ten clinical professors had thirteen chief assistants and fifty-six sub- ordinates, making a total of one hundred and thirty-seven members of the teaching corps in the College and Hospital combined. When attempting to raise endowments to carry out the expen- sive improvements they had projected, the Trustees and Faculty often encountered the objection that as the receipts in excess of expenditures were divided among the Faculty, they were practically asking for money to be given to the Faculty, and not to the cause of medical education or suffering humanity. In order to end this system, complete reorganization was effected by the Trustees, which was cheerfully accepted by the Faculty. By their act of February 1, 1895, entire control of the College and Hospital was assumed by the Trustees, the Faculty receiving salaries in lieu of a proportion of the net receipts. The College was put under the supervision of a standing committee of seven Trustees elected annually. Another committee of like character had charge of the Hospital. Hon. Edwin H. Fitter had succeeded Judge Allison as President in 1893. After holding office for two years, he had retired, and at the time of the reorganization Hon. Joseph B. Townsend, LL.D., was President. His death in 1896 left a vacancy, which was filled by the election of Hon. William Potter. President Potter, unlike his venerable predecessors, was in the prime of life. In carrying out his College and Hospital enterprises he had need for all his native energy and tenacity of purpose. These qualities were supplemented by knowl- edge of affairs and tact gained by his experience in the world of affairs and diplomacy. Since the opening of the Hospital in 1877, which event has been previously referred to, it had been a great factor in medical teaching Jefferson Medical College 281 as well as in the cure of disease. Primarily intended as a hospital for teaching medical students, this 'feature had been found to redound to the advantage of the patients. It had at command with- out cost the professional services of leading practitioners of med- icine, surgery and the specialties, chosen for eminent ability. The surgical and other treatment had been done openly under the eye of curious critics, quick to detect inefficiency and to condemn neglect. A bright light of publicity beat upon the clinician which inspired him to do his best for the case in hand. The percentage of baffling and difficult cases had been unusually large. From the city and all parts of this and neighboring States patients suffering from com- plicated disorders were sent to this clinic for diagnosis and treat- ment. Those calling for greater skill in surgery than the ordinary practitioner can acquire were far from rare. To meet the call for the latest appliances a costly "Eoentgen Kay" apparatus was put in, and proved its value at once by wonderful results. The building was commonly overcrowded, especially for the hours between eleven and two. Not only was all the suitable room in the building occupied, but the side corridors and dark closet-like places under the amphitheatre were daily thronged with patients. The accident work of the hospital grew to great proportions. Its central location was well adapted for the care of such patients, who were quickly brought to its doors by an active ambulance service. The disproportion between the facilities afforded and the actual needs of the institution became so marked that in 1892 the maternity ward was removed from its cramped and unsuitable quarters in the Hospital to a rented building, No. 327 Pine Street. The increased expenses entailed were met partly by the Trustees and partly by private subscriptions raised by a Board of Lady Managers in charge of this department. The success of this branch was mainly due to the personal efforts of the ladies whose chairman was Mrs. E. D. G-illespie. By affiliation with other charities, the devoted managers were able to care for the homeless children, and exert an elevating moral influence upon those who came to them for help. The nurses of the Training School and the students of the College received special instruction at the Maternity from its medical director, Prof. E. P. Davis, M.D. It was soon found that this building was over- taxed, and accordingly a more commodious house, 224 South Seventh Street, was taken in the autumn of 1894. In 1891, a Training School for Nurses was established in 282 Medical, Pharmaceutical and Dental Colleges connection with the Hospital, by which a great improvement was obtained in the character of the nursing. A well qualified Direct- ress had charge of the School, who was assisted in the teaching by lecturers who gave annual courses to the nurses on subjects related to their employment. To maintain the Hospital in its beneficent work appeal was made to the Legislature. The appeal was not in vain. Annually for six years or more the deficit in running expenses was reduced by the $5,000 a year donated by the State. In 1892 the sum of $100,000 was appropriated to aid in the construction of a new build- ing better suited to the demands of the time than the twenty-year- old structure, found inadequate in many ways. To obtain this sum, the Trustees were required to raise a large amount outside and begin work within two years. The business depression of 1893 arrested all progress in this direction and the appropriation became inopera- tive. In 1894 the Legislature confirmed the action of their predecessors, and with this donation a six-storied building was purchased, situated at the corner of Tenth and Moravian Streets, adjacent to the Hospital. In the two lower floors of this building, called the "Hospital Annex," temporary quarters were arranged for certain special clinics by constructing partitions and hallways. A receiving and an examining room were provided for each of the following out-patient departments: Diseases of Children, of the Eye, of the Throat and Nose, of the Ear, of the Nervous System and of the Skin. In the main building were still housed the dis- pensaries for Genito-Urinary Diseases and Diseases of Women, besides those for General Medicine and Surgery. In 1896, the alumni having contributed $10,000 to purchase laboratory appliances, which were of the most recent and improved pattern, and necessarily very expensive, the Trustees set apart three upper floors for the elaborate study of diseases, required by the advanced science of the day. It was at the time considered the most complete hospital laboratory in this country. The entire floors were renovated from top to bottom, with new plumbing, electric lights and steam heat. Abundant light shone in through large windows on three sides. On the fourth floor was the laboratory for studying the normal conditions of the tissues and fluids of the body. Each investigator was furnished with a locked desk of substantial make for holding the apparatus needed in his study. Other cases were placed about the room for holding reagents, chemical appara- »**• ' *; 0& *£• *% i* ... t *> r4 *H.' / * , -/ * / *<\ f * • . n | ■ U*' * ■ ■■.: ^^ "~S£. 4» **•■ i j^» jm,>~vwi* | . jib t* 'H» \ w ^ Jefferson Medical College 283 tus, microtomes, blood measures and forty microscopes. Opening into the laboratory was a record room for keeping the reports and archives. On the fifth floor was the laboratory for studying diseased conditions of the tissues and fluids. The furniture was much the same as that on the fourth floor; the instruments were adapted to taking observations of morbid changes in the blood in tumors and inflamed structures. The microscopes belonging to this laboratory were of high magnifying power and with very delicate means of adjustment. Connecting with it was a photographic dark-room with appliances for developing the X-ray pictures taken from the Hospital cases. On the sixth floor was the laboratory for investigating the causes of disease. The bacterial germs of infection were here studied with reference to their detection and destruction. Here the means of disinfection could be tested, adulterations of food proven and reports made upon sewage pollution and the effects of filtration upon drinking water. The direction of these hospital laboratories was given to Professor Coplin and to H. F. Harris, M.D., who was made Associate Profes- sor of Pathology and Bacteriology, assisted by Dr. Eandle C. Kosen- berger as demonstrator, all of them trained experts in this new field of study. In order to extend the benefits of these laboratories to the many physicians whose college education did not include this advanced culture, the Trustees instituted a system of summer work for post-graduates of medicine, in no way interfering with the regular under-graduate winter instruction. Having established laboratories and some of the clinics in this building, it was soon found that, although the Hospital congestion had been relieved somewhat, every inch of floor space was occupied and more room demanded. The urgency of this need developed a more far-reaching plan, which should provide for the needs of this great charity through a long period of time. A great modern hospital was projected, the ground for that purpose being the site of the old college building, extending from Tenth to Juvenal Street, and from Sansom to Moravian Street. The new hall and laboratories now occupy the corner of Tenth and Walnut Streets, a description of which is given on pages 285 and 286. In the winter of 1897-98 occurred the death of Professor Theophilus Parvin. For many years he had enjoyed an inter- national reputation as an authority in obstetrics. To this he joined accuracy in scholarship, a graceful literary style and a fervid 284 Medical, Pharmaceutical and Dental Colleges eloquence peculiarly suited to public occasions. The vacant chair was filled by giving to the clinical professor, B. P. Davis, the title of Professor of Obstetrics and the didactic as well as clinical lectures with a seat in the Faculty. To the professor of clinical gynecology, E. P. Montgomery, was assigned the title Professor of Gynecology, his work to be both didactic and clinical. In 1897, Professor Dercum was given a seat in the faculty with the title of Professor of Neurology and Mental Diseases. At the same time Professor J. Chalmers Da Costa was elected to share in the didactic work with duties as a member of the faculty. His title was Professor of the Principles of Surgery and Clinical Surgery. The fidelity and enthusiasm of the group of clinical Profes- sors suggested the propriety of further recognition, and in May, 1904, they were admitted to full faculty chairs, the qualifying title of "Clinical" Professor being omitted. At the same time, the business of the faculty was entrusted to the "Administration Committee," which was made up of the former faculty and in addition two representatives elected an- nually by the remaining members of the new faculty. As this arrangement did not prove satisfactory it gave place, in May, 1908, to the present organization of twenty-two professors of equal rank and responsibility. To facilitate business the faculty has been divided into nine standing committees, which report to the general faculty at the bi-monthly meetings. The details of instruction, examination and discipline are delegated to the faculty, subject to the approval of the Board of Trustees. On December 17, 1905, occurred the death of Professor Forbes, at the age of seventy-four years. The course of lectures in anatomy for the remainder of the session was delivered by Dr. Addinell Hewson, who as Assistant Professor, had for several years taken much of the burden from the shoulders of Professor Forbes. After much consideration it was concluded to divide the work of this important department under two full professors. Dr. Edward A. Spitzka, who had made his mark as writer and teacher while on the staff of Columbia University, New York, was made Professor of General Anatomy, teaching the students of the first and second year. Dr. George MeClellan, a grandson of the founder of that name, widely and favorably known as Professor of Anatomy at the Academy of Fine Arts and author of sev- Jefferson Medical College 285 eral books on the subject, was elected Professor of Applied Anatomy and assigned to the task of instructing the third-year students. Upon the death of Professor Brinton, at seventy-three years of age, which occurred March 18, 1909, Dr. John Gibbon was elected his successor. Dr. Brinton had graduated at the Col- lege fifty-seven years before, and through all that time was con- nected with its teaching corps, with the exception of the Civil War period, when he served as Surgeon and Medical Director in the Federal Army. Dr. Gibbon had served on the staff of sur- gical instructors of the College, and was one of that select body of eminent men — the staff of the Pennsylvania Hospital. THE NEW MAIN BUILDING With the inauguration of the graded four-years' course was created a requirement which the old buildings did not meet. For some years the Trustees had struggled with the problem how to provide for the present and future classes under a curriculum constantly developing with the advancement of science. It is believed that the new buildings present a solution satisfactory as far as they go. A much enlarged hospital building was projected which would supplement the new hall and adequately provide for every modern feature in medical education. The new hall, fireproof in construction, is at the corner of Tenth and Walnut Streets, with a front on Walnut and the side joined to the new laboratory building. This situation has been chosen as the best for the purpose, because its central location insures a constant supply of clinical material at the dispensaries and at the Hospital, besides having the advantage of nearness to the Pennsylvania Hospital. The exterior is designed in formal English Eenaissance, so as to suggest its academic uses, with a regularity of construction in such marked contrast with the heterogeneous buildings surrounding it as to enhance the dignity of its noble proportions. The construction is fireproof through- out. The second floor has a large museum room, newly equipped by the donation of Charles S. Smith, Esq. It will store in the best manner for study the great collections of the late Professor Samuel D. Gross, of the late Professor Parvin, of Emeritus Pro- fessor Da Costa, and a large collection of models, preparations and specimens. 286 Medical, Pharmaceutical and Dental Colleges The system for heating and ventilation embodies the latest principles and is entirely adequate. Fresh air is taken from above the building through a special shaft blown by an enormous fan over a heating stack of steam coils and forced into every room. At the top of the exit shafts accelerators exhaust the foul air from every room by a system of flues. THE NEW LABORATORY BUILDING The College has ten large laboratories for students, and seventeen smaller private rooms for individual research. Most of these are provided for in the structure which adjoins the medical hall and is directly connected with it. All the student labora- tories are lighted by windows on three sides, besides incandescent electric lights, and have individual desks and outfits entirely under the control of the students while working. This equipment was pro- vided, in part, by funds subscribed by the alumni; it has, among other notable features, one hundred and fifty microscopes of the most recent make, a complete outfit for electric lantern projection and one for photography, besides the microtomes, models and other apparatus required for thorough study. THE NEW HOSPITAL No part of the history of the Jefferson Medical College is more interesting than the evolution of its great Hospital, which is now under the skillful management of Professor Coplin, who contributes the remainder of this sketch. In May, 1825, several months in advance of the opening of the first session of lectures, an Infirmary had been organized within the walls of the building in which was to be inaugurated the infant medical college. On May 9, 1825, Dr. George McClellan performed the first operation in the amphitheatre and in the Infirmary administered to the first patient. From this modest beginning, involving a single room, a small lecture amphitheatre and an outlay of but a few dollars, was laid the foundation of the movement which nearly two-thirds of a century later culminated in the erection and equip- ment of an institution at that time the best of its kind on the continent. In 1841 the reorganization of the school provided for sys- tematic college clinics in both medicine and surgery. In 1843 rooms adjoining the College building were rented and fitted up Jefferson Medical College 287 for the reception of patients. A gradual increase in bed accom- modation evolved this miniature hospital into one having crowded accommodation for twenty patients. The growing work of the College and the more general recognition of the vastly superior advantages of clinical teaching, led the Faculty and Alumni to dream of better and more adequate facilities, and eventually from the ill-defined dream evolved the hope which later was to mature into a new hospital. Through 1870 and 1871 many plans for financing the proposition were discussed, but aside from arousing enthusiasm and awaking practical interest in the project, nothing of importance was accomplished. In December, 1872, the Alumni Association met in the old College building on Tenth Street and formally decided to act. On the condition that a feasible plan for further financing projects would be matured, the sum of fifteen thousand dollars was on this occasion pledged. Committees of the Alumni, Faculty and Board of Trustees were formed for the purpose of soliciting subscriptions, approaching the Legislature of the Commonwealth for a grant, and in other ways raising the necessary funds. The Board of Trustees appointed a Building Committee, consisting of Messrs. Phillips, Lippineott and Gar- dette, and later a Finance Committee, composed of Henry M. Phillips, Asa Packer and James Campbell. Later these com- mittees were merged and joined with a committee of two from the Faculty and a like number from the Alumni Association. On November 4, 1875, the contract was placed, and on April 27, 1877, the new Hospital was completed and officially opened, receiving its first patient on May 1st. The new institution, with its entire equipment, cost $185,919.83; it afforded four large wards, a number of smaller wards adapted to isolation and segre- gation of selected cases, and ten private rooms. The maximum capacity for in-patients was 125, and the out-patient service was correspondingly small. Of the former, 441 were admitted during the first year, 621 in the second and 890 in the third. A corre- sponding increase was shown in the out-patient department, in which during the first year 4,659 patients were treated and in the third year, 5,497. For thirty years this institution continued to grow in influ- ence and in the amount of work accomplished. During the last year of its existence as a Hospital 2,392 patients were treated in the wards, 3,840 emergencies met, and 101,229 visits paid by out- 288 Medical, Pharmaceutical and Dental Colleges patients. In the thirty years of activity 2,000,000 beneficiaries passed through its doors, 50,000 accident cases were treated, 5,000 doctors were equipped in its halls, and nearly 150 nurses grad- uated from its Training School. ' The amphitheatre of the Jefferson Hospital became renowned for the extent and quality of the clinical teaching that it afforded. It was the arena in which operated such surgeons of imperishable fame as the Grosses and the elder Pancoast. There the illustrious J. M. Da Costa taught and the erudite Bartholow lectured. "There spoke Levis, Parvin, Wallace, Biddle, Brinton, Maury and others. There, as guests have stood Esmarch, of Kiel; Mikulicz, of Breslau; Faure, of Paris; Lorenz, of Vienna; Bryant, Dur- ham, Horsley, Ballance and MacCormack, of London; Macewen, of Glasgow ; Lawson Tait, of Birmingham ; Annandale and Cheyne, of Edinburgh; Emmett, Weir and Thomas, of New York; Senn, of Chicago; our own Marion Sims, and a host of others." Gradually the institution became totally inadequate for the demands thrown upon it. The higher standard of preliminary education required for the admission of students, the lengthening of the course of instruction, the improvement and extension of methods of teaching and other factors gradually led to the entrance into medical study of men possessing more advanced qualifications, and justly demanding proportionately increased facilities. In this improvement of conditions of medical educa- tion the Jefferson Medical College has ever taken a foremost rank, and now felt no inclination to recede. The Hospital originally was started as an adjuvant to teaching methods largely evolved within its hall, and, while accomplishing, as no institution could have better done the purposes for which it was created, had con- currently extended its influences along other humanitarian lines becoming a magnificent charity. Brought forth as a teaching institution, it grew to be one of the greatest charities among the many for which Philadelphia is deservedly noted. The wards became inadequate for the ever-increasing demands upon them; the out-patient departments no longer afforded anything like proper facilities for the care of those applying for treatment. A new hospital was needed. While both Faculty and Alumni recognized the inadequacy of the old institution and desired something better, it is particularly to the Board of Trustees whose indefatigable energy has marked Jefferson Medical College 289 the rejuvenation of the new College that all are indebted for the completion of the new Hospital. Fully fifteen years before a stroke of work had been expended upon the new institution the Board began feeling its way toward the consummation of an idea which was then little more than a dream. Properties east of the old Hospital and lying between that structure and the old Col- lege were purchased; a new College building, at the corner of Tenth and Walnut Streets, was planned, constructed and occupied. In this way became available a plot of ground extending from the old Hospital to Tenth Street. For financing the proposition one million and a half dollars was necessary. The location, in the midst of the most closely built-up portion of the city, demanded that it should be absolutely fireproof; the enormous value of the ground prohibited the acquisition of a large building plot and consequently the structure must be many storied. No two ele- ments add more to the expense of construction than fireproofing and height. The institution must be ideal from sanitary aspects and in every detail adapted to its contemplated purposes — a great charity, a tremendous teaching plant, safe from fire and com- pletely equipped. To attain these ends many paths had to be blazed, requiring time and money, so that from the date upon which the architect first put pen to paper to the dedication of the new building over five years elapsed. It was worth waiting for. The old Hospital, when crowded, accommodated 125 patients; the new has ample facilities for over 300. The old was dark, gloomy, inflammable— as were all institutions of its time — the new capacious, fire-proof, sunny and well ventilated. Open streets on three sides with electricity for light and power, assures a cool, quiet building in summer and steam heat affords a comfortable winter temperature. IBuilt of steel, brick, terra-cotta, concrete and tile, the structure is fireproof. Capacious roof gardens afford facilities for open air treatment preferable to lawns. Every ward possesses an out-door balcony. The building contains eight oper- ating rooms, each fully equipped for its specific uses. Of the fourteen wards, seven afford accommodations for twenty-four patients each, two for fourteen patients, and the smaller for from one or two to eight patients. Numerous single rooms on the public floors are used for isolation or seclusion of those dangerously ill or for other purposes requiring segregation. During the last year in the old Hospital 2,267 patients were 19 290 Medical, Pharmaceutical and Dental Colleges admitted to the wards. In the present year (1909) in the new institution the number will reach 5,000. On June 1st, in the old Hospital, the house census was 101; on the same date, 1908, in the new Hospital, it was 198, and on February 1, 1909, 210. In the emergency department a like increase has occurred, amounting to over 40 per cent, in eleven months. In numbers these statistics tell something of the work done; the yearly cost exceeds $200,000, of which $80,000 is contributed by the Com- monwealth, and over $120,000 provided by contributions from those charitably inclined, by income from investments, and by the earnings from various sources, principally the private room service. The Maternity Department of the Jefferson Hospital occupies separate quarters at 224 West Washington Square. Its wards provide for the care of patients during confinement, its dispensary administers to hundreds seeking medical advice and aid, and by a most thoroughly organized system arrangements are constantly maintained for attending poor women at home. Situated on the border of a larger district in which poverty is common, the very location of the Maternity Department renders it available in the most trying period of woman's life. It affords help to the most helpless class and prompt aid at a time when delay means danger and unobtainable assistance, death. Yearly it ministers to hundreds of mothers and their babes. Hahnemann Medical College and Hospital of Philadelphia By THOMAS LINDSLEY BRADFORD, M.D. THIS institution, originally chartered as the Homoeopathic Medical College of Pennsylvania, is the oldest college devoted to homoeopathy in the world. It was founded in 1848. At this time there was no institution where homoeopathy was taught. Its practitioners were converts from the ranks of the dominant medical profession, and any medical student who wished to prac- tice this system was compelled to graduate from an established college supplementing this by a course of study under a homceo- pathic practitioner. Previous to this Dr. Constantine Hering, with a number of colleagues, had, in 1835, established a school for homoeopathy at Allentown, Pa. This was regularly chartered June 17, 1836, under the name of The North American Academy of the Homoeo- pathic Healing Art, and was entitled to confer the degree of Doctor of Homoeopathia upon its graduates. The instruction was in German. This school was closed after a few sessions. In 1845, homoeopathy had practitioners in twenty-two States, about 250 in number. In 1844, a national organization was effected — the American Institute of Homoeopathy. In 1846, the American Medical Association was organized, and at a meeting held in May, 1847, resolutions were passed tending to prevent the extension of the new doctrine of homoeopathy in the United States, it being resolved that the certificate of an irregular prac- titioner should not be received by the medical schools. This was reiterated at other meetings of the Association. Of course, to the average medical practitioner of that day the follower of and believer in the doctrines promulgated by Hahnemann was decidedly irregular, and the medical student, if known to have any inten- tion to practice homoeopathy, was not received by the colleges, or, if received, was not allowed to graduate. Hence it became of paramount necessity for the future welfare of the homoeopathic system that its members establish a medical school where its tenets should be taught and its students legally graduated. The matter (291) 292 Medical, Pharmaceutical and Dental Colleges was discussed by the profession at large, and especially by the homoeopathic physicians of Philadelphia, then a center for homoeo- pathic practitioners. One evening in February, 1848, Drs. Con- stantine Hering, Walter Williamson and Jacob Jeanes met at the house of the latter, and it was decided that a college for the teach- ing of homoeopathy be established. The Legislature was then in session and a petition signed by eighteen physicians and many lay- men was two days afterwards presented to that body asking for a charter. This was successful, and the Act incorporating The Homoeopathic Medical College of Pennsylvania in Philadelphia was passed April 5th, and signed by the Governor April 8, 1848. The first meeting of the corporators was held on Hahne- mann's birthday, April 10, 1848, in the Athenaeum Building, on the southeast corner of Sixth and Adelphi Streets, opposite Wash- ington Square. With the exception of one meeting held at the Assembly Buildings, Tenth and Chestnut Streets, all the meetings of the College authorities were held at the Athenaeum. At a meeting held on September 16th, the Committee on Buildings reported that arrangements had been made for renting rooms at No. 229 Arch Street for the use of dispensary and college. The first announcement was only a circular, upon which the following was printed : — "HOMCEOPATHIC MEDICAL COLLEGE OF PENNSYLVANIA, "College Building, located in the rear of 229 Arch Street, "Philadelphia. "Preliminary Instructions will commence on Monday, the sixteenth day of October, 1848. "The Eegular Course will begin on Monday, the sixth day of November, and continue until the first of March ensuing. "Jacob Jeanes, M.D., Professor of Principles and Practice of Medicine; Caleb B. Matthews, M.D., Professor of Materia Medica; Walter Williamson, M.D., Professor of Midwifery and Diseases of Women and Children; Francis Sims, M.D., Professor of Surgery; Samuel Freedley, M.D., Professor of Botany; Matthew Semple, M.D., Professor of Chemistry; William A. Gardiner, M.D., Pro- fessor of Anatomy. The chairs of Physiology and Pathology remain to be filled. "Clinical Instruction in Medicine and Surgery will be given at the College. Hahnemann Medical College and Hospital 293 "Lectures will be delivered throughout the year, but the win- ter course only will be obligatory — attendance on the summer course being at the option of the student. "Standard works on Homoeopathy and such books as are gen- erally used in other medical schools can be used as text-books. "Students who have attended a full course of lectures in another medical school can, after attending the winter course of this College, graduate next spring, if their attainments justify it. "Pee for full Course, $100; Practical Anatomy, $10; Grad- uation Fee, $30. "W. Williamson, M.D., Dean of the Faculty, "No. 80 North 11th Street, Philadelphia." Dr. A. E. Small was subsequently appointed to the chair of Physiology. The rooms at 229, now 635 Arch Street, had pre- viously been used for a school and for a meeting room for the Swedenborgian Church. The front of this building was for many years used for a homoeopathic pharmacy by Messrs. Sheek and Eademacher, and later by Dr. F. E. Boericke. The College opened at the advertised time with fifteen stu- dents : John G. Shultz, Henry F. Davis, D. E. Luyties, Frederic Humphreys, Samuel O. Scudder, Nathan S. Engle, Joseph K. Clark, J. Loxley Ehees, E. Bently Hall, M.D., John L. Jahvens, Daniel E. Gardiner, Frederick Sheek, J. H. P. Frost, Thomas S. Eodman, M.D., Charles G. Eaue. The first public commencement was held on Thursday, March 29, 1849, and the degree of the College was conferred by the President, the Hon. A. Y. Parsons, upon Joseph K. Clark, of Massachusetts; Henry F. Davis, of Ohio; Nathan S. Engle, of New Jersey; Daniel E. Gardiner, of Pennsylvania; E. Bently Hall, of New Jersey; Samuel O. Scudder, of New York. But one course of lectures was given in the building on Arch Street ; the accommodations were inadequate and a building that had been occupied by the Pennsylvania Medical College was rented. This building, originally built by Mr. Matthew Newkirk for the Philadelphia Institute for the Instruction of Young Men, and which had been also used for a church, was situated on the north side of Filbert Street, between Eleventh and Twelfth Streets, being No. 1105 Filbert Street. The announcement for the second session was an octavo 294 Medical, Pharmaceutical and Dental Colleges pamphlet of sixteen pages. The officers of the College consisted of a Board of Managers, the President and twelve elected from the 106 corporators. The faculty elected its own officers. The term began in October and ended in March. The second session began in the new College October 1, 1849, and ended March 2, 1850. There were fifty-five matriculates, of whom twenty grad- uated. The demands for medical education were much less than at the present day. The requirements for graduation at the Uni- versity of Pennsylvania in 1852 were: "Candidate must be twenty-one years old; have studied medicine for three years; during two years have been the private pupil of a respectable practitioner of medicine; two full courses of lectures in that institution; a course of clinical instruction at the Pennsylvania Hospital or some other approved institution. Also to present a thesis." The rules at Jefferson and at Harvard were the same. The Homoeopathic College rules, as presented in the second announcement, were: "Candidate for graduation must be of good moral character; be possessed of sufficient preliminary education; have attained the age of twenty-one; have applied himself to the study of medicine for three years; attended two courses of med- ical lectures, the last of which must have been in this institution; and have been the private pupil of a respectable practitioner of medicine." The standard of medical education was the same as that required by other medical colleges. The Homoeopathic College was now an established fact, and continued to hold yearly sessions. There were the usual vicissi- tudes and changes of college life. In 1855, the College building previously rented from Mr. Newkirk was bought by the College corporation, with two buildings in the rear, a mortgage being given in part payment. From this time the College labored under debt, and, in 18G4, in order that affairs should be put upon a sound financial basis a new charter was obtained; the corporation hav- ing a capital stock of $60,000, divided into 3,000 shares of $20 each; the College to have power to grant the degree not only of medicine, but of doctor of homoeopathic medicine. On these shares money could be borrowed. At this time, in 1865, it was thought advisable to publish a medical magazine in the College interests. A college journal, The Philadelphia Journal of Homoeopathy, had been issued monthly from 1852 to 1856, when it was discontinued. In August, 1865, the first number of the new HOMOEOPATHIC MEDICAL COLLEGE OP PENNSYLVANIA, 1105 FILBERT STREET. » IiiiiJMBI liiiMHiiiii ] i |S ' ' *-' -^ ."TW' ■ "-."i """i i iTn"- 1-| j .n ITil^jjIi'l'jll |H 'Jjp -I ill il_-l!^L|ilr^-4l!!^||lllll yyj-— - - 1 MIS B^$$$M&0JR ml ,| I Ml M (i^Hmkfmf^pfy^ kijImHHii H ■H ml ..- - &rtH HOMOEOPATHIC HOSPITAL, CUTHBERT STREET. Hahnemann Medical College and Hospital 295 journal, The Hahnemannian Monthly, was issued. This has been published under several managements ever since, and is now con- sidered one of the standard journals of the Homoeopathic School. During the session of 1866-67 there was some difference of opinion among the members of the faculty of the College, and at the close of the session several of them severed their connection with the institution. During the summer a new college was organized by these gentlemen. The charter of the old Eclectic College was secured and its name changed by the Courts to The Hahnemann Medical College of Philadelphia. It was organized with a Board of Corporation Trustees, a Medical Faculty, or Board of Professional Trustees, and a Board of Curators. The second and third stories of the building at 1307 Chestnut Street were rented, and a preliminary course was opened there on September 30, 1867, the regular course commencing October 13th. But one course was held in this building. During the summer of 1868 the College was removed to Nos. 16-18 North Tenth Street, where the session of 1868-69 was held. In the meantime the old College held sessions in the building on Filbert Street, and there was con- siderable rivalry between the two institutions. In the summer of 1869 it became evident that for the well- being of both schools, and of the cause, they should be united. The Legislature was petitioned, and in April, 1869, an Act was passed consolidating the Hahnemann Medical College of Philadel- phia and the Homoeopathic Medical College of Pennsylvania into one corporation. This was done, and to the regret of some of the older graduates the old name was done away with and the name of the new corporation became : The Hahnemann Medical College of Philadelphia. A new faculty was organized from the two faculties and possession was taken of the old College building on Filbert Street. With this new departure, in the announcement for 1869-70, mention is made of the need of a course of lectures to extend over three collegiate years. This was advisable, but left optional with the student. This optional three years' course originated with the Hahnemann Medical College of Philadelphia, and thus we find this institution the pioneer in the advancement of the require- ments for a medical education. Preliminary courses of lectures were also inaugurated. During the next ten years the College sessions were held 296 Medical, Pharmaceutical and Dental Colleges regularly in the old College. The commencements were held in the Academy of Music, and from fifty to eighty students were graduated yearly. For some time the College building had been inadequate for the increasing demands of the curriculum, and in 1882 efforts were made to secure a situation for the erection of college and hospital buildings. A plot of ground was selected on Broad Street, between Eace and Vine Streets, and extending from Broad to Fifteenth Street. This included the numbers from 221 to 233 Xorth Broad Street, and extended to and also included the Fif- teenth Street frontage, the entire lot embracing one and one- eighth acres. On November 6, 1884, the corner-stone of the new College was laid with Masonic ceremonies (at the northeast angle of the foundation on a level with the basement window). The building was completed in 1886. The last course in the Filbert Street college ended in the spring of 1886. The new college was completed, and from Sep- tember 20th to 25th, in place of the usual preliminary lectures, there was held at the new college a dedication week. This included the dedication of the new building, its inspection by physicians, a reunion of graduates from 1849 to 1886, a reception to visiting physicians, a general reception, and the twenty-second session of the Homosopathic Medical Society of Pennsylvania. The dedication was held upon the evening of September 21st. The lectures opened on September 27th with 173 matriculates. With this session the three years' course was rendered obligatory. Previous to this there had been but little division of classes, but now the curriculum for the men of different years became inde- pendent with each class for each year, although as yet the students were only known as first, second and third-year students. The examinations of each of the classes were also different. The old college was sold to a hotel company, was remodeled and afterwards became the Hotel Hilton. The great terminal depot of the Eeading Bailroad now covers the ground where the old college stood. The teaching corps, which originally consisted of but seven professors, now embraced chairs of Anatomy; Obstetrics and Puerperal Diseases, and Diseases of Infants; Gynaecology and Paedology; Physiology and Sanitary Science; Operative and Clinical Surgery, and Ophthalmology; Principles of Surgery and Hahnemann Medical College and Hospital 297 Clinical Surgery; Materia Medica and Therapeutics; Pathology and Practice of Medicine ; Natural Philosophy ; General and Med- ical Chemistry; Adjunct Professor of Obstetrics; with also Lecturers on Surgical Anatomy; on Pharmacy and Toxicology; Microscopy and Histology; History and Institutes of Medicine; Ophthalmology; Laryngology and Otology; Medical Jurispru- dence; General Pathology and Morbid Anatomy; Medical Den- tistry; Psychological Medicine; Demonstrators of Surgery, Ob- stetrics, Chemistry and Anatomy. This curriculum was the equal of that of any other medical school. In 1890, the College authorities offered a plan for a four years' graded course. This had been recommended by the Inter- collegiate Committee of the American Institute of Homoeopathy, and with the session of 1894-95 this four years' course became obligatory. The classes were now divided into Freshmen, Sopho- mores, Juniors and Seniors, and each class attended its special lectures. The corps of professors, lecturers and clinical instruc- tors was greatly increased. A preliminary examination was also demanded. A notable event in the history of the College occurred in 1898, when the institution celebrated its golden jubilee. It occurred at the time of graduation, May 11 and 12, 1898. There was a large gathering of the Alumni from many States, together with other physicians of the Homoeopathic School. The first day was devoted to addresses and conferences upon subjects relating to medical education, and on Thursday, May 12, at 2 o'clock in the afternoon, the commencement was held in the Academy of Music, and immediately afterwards a golden jubilee reunion and meeting of the Alumni Association was held in Horticultural Hall, followed in the evening by a banquet in the same place. For the last ten years the didactic and clinical advantages of this medical school have been constantly increasing until the present time. The number of teachers has been greatly increased. There are now professorships as follows: Emeritus Professor of Medicine; Emeritus of Ophthalmology and Otology; Professor of Gynaecology; Surgery; Anatomy; Chemistry and Toxicology; Materia Medica and Therapeutics; Physiology; Practice of Medicine; Medical Diagnosis and Clinical Medicine; Eegional and Applied Anatomy; Pathology; Obstetrics; Physiological Materia Medica and Drug Mechanics; Neurology; Dermatology; 298 Medical, Pharmaceutical and Dental Colleges Ophthalmology; Laryngology and Rhinology; Genito-TJrinary Diseases; Associate of Surgery; Associate of Gynaecology; Asso- ciate of Clinical Medicine; Paediatrics; Neuro-Histology and Mental Diseases; Clinical of Paediatrics; Emergencies; Pharma- codynamics and Pharmaceutics; Otology; Anaesthetics; Associate of Clinical Medicine; Lecturers on Medical Terminology; Em- bryology and Demonstrator of Physiology; Materia Medica and Institutes; Histology; Electro and Hydrotherapy. There are also thirty-eight instructors and demonstrators of the various branches taught. Not only didactic lectures are given, but the students are required to do practical laboratory and clinical work in the various branches of medical science, the large hospital and dispensary attached to the College rendering this possible. Almost from the first days of the institution it became the aim to establish a museum. The first entry regarding specimens is in 1850. In 1851 the museum already contained wax models, anatomical preparations and many anatomical and obstetrical plates, a cabinet of minerals, botanical specimens, philosophical instruments. During the summer of 1869 the summary of the collection was: thirteen human skeletons; 15 skeletons of inferior animals; 204 dried arterial, nervous, venous prepara- tions; 68 French elastic anatomical preparations; 12 models in wood; 23 papier mache pathological models; 124 wax anatomical preparations; 547 osteological specimens; 128 specimens of com- parative anatomy; 237 pathological and anatomical specimens in glass jars; 428 materia medica specimens; 1,000 mineralogieal specimens; 600 dried plants. Since that time much has been added. Of recent years it has been the aim to do away with use- less specimens and make the museum an adjunct to the teaching. There is not a branch taught that cannot be aptly illustrated by means of specimens from the museum in most cases actual wet or dry anatomical preparations. These marvelous anatomical prep- arations are the work of Dr. R. B. Weaver, long the curator. At the World's Fair at Chicago were exhibited various dissections of the human body, including eight dissections of the eye, showing the retina and optic nerve, and that unique specimen — the cere- brospinal nervous system of a human body, the only one in existence. This received a medal. There is also a series of preparations of the brain to illustrate the topographical surgery of that organ. This museum is open daily. FIRST HOMOEOPATHIC HOSPITAL IN 1 PENNSYLVANIA. CHESTNUT STREET. "'1 - Hahnemann Medical College and Hospital 299 The library was really commenced about 1866. It has been gradually enriched by donations of books, until at the present time it contains about 15,000 volumes and some 300 volumes of bound pamphlets. It contains nearly all the literature of homoeo- pathy, and also files of the standard medical journals and books of other systems. The anatomical library of Dr. A. E. Thomas, rich in old folios and rare tomes, fills a large glass case; Dr. Ber- ing's collection of books by and about Paracelsus fills another case, and is probably the most complete collection extant. The library contains a set of Hahnemann's writings in the original German, many being annotated and enriched volumes. It has a complete card catalogue. It is at present also used as a reading and study room for the students, and as the College office. With its clinical facilities, its well-equipped hospital and dis- pensary, and its strict educational requirements, Hahnemann Medical College and Hospital takes rank to-day with the best institutions of the land. Since the opening of the College, in 1848, the total number of graduates is 2,936. THE HOSPITAL The first Hospital in the United States devoted to homoeo- pathy, and no doubt having connection with the newly organized homoeopathic college, was opened in 1852. Its charter was ob- tained April 20, 1850. A large four story building on the south- east corner of Twenty-fourth and Chestnut Streets, was rented, fitted up and opened with a capacity of from thirty to forty beds. This building is still standing, although as the street has been raised the building is much lower than in the old days. It had formerly been a hotel. In the fall of 1853 a fair was held in the Chinese Museum, at Ninth and Sansom Streets, for its benefit, at which $2,800 was raised. The hospital was continued but two years, and the money in the treasury, with furniture and appli- ances, was afterwards given to the Soldiers' Homoeopathic Hos- pital. Dr. Hering tells us that Dr. Geo. Bute, his first student, who preceded him in coming to Philadelphia, had a cholera hospital in Cherry Street in 1832. Although Dr. William Channing made experiments in New York in the cholera epidemic of 1832, Dr. Bute's hospital is probably the first hospital in the United States 300 Medical, Pharmaceutical and Dental Colleges using homoeopathic treatment, the Chestnut Street hospital be- ing the second. The next homoeopathic hospital was that for sick and wounded soldiers. In June, 1862, rooms were fitted up in the two buildings on Cuthbert Street, in the rear of the college, by the management of the college aided by a Ladies' Association. A medical corps was appointed of fourteen physicians, seven surgeons, and a medical steward and the use of the hospital offered to the Government. This offer was refused. Only discharged soldiers were treated, about fifty in number. The hospital was not long kept open. From 1865 to 1866 the subject of a hospital was often discussed by the faculty of the college. In 1866 it was decided that the hospital be kept open and .that the matron be allowed to receive students to board, the faculty placing in it such patients as seemed proper. Later in 1866 it was rented for a student's boarding house. In October, 1866, meetings were held to devise plans for a hospi- tal. The division of the colleges occurring in 1867 nothing seems to have been done to establish a hospital until 1869, after the union of the colleges. In April, 1869, the hospital project was again dis- cussed ; preparations were made during the summer and fall. The Ladies' Homoeopathic Hospital Fair Association was organized; friends in neighboring towns became interested, and in November, 1869, a great fair was held in Horticultural Hall, opening on No- vember 17 and closing on November 30. From this fair the sum $17,000 was realized. It was the wish of many that this money be made the nucleus of a larger sum to be used in the erection of a large and complete institution to cost $100,000. But it was decided by the college authorities to invest the funds in the purchase of the college property and to build a hospital on the ground located on Cuthbert Street. Although this met with opposition from many who were instrumental in raising the money, yet it was done and the hospital formally opened for patients on January 9, 1871. But although a hospital in connection with the college was now in operation, it was thought by many of the profession that Philadel- phia should have a large general homoeopathic hospital independent of the college. It was advised by a committee on the subject that the college authorities turn over the grounds and buildings to a board of trustees to be elected by the whole profession of Philadel- phia, with the understanding that the new hospital building should be so constructed as to give the college clinical facilities. A charter was procured March 5, 1874, for the Homoeopathic Hospital of Hahnemann Medical College and Hospital 301 Pennsylvania at Philadelphia. There was opposition by the college authorities, but a compromise was afterwards made and the real estate held by the college was transferred to the hospital trustees. The relations between the trustees of the college and the trustees of the hospital were from 1874 to 1877 rather strained. In 1877, a great mass meeting was held and a committee appointed to report upon a plan for a hospital to represent the whole profession. In the next few years various fairs were held and the legislature petitioned. On May 1, 1883, there occurred a complete severance between the college and hospital authorities. The college took the college charter, the college property, the museum, library and fix- tures; the hospital authorities took the hospital property and the building. The newly elected college trustees appointed a committee to secure a lot for a new college and hospital buildings. This was procured on Broad Street as has been previously stated. At this time the old hospital was closed but its expenses being assured by the faculty, was reopened. In 1885, it was decided to again merge the hospital with the college. This merger was completed by a new charter and the new institution was consolidated under the present name: The Hahnemann Medical College and Hospital of Phila- delphia. The old hospital property was sold and became a nucleus for the new hospital endowment. In 1886, the Pennsylvania Homoeopathic Hospital for Children, located in West Philadelphia, was merged into the Hahnemann Hospital. It is to be remembered that the new college was built first and that the initial session was held in 1886-87. Some time in 1885 ground was broken for a building in the rear of the college. This is the building now used as a dispensary and known as Clinical Hall. It is situate on a line with and in rear of the college. It is built of brick, finished like the college, and is of three stories, with a very handsomely appointed clinical and surgical amphitheatre extending through two stories at the upper part of the building having a seating capacity of four hundred. The first of the hospital buildings was opened on October 3, 1887. It contained five wards and twenty-five beds, soon increased to thirty. Soon after the college removed from Filbert Street, the old Cuthbert Street Hospital was closed. One impor- tant factor in the organization and advancement of the new hospital project was the Women's Hospital Association of the Hahnemann Medical College of Philadelphia. This was organized January 26, 1886, and through its efforts, fairs, receptions, teas, garden parties, 302 Medical, Pharmaceutical and Dental Colleges and a great international carnival were held. Legislative appro- priations were also secured. In the meantime the new hospital was crowded for room and work was being rapidly advanced upon the main hospital buildings. As soon as this completed hospital was formally opened October 21, 1890, the dispensary which had previously been in the basement of the college, was removed to the building, formerly used as a hospital, intended for dispensary purposes. The hospital has been benefited by many handsome donations ; from 1890 to 1908 there have been 36 beds endowed. The hospital at present (1908) contains twenty wards with a capacity of 220 beds, besides forty-five rooms and wards for the treatment of private patients. All of the clinical work is conducted in one of the hospital buildings known as Clinical Hall, located directly in the rear of the college, each floor connecting by corridors with the general hospital. On the same day the hospital was opened a nurse school was organized and this has been in active operation ever since. The acceptable ages for admission are from 21 to 35 years. Applicants are received at any time, must be of good moral character, and of sound health. During the month of probation there are examina- tions in reading, penmanship, simple arithmetic and English dictation. If satisfactory, at the end of the probation, the applicant will be accepted as a pupil nurse and must sign an agreement to remain two years and obey the rules of the school and hospital. She must reside in the hospital and serve for the first year as assistant nurse in the wards. The second she must perform any duty either outside or inside to which she may be assigned. The period of study was extended to three years soon after the school was organized. Student nurses also receive pay of from $5 to $10 monthly for incidental personal expenses. From 1890 to 1908 there have been 162 nurses graduated. There is also a nurse directory with a registration of trained nurses. For some years after the opening of the hospital the need of maternity wards was felt. Although unable to obtain State aid, in 1897 a large four story house at 1713 Vine Street was rented with accommodations for twenty patients. It was opened in January, 1898. From, and even before, 1898, the hospital had need of more room. With the rooms given up to the nurse pupils, private V; j i/i: >'•' ii" ' i ■;/»/'* I (■I y. II Si I fc I SB- 1 k ; >v > ** l ~~: '» Hahnemann Medical College and Hospital 303 patients often could not be accommodated; the maternity house on Vine Street was also inadequate. In 1901, through a generous donation of land it became possible to erect three large buildings on the north of the hospital, on Fifteenth Street, extending through towards Broad Street. The first building is the Nurses' House; the second is the Women's Building, or Maternity Hospital and the third is the Power House. The Nurse's Home was the first building formally opened and dedicated and this occurred on April 24, 1906. This building is devoted to the nurse students and the resident nurses and contains usually from forty to sixty nurses. The Women's Building (the Maternity) was opened in 1908. The Power House was put into operation in the spring of 1907. This gave much additional room in the dispensary building, where the engines and fire appliances had formerly been located. The hospital has now a complete steam heating apparatus, electric lighting, a refrigerating plant, making the ice used in the hospital, and it is supplied with the most complete hygienic and sanitary appliances. THE DISPENSARY The dispensary was opened with the college. It was called the Dispensary of the Homoeopathic Medical College of Pennsylvania, in Philadelphia. Eighteen of the homoeopathic physicians of Philadelphia were appointed to serve consecutively. In 1851, a salary was given to the dispensary physician. The dispensary was located in the basement of the college on Filbert Street, and students were allowed to prescribe. In 1877, for a time, it was located on the third floor of the college. In 1886, when the college removed to its new home on Broad Street the dispensary was located at first in the basement of the college, the entrance being from the side door on the south, under the college steps. Here it remained until the new hospital was opened in 1890, when it was removed to its present building, the first building erected after the college, and the one first used as a hospital. This building is connected with the hospital. A very interesting chapter in the history of the dis- pensary is the account of the branch established at Johnstown, Pa., after the great flood in that place in 1889. This was of great usefulness in furnishing relief to the suffering people. It was continued from June until December, 1889. The patient who ascends the steps of Clinical Hall in search 304 Medical, Pharmaceutical and Dental Colleges of relief, first passes into a room on the left side of the entrance, which is filled with wooden benches, and waits his turn to approach the desk of the executive officer, who examines him and gives a card assigning him to one of the ten departments into which the dis- pensary is divided. These apartments are placed on either side of the corridor further along. The room of the pharmacist is on the same floor in a corner room fitted as a complete pharmacy and here the patient gets his medicine. Since the Power House was opened the basement of the dispensary is entirely devoted to patients. The departments are each governed by a chief and each has several assistants. All of these are physicians. The college has an alumni association. Several associations were formed from 1857 to 1871, but not until 1884 was a per- manent organization formed. This is still in active operation and has its meeting at the time of the commencement. The college has a student's society called The Hahnemannian Institute which meets regularly during the sessions, and confers a diploma. It also publishes a college paper. Beta Chapter of Alpha Sigma Fraternity was instituted in 1897. This fraternity has also a clubhouse. The Woman's Medical College of Pennsylvania 1 By CLARA MARSHALL, M.D. THIS, the first college in the world regularly organized for the education of women for the medical profession, was incor- porated March 11, 1850, under the title of the Female Medical College of Pennsylvania, afterward (1867) changed to the more specific title of the "Woman's Medical College of Pennsylvania. A few rooms were fitted up in the rear of 627 Arch Street, and on October 7, 1850, the institution was opened for the recep- tion of students. The first graduating class contained eight mem- bers, one of the number, Dr. Ann Preston, being soon after elected to the Professorship of Physiology and Hygiene in the College, and subsequently became Dean of the Faculty, both positions being held by her until her death, in 1872. Dr. Ann Preston may also be considered the founder of the Woman's Hospital of Phila- delphia. 2 The first annual announcement of the College makes note of clinics held at the College building, but neither the professors nor the students were long content with the meagre opportunities thus afforded, and the endeavor to obtain adequate clinical instruction constitutes one of the most significant chapters in the history of the College. An address introductory to the eleventh annual session, Octo- ber 17, 1860, contains the first official reference to the founding of the Woman's Hospital of Philadelphia, and the fourteenth annual announcement says : "A hospital for the treatment of dis- eases of women and children has been established under the auspices of this institution." On August 27, 1860, Dr. Emeline H. Cleveland, Professor of Anatomy, entered the School of Obstetrics in connection with La largely compiled from "Woman's Medical College of Pennsylvania, an Historical Outline," by Clara Marshall, M.D. Published by P. Blakis- ton Son & Co., Philadelphia, 1897. 2 So highly did the managers of the Woman's Hospital value the services of Dr. Ann Preston in its behalf that their annual report, published after her death, contains the following: "To her efforts more than to all other influences may be traced its very origin." 20 (305) 306 Medical, Pharmaceutical and Dental Colleges Maternite, Paris, where she prosecuted her studies with charac- teristic zeal and intelligence. At the close of her term of service, June 28, 1861, she received the diploma of the school, and with it five prizes (two of them first prizes) with honorable mention for "clinical observation." The charter of the Woman's Hospital of Philadelphia bears the date of March 22, 1861, and in the autumn of 1861 Dr. Cleve- land entered upon her duties as Eesident Physician. In 1862, she was transferred from the chair of Anatomy to that of Obstetrics, which she occupied with distinguished ability until her death in December, 1878. In connection with the establishment of the Woman's Hospi- tal of Philadelphia a mistake of vital interest to the College was made, viz. : the obtaining of a separate charter instead of amend- ing the charter of the College so as to keep the Hospital an integral part of the latter, at the same time providing for those peculiar features of its organization which exist to this day. Con- sequently, the Hospital, instead of becoming a lona fide depart- ment of the College, was legally a distinct and separate institution. At one time every chair in the College, with the exception of that of Chemistry, of which the occupant was not a physician, was represented on the staff of the Hospital, but gradually, what was. at best a moral bond, lost its force until in January, 1904, the faculty was without a single representative on the staff of the Woman's Hospital of Philadelphia. The College, then in the fifty-fourth year of its existence, was forced to establish a hospital of its own. A pavilion of twenty-one beds was erected, and, since a maternity of sixteen beds at Nos. 333-335 Washington Avenue was already in existence, the institution represented an adult bed capacity of thirty-seven. This Hospital was opened for the recep- tion of patients September 21, 1904. The permanent Hospital building is in course of erection, a part of it being at present occupied with a consequent total increase in bed capacity to forty-three. In the meantime other clinical opportunities were gradually being opened to our students. For the first time in the annals of Philadelphia a distinguished clinician, Alfred Stille, M.D., LL.D., on January 2, 1869, prefaced his lectures in the amphitheatre of the Philadelphia Hospital with the following words: "Ladies and Gentlemen: I have pleasure in meeting you to-day. It is the first time in my medical experi- Woman's Medical College of Pennsylvania 307 ence that I have had the opportunity of addressing women among the audience of my pupils. We are sometimes shocked at what is novel, simply because it gives us an unaccustomed impression, but in the present instance I must say that, so far as I am personally concerned, I not only have no objection to seeing ladies among a medical audience, but, on the other hand, I welcome them." November 6, 1869, was also a memorable day in the history of the College. Permission having been given by the managers of the Pennsylvania Hospital for attendance upon the clinical lec- tures of that institution, about thirty women students were pre- sent on that day. The conduct of the male students was such as to raise a storm of public indignation in Philadelphia and other cities, and, as a consequence, the subject of clinical instruction to "mixed" classes was discussed in extenso in the public press. But opposition to the attendance of women at the clinics of the Pennsylvania Hospital was not confined to students. A meet- ing was convened on the 15th instant at the University of Penn- sylvania to consider the subject of clinical instruction to mixed classes of male and female students of medicine, when a remon- strance was unanimously adopted and signed by the faculties of the University of Pennsylvania, of Jefferson Medical College, by the medical staffs of the various hospitals of Philadelphia, and by members of the profession at large. This was succeeded by a statement from the Faculty of the Woman's Medical College of Pennsylvania. At a meeting of the contributors of the Pennsylvania Hos- pital, May 29, 1871, the subject of the admission of women to the clinics was discussed, and the following action was taken by the Managers : — i"The contributors at their annual meeting in fifth month, 1870, having directed that appropriate, thorough clinical instruc- tion be given to the students of the Woman's Medical College of Pennsylvania, if practicable, at the Pennsylvania Hospital, and having, at the last annual meeting, given reiterated instructions to the same effect, "Resolved, That it is hereby made the duty of the Medical and Surgical Staff to carry into effect the instructions given by the contributors, as above mentioned, during their term of office." At the same meeting the following letter was read : — 308 Medical, Pharmaceutical and Dental Colleges «•..- -r -r. -r "1611 Chestnut Steeet. "Me. Jacob P. Jones. "Deae Friend : — Should a willingness to give surgical instruc- tion to female students be required as a condition of election on Monday, I desire that you will do me the favor to withdraw my name, as I should regret to do anything which would embarrass the Board in carrying out the wishes of the contributors. "Very truly your friend, "D. Hates Agnew." Immediately upon receiving this communication, the follow- ing resolutions were passed by the Board of Managers : — ""Wheeeas, A communication this day has been received from Dr. D. Hayes Agnew, declining to be considered a candidate for re-election if surgical instruction be given to female students, in accordance with the directions of the contributors at the last annual meeting; and, i "Wheeeas, The Board feels bound to carry out the instruc- tions of the contributors; therefore, "Resolved, That in accepting the declination of Dr. Agnew the Board desires to express their deep sense of his eminent abili- ties as a surgeon, as well as the faithful manner in which he has discharged the arduous duties devolving upon him while connected with the institution." "Women students attended the separate clinics provided for them at the Pennsylvania Hospital for a time, but gradually dis- satisfaction arose because of the inadequacy of the material pre- sented and the evident discrimination in favor of the male classes. Attendance upon clinics at the Philadelphia Hospital, which had been abandoned on the opening of the Pennsylvania Hospital, was therefore resumed. During the session of 1882-83, the students of the College were admitted to the regular weekly clinics at the Pennsylvania Hospital. It is interesting to note that Dr. Agnew, six years after his resignation, was invited by the Managers of the Pennsyl- vania Hospital to resume his place on the staff, that his letter of acceptance contains no reference to the vexed question of women students, and that he lectured to a mixed class during this second connection with the Hospital whenever women chose to attend his clinics. In the latter part of his life Dr. Agnew accepted invitations to consult with women physicians. In the meantime 310 Medical, Pharmaceutical and Dental Colleges in reference to the status of women physicians; and as a sub- scriber to the Reporter, and one personally interested in the bear- ing of that decision, I trust I may be permitted, through the same channel, to examine the arguments which support the resolution. "Although shrinking from all controversy and seeking the quiet path of duty, the time has come when fidelity to a great cause seems to demand that I should speak for myself and for the women with whom I am associated in this movement, and give a reason for the course we are pursuing. "The 'very grave objections to women taking on themselves the heavy duties and responsibilities of the profession' appear to be based, in the first place, on the assumption that they do not possess the 'ability to bear up under the bodily and mental strain to which they would be unceasingly subjected in this new voca- tion;' in the second, on the presumed incompatibility of profes- sional practice with the best home influence of the woman and the duties of the mother; in the third, on the collision and prac- tical difficulties that might arise if different members of the same family should employ two physicians — a man and a woman; and lastly, on the ground of the equivocal effect of medical consulta- tion upon the modesty and delicacy of feeling of those who may thus meet, and also on the fact that 'in no other country but our own is a body of women authorized to engage in the general prac- tice of medicine.' "In regard to the first difficulty, few words need be expended. Pausing merely to allude to the fact, that in barbarous communi- ties woman is pre-eminently the laborious drudge, and that in civilized society she is the nurse, keeping her unceasing vigils, not only by the cradle of infancy, but by every bed of sickness and suffering, with a power of sustained endurance that man does not even claim to possess; that her life is as long, and her power of surmounting its painful vicissitudes not inferior to his, we come to the open, undeniable fact, that women do practice medi- cine, that they are able 'to bear up under the bodily and mental strain' that this practice imposes, and that 'natural obstacles' have not obstructed their way. "There are in this city women who have been engaged in the practice of medicine a dozen years, who to-day have more vigor and power of endurance than they possessed in the beginning of their career; and the fact of 'their delicate organization and pre- Woman's Medical College of Pennsylvania 311 dominance of the nervous system, combined with their trained self-command/ is the very reason that in some cases their counsel has been preferred to that of the more robust man. "The second objection, bearing upon the home influence of woman, has certainly another side. "Probably more than half the women of this city and country are under the stern necessity of supporting themselves by their own exertions. Some mothers leave their young children day by day and go out to labor, in order to be able to bring them bread at night; others sew away their strength for the pittance which barely keeps famine from their doors, and, exhausted with their labors, they are indeed not in 'a fit frame of mind to interchange endearments with their beloved little ones;' nor can they, even with the price of life itself, surround them with the home influ- ences and comforts needful to their healthful and harmonious development. "If the woman who has studied medicine should be sur- rounded by a family of young children, we should surely regard it as a misfortune if the same overpowering necessity should com- pel her to follow an active practice during the period that these heavy maternal claims were pressing upon her; although even then, her duties would be less exhausting, and her time less con- tinuously occupied than is hers who supports her family by sewing or washing. "But, although the mother may not actively exercise her pro- fession, the knowledge of preventive medicine which she possesses will surely aid her in training her children in accordance with those hygienic rules which are now so sadly neglected in families, and will not detract from that pure, sweet 'home influence' which is the safeguard of the happiness and integrity of society. "We know of quite a number of medical women, who, in con- sequence of the remunerations of their practice, have been able to make themselves the centers of happy homes, which otherwise they could not have done; and some of these, in their thanksgiv- ings for the daily interests and enjoyments of their lives, count it among their deepest blessings that they have been enabled to pur- sue a course which so richly satisfies their womanly sympathies and affections, and which gives scope to their intellectual cravings and powers. "The third objection, in regard to collisions and Tieart-burn- 312 Medical, Pharmaceutical and Dental Colleges ings,' could scarcely apply to high-toned physicians who know what belongs to the proprieties of their position. The danger would seem to be equally imminent if the medical advisers were both of the same sex, and yet we all know that it is quite common in this city for more than one practitioner to attend the different members of the same family, one being preferred for his supposed skill in one class of cases, another for his superior reputation in another class; and we have yet to learn that injurious results follow this proximity of practitioners. ' "The natural tendency would seem to be to foster care and research; and if mutual observation of the results of treatment should occasionally suggest improved methods and break up old, sluggish routine in either party, the profession and the community will surely be gainers by this mutual stimulus. "The objection upon the ground of the invasion of delicacy in examining questions of disease and treatment is indeed an astonishing one, to come from a body of scientific and right- minded physicians. Who are the patients treated by these men? Often women — the sensitive and refined. The whole nature of the malady must be investigated and the means of recovery enforced. If, as frequently happens, to save the shrinking sensi- tiveness of the young woman, some tender experienced mother or elder friend informs the physician of the symptoms and conveys to the patient his conclusions, she, for the time, performs the part of the attending physician in reference to the consulting one; yet who will dare assert that her womanly modesty is comprom- ised, or that 'the delicate reserve with which a man is accustomed to address woman in the sickroom' is injuriously affected by this necessary and humane intervention? "Among the motives which have contributed to the support of this movement, that of shielding the sensibilities of shrinking women has not been the least. "Men opposed to the medical education of women have, in some cases, changed their views when the subject has been brought home to their feelings in the person of some beloved member of their own families, and they have appreciated the mental suffer- ing which the dread of medical investigation has caused. Phy- sicians, too— the father, husband, and brother — have asked our counsel in the cases of those dearest to them; and they have asked it because we are women, and as such, they believed we might Woman's Medical College of Pennsylvania 313 elicit the cause of suffering, and apply the means of relief, as they had not been successful in doing. "But leaving these special points, there are broad, general grounds upon which, as physician and as women, we stand, and appeal from the resolutions of the Philadelphia County Society to the better judgment of true-hearted professional men. "When once it is admitted that women have souls, and that they are accountable to God for the uses of the powers which he has given them, then the exercise of their own judgment and con- science in reference to these uses becomes a thing which they can- not, rightfully, yield to any human tribunal. "As responsible beings, who must abide by the consequences of our course for time and for eternity, we have decided for our- selves that the study and practice of medicine are proper, womanly and adapted to our mental, moral and physical constitution. "We shall scarcely be charged with presumption in supposing that our instincts may be as pure, our intuitions as clear, our sense of what is right and fitting for ourselves as reliable, as are those of the men who condemn our course. "We are sustained by the approval and sympathy of the best men and women, by the moral sentiment of the general com- munity. We feel, and society feels, that we are not usurping the place of men, but taking a position in the broad field of medicine which appropriately belongs to women; and that we shall enlarge the sphere of professional usefulness, and contribute to the knowledge which shall bless the race. "The names of those who support our hospital and college are largely the names of those of whom Philadelphia is justly proud, as representatives of her intelligence, respectability and moral worth. "That we have not had the facilities for acquiring medical information is a charge that, it seems to us, should hardly come from those who have systematically closed hospitals and colleges against our applications for admission, and who have endeavored to prevent the members of their fraternity from assisting in our struggles for knowledge. "That we have stemmed this tide of opposition, and found opportunities for obtaining medical instruction — some in other cities and across the ocean, some by persevering and long-con- tinued efforts in various .ways at home — that we have found noble 314 Medical, Pharmaceutical and Dental Colleges men in the profession to assist us, and that we have been able to found hospitals and open various channels for practical educa- tion, is due to the inherent vitality of our cause, and its strong hold upon the sympathies and convictions of the community. "That we have not yet all the facilities for instruction that are needed, we are fully aware. "That 'there are female graduates who are a disgrace to the medical profession/ we also know too well; for the sake of humanity we would that we could truly add that the graduates who disgrace the profession are found only among women! "From the nature of the relation of physicians to society, not more than one man in hundreds follows medicine as a profession, and the proportion of women, under the most favoring circum- stances, will probably not be greater; but the systematic training and the knowledge of physiological functions and hygienic condi- tions involved in a thorough medical education for the few, will, we believe, be reflected in many homes, and be one of the means of radically changing that mistaken plan of education, and those destructive social customs and habits, which are now undermining the health and darkening the lives of so many women of this country. "If it be true that 'in no other country but our own is a body of women authorized to engage in the general practice of medicine/ the fact is no more an argument against its propriety than is the fact that in no other country are the rights of the people so acknowledged and secured, an argument against the propriety of republican institutions. "We regard this movement as belonging to the advancing civilization of the age, as the inevitable result of that progressive spirit which is unfolding human capabilities in many directions, and which has perceived that, it is the condition of the highest health and happiness for woman, that she, also, should exercise the powers with which she has been endowed in accordance with her own convictions and feelings, and in harmony with her nature and organization. "That our position is womanly; that this work is established in the fitness of things and in the necessities of society, and that the movement belongs to the 'revolutions which never go back- ward/ we have no shadow of doubt. "For us it is the post of restful duty — the place assigned to Woman's Medical College of Pennsylvania 315 us, as we believe, in the order of Providence, and we can do no other than maintain it. •'But, on behalf of a little band of true-hearted young women who are just entering the profession, and from those whose path- way we fain would see annoyance and impediments removed, we must protest, in the sacred name of our common humanity, against the injustice which places difficulties in our way, not because we are ignorant or pretentious, or incompetent, or unmindful of the code of medical or Christian ethics, but because we are women. "Truly yours, "Ann Peeston, M.D. "Philadelphia, April 22, 1867/' Space does not permit of giving the successive steps by which our alumnae gained professional recognition in Philadelphia and elsewhere. Suffice it to say that in October, 1881, women were by resolution voted to be eligible to membership to the Philadelphia County Medical Society. Nevertheless, none of the women candidates whose names were presented from time to time was elected. After a truce of four years, during which time no name had been presented, the women physicians themselves entered into an active canvass resulting in the election of their candidate, since which time, as far as known to the writer, no women candidates have been defeated. Soon after the opening of the Woman's Hospital of Philadel- phia, in 1861, the College moved to North College Avenue, where rooms were rented from the Woman's Hospital, which rooms were occupied until, in 1875, it was removed into the present com- modious building — the first in the world erected expressly for the education of women in medicine. 1881: Three years' attendance upon a graded course of instruction during both the Winter and Spring Terms was made obligatory in October of this year. 1887: Entrance examinations were established. 1888 : The opportunities at the Woman's Hospital were sup- plemented by the establishment of an out-obstetric department of the College, by the Professor of Obstetrics, Dr. Anna B. Broomall. This department became a valuable teaching adjunct, and the work was still further increased in 1903 by the establish- ment of a Maternity Hospital at 335 Washington Avenue. The 316 Medical, Pharmaceutical and Dental Colleges gift of an additional house adjoining has added to the efficiency of this department of the College. At present every candidate for graduation must have taken charge of at least ten obstetric cases at their homes before she can receive her degree. 1893: A four years' course, hitherto optional, was made obligatory for all students. 1895 : A dispensary in the interest of the poor and to furnish opportunities to the students and graduates of the Woman's Med- ical College of Pennsylvania was opened at No. 1212 South Third Street. It is known as the Amy S. Barton Dispensary, in honor of its founder. In order to appreciate the present status of the College Hos- pital (which consists of a main department adjoining the College, a Maternity Hospital on Washington Avenue and the Barton Dis- pensary at 1207 South Third Street) it is in place to give the general summary of all departments, from June 1, 1907, to June 1,1908:— Total number of in-patients 733 " free patients 537 " " " part-pay patients 144 « " « full-pay patients 52 " bed days 13,306 " " " out-patients 5,246 " " visits from out-patients.... 25,469 " prescriptions compounded.. 11,600 " births 498 " operations performed 759 " visits to patients at their homes 4,893 Pifty-seven years of experience in the practice of medicine by the alumnas of the College, representing forty-three States and Territories and twenty-four foreign countries, have proved the wisdom of its founders in recognizing and seeking to meet the demand of the public for a body of educated women physicians. It is to be remembered in this connection that no branch of medi- cine requires a higher degree of self-possession and promptness in the selection and application of scientific methods than modern obstetrical practice, nor does any department of surgery present graver difficulties than the operations included in the practice of gynaecology. Woman s Medical College of Pennsylvania 317 FACULTY Hannah T. Croasdale, M.D., Emeritus Professor of Gyne- cology; Anna E. Broomall, M.D., Emeritus Professor of Obstet- rics; Clara Marshall, M.D., Emeritus Professor of Materia Medica and Therapeutics; Henry Leffmann, M.D., Professor of Chemis- try, Toxicology and Hygiene ; Frederick P. Henry, M.D., Professor of the Principles and Practice of Medicine and Clinical Medicine; Arthur A. Stevens, M.D., Professor of Materia Medica, Thera- peutics and Clinical Medicine; Adelaide Ward Peckham, M.D., Professor of Bacteriology; Ella B. Everitt, M.D., Professor of Gynaecology ; Euth Webster Lathrop, M.D., Professor of Physiology ; Henry Morris, M.D., Professor of Anatomy; Alice Weld Tallant, M.D., Professor of Obstetrics; Aloysius 0. J. Kelly, M.D., Pro- fessor of Pathology; Harry C. Deaver, M.D., Professor of the Principles and Practice of Surgery and Clinical Surgery. Auxiliary Instructors. Emma E. Musson, M.D., Clinical Professor of Otology; James K. Young, M.D., Clinical Professor of Orthopaedic Surgery; Ed- ward Martin, M.D., Clinical Professor of Surgery; Charles P. Noble, M.D., Clinical Professor of Gynaecology; Henry F. Page, M.D., Clinical Professor of Medicine; Henry R. Wharton, M.D., Clinical Professor of Surgery; William G. Spiller, M.D., Clinical Professor of Neurology; Frances C. Van Gasken, M.D., Clinical Professor of Medicine and Instructor in Physical Diagnosis; J. Norman Henry, M.D., Clinical Professor of Medicine; Margaret F. Butler, M.D., Clinical Professor of Laryngology and Rhinology; Charles A. Oliver, M.D., Clinical Professor of Ophthalmology; B. Franklin Stahl, M.D., Clinical Professor of Medicine; Milton B. Hartzell, M.D., Clinical Professor of Dermatology; Theodore Le Boutillier, M.D., Clinical Professor of Pediatrics; Martha Tracy, M.D., Associate Professor of Chemistry and Director of the Lab- oratory of Chemistry; Daniel Joseph McCarthy, M.D., Lecturer on Medical Jurisprudence; Harriet L. Hartley, M.D., Lecturer on Surgery; Annie Bartram Hall, M.D., Associate in Physiology; Herbert H. Cushing, M.D., Director of the Laboratories of His- tology and Embryology; Katharine J. Musson, P.D., Director of the Laboratory of Pharmacy; Foster K. Collins, M.D., Demon- strator of Surgery; Harriet I. Noble, M.D., Demonstrator of 318 Medical, Pharmaceutical and Dental Colleges Anatomy, Curator of the Department of Anatomy and Prosector; F. Mortimer Cleveland, M.D., Demonstrator of Histology and Embryology; Charlotte B. Mitchell, M.D., Norman B. Gwyn, M.D., Demonstrators of Pathology; Florence E. Kraker, M.D., Demonstrator of Obstetrics; Ellen Culver Potter, M.D., Demon- strator of Gynaecology and Instructor in Practice of Medicine; Charlotte B. Mitchell, M.D., Instructor in Clinical Gynaecology; Edith Tiedemann Waldie, M.D., Sarah Mae Lichtenwalner, M.D., Mary Fry Shedwick, M.D., Helen Jean Cowie, M.D., Assistant Demonstrators of Anatomy; Sarah Mae Lichtenwalner, M.D., Assistant Demonstrator of Histology and Embrj^ology ; Mary Louise Dixon Bickings, M.D., Assistant Demonstrator of Surgery; Blanca H. Hillman, M.D., Assistant Demonstrator of Gynaecology; Mary V. Madigan, Assistant Demonstrator of Physiology; Char- lotte Fairbanks, M.D., Instructor in Materia Medica and Thera- peutics; Mary G. Haskins, M.D., Instructor in Gynaecology; Laura M. Preble, Assistant in Laboratory of Chemistry; Berta Whaland, P.O., Assistant in Laboratory of Pharmacy; Adele E. Sheplar, Elizabeth E. Clark, Student-Assistants in Laboratory of Physiology; Charlotte B. Mitchell, M.D., Curator of the Museum; Henrietta Neuburger, Clerk and Librarian. Dean. — Clara Marshall, M.D. Secretary to the Dean. — Amie W. Bosworth, at the College Building, Twenty-first Street and North College Avenue. The Medico-Chirurgical College and Hospital 1 By T. H. WEISENBURG, M.D. NO more remarkable example of progress and growth in the history of medical teaching institutions can be found than in the career of the Medico-Chirurgical College. When it is con- sidered that this institution will graduate its twenty-seventh class in June, 1909, and that it now averages 700 students and a teaching force of 143, its achievements can only be partially appreciated. It is perhaps the only true medical university in this country embodying, as it does, the departments of Medicine, Dentistry, Pharmacy and Pharmaceutical Chemistry. The opening address of the first regular session of the college was delivered April 4, 1881, by Geo. Powell Oliver, the founder of the college who, in defining the policies of the school, announced: "It is the intention of the faculty to use every means that can be made available to advance students and to render them proficient in the duties of their profession. We deprecate the system of cram- ming now in use in many of the medical colleges in various parts of the country, crowding into two winter sessions the entire medical tuition of the student. Owing to the shortness of time, sufficient instruction cannot be given and the student fails to complete his medical education properly. With a view of elevating the standard of medical education, our college has adopted a curriculum embrac- ing a full three years' graded course. By this action we believe we will assist in placing some safeguards around society that are being sadly neglected by many medical colleges in America." It is interesting to note that from its very incipiency the Medico-Chirurgical College stood for higher education, closer con- tact with the student and an increased graded course of study, it being the first medical school in Philadelphia to establish a three- year graded course. It is only fitting, therefore, that this insti- tution should have been the first medical school in Philadelphia to establish a five-year graded course in 1907. ■I am indebted to Dr. Charles A. Oliver for many details. Liberal use has been made of the previous history of the College written by Dr. James M. Anders. (319) 320 Medical, Pharmaceutical and Dental Colleges What more encouraging and inspiring sentiments can animate an institution than those contained in the closing words of the first address of its founder : "To both young and old, in our profession, who are being satisfied with the laurels already gained in former days, we desire to say, Fall in line and march to the front; assist your brethren to break down the formidable barricades that have been erected by unscrupulous men, who have almost run their course, but who are still attempting to control the destiny of our profession. To our friends who have honored us with their presence to-day, we tender the thanks of grateful hearts. We feel that our success will not depend upon ourselves alone; much will be due to the encouragement we receive from those who are in full sympathy with us. Give our college and our sister colleges, who are engaged in this noble work, your aid and counsel, and the great object will, in a short time, be effected. We know we will have a severe struggle at first, but we are determined to hold on, even though we have to fight the battle alone. Other colleges may falter, as one in New York already has, but with the full assurance that we are doing right we intend, with the assistance of Divine Providence, to per- severe manfully until victory shall crown our efforts." How satis- fying it would have been to the founders of this institution had they lived to contemplate the progress and dignified position among medical colleges which, in the 28th year of its existence, this institu- tion has attained ! George Powell Oliver, the founder of the Medico-Chirurgical College, was a Philadelphian, born in 1824, the son of Major W. G. Oliver of the 42d U. S. Infantry, who served in the War of 1812. After receiving an education in the academies of the city, he began to study medicine with Dr. J. P. Bethell in 1812. After one year at the Medical Department of Pennsylvania College (1847-8), he entered the Philadelphia College of Medicine in 1850, and graduated in 1851. In 1854, he became a resident at the Philadelphia Hospital and afterwards chairman of its clinical committee. In 1859, he attended a course of lectures in the Medical Department of the University, and received his degree from that institution, after which he spent the following year, 1860, in pursuing his studies in Europe. He had already, in 1851, begun practice, which was interrupted by a brief residence in Cincinnati, where he served as city physician. In 1861, he was made assistant surgeon of the 98th Volunteers, but the following year was made post-surgeon of the Medico-Chirurgical College and Hospital 321 llth Volunteers, and served for three years. He was twice wounded and once taken a prisoner, and had an excellent record as an army surgeon. On his return he resumed practice, but in 1878 removed, first to New York and then to Brooklyn, returning in 1880 to his native city. Although it was not until after Dr. Oliver's return to Phila- delphia in 1880 that the Medico-Chirurgical College as a medical institution began its career, the original charter of the college was obtained by him and some of his associates, on April 10, 1867, when an amendatory act was secured, according to a previous reso- lution of the Medico-Chirurgical Society, providing that "George P. Oliver, Charles M. Griffith, Edward Donnelly, H. St. Clair Ash and George H. Cooke, Doctors of Medicine, and members of the said college, with their associates, are hereby empowered to meet on the first Saturday in May, one thousand eight hundred and sixty-seven, at four o'clock in the afternoon, in the city of Philadelphia, and elect such officers and professors for said college as may be necessary for the proper dissemination of medical knowledge in all its various branches," and that "the said officers and professors, by this act, shall have conferred upon them all the rights, immunities and privileges, as to lecturing, granting diplomas, and conferring degrees in medicine, as are possessed by the officers and professors of the University of Pennsylvania at this time." The original Medico-Chirurgical Society, or College as it was first known, had its origin as a society, whose plans and purposes were intended to be somewhat similar to those of the College of Physicians of Philadelphia, on the thirteenth of May, 1848, when there met at the house of Dr. James Bryan, at the northeast cor- ner of Arch and Tenth Streets, Drs. Bryan, Levi Curtis, Thomas N. Flint, Zebedee E. Jones, John T. Nicholas, Henry Y. Smith, William P. White and Allen Ward, the first members. Others were soon added during the succeeding months so that by the close of 1848 there were fifty-three members. In February, 1849, a per- manent constitution was adopted with the title of the Medico-Chi- rurgical College, declaring that "Its object shall be the dessemina- tion of medical knowledge, the defense of the rights and preservation of the repute and dignity of the medical profession." It had senior, junior and honorary members, the only condition of senior member- ship being a degree from some reputable school and a reputable standing. 21 322 Medical, Pharmaceutical and Dental Colleges There were twelve sections: Anatomy, Surgery, Obstetrics, Practice, Materia Medica, Chemistry, Physiology, Medical Juris- prudence, Public Hygiene, Diseases of Women and Children, Pharmacy and Pathology, all members joining some section or sections, the regular meetings being held on Saturday evenings excepting in midsummer. The first officers elected were Dr. James Bryan, President; Charles M. Griffith and John Dawson, Vice- Presidents; H. S. Porter, Senior Recording Secretary ; L. Gebhard, Junior Recording Secretary; Henry Y. Smith, Corresponding Secretary; William Gardiner, Treasurer; A. H. Todd and William Bryan, Curators; James Bryan, Orator; E. Foster, Alternate, and T. Dunn English, Counselor. A year later, on February 12, 1850, the society was incorpo- rated with ninety-four members, with power to "grant diplomas of fellowship, honorary membership, senior membership, and junior membership, but this grant shall not be construed into the grant of any power to confer the degree of Bachelor of Medicine or Doctor of Medicine." It was not until September 23, 1848, some months after the formation of the society, that Dr. George P. Oliver became a member. He was, however, one of the original incorporators of the society. It is interesting to note that the American Medical Association was founded in Baltimore on May 2, 1848, a few days before the foundation of the Medico-Chirurgical College, and that the first representatives to be sent to its annual meeting were Drs. Henry Wadsworth and Samuel Walsh, who attended as delegates at the fifth annual meeting in 1852, held at Eichmond. From this time on (1850) the society did not have a very vig- orous existence until after the close of the War, when it occurred to Dr. Oliver and a few associates, members of the old society, that they could, by securing changes in the charter, completely transform the organization of the old society into a regular medical college, which was done as has been detailed, on April 10, 1867. The first faculty was composed of Drs. George P. Oliver, J. A. Meigs, J. Solis Cohen, Edward Donnelly, D. D. Eichardson, D. D. Clark, and Samuel Walsh. For various reasons this faculty gradu- ally dissolved and nothing further was done until 1881, when Dr. Oliver, who still had the charter, began for the second time the foundation of what is now the Medico-Chirurgical College. The reorganization took place at the home of Dr. G. E. Stubbs, on the Medico-Chirurgical College and Hospital 323 northeast corner of Seventeenth and Jefferson Streets in October, 1880. Drs. George P. Oliver, G. E. Stubbs, and G. B. H. Swayze were appointed a committee to secure a building, and they succeeded in obtaining the upper story of the bank building on the southwest corner of Broad and Market Streets opposite the Pennsylvania Sta- tion. On April 4, 1881, after arrangements had been made for the embryo hospital, dispensary, and college. Dr. Oliver delivered the opening address. The faculty for the spring session consisted of Drs. Oliver, Practice; H. E. Goodman, Surgery; G. B. H. Swayze, Obstetrics; G. E. Stubbs, Anatomy; W. P. Waugh, Materia Med- ica; A. S. Gerhard, Physiology and Medical Jurisprudence, and C. L. Mitchell, Chemistry; S. B. H. Swayze, Dean. By the opening of the first regular fall session, changes were made in the faculty which then consisted of Drs. George P. Oliver, President; Charles L. Mitchell, Secretary; George E. Stubbs, Treasurer; Drs. George P. Oliver, Principles and Practice of Surgery and Clinical Surgery; Hugo Engel, Principles and Practice of Medicine and Clinical Med- icine; Charles L. Mitchell, Chemistry, Sanitary Science, and Ven- ereal Diseases; William F. Waugh, Materia Medica, Therapeutics, Pharmacy, and Clinical Medicine ; Abraham S. Gerhard, Physiology and Medical Jurisprudence; William S. Stewart, Obstetrics and Gynaecology and Clinical Gynaecology; T. Elwood Conard, Demon- strator of Chemistry and Lecturer on Urinary Analysis; Alonzo Boice, Clinical Professor of Oral Surgery and Diseases of the Mouth. Adjunct Faculty : Frank 0. Nagle, Demonstrator of Anatomy ; G. Betton Massey, Clinical Professor of Diseases of the Mind and Nervous System and Electro Therapeutics; Frederick Loos, Jr., Demonstrator of Pharmacy; Isaac Barton, Clinical Professor of Diseases of the Throat and Nasal Passages. Dean, H. Earnest Goodman. It was the intention of the college that the spring or auxiliary term should begin on April 14, 1881, and continue for three months, and the winter session on September 12th and continue for six months. In the announcement of the second session of 1882 and '83 there was an autumn preliminary term beginning September 4, 1882, lasting four weeks; the winter session commencing October 2d, lasting six months, and the auxiliary literary term commencing on April 16, 1883, and closing June 11th. The spring term was de- signed for students whose qualifications were not sufficient to enable them to fully comprehend the teaching of the winter sessions. 324 Medical, Pharmaceutical and Dental Colleges During the spring session instruction was given in natural phi- losophy, botany, physical geography, mental philosopy, principles of English and composition, elements of the Greek and Latin languages, mathematics, comparative anatomy, zoology, miner- alogy, and geology. Considerable change was made in the second faculty (1882-3) which consisted of : — Drs. George P. Oliver, President, Principles and Practice of Surgery and Clinical Surgery ; George E. Stubbs, Treasurer, Anat- omy and Clinical Surgery; Charles L. Mitchell, Chemistry and Sanitary Science; William P. Waugh, Secretary, Principles and Practice of Medicine and Clinical Medicine ; Abraham S. Gerhard, Physiology and Medical Jurisprudence; William S. Stewart, Obstet- rics, Gynaecology, and Clinical Gynaecology; Prank 0. Nagle, Ma- teria Medica, Therapeutics and Clinical Medicine. Dean, William S. Stewart. Adjunct Faculty : G. Betton Massey, Clinical Professor of Dis- eases of the Mind and Nervous System, and Electro-Therapeutics; Isaac Barton, Clinical Professor of Diseases of the Throat and Nasal Passages; John K. Foulkrod, Demonstrator of Surgery; P. le Sieure Weir, Clinical Professor of Dermatology ; G. Maxwell Chris- tine, Assistant Professor of Materia Medica and Demonstrator of Pharmacy ; William H. Ireland, Assistant Professor of Practice of Medicine and Lecturer on Physical Diagnosis; Arthur G. Allan, Clinical Professor of Otology; T. Wallace Simon, Professor of Pathological Histology ; Samuel J. Liggett, Demonstrator of Chem- istry and Chief of the Medical Dispensary; E. Stanley Perkins, Demonstrator of Anatomy ; W. A. Chandler, Assistant Professor of Chemistry, and Charles E. Pike, Clinical Professor of Oral Sur- gery and Diseases of the Mouth. The first annual Commencement of the Medico-Chirurgical Col- lege was held in Association Hall, Fifteenth and Chestnut Streets, on Tuesday, March 14, 1882, at 12 o'clock, the graduates being Parmenas Appleman, Thomas H. Hicks, and Leolf Eeese. The valedictory address was delivered by Dr. William F. Waugh, Professor of Materia Medica, Therapeutics, Pharmacy, and Clinical Medicine. While these gentlemen were the first grad- uates of the Medico-Chirurgical College, they entered the institu- tion as senior students, and although Parmenas Appleman has the distinction of being the first graduate, it was not until Medico-Chirurgical College and Hospital 325 1884 that the first regular three-year students of the institution graduated. In the announcement of 1883-4 there were again several changes in the faculty: Charles L. Mitchell was made Secretary, and T. W. Simon and S. J. Liggett were dropped from the faculty, and T. M. Chance was appointed Instructor in Minor Surgery. In the second annual Commencement, held on March 29, 1883, at 8 p.m., the degree of Doctor of Medicine was conferred upon the following gentlemen by the President, Dr. George P. Oliver : E. F. Burnside, E. V. Danne, Henry Fisher, B. M. Goldberg, Bmil M. Herwig, Frederick Loos, Jr.; Julian F. Meade, Joseph W. Seed, John A. Eeese, and David Wear. On February 20, 1884, Dr. Oliver passed away in his sixtieth year. From its incipiency he had been the life of the college, and although he conducted its affairs only for about three years, it is unquestionably due to his energetic, persevering, and indomitable spirit that it was possible for the Medico-Chirurgical College to have existed. He was, besides, a charter member of the Methodist Epis- copal Hospital, and in 1881 received the degree of Master of Arts from Westminster College. He also held honorary degrees from several other institutions. "As a teacher," says Dr. Stubbs, "lie was impressive, clear, and particular, insisting upon the student's fixing the facts and principles advanced, firmly in his mind. Professor Oliver was a warm-hearted, sympathetic physician, to whom the poor patient could look ever for help and counsel in time of trouble." The third graduating class consisted of four men, and was really the first class to graduate in which the students took the regu- lation three-year course, and therefore Edward F. Menger has the honor of being the first regular graduate of the Medico-Chirurgical College. It is interesting to note that during the first year of its existence there were thirty-one students in attendance, during the second twenty-seven, and during the third only twenty-four. Dr. Henry Earnest Goodman, also one of the founders of the institution, was elected to the chair of Surgery, succeeding Dr. Oliver. His career is of extreme interest as showing the type of men who composed the original faculty. Dr. Goodman was of Ger- man descent, and a grandson of an officer of the American Eevolu- tion. He was born in Speedwell, near Philadelphia, in 1836, and was graduated from the University Medical School in 1859, in the 326 Medical, Pharmaceutical and Dental Colleges same class with Dr. Oliver and with him was a resident in the Phil- adelphia Hospital. Later, he became a resident in Wills Hospital, becoming interested in the speciality to which he devoted the greater part of his time in after life. He was also one of the surgeons of the Orthopaedic Hospital, and held many public positions. Thus, for six years, he served as port physician. "In 1885," says Dr. An- ders in a memoir before the College of Physicians, "he was made Professor of Surgery at the Medico-Chirurgical College, a position he filled most worthily and acceptably for six years. His lectures were noteworthy for their perspicuity, as well as for the safety and soundness of their substance. As a teacher he was concise, yet ex- pressed fully the truths he wished to impart, while his sympathetic nature and warmth of manner quickly led to the establishment of pleasant personal relations between himself and his students." He was a member of various leading societies and rendered eminent service in the civil war, acting as surgeon to the Twenty-eighth Pennsylvania Infantry from 1861 to 1864, becoming medical direc- tor of the Army of Georgia, with the rank of colonel. Dr. Goodman lived to the age of sixty, his death occurring on February 3, 1896. In 1885, Drs. William H. Pancoast, John V. Shoemaker, and E. E. Montgomery entered the faculty and Board of Trustees. The entrance of these men combined with the consolidation with the Philadelphia Dental College and the Philadelphia School of Anat- omy, to be discussed later, formed a new era, and it was from this time that the Medico-Chirurgical College entered upon its present career of progress. William H. Pancoast, A.M., M.D., came from the Jefferson Medical College, where he had been Professor of Anat- omy for eleven years. He was a native of Philadelphia, born in 1835, and educated in Haverford College, receiving his diploma in 1853. He studied medicine under his distinguished father, Joseph Pancoast, and was graduated from Jefferson Medical College in 1856. He spent three years in the hospitals and medical institu- tions of Europe, and, in 1862, returned to Philadelphia and became Demonstrator of Anatomy in the Jefferson Medical College. In 1885, he resigned from Jefferson to accept the chair of Anatomy in the Medico-Chirurgical College, and at once became one of the greatest powers in the new development of the school, and soon was made president of its Board of Trustees. "Dr. Pancoast," says one of his biographers, "was a man of striking personality, of courtly manner, and was greatly beloved by his students and friends. As a o a K H * J « Z 5 s g H 5 & 2 o Medico-Chirurgical College and Hospital 327 lecturer on anatomy he was pre-eminent, and as an operator he was equally successful." During the Civil War he was surgeon-in-chief and second in command at one of the military hospitals. He was surgeon to the Philadelphia Hospital for many years, and was prominent in nearly all the leading medical societies of Philadel- phia. He was especially active in the county, State, and national societies, and was vice-president of the American Medical Associa- tion in 1884, and delegate to various international congresses. Dr. Pancoast died in January, 1897, having lived long enough to wit- ness the remarkable development of the school of which he was so great a promoter. Dr. John V. Shoemaker, before his entrance into the Medico- Chirurgical faculty, lectured for several years on diseases of the skin in the post-graduate course of the Jefferson Medical College, and was elected Professor of Dermatology in 1889, and later, of Materia Medica and Therapeutics. The Philadelphia Hospital for Skin Diseases, under his charge, with all its appurtenances, was transferred to the new location on Cherry Street. Dr. Shoemaker still occupies these positions. It is difficult, in contemplating the career of this remarkable man, to do him adequate justice for the work he has performed for the Medico-Chirurgical College and Hos- pital. For twenty-four years he has labored for it, not because he felt that, as a member of its faculty, it was his duty to do so, but because for him there is only one institution, one hospital and one love — the Medico-Chirurgical College. E. E. Montgomery, the third member who entered the faculty and Board of Trustees of the College in 1885, was elected Professor of Gynecology, a special chair being created for him. He occupied this position until 1892, when he returned to the Jefferson Medical College. The combined energy of these three men: William H. Pan- coast, John V. Shoemaker, and E. E. Montgomery, did much to reorganize the faculty and Board of Trustees in 1886. About this time forces were joined with the Philadelphia Dental College and the Philadelphia School of Anatomy, and more commodious and appropriate buildings were procured for the use of both institutions. The site selected was the north side of Cherry Street below Eigh- teenth, the present location of the institution. The affiliation with these institutions served to bring into the faculty a forcible personality, James E. Garretson, who was long 328 Medical, Pharmaceutical and Dental Colleges associated with D. Hayes Agnew in the School of Anatomy. Dr. Garretson was born October, 1828, in Wilmington, Del., and during his youth became interested in dentistry, graduating from the Phil- adelphia Dental College in 1857. Eealizing the medical relations of dentistry, he also graduated in medicine from the University of Pennsylvania in 1859. It was then that Dr. Agnew secured him as an associate in the School of Anatomy, of which he assumed sole charge on the formers withdrawal to the University. Dr. Garret- son then made a specialty of surgery of the mouth and neighboring parts, soon becoming widely known as an "oral surgeon." In 1869 he was elected to the chair of Oral Surgery in the University, and nine years later was chosen Professor of Anatomy and Surgery in the Philadelphia Dental College, of which he became Dean in 1881. To Dr. Garretson must be given the credit of founding the present hospital of the Medico-Chirurgical College. He died on October 26, 1895. The affiliation of the three institutions continued uninterrupt- edly until 1895, when it was decided to dissolve the previous rela- tion, this taking effect in the season of 1896-7, when, at the latter date, both the Philadelphia Dental College and the Philadelphia School of Anatomy removed to their present site at the southwest corner of Eighteenth and Buttonwood Streets, the Medico-Chirur- gical College then assuming ownership of the entire property pre- viously held by the three institutions. It was not until 1887 that the removal to the new quarters of the college on Cherry Street was accomplished. The building had previously been known as the Home for Aged and Indigent Women, and was altered to meet the requirements of a modern hospital building. At the same time sufficient adjacent property was pur- chased to erect thereon a eollege building containing three spacious lecture halls or amphitheatres, this being completed in 1888. The upper floor of the south side of this structure was furnished as a dissecting room with every needed appliance. This was leased by the Philadelphia School of Anatomy with the distinct proviso that the students of the Medico-Chirurgical College and of the Phila- delphia Dental College be privileged to dissect therein under certain terms and requirements. It may be mentioned here that imme- diately after the separation of the Medico-Chirurgical and the Phil- adelphia Dental Colleges, their dissecting room reverted to the former institution. Within the ample confines of the college and EXTERIOR OF CLINICAL AMPHITHEATRE. Medico-Chirurgical College. Medico-Chirurgical College and Hospital 329 hospital, adequate space was found for the histological, pathological, bacteriological, and chemical laboratories, all of which were at once properly equipped. It was soon discovered that for reason of lack of accommoda- tions it would be necessary to enlarge the hospital building, and to this end, in 1890, it was determined to reconstruct the hospital on a larger scale. As a result the original hospital was replaced by an extensive six-story building which doubled its former capacity. On November 10, 1891, the new hospital building was opened, its first superintendent being Alexander Eamsey. The new hospital and college buildings were then connected by an extension, and this sufficed for a time, when it was found necessary, because of the growth of the institution, to acquire six properties located at the northeast corner of Eighteenth and Cherry Streets. These houses were made use of as maternity and children's departments. Soon after this the property extending from the college to the corner of Seventeenth and Cherry Streets was also purchased, the College then owning the whole block facing on Cherry Street between Sev- enteenth and Eighteenth Streets. Prom this time on the structural growth of the Medico-Chi- rurgical College was rapid. In 1896, the corner-stone of the new clinical amphitheatre was laid, and in 1901 it was opened. It is believed to be the finest, as well as the largest, building of its kind which has yet been erected in the United States or Europe. Its con- struction is fireproof throughout, of concrete arches on iron beams. Its floors and wainscots are marble. All the plastering is finished in enamel, and wood work has been used only in the doors, windows, and seats. Its seating capacity is about 500. It contains, beside the large amphitheatre, many smaller operating rooms: preparing, dressing, waiting, skiagraphing, electrical, and other rooms which go to make up a well constructed operating mechanism. In 1900, the construction of the new dispensary and laboratory building, at the northwest corner of Seventeenth and Cherry Streets, was begun, and was completed in 1902. It has a total area of 40,000 square feet of floor space, and contains, besides the various dispensaries of the hospital and the Department of Dentistry, complete laboratories of organic, inorganic, analytic and hygienic chemistry, toxicology, dental metallurgy, pathology, bacteriology, morbid anatomy, his- tology, and a thoroughly up-to-date dissecting room. The building is of steel construction and fireproof. 330 Medical, Pharmaceutical and Dental Colleges In 1903, an explosion of the hot water generator in the base- ment of the hospital caused such damage that it was necessary to reconstruct the whole building. It was entirely remodelled and thoroughly modernized in every respect, so that it is now one of the model institutions of its kind in the city. It is in direct con- nection with the clinical amphitheatre, as is also the new maternity and children's hospital, which has just been opened on the north- east corner of Eighteenth and Cherry Streets. The new maternity and children's hospital, the newest and per- haps the most modern of the buildings of the Medico-Chirurgical College, is designed after the French school of architecture. It is now only partially finished, and when completed will be the most dignified of the many buildings which form the plant of the insti- tution. The primary object of every medical teaching institution is to have good hospital and clinical facilities so as to be able to instruct it students. To give an adequate idea of the advantages of the Medico-Chirurgical College, it is only necessary to quote the hos- pital and clinical statistics for one year. According to the report of the President of the Board of Trustees for the year ending De- cember 31, 1907, there were admitted to the hospital 2,024 patients, 1,655 into the wards and 369 into the private rooms. A total of 2,129 were treated in the main hospital; in the out-patient depart- ment 59,951, in the accident room 8,185, in the electrotherapeutic department 2,666, and in the X-ray department 1,616. The number of days in which patients were maintained in the hospital was 40,129. It is hardly necessary to discuss the equipment of the different laboratory and hospital buildings. Suffice it to say that it fills every need of a well-working and organized medical teaching plant. It is, however, only just to mention the excellent work done by the nurses of the training school. This was founded in 1891, and the first class was graduated in 1892. It now numbers about seventy pupils, and the average graduating class is seventeen. The instruction consists of a three-year graded course. After the reorganization of the faculty in 1886, the growth of the institution was rapid. This was entirely due to the efforts of the teaching faculty, which then also constituted the Board of Trus- tees. Among those who assisted in this pioneer work and who joined the institution early were Jas. M. Anders (1889) and Ernest INTERIOR VIEW, CLINICAL AMPHITHEATRE. LABORATORY BUILDING Medico-Chirurgical College and Hospital 331 Laplace (1890). There were at first many changes in the faculty, but gradually there were acquired young and energetic men who have grown up with the institution, until now the teaching faculty is composed of individuals who compare favorably with those of the faculty of similar institutions, not only in teaching ability, but also in scientific attainments. The list of the professors who have held the various chairs up to the present are as follows : — • The chair of Principles and Practice of Medicine and Clinical Medicine, Hugo Engel, A.M., M.D., 1881-83 ; William P. Waugh, A.M., M.D., 1883-91; James M. Anders, M.D., LL.D., 1891. The chair of Surgery and Clinical Surgery, George P. Oliver, A.M., M.D., 1881-84; H. Earnest Goodman, M.D., 1884-91; Er- nest Laplace, M.D., LL.D., 1891. The chair of Materia Medica and Therapeutics, William F. Waugh, A.M., M.D., 1881-82 ; Prank 0. Nagel, A.M., M.D., 1882- 84 ; Frank Woodbury, M.D., 1884-89 ; John V. Shoemaker, M.D., LL.D., Professor of Materia Medica, Pharmacology, and Thera- peutics, 1889. The chair of Obstetrics, Gynaecology and Clinical Gynaecology, George B. H. Swayze, M.D., 1881 (during preliminary term) ; William S. Stewart, A.M., M.D., 1881-91; E. E. Montgomery, A.M., M.D., 1886-92. This chair was divided and W. Frank Haehnlan, M.D., Ph.D., elected to the chair of Obstetrics in 1892, and W. Easterly Ashton, M.D., LL.D., the present incumbent, elected to the chair of Gynaecology in 1892; additional Professor Clinical Obstetrics, George M. Boyd, M.D., 1898. The chair of Clinical Medicine, Frank Woodbury, A.M., M.D., 1891-94; William E. Hughes, M.D., Ph.D., 1894-'03, and Judson Daland, M.D., 1903. Clinical Surgery, George E. Stubbs, A.M., M.D. (including surgical pathology), 1886-92. William H. Pancoast, A.M., M.D., Professor of Anatomy and Clinical Surgery, 1893-97 ; William L. Eodman, A.M., M.D., Professor of the Principles of Surgery and Clinical Surgery, 1897. Ophthalmology, P. D. Keyser, A.M., M.D., 1884-95 ; L. Web- ster Fox, A.M., M.D., 1893. Anatomy, George E. Stubbs, A.M., M.D., 1881-86; William H. Pancoast, A.M., M.D., Professor of General Descriptive and Surgical Anatomy, 1886-97; John C. Heisler, M.D., 1897. 332 Medical, Pharmaceutical and Dental Colleges Physiology and Medical Jurisprudence, Abraham S. Gerhard, A.M., M.D., 1881-86; Thomas C. Stelwagen, A.M., M.D. (Physi- ology only), 1886-89; Samuel Wolfe, A.M., M.D. (Lecturer), 1889- 90; Samuel Wolfe, A.M., M.D. (Professor), 1890-93; Henry T. Slifer, M.D., 1893-94; Isaac Ott, A.M., M.D., 1894. The chair of Chemistry, Charles L. Mitchell, M.D., Ph.D., 1881-86; S. B. Howell, A.M., M.D., 1886-93; H. H. Boom, M.D. (Adjunct Professor), 1893-97; G. H. Meeker, B.S., M.S., LL.D., 1897. Pathology. This chair was held by different lecturers up to 1886, but as some of the records are missing, their names cannot be furnished. Abraham S. Gerhard, A.M., M.D., Professor of Pathol- ogy, Medical Jurisprudence and Clinical Medicine, 1886-90; Er- nest Laplace, M.D., LL.D., Professor of Pathology and Bacteriology, 1890-96; Joseph McFarland, M.D., 1896. Sanitary Science and Pediatrics, AYilliam B. Atkinson, A.M., M.D., 1884-89 ; James M. Anders, M.D., LL.D., 1889-92 ; Charles M. Seltzer, M.D., Professor of Hygiene, 1892-93 ; Seneca Egbert, A.M., M.D., Professor of Hygiene, 1893. Assistant Professor of Practice and Clinical Medicine, Albert Koussel, A.M., M.D., 1894. Clinical Professor of Otology, Edward B. Gleason, M.D., LL.D., 1894. Clinical Professor of Nervous Diseases, G. Betton Massey, M.D., 1881-84; Samuel Wolfe, M.D., 1892-4; Charles W. Burr, M.D., 1894, Clinical Professor of Nervous and Mental Diseases, 1896, resigned 1900; F. Savary Pearce, M.D., 1900-04; William Pickett, M.D., 1904-7 ; Charles S. Potts, M.D., 1907 ; Theodore H. Weisenburg, M.D., 1907, also Professor of Neuropathology; Albert C. Buckley, Lecturer on Mental Diseases, 1907. Clinical Professor of Laryngology, Arthur H. Cleveland, B.S., M.D., 1894. Professor of Laryngology, Charles E. de M. Sajous, M.D., 1906-7. Professor of Orthopaedic Surgery, James P. Mann, M.S., M.D., 1897. Clinical Professor of Genito-Urinary Diseases, Elwood E. Kirby, 1898, resigned 1902; Hilary M. Christian, M.D., 1904. Associate Professor of Histology, C. L. Purbush, M.D., 1898, resigned 1899; Albert C. Buckley, M.D., 1899. -MAIN HOSPITAL BUILDING. Medico-Chirurgical College and Hospital 333 Assistant Professor of Therapeutics, George W. Pfromm, Ph.G., M.D., 1899, resigned 1906. Professor of Pediatrics, W. C. Hollopeter, A.M., M.D., 1900. Adjunct Professor of Chemistry, Mathew Beardwood, Jr., A.M., M.D., 1902. Assistant Professor of Physical Diagnosis, Howard S. Anders, A.M., M.D., 1904. Adjunct Professor of Medicine, L. Napoleon Boston, A.M., M.D., 1905. The faculty at the present writing is as follows : John V. Shoe- maker, M.D., LL.D., Professor of Materia Medica, Pharmacology and Therapeutics; James M. Anders, M.D., Ph.D., LL.D., Professor of Theory and Practice of Medicine and Clinical Medicine ; Ernest Laplace, M.D., LL.D., Professor of Surgery and Clinical Surgery; W. Easterly Ashton, M.D., LL.D., Professor of Gynaecology; L. Webster Eox, M.D., LL.D., Professor of Ophthalmology; William L. Eodman, M.D., LL.D., Professor of Principles of Surgery and Clinical Surgery; W. Erank Haehnlen, M.D., Ph.D., Professor of Obstetrics; George M. Boyd, M.D., Professor of Clinical Obstetrics; W. C. Hollopeter, A.M., M.D., Professor of Pediatrics; Seneca Egbert, A.M., M.D., Dean, Professor of Hygiene; Isaac Ott, A.M., M.D., Professor of Physiology; Joseph McFarland, M.D., Professor of Pathology and Bacteriology; John C. Heisler, M.D., Professor of Anatomy; George H. Meeker, M.S., Ph.D., LL.D., Professor of Chemistry; Judson Daland, M.D., Professor of Clinical Medicine; John V. Shoemaker, M.D., LL.D., Clinical Professor of Medicine and Skin Diseases; Arthur S. Cleveland, B.S., M.D., Clinical Professor of Laryngology; Edward B. Gleason, M.D., LL.D., Clinical Professor of Otology; James P. Mann, M.S., M.D., Profes- sor of Orthopaedic Surgery; Hilary M. Christian, M.D., Clinical Professor of Genito-Urinary Diseases; Charles S. Potts, M.D., Professor of Neurology; Theodore H. Weisenburg, M.D., Professor of Neuro- Pathology and Associate Professor of Neurology; Albert E. Eoussel, A.M., M.D., Adjunct Professor of Practice and Clinical Medicine; Albert C. Buckley, A.M., M.D., Associate Professor of Histology; Mathew Beardwood, Jr., A.M., M.D., Adjunct Professor of Clinical Chemistry and Toxicology; Howard S. Anders, A.M., M.D., Assistant Professor of Physical Diagnosis; L. Napoleon Boston, A.M., M.D., Adjunct Professor of Medicine; Arthur C. Morgan, M.D., Assistant Professor of Medicine; George E. Pfahler, 334 Medical, Pharmaceutical and Dental Colleges M.D., Adjunct Professor of Symptomatology; W. Hersey Thomas, M.D., Assistant Professor of Surgery ; W. Egbert Kobertson, M.D., Associate Professor of Clinical Medicine ; John A. McGlinn, A.B., M.D., Assistant Professor of Gynaecology. Emanuel S. Gans, M.D., Lecturer on Dermatology; Joseph V. C. Eoberfs, M.D., Lecturer on and Instructor in Clinical Medicine; Mitchell P. Warmuth, A.B., M.D., Lecturer on Surgery; Seneca Egbert, A.M., M.D., Lecturer on Medical Jurisprudence; Guy Hins- dale, M.D., Lecturer on Climatology; Herbert J. Smith, Ph.G., M.D., Lecturer on and Instructor in Applied Therapeutics ; Albert C. Buckley, A.M., M.D., Lecturer on Psychiatry; John M. Swan, M.D., Lecturer on Tropical Medicine; H. Brooker Mills, M.D., Lecturer on Pediatrics. Frank S. Bowman, M.D., Demonstrator of Anatomy ; Mitchell P. Warmuth, M.D., Demonstrator of Operative Surgery; George E. Pfahler, M.D., Demonstrator of Physical Diagnosis; Philip Fis- chelis, M.D., Demonstrator of Histology and Embryology; J. Hamilton Small, Ph.G., M.D., Demonstrator of Bacteriology; Van Duyne A. Sutliff, M.D., Demonstrator of Anatomy; Edward M. L'Engle, M.D., Demonstrator of Pathology; Warren C. Batroff, A.B., M.D., Director of the Clinical Laboratory; Joseph F. Ulman, M.D., Demonstrator of Physiology; William J. Bitter, Ph.G., M.D., Demonstrator of Hygienic Chemistry ; F. A. Mantz, M.D., Demon- strator of Pharmacy and Materia Medica ; William G. Shields, Jr., M.D., Demonstrator of Morbid Anatomy; Henry S. Wieder, M.D., Demonstrator of Surgical Pathology; Louis H. Mutschler, M.D., Prosector to the Chair of Anatomy; Charles B. Beynolds, M.D., Demonstrator of Gynaecology ; Frank White, M.D., Demonstrator of Orthopaedics; Eobert J. Hunter, M.D., Demonstrator of Physical Diagnosis; John P. Bethel, M.D., Demonstrator of Physical Diag- nosis; J. D. Brittingham, M.D., Demonstrator of Pediatrics; Walter J. Fralic, M.D., Demonstrator of Chemistry ; S. A. Lowen- berg, M.D., Demonstrator of Physical Diagnosis ; Balph A. Spang- ler, A.B., M.D., Demonstrator of Pediatrics; Francis A. Faught, M.D., Director of the Laboratory of Clinical Medicine; John J. Gilbride, A.B., M.D., Assistant Demonstrator of Anatomy; Henry S. Turville, M.D., Assistant Demonstrator of Operative Surgery; John J. Kennedy, M.D., Assistant Demonstrator of Operative Sur- gery; Paul A. Zoells, M.D., Assistant Demonstrator of Anatomy; J. Henry Schaeffer, M.D., Assistant Demonstrator of Operative EXTRAXCE TO STUDENTS" CLUBHOUSE. Medico-Chirursical College. Medico-Chirurgical College and Hospital 335 Surgery; Oliver P. Mershon, M.D., Assistant Demonstrator of Anatomy; Albert M. Moore, M.D., Assistant Demonstrator of Anatomy; Eobert Parrish, M.D., Assistant Demonstrator of Anatomy; Howard L. Jameson, M.D., Assistant Demonstrator of Physical Diagnosis; Peter H. Lane, Litt.B., M.D., Assistant Demon- strator of Physical Diagnosis ; John C. Scott, P.D., M.D., Assistant Demonstrator of Physiology; F. Eaymond Keating, M.D., Assistant Demonstrator of Physical Diagnosis; James E. Scheehle, M.D., Assistant Demonstrator of Operative Surgery; A. D. Halperen, M.D., Assistant Demonstrator of Physical Diagnosis; Eugene A. Case, M.D., Assistant Demonstrator of Pathology; Mulford K. Fisher, M.D., Assistant Demonstrator of Pharmacy. Albert E. Blackburn, M.D., Instructor in Medicine; John A. McKenna, M.D., Instructor in Surgery; Stillwell C. Burns, M.D., Instructor in Surgery; James S. Eaudenbush, M.D., Instructor in Obstetrics; Samuel D. Ingham, M.D., Instructor in Neurology; B. Frank Walters, M.D., Instructor in Laryngology; William M. Menah, M.D., Instructor in Otology; J. B. Euffell, M.D., Instructor in Ophthalmology; John A. Brophy, M.D., Instructor in Ophthal- mology; A. Wiese Hammer, M.D., Instructor in Surgery; Frank White, M.D., Instructor in Orthopaedics ; Ealph H. Spangler, A.B., M.D., Instructor in History-Taking; Emil A. Welty, A.B., M.D., Instructor in Surgery; Francis J. Dever, M.D., Instructor in Medicine; Eobert J. Hunter, M.D., Instructor in Medicine ; Charles B. Eeynolds, M.D., Instructor in Obstetrics; Arthur McG-innis, M.D., Instructor in Surgery; Louis Jacobs, M.D., Instructor in Obstetrics; Eugene Lindauer, Instructor in Nervous Diseases; Peter H. Lane, Litt.B., M.D., Instructor in Symptomatology; Louis Schwartz, M.D., Instructor in Electro-Therapeutics ; Samuel A. Lowenberg, M.D., Instructor in Medicine. In 1901 the policy of the whole institution was changed. Up to this time the Board of Trustees was composed solely of members of the major faculty. It was found, however, that while this arrangement was satisfactory during the early growth of the insti- tution, the work of managing the different departments became so large that it was decided to appoint a Board of Trustees consisting entirely of laymen. Accordingly a committee, consisting of Drs. James M. Anders, Chairman; Ernest Laplace and William L. Eodman, was appointed to secure a president who, when elected, would be at liberty to name his associates on the Board. The orig- 336 Medical, Pharmaceutical and Dental Colleges inal lay board of trustees was composed of Hon. Edward M. Pax- son, LL.D., President; Theodore Voorhees, Vice-President; Henry D. Paxson, Esq., Secretary; Mr. W. Howard Pancoast, Treasurer; the other members were Hon. James P. Sterrett, Hon. Abraham M. Beitler, Hon. James A. Logan, Mr. Pemberton S. Hutchinson, Mr. Joseph L. Caven, Mr. David Milne, Mr. George A. Huhn, and Hon. John C. Grady. The late Chief Justice Edward M. Paxson resigned the presidency of the Board of Trustees in 1903, owing to his advanced age and inability to carry out the duties of that important office. His successor was not chosen until the following year, when the Hon. Henry P. Walton, who had previously manifested a deep interest in the institution, was elected, the place having meanwhile been filled by the Chairman of the Finance Committee, Hon. Abra- ham M. Beitler. The death of Chief Justice Paxson, which occurred in September, 1905, was greatly lamented by the friends of the Medico-Chirurgical College. In 1902, Dr. Ludwig S. Filbert was elected to the Board of Trustees to fill the vacancy caused by the death of Hon. James P. Sterrett, being at the same time made Vice-President. Dr. Filbert died in October, 1903, and his passing away left a vacancy which it was difficult to fill. In 1903, Mr. Charles M. Swain was added to the Board of Trustees to fill the vacancy caused by the resigna- tion of Joseph L. Caven. His loss, by his untimely death, was severely felt, since he had manifested an active interest and hearty co-operation in the work of the institution. Among others who have rendered valuable service as members of the Board of Trustees at various times are A. F. Bornot, William Clark Nason, and John H. Gay. The Board of Trustees, as constituted at present, is as follows: Hon. Henry F. Walton, President; John G. Carruth, Vice-President; Charles S. Hawkins, Secretary; William H. Greene, M.D., Treasurer of College; David Milne, Treasurer of Hospital; Hon. John C. Grady, W. Howard Pancoast, Joseph H. Bromley, Edwin J. Houston, Ph.D.; Hon. Walter T. Merrick, Hon. William P. Potter, Thomas J. Jeffries. After the disruption of the three departments of Medicine, Dentistry, and the School of Anatomy in 1895, the Medical School continued alone until 1897, when it was decided to establish a dental department, the authority to confer the degree of Doctor of Dental Surgery being embodied in the original charter of 1850, and confirmed by the Supreme Court of the State of Pennsylvania w m mz&. .rise a&/jjg$ I Medico-Chirurgical College and Hospital 337 in 1897. Dr. E. Walter Starr was made the first Dean of the Dental Faculty and Professor of Operative Dentistry and Crown and Bridge Work. With him were associated Drs. E. H. Nones, Pro- fessor of Prosthetic Dentistry and Metallurgy, who was to become the second dean a year later; C. E. Jefferies, who occupied the chair of Dental Pathology, Therapeutics, and Materia Medica; John V. Shoemaker, Anaesthesia and Anaesthetics ; Ernest Laplace, Oral Surgery; Isaac Ott, Physiology; George H. Meeker, Chem- istry; John Heisler, Anatomy; Joseph McFarland, Pathology. Such was the personnel of the first faculty whose professional attainments and standing assured a combined class attendance of fifty-nine students for its first year. The session of 1898-99, with Dr. E. H. Nones as Dean, Dr. Walter H. Neall, Professor of Operative Dentistry, and Dr. James D. Price, Professor of Dental Pathology, opened with an attend- ance of 90. This year also saw the addition of Dr. Earle C. Eice to the teaching force, who was later, in 1901, appointed Lecturer on Clinical Dentistry, and, in 1903, Professor of Dental Pathology. Dr. George W. Cupit, first as Professor of Dental Pathology and later of Operative Dentistry, was a member of the faculty from 1899 to 1906. Other eminent practitioners who helped to bring the Dental Department of the Medico-Chirurgical College to its pre- sent enviable position, some of whom are still connected with it, include Dr. W. Stover How, Dr. S. Kimmel, Dr. W. A. Borden, Dr. J. E. Yorks, Dr. W. W. Babcock, Dr. A. E. Dray, Dr. H. P. Smith, Dr. P. G. Hawksworth, Dr. T. J. Clemens, Dr. John M. Fogg, Dr. George W. Pfromm, etc. The fall of 1906 witnessed a reorganization of the faculty under the direction of Dr. I. N. Broomell as Dean, Professor of Prosthetic Dentistry, Dental Anatomy and Dental Histology. The re-entrance of Dr. E. Walter Starr, as Professor of Crown and Bridge Work and Clinical Dentistry, is also noted. Dr. L. Ashley Faught, Pro- fessor of Operative Dentistry ; Dr. M. I. Schamberg, Professor of Oral Surgery; Dr. John V. Shoemaker, Dr. Isaac Ott, Dr. John Heisler, Dr. Joseph McFarland, and Dr. George H. Meeker, com- plete the list of those now holding chairs in the Dental Depart- ment. The Department of Pharmacy was instituted in 1898, and the first course of lectures and laboratory work was begun during the first week of October of that year. The course embraced two ses- 22 338 Medical, Pharmaceutical and Dental Colleges sions of seven months each, and all the work was done upon five evenings of each week. The department opened with five students : Messrs. George C. Wilson, Jr. ; Harvey Eugene Wenner, Alvin W. Lum, Frank M. Mooney, and J. Bertram Hagenbuch. The first faculty was as follows: Carl E. Smith, Ph.C, Dean and Professor of Pharmacy; George H. Meeker, M.S., Ph.D., Pro- fessor of Physics and Pharmaceutic and General Chemistry ; Henry C. Maisch, Ph.D., Professor of Botany and Materia Medica; Isaac Ott, A.M., M.D., Professor of Physiology. At the opening of the second session (1899-1900) Harvey H. Mentzer, Ph.G., succeeded Professor Smith as Dean and Professor of Pharmacy, and the faculty was strengthened by the addition of the chair of Hygiene, held by Seneca Egbert, A.M., M.D. Dr. Maisch, owing to illness, was obliged to resign his professorship upon the opening of the third course of lectures, and was succeeded by Henry Fisher, M.D. During this session one afternoon a week was added to the evening course. In October, 1903, the evening courses were abolished. The college year was extended to thirty weeks, embracing three after- noons of each week. The laboratory periods were extended to almost double the time required previously. During this year Charles H. Shaw, A.M., Ph.D., was elected Adjunct Professor of Botany. In 1905, the course was further extended by adding one forenoon each week to the Junior, and two forenoons to the Senior courses of instruction. During this year a three months' course in bacteri- ology, under Dr. Joseph McFarland, was added. In 1906, the faculty of the school was reorganized. I. Y. Stan- ley Stanislaus, Ph.G., M.Sc, Phar.D., was elected Dean and Pro- fessor of Pharmacy; William G. Greenawalt, Ph.G., Professor of Materia Medica, and Dr. Charles H. Shaw was advanced to the Professorship of Botany and Pharmacognosy. The course was lengthened to thirty-two weeks, and made to embrace two full days and one half-day period during the Junior, and three full days during the Senior session. In the spring of 1907 Professor Wm. G. Greenawalt resigned, and Charles H. Kimberly, Ph.C, M.S., Ph.D., was elected to succeed him. During this (1908), the second year of Professor Stanislaus' deanship, the courses were further extended so that each class must now attend for three whole days each week (or twenty-four hours weekly) for thirty-four weeks, each student receiving a grand total Medico-Chirurgical College and Hospital 339 of seven hundred hours of laboratory instruction, and over eight hundred hours of lectures and recitations during the two years of the college course. The work of the faculty was further extended by the estab- lishment of a department of Pharmaceutic Chemistry, which is intended to provide a thorough education for young men aspiring to fill the numerous positions available under the Food and Drugs Act of 1906. The course in this department covers two years of thirty-five weeks each, and embraces a grand total of 2,000 hours of laboratory work, and about 1,000 hours of lectures. Prof. George H. Meeker, Phar.D., Ph.D., LL.D., is the Dean of the faculty, which embraces the entire teaching staff of the pharmacy school, and a corps of lecturers and teachers, among whom may be mentioned Prof. Frederick A. Genth, Food Chemistry ; Prof. Chas. E. Vanderkleed, Drug Chemistry; Prof. George E. Pfahler, Eoent- genology; Prof. Arthur H. Cleveland, Agricultural Chemistry, and Prof. Edward B. Gleason, Sewage Disposal. The Food and Drug Laboratory is in charge of Prof. Charles H. Kimberly, formerly of the TJ. S. Drug Laboratory, Washington, D. C. It will be seen, therefore, that in a period of twenty-eight years, the Medico-Chirurgical College has grown from a humble medical school with an attendance of thirty-one students and quarters con- sisting of the upper floor of a bank building, to a large medical university with departments of medicine, dentistry, pharmacy, and pharmaceutical chemistry with an average of seven hundred stu- dents, a teaching force of one hundred and forty-three men, and a structural plant of buildings the equal of any medical institution in Philadelphia. There have been altogether 1,992 graduates. Of these 1,490 were from the Medical Department, 210 from the Dental, and 293 from the Pharmaceutical. It would hardly be in place here to dis- cuss the achievements of graduates of this institution, for the oldest living graduate is only of twenty-seven years standing. It is satis- fying, however, to know that they hold positions in the community which are not only a credit to them, but to their alma mater as well. The present condition of the institution is most satisfactory. The number of students is gradually increasing in spite of the fact that year by year the entrance requirements are made more diffi- cult. In 1907, in order to be among the first to comply with the 340 Medical, Pharmaceutical and Dental Colleges recommendation of the American Medical Association as expressed in the statement that it "favors beyond present requirements, as soon as conditions warrant, the enlargement of preliminary scien- tific education to include a thorough course in physics, chemistry, and biology, and also one modern language, preferably German," and also because this institution is peculiarly well qualified to sup- ply this instruction in a manner thoroughly in accord with peda- gogic principles, the Medico- Chirurgical College instituted in June, 1907, a five-year course in Medicine which is carried on concur- rently with the regular course in this Department. For the present this enlarged course is optional, and is designed for those students who have not had the advantages of some College or University training. From the point of historical interest it might be well to state that the present four-year course was established in the session of 1899-1900. Kealizing the fact that one of the most important adjuvants of a successful teaching institution is the proper care of the student body, a club was established in 1907. Accordingly a commodious building, which is at 1609 Arch Street, was secured, and it is now a home both for under-graduate students and alumni, and enables the College to provide for the moral and social welfare of the stu- dent body in a manner hitherto impossible. Such a history as this would hardly be complete without some reference to the future. It is only a question of a few years when the Parkway will be completed from Fairmount Park to City Hall. Its lines are such that it will take in the New Laboratory Building at Seventeenth and Cherry Streets, the Old College Hall and a corner of the Hospital, leaving a triangular area whose apex is at Eighteenth and Cherry Streets. While this will demolish a struc- tural part of the institution it will furnish an opportunity such as is given to few institutions — to have a frontage on the boulevard which is to be the Champs Elysees of America. Who will deny that with such possibilities combined with the honesty of purpose which characterizes the work of the Board of Trustees, Faculty, Alumni, and student body, the Medico-Chirurgical College will attain such heights as will always be an inspiration and a guiding star to the faithful ? The Temple University By L. H. CARNELL, Litt. D. THE Temple University was organized in December, 1884. It numbered seven students and one teacher, and was created in response to an inquiry from some young men of their pastor as to how they could prepare for college while earning their living. At that time there was in Philadelphia no evening instruction of any kind being given, except at a few notoriously disorderly public night schools of a very elementary grade, open only for a few months. Eussell H. Conwell, the pastor of these young men, agreed to teach them himself, but soon found that they were representa- tive of hundreds more, for, as soon as it was known that this class had been formed, requests came from all sides for permission to join it. Other teachers were employed, and by 1888 so large had this body become that President Conwell and the Trustees associated with him decided to apply for a charter. Temple Col- lege was chartered as a non-sectarian institution, primarily intended to give an education to wage-earners and to make it possible for them to receive all the benefits of a liberal education available to those more fortunately placed, who are not compelled so early in life to earn a living. There were five hundred and ninety students when the char- ter was applied for. Until 1891 the work was carried on entirely in the evenings. The subjects taught were those of the element- ary, high and business schools, with a few classes in more advanced work. The demand, however, for higher work was becoming so great that the Trustees decided to apply for the right to confer degrees. This was granted. As it was not practical to carry on college work without a stable faculty, whose whole time would be at the disposal of the college, in the same year in which the right to confer degrees was granted, the day department was opened. This made possible the ideal of the President to have classes at any hour, day or evening, for which a sufficient number of stu- dents applied, and in any subject for which there was a real demand. (341) 342 Medical, Pharmaceutical and Dental Colleges The work of the day followed the same lines as that in the evening departments. In 1893, the Theological Department was opened as a non-seetarian seminary, the professors being elected from various denominations. This department has sent out many students into all lines of Christian activity. The ministry, the mission fields, and philanthropic efforts of all kinds have received their share. In response to repeated inquiries it was decided to open a correspondence course in Theology for the help of minis- ters in foreign fields or in country districts who wished to keep in touch with modern theological thought, or who wished to sup- plement insufficient training. This department rapidly grew in numbers. In the fall of 1908, again in response to a well-defined want in the community, a Bible Training School for Christian workers was organized, with thirty-five in the opening class. This also has in its turn led to a new demand upon us that this work shall be given by correspondence. The Law School was opened in January, 1895. The history of the Law Department of the Temple Univer- sity, if fully written, would seem to be almost fiction. It is the record of something created out of nothing. On a warm summer day in 1894 two students called at the College office, and made inquiry as to a course in law. They were told that there was no law course and no law school in the city at that time open to students who were obliged to work during the day and study at night. They insisted upon being taught, and were told that it was the rule of the College not to begin any new course or to give any new branch until a class of at least six was assured; that if they desired a course in law they must first create the class by getting together other students anxious like themselves for a legal education. Nothing was heard of the matter from this time until early in the year 1895, when the would-be law students again walked into the Dean's office and announced that they had secured the class and wished arrangements made for immediate instruction. Such earnestness on the part of the students was at once met by the College authorities by the founding of a law school. The school thus began was of a very rudimentary character, so far as its equipment was concerned. It had no library and none of the other adjuncts which are to-day considered necessary for a well-equipped school. Its faculty was composed of two COLLEGE HALL. Temple University. The Temple University 343 members, and the first class, of six students. Some one has said that a university can be made of one scholar plus one teacher, sufficiently broad-minded. As the years have passed, the school, which had such humble beginning, has demonstrated its ability to give a high-grade legal education, notwithstanding the difficulties which surround the course of a student working at night. During the intervening years it has numbered among the teachers in its faculty many prominent men, among whom can be named Samuel P. Eotan, Esq., now District Attorney of Phila- delphia County, a member of its original faculty and at one time Dean of the Department; Eeuben 0. Moon, Esq., now a member of Congress and known as the leading spirit in the codification of the criminal laws prevailing in the Federal courts, a very able and successful lawyer in practice at the Philadelphia bar; Henry Budd, Esq., a very learned lawyer, and known as one of the editors in collaboration with Chief Justice Sharswood, of Sharswood & Badd's Cases on Eeal Property, and William Eighter Fisher, Esq., one of the best beloved of the teachers whom the school has had, a man who has taken so deep an interest in legal education that he is at the present time one of the Assistant Examiners of the State Board of Law Examiners. There have been many other very faithful teachers in the school, perhaps not so well-known to the general public. Among them can be mentioned George C. Bowker, Esq.; Alfred E. Haig, Esq.; T. Elliott Patterson, Esq.; Crawford D. Hening, Esq., now a Professor of the Law Depart- ment of the University of Pennsylvania; A. W. Bomberger, Esq., and others. Any history of the Law Department, even partial, would be valueless which does not recognize the years of faithful service given by Henry S. Borneman, Esq., both as an instructor and Dean of the Department. About 1902 a number of changes were made in the faculty for various reasons, and the faculty as now constituted is as fol- lows: Francis Chapman, LL.B., Dean; S. Stanger Iszard, A.M., LL.B.; J. Claude Bedford, LL.M.; J. Howard Ehoads, LL.B.; Holden Bovee Schermerhorn, Ph.B., LL.B.; Andrew Wright Crawford, and George B. Evans, LL.B. Prior to 1904 the department did not grant the degree of LL.B. to any student who had not passed his State or County Board Bar Examinations in addition to passing the examination 344 Medical, Pharmaceutical and Dental Colleges of the school. In 1904, it was determined to thereafter make the granting of the degree dependent only upon the student passing his department examinations. The work of the department originally begun for the benefit of Pennsylvania students has now so broadened that it has been necessary to add to the faculty a member of the Bar of New Jer- sey, whose attention is devoted to instructing the New Jersey students in practice in the courts of New Jersey, thus fitting them for the examinations of their State Board. The present standing of the Temple Law School, thus built up from such small beginnings, is sufficiently evidenced by the fact that the School has the full recognition of the Boards of Law Examiners of the State of Pennsylvania and of Philadelphia County, respectively; compliance with the clerkship rule being, by the action of these boards, waived in favor of students who are graduates from the School. The School is likewise approved by the formal action of the Board of Bar Examiners of the State of New Jersey as one of established reputation. At the present time the department has very nearly one hun- dred students, a faculty of seven members and a record of unbroken success, so far as the students are concerned in their final examination, and the prospect of ever-increasing usefulness. The same year, 1895, a School for the Training of Kinder- gartners was opened. There had been for a number of years a kindergarten for little children, which became a Model Kinder- garten under the direct supervision of the Training School. The Training School graduates annually from twenty to thirty kinder- gartners. Many of these take the examinations of the City of Philadelphia, and in due time enter the ranks of its regular teach- ing force. This year also saw the reorganization and strengthening of the College Department with a largely increased faculty. The first regular class graduated from a four years' course in 1901. In the fall of this year, several of the city teachers being unable to get any undergraduate work in the city out of school hours, asked to be given classes on Saturday, after school hours and in the evening. This led to the establishment of the classes in col- lege work for teachers which have proved so successful. Many of the young men in the higher ranks of Philadelphia educational systems have their Bachelor's degrees from Temple University. The Temple University 345 A gymnasium had been formed about the time of the estab- lishment of the Day Department, but in 1896 the first instruction was given in the training of teachers in Physical Education. This department now graduates each year a large class of young men and young women. These are scattered all over the country as directors of colleges, high schools, preparatory schools, Y. M. C. A. and Y. W. C. A. gymnasiums. Some of them are also teaching in our public schools. In 1901, the Departments of Pharmacy and Medicine were established. So many inquiries had been made concerning a course in Pharmacy that as early as 1899 it was decided to open this department, but the work was not fully organized until 1901. Until 1907 the course was given entirely in the evening, but it was found that many of the students preferred the afternoon hours, so, at the present time, there are both afternoon and even- ing sessions. The number of teaching hours of both the day and evening students conform with the requirements as specified by the Conference of Pharmaceutical Faculties of the American Phar- maceutical Association. In 1904, an evening course in Civil Engineering was first announced. In 1905, classes in Pedagogy and Pedagogical Psychology were opened in connection with the College Department to prepare teachers for the various examinations held by city, county and State. In 1907, the Philadelphia Dental College was affiliated with the Temple University. The Medical Department By I. NEWTON SNIVELY. M.D. The Medical Department of Temple University advocates a high standard in medical education. Its teachers are carefully selected from men and women well qualified by training, educa- tion and experience for teaching their special subjects. Temple University has required of all its graduates in every department a high standard of scholarship. It has not granted degrees unless the applicants have been entirely worthy. By pursuing this policy it has given an opportunity to ambitious, 346 Medical, Pharmaceutical and Dental Colleges capable and willing students to place themselves on the same plane educationally as that occupied by their more fortunate neighbor. The Medical Department of the Temple University, like all the other departments of this institution, was not opened until a demand was made by a representative number of ambitious young men and women for an evening course. President Conwell had frequently been appealed to by students of other departments for a course so arranged, that they could earn a living and college expenses, and at the same time pursue a course in medicine. In the spring of 1901 the Board of Trustees decided to open an even- ing medical school. A faculty and department was organized, and a circular arranged, announcing that a course consisting of five years' evening instruction would be given by Temple College. The first faculty consisted of twenty professors, lecturers, demon- strators and instructors. The curriculum was so arranged that the same number of hours would be devoted to it as in the day schools. There were about thirty students matriculated for the College session of 1901-02. It was found that the students who applied for evening instruction in medicine were willing to make any personal sacrifice to acquire a medical education. They there- fore applied themselves most diligently to the work. The high standard attained by the graduates of this depart- ment before the various State Boards of Medical Examiners has been preeminently satisfactory, a fact of which the Institution is justly proud. The Faculty of the Department of Medicine decided upon a correlated system of teaching medicine. This system was intro- duced in a partial way very soon after the opening of the first session of the School. It was improved upon, however, as time advanced, until about the year 1903-04, when the work for the third-, fourth- and fifth-year classes was almost entirely correlated. This correlation of the course was found to be a most efficient method of teaching. To illustrate more fully, when the Professor of Physiology is lecturing upon the Physiology of the kidney, the Professor of Anatomy is lecturing upon the Anatomy of this organ; the Professors of Pathology, Practice, Surgery, Thera- peutics and Chemistry, and, in fact, all the teachers in the Institution, are delivering their particular course of lectures on this one organ at the same time. This method of teaching is The Temple University 347 considered the ideal, and undoubtedly will be universally adopted in all medical schools in the very near future. The Samaritan Hospital was opened to the students, and clinical teaching is conducted in the amphitheatre, dispensaries and wards of this growing Institution. The faculty was gradually and carefully increased, and conditions improved as the classes grew. In the year 1907 the Temple College was granted the title of "Temple University" by the courts of Philadelphia. This made the Medical Department in name as in fact the department of a great University. Shortly after the granting of the name Temple University there was an affiliation of the Temple University with the Philadelphia Dental College and the Garretson Hospital, and the Medical School was, in 1907, transferred to the Philadelphia Dental College buildings, Eighteenth and Buttonwood Streets. This at once gave the School commodious quarters. The coupling of the Garretson Hospital with the Samaritan Hospital increased very materially the facilities for clinical and bedside teaching. The two hospitals together have a bed capacity of about two hun- dred. Both have a large dispensary service. The laboratories at the Philadelphia Dental College Building, now called Medical Hall, were remodeled, modernized and re-equipped. The Medical Department of the Temple University, in 1901, had thirty-one matriculates; for the year 1908-09 it enrolled 232 medical students. In the year 1907 the School established a four years' day course of nine months' each. The faculty considered that it would be of decided advantage to the students to have all of the work, especially in the Junior and Senior years, done in the day time. Prior to this, however, many of the evening students had been devoting, during the College course, one thousand or more hours to day work. This day work, however, had not been compulsory. The course, as now arranged, allows students, who, for financial reasons, cannot attend in the day time, to continue their medical course for three years in the evening, and during these three years to cover the same work that is being covered by the day students in two years. This gives an opportunity for young men and women of limited means to earn their living and college expenses while studying medicine. All students, whether day or evening, are required to take two years (Junior and Senior) of day work. Not a few of the evening students save sufficient money while pursuing the first three years' work to discontinue 348 Medical, Pharmaceutical and Dental Colleges their pursuits and follow the curriculum of the Junior and Senior day classes. FACULTY OF THE DEPARTMENT OF MEDICINE I. Newton Snively, A.M., M.D., Dean, Professor of Materia Medica, Therapeutics and Clinical Medicine; Samuel Wolfe, A.M., M.D., Professor of Theory and Practice of Medicine, and Clinical Medicine; W. Wayne Babcock, A.M., M.D., Professor of Surgery and Clinical Surgery ; Albert Eobin, M.D., Professor of Pathology, Bacteriology and Hygiene; Henry P. Slifer, M.D., Professor of Physiology; John Chew Applegate, M.D., Professor of Obstetrics; Wilmer Krusen, M.D., Professor of Gynaecology; John Byers Boxby, M.D., Professor of Anatomy and Histology; James Conner Attix, M.S., D.D.S., M.D., Professor of Chemistry and Toxicology; Wendell Eeber, M.D., Professor of Ophthalmology. Clinical Professors. — Nathan 6. Ward, M.D., Clinical Professor of Laryngology and Ehinology; William A. Hitschler, M.D., Clinical Professor of Otology; Collier P. Martin, M.D., Clinical Professor of Proctology ; William A. Steel, M.D., Clinical Professor of Genito-Urinary Surgery ; James Herbert McKee, M.D., Clinical Professor of Pediatrics. Adjunct and Associate Professors. — Truman Auge, A.M., M.D., Adjunct Professor of Physical Diagnosis; Mervyn Ross Taylor, M.D., Adjunct Professor of Materia Medica; Frank C. Hammond, M.D., Adjunct Professor of Gynaecology; Sydney E. Bateman, A.M., M.D., Adjunct Professor of Histology and Embryology; I. Otto Schobl, M.D., Associate Professor of Pathology and Bacteriology; H. Everett Kendig, Ph.G., M.D., Professor of Thera- peutics; H. Augustus Bacon, M.D., Adjunct Professor of Clinical Surgery. Associates. — Robert B. Ludy, M.D., Associate in Medicine; Edward B. Finck, M.D., Associate in Dermatology and Syphilog- raphy; Henry C. Groff, M.D., Associate in Medicine; G. Morton Ulman, M.D., Associate in Medicine and Medical Jurisprudence; Jesse 0. Arnold, M.D., Associate in Obstetrics; Joseph Clothier, M.D., Associate in Ophthalmology; Richard J. Swoboda, Ph.G., M.D., Associate in Chemistry; Charles S. Barnes, M.D., Associate in Obstetrics. Lecturers. — Nathan G. McManus, M.D., Lecturer on Materia Medica; Harry A. Duncan, A.M., M.D., Director of the Clinical Laboratory; E. D. Reed, M.D., Lecturer on Pharmacology; Howard Reed, M.D., Lecturer on Pediatrics. The Temple University 349 Demonstrators and Instructors. — Ernest B. Mongel, M.D., Clinical Instructor in Ophthalmology ; Frederick Blunt Allen, M.D., Instructor in Physiology; Earl L. McDaniel, M.D., Instructor in Materia Medica and Therapeutics; Carl L. Felt, M.D., Instructor in Laryngology and Otology ; Mary E. Sheppard, M.D., Instructor in Physiology; Henry 1ST. Thissell, M.D., Instructor in Pharmac- eutical Chemistry; Eae Shepherd Dorsett, M.D., Instructor in Medicine ; Harry A. Duncan, A.M., M.D., Instructor in Gynaecology ; Albert N". Cole, M.D., Clinical Instructor in Dermatology; John Leedom, M.D., Instructor in Surgery; Henry B. Keech M.D., Instructor in Surgery; C. Howard Pratt, M.D., Instructor in the Eectal Dispensary; Charles S. Barnes, Instructor in Gynaecology; D. M. Wagenseller, A.M., Instructor in General Chemistry; Carl Smith, M.D., Assistant Demonstrator of Anatomy; C. Howard Pratt, M.D., Assistant Demonstrator of Anatomy; Daniel J. Don- nelly, M.D., Instructor in Materia Medica; Michael Gradess, M.D., Clinical Assistant in Ophthalmology; Matthew C. O'Brien, A.M., M.D., Demonstrator of Anatomy ; Paul G. Weston, M.D., Demon- strator of Pathology and Bacteriology and Director of the Patho- logical and Bacteriological Laboratories; Milton F. Percival, M.D., Instructor in Surgery ; Matthew C. O'Brien, A.M., M.D., Instructor in Clinical Surgery; Carlton E". Eussell, D.D.S., M.D., Assistant in Surgery; Frank E. Freeman, Assistant in the Histological and Clinical Laboratories; E. Olivia White, M.D., Assistant Demon- strator of Anatomy; Matthew C. O'Brien, A.M., M.D., Instructor in Chemistry ; Samuel P. Gerhard, M.D., Demonstrator of Medicine ; Carl Smith, M.D., Instructor in Surgery; Carlton N. Eussell, M.D., Demonstrator of Medicine; Michael Gradess, M.D., Instructor in Medicine; Arthur D. Kurtz, M.D., Assistant in Orthopedic Surgery; George Eoss Eogers, M.D., Instructor in Obstetrics; Neafle Eichard- son, M.D., Instructor in Otology; W. S. Schantz, M.D., Instructor in Pediatrics; Horace B. Morse, Ph.G., M.D., Instructor in Phar- macy; H. Morton Cameron, Ph.G., Instructor in Pharmacy; William H. Tomlinson, M.D., Instructor in Otology and Laryn- gology; M. E. Staudenmayer, Ph.G., Instructor in Pharmacy; Paul F. Bremer, M.D., Instructor in Medicine; Howard Fretz, M.D., Assistant in Genito-Urinary Surgery; William D. Lithgow, Ph.G., M.D., Instructor in Materia Medica; John C. Eommell, Assistant in the Chemical Laboratory; H. K. Carey, M.D., Instructor in Pediatrics; Charles West, M.D., Clinical Assistant in 350 Medical, Pharmaceutical and Dental Colleges Pediatrics; John Leedom, M.D., Instructor in Laryngology and Otology; Howard K. Mitchell, M.D., Instructor in Laryngology ; Daniel J. Kennedy, M.D., Instructor in Physiology; C. Howard Pratt, M.D., Assistant in Genito-Urinary Surgery. History of the Philadelphia Dental College By SIMEON H. GUILFORD, D.D.S. The first institution established in Pennsylvania for the imparting of knowledge in the science and art of dentistry was organized in 1852 under the title of the Philadelphia College of Dental Surgery. After a useful but short life of four years, it yielded to the throes of internal dissension and ceased to exist. In the fall of 1862, Dr. John H. McQuillen, holding the chair of Operative Dentistry and Physiology in the Pennsylvania Col- lege of Dental Surgery, retired from the faculty, and in 1863, with the assistance of other members of the profession in the city and State, and after the expenditure of much effort and the over- coming of great opposition (for charters were not as readily obtained in those days as now), succeeded in obtaining from the Legislature of Pennsylvania a charter for a new institution under the name of The Philadelphia Dental College. After securing a competent Faculty and Board of Trustees, the new institution began its first term in November of the same year. The Trustees were Eev. Eichard Newton, D.D., President; Peter F. Eothermal; Wm. Dulty; Geo. J. Zigler, M.D.; George Williams; Eobert L. McClelland, D.D.S. ; Oliver Lund; E. Shel- ton MeKensie, D.C.L., Secretary; Colson Heiskell; S. Fisher Corlies; James L. Claghorn; Lewis D. Harlow, M.D. ; Chas. S. Beck, M.D. ; Henry Crumley. Its Faculty consisted of Dr. J. H. McQuillen, Professor of Anatomy, Physiology and Hj r giene; Dr. J. Foster Flagg, Professor of Institutes of Dentistry; Dr. C. A. Kingsbury, Professor of Physiology and Operative Dentistry; Dr. Thomas Wardell, Professor of Mechanical Dentistry and Metal- lurgy; Dr. Henry Morton, A.M., Professor of Chemistry. Dr. McQuillen was elected Dean, and held that office continuously until his death. In 1865, Professors Kingsbury and Morton resigned, and were succeeded by Dr. Geo. W. Ellis and Alfred E. Leeds, A.M. In I860, Professor Ellis resigned, and Professor PHILADELPHIA DENTAL COLLEGE. Temple University. The Temple University 351 Kingsbury resumed his former chair. In 1867, Professor Wardell resigned, and Dr. D. D. Smith was elected to succeed him. The same year two new chairs were created, one of Principles and Practice of Surgery and the other of Anatomy. Dr. James E. Garretson was chosen incumbent of the former and Dr. Harrison Allen of the later. In the following year, 1868, Professors Garretson and Leeds resigned, and Dr. S. B. Howell was elected to succeed Professor Leeds. In 1869, Professor Kingsbury resigned his chair, and was made Emeritus Professor, and Dr. E. C. Stellwagen was chosen as his successor. In 1870, Professor Flagg resigned his chair, which was divided among the others. In every year but one, thus far, some change had taken place in the personnel of the faculty. During the succeeding eight years no change occurred, but, in 1878, Professor Garretson resumed his chair of Anatomy and Surgery, and Dr. Henry I. Dorr was made Adjunct Professor of Practical Dentistry. In 1897, the chair of Dental Pathology and Therapeutics was estab- lished, and Professor Flagg was chosen to fill it. Owing to the lamented death of Professor McQuillen during this year some changes in the chairs were made necessary. Professor Stellwagen succeeded Professor McQuillen in the chair of Physiology, and his former chair of Operative Dentistry was united to that of Mechan- ical Dentistry. At the same time a new chair of Clinical Dentistry was established, and Professor H. I. Dorr chosen to fill it. In 1881, Professor Smith resigned, and Dr. S. H. Guilford was elected incumbent of the chair of Operative and Prosthetic Dentistry. In 1889, Professor Dorr's chair was changed to that of Practical Dentistry, Anaesthesia and Anaesthetics. From then until the death of Professor Garretson, in October, 1895, a period of fourteen years, no changes occurred, but after his death Dr. H. C. Bcenning was elected to the chair of Anatomy and Surgery, and Dr. M. H. Cryer, for many years the assistant of Professor Garretson, was chosen Adjunct Professor of Oral Surgery. In January, 1896, Professor S. H. Guilford was elected Dean of the Faculty. In the spring of the same year Professors Dorr and Flagg resigned, owing to ill health. Dr. Leo Greenbaum was thereupon chosen to succeed Professor Dorr, and the chair changed to include Materia Medica, Anaesthetics and Odonto- techny. Dr. H. H. Burchard was also chosen to fill the place of 352 Medical, Pharmaceutical and Dental Colleges Dr. Flagg and made Special Lecturer on Dental Pathology and Therapeutics. After serving the School most acceptably for three years Dr. Burchard's failing health compelled his resigna- tion. In October, 1896, Dr. Cryer resigned, to accept a position in the Dental Department of the University of Pennsylvania. In May, 1899, Dr. A. H. Thompson, of Topeka, Kansas, and Dean of the Kansas City Dental College, was chosen to succeed Dr. Burchard, and the chair was extended to include Comparative Dental Anatomy. In May, 1900, Dr. Thompson resigned to resume his former Professorship in the Kansas City Dental Col- lege, and Dr. Otto E. Inglis was elected Special Lecturer on Dental Pathology and Therapeutics. In October, 1901, Dr. Boom succeeded Dr. S. B. Howell, who became Professor Emeritus of Chemistry, Physics and Metallurgy. At this time also Dr. Otto E. Inglis was elected to the chair of Dental Pathology and Therapeutics. Few changes have occurred in the Deanship of the institution. Professor MeQuillen held the position from the establishment of the School, in 1869, until his death, in 1879. He was succeeded by Professor Smith, who held the office for two years. Professor Garretson assumed the office in 1881, and retained it until his death, in 1895, after which Professor Guilford, the present incum- bent, was elected to the position. The College has witnessed but few changes in the Presidency of the Board of Trustees. The first incumbent was Rev. Richard Newton, D.D. At his death he was succeeded by the Hon. James Pollock, LL.D., ex-Governor of Pennsylvania, who retained the office during the remainder of his life, after which General James A. Beaver, LL.D., ex-Governor, was elected to the Presidency, which position he retained until the College became affiliated with Temple University in 1907. At the time of the incorporation of the Philadelphia Dental College there were but three other dental schools in the country, one in Cincinnati, one in Baltimore and one in Philadelphia, with a combined attendance of less than one hundred students. To- day there are in the United States more than fifty institutions in which dentistry is regularly taught, with a total yearly attend- ance of about five thousand students. In the forty-five years of its existence, the Philadelphia Dental College has graduated no less than thirty-two hundred students. Along with other schools The Temple University 353 it has advanced from a two years' course of four months each to a three years' course of eight months. For many years the requirements of students for entrance were those obtained in the elementary schools, but now the equivalent of high school graduation is demanded. Prom an annual curriculum that required but thirty-four lectures from each professor, it has developed into one in which more than one hundred didactic lectures are given annually by the incumbent of each chair. In addition to this, the clinical facilities have been greatly enlarged year by year, giving to the students opportunities for the attainment of a manual dexterity undreamed of years ago. One of the most prominent advances in recent years has been the establishment of technie courses in the Freshman and Junior years, cultivating not only the hand, but the eye and brain, and thus adding greatly to the symmetrical development of the pupil. The Philadelphia Dental College was the first to introduce into its curriculum a course in oral surgery, and the first also to establish a hospital for the treatment of diseases of the oral cavity. The late Professor Garretson was the first to make a special study of such diseases, and to constitute their considera- tion a part of the dental curriculum. With him the trained hand of the dentist, in conjunction with the medically educated mind, made possible operations never before attempted. In its many years of existence the institution has lost but seven professors through death, but of those who have thus been removed two were conspicuous lights, with reputations that were world-wide. Both were men of indomitable energy, wise judg- ment, greatness of heart and nobility of character. Each was a master in the art of teaching, and each, at the time of his death, was not only the Dean of the School, .but the most distinguished member of the faculty. Dr. MeQuillen was the founder of the School. He labored unceasingly for its proper establishment, and then, through the remaining years of his life, faithfully devoted himself to its development. Practice, comfort, health, and finally life itself were sacrificed in order that the school which he loved might become a temple of knowledge worthy of the respect of all men. Dr. Garretson was as ambitious as his predecessor for the advancement of the institution with which he was connected, and 23 354 Medical, Pharmaceutical and Dental Colleges for the true elevation of the profession he loved. He was a man among men, capable of inspiring in others the confidence he felt in himself, and by his counsel and acts and teachings stimulating those under his care to the attainment of all that is noble and best in life. During its existence two changes of location have been made necessary by the growth of the College. Upon its establishment it was located at the northwest corner of Tenth and Arch Streets. There it remained until 1887, when it removed to a new and larger building on Cherry Street below Eighteenth. Outgrowing these quarters in the course of eight years, it was decided to pur- chase ground in a new locality and erect a large and commodious building, adapted solely to its own educational purposes. In 1896 a suitable location was found at Eighteenth, Buttonwood and Hamilton Streets, and after the preparation of satisfactory plans, ground was broken and the erection of the building begun. The corner-stone was laid with Masonic ceremonies January 13, 1897, and the structure completed in August, 1897. The building was opened for the Fall Term on September 1st, and formally dedicated on October 4th. Yielding to a growing sentiment among practitioners and teachers that dental colleges could better fulfil their mission when attached to larger institutions or universities, the Philadelphia Dental College, in 1907, became affiliated with Temple Univer- sity, and is now one of its recognized departments. History of the Garretson Hospital By SIMEON H. GUILFORD, D.D.S. When, in 1878, Dr. Garretson re-entered the Faculty of the Philadelphia Dental College and assumed the chair of Anatomy and Surgery he was imbued with the idea that oral surgery, to which he had devoted years of study and investigation, could not be properly taught to his classes without the aid of clinical or hospital facilities. He therefore secured the use of a small room in the building in which the Philadelphia Dental College was then located at the northwest corner of Tenth and Arch Streets. In this he placed a single cot-bed, which, with pillows and sheets donated by personal friends, constituted the entire equipment of the budding hospital. GARRETSON HOSPITAL. Temple University. The Temple University 355 With Dr. Garretson as chief surgeon and Dr. M. H. Cryer as his assistant, and with a single patient, the Hospital of Oral Surgery had its beginning in 1879. With the advent of addi- tional patients more room and increased facilities were needed. At this time the Medico-Chirurgical College, then in its infancy, felt the need of a hospital for its medical students, and it was proposed that the Hospital of Oral Surgery should become the joint hospital of both institutions with a staff selected partly from each. The arrangement was consummated and the hospital re- moved to the third floor of the Third National Bank, at the southwest corner of Market Street and Penn Square, where the Medical College was then located. After a few years the accom- modations again proved inadequate, and another building had to be provided. The Old Ladies' Home, which for many years was located on Cherry Street, west of Seventeenth, having secured a new location on Chestnut Street, west of Thirty-sixth, and erected commodious buildings thereon, moved into its new quarters and offered its former establishment for sale. Through personal subscriptions money was obtained, and the site purchased by the Medico-Chirurgical College. When the College moved into its new location the Hospital of Oral Surgery was transferred with it, and occupied part of the same building. After this the hospital rapidly grew in importance and usefulness, being governed by a large and public-spirited body of trustees, and having a staff of devoted and distinguished practitioners. Dr. Garretson was the surgeon-in-chief, and with him were associated such eminent surgeons and physicians as William Pan- coast, P. D. Keyser, H. E. Goodman and others. Upon the Board of Trustees were several members of the Faculty of the Philadel- phia Dental College, which was then occupying a building imme- diately adjoining the Medical College and Hospital. When the Dental College severed its relations with the Med- ical School, in 1896, and removed to its own building at Eighteenth and Buttonwood Streets, the Hospital of Oral Surgery was trans- ferred with it, and accommodation made for it under the same roof. Being now located in a manufacturing district, it gradually took on the character of a general hospital, receiving into its wards any cases requiring either surgical or medical treatment. 356 Medical, Pharmaceutical and Dental Colleges Dr. Garretson having died in 1895, Dr. Boenning, who succeeded him as Professor of Anatomy and Surgery in the Philadelphia Dental College, became the head of the hospital, and so continued until his death, in 1907. In 1897 it was decided to have the hos- pital regularly incorporated and its name changed to the Garret- son Hospital, in honor of its founder. The charter was granted September 20th, bearing the follow- ing names as directors : Henry C. Boenning, Simeon H. Guilford, Leo Greenbaum, Samuel B. Howell, Thomas C. Stellwagen. The staff was organized as follows: Chief of Staff, Henry C. Boenning, M.D.; Staff Assistants, H. Augustus Bacon, M.D., Ph.G., Chief Surgical Assistant; W. Wallace Fritz, M.D., D.D.S., Chief Medical Assistant; C. P. Franklin, M.D., Chief of Eye Clinic. With the continued growth of the hospital and the steady increase in the number of patients applying for treatment, its quarters in the Dental School soon again became inadequate, and an application was made to the Legislature of 1903 for an appro- priation toward the erection and equipment of a building entirely devoted to hospital purposes. The sum of forty thousand dollars was voted, twenty-five thousand of which was for the new build- ing and fifteen thousand for maintenance. Plans were now drawn up, and after they had been approved by the State, the erection of the new building was begun on a plot of ground on the north side of Hamilton Street, above Eighteenth. The sum appro- priated proving only sufficient for the laying of the foundations and the construction of the shell of the building, further work had to be abandoned until two years later, when another appro- priation was obtained from the State sufficient to complete the lower floors of the structure and fit it for occupancy. The partially completed building was formally opened and dedicated on March 2, 1908, and the first operation was performed March 5, 1908. The basement and two lower floors only have been completed, but in spite of the limited capacity during the past fiscal year, 413 patients have been admitted to the Hospital, and more than 14,000 treatments have been given in the various free out-patient dispensaries. The building is of brick with terra-cotta trimmings, four stories high, 75 feet long and 36 feet wide. The finished portion is fitted with modern hospital furnishings and equipment, has a The Temple University 357 large and efficient staff, and is daily ministering to a large num- ber of patients. In addition it serves to familiarize the medical and dental students of Temple University with the injuries and diseases common to man and their successful medical and surgical treatment. The staff of the hospital has been largely augmented by the addition of members of the medical faculty of the Temple Uni- versity, which insures an efficient service. The work of the hospital and the people to whom it affords relief make it a charity of the broadest kind, and in order to carry on this good work we must, of necessity, rely upon the charitably disposed, and those who are interested in helping us to carry it on. History of the Samaritan Hospital of Philadelphia By W. WAYNE BABCOCK, M.D. The history of the Samaritan Hospital may be divided into three periods. First, the period dealing with a small institution which was chartered by a society of physicians as the North Philadelphia Hospital. This hospital had a brief existence, finally was closed, but soon was reopened by Dr. Eussell H. Conwell. A few months later a new building was secured, and the institution named the Samaritan Hospital. The second period comprises the time from the founding of the Samaritan Hospital (1891-1901) to the formation of a medical department of the Temple College. This period shows the pro- gressive growth of the institution under the presidency of Dr. Conwell. The third period dates from the association of the hospital with the medical department of the Temple University, and is characterized by the recent marvelous growth and development of the Samaritan Hospital. EARLY HISTORY During the past century, in the latter eighties, there existed in Philadelphia a society called the North Philadelphia Medical Society. The membership of this society included about ten phy- sicians residing in Tioga, Franklinville and Germantown. When a death occurred in the practice of one of these physicians the 358 Medical, Pharmaceutical and Dental Colleges other members were called that the cause of the death might be scientifically studied. Regular meetings, which included a social evening and banquet, were held in the homes of the different members of the society. After the society had been in existence for several years, at one of the meetings it was suggested that there was need of a hospital in North Philadelphia, which should be under the direction of the society. This suggestion being favor- ably acted upon, legal advice was secured, and a charter obtained for the institution, which was called the North Philadelphia Hos- pital. Dr. F. S. Bower was elected the first President, Dr. William Howell, Secretary, and Dr. Van Artsdalen, Treasurer of the organi- zation. A brick building, 3320 North Broad Street, was rented (a building later temporarily used by St. Luke's Hospital, but now destroyed), and Mrs. Clara Fricke was appointed Matron, and a single nurse, Miss Powell, secured. The hospital was used by all members of the Medical Society, was fitted with ten or fifteen beds and received free as well as paid patients, and offered a dis- pensary service. For its support voluntary contributions from the public were solicited. Although many contributions were received, five months after the hospital had opened it was in arrears, and the President, disapproving of the financial policy, resigned. Through certain of the other physicians the ladies of one of the Baptist churches became interested in the hospital and aided in cancelling the debts. It was soon evident, however, that the hospital could not continue unless reorganized. An appeal was, therefore, made to the Eev. Bussell H. Conwell, who had already, in many ways, demonstrated his remarkable ability as an organizer of institutions and as a leader of men, to take charge of the hospital. Dr. Conwell at once recognized the great need of such a charitable institution in North Philadelphia, and entered upon this additional work with characteristic zeal and enthusiasm. The hospital, which had, in June, 1891, been closed through lack of funds, was reopened, and the work resumed under the old name of the North Philadelphia Hospital. A few months later the old building was abandoned, and a brick dwelling, the second north of Ontario Street, on the east side of Broad Street, was rented, and on January 18, 1892, was purchased. On January 30, 1892, this building was dedicated and formally opened as the Samaritan Hospital, under the leadership and inspiration of Dr. Conwell. On December 8, 1893, application was made for a charter from o X z < 2 < < The Temple University 359 the State of Pennsylvania, which was granted, establishing the corporation known as the Samaritan Hospital. In the latter part of 1892, a report of the first six months of the hospital work was published. Prom this report the following sketch of the hospital is taken: — "The Samaritan Hospital was founded by Eev. Dr. Eussell H. Conwell early in 1891. The building selected for carrying on this humane work is located on the east of Broad Street, above Ontario — a neighborhood in which the need of a hospital had long been felt. The house is a large double one with fourteen rooms, admirably adapted to hospital purposes. It stands on a plot of ground fifty by two hundred and twenty feet, which is tastefully laid out in lawns, flower beds, trees, walks, etc., and presents an appearance, inside and out, of a large private home rather than a hospital — a feature quickly observed and highly appreciated by the patients. "The Samaritan was dedicated on the afternoon of January 30, 1892, by appropriate religious ceremonies by Mr. Conwell and others, after which the building was thrown open to visitors for inspection from 3 to 10 p. m. On February 1st the hospital and dispensary were opened to patients, and from that time on the work has been growing rapidly, until now we are obliged, owing to our still limited accommodations, to turn away many who apply for admission. "The Arrangement of the Booms for Wards, etc. — The first floor is occupied by the men's surgical, the patients' reception room and the dispensary department. The dining-room and kitchen are in the rear of the building. "On the second floor are the gynaecological, the men's med- ical and the women's medical and surgical wards. In the rear of the floor is the operating room, which, being the lightest room in the house, is the best adapted for that purpose. It is thoroughly equipped with all the modern surgical appliances. "The third floor is occupied by the resident physician, matron, nurse and servants. The hospital is supported by voluntary con- tributions, and is purely non-sectarian. "Its Objects. First.— To provide free medical and surgical aid for those whose circumstances are such that they cannot afford to be treated at their own homes or to go to a doctor's office, or whose homes or lodgings, in consequence of poverty, are not 360 Medical, Pharmaceutical and Dental Colleges hygienically suitable for the treatment of their eases. Under these circumstances persons of any creed, nationality or color may be admitted to the hospital wards or be treated in the dispensary, provided they comply with the rules governing the admission of patients to the hospital and their treatment in the out-patient department, which are as follows: — "First. That all applications for the admission of patients shall he made to the medical director, and upon his recommenda- tion only shall they be admitted. "Second. That no contagious diseases shall be admitted. "Third. That no venereal diseases shall be admitted. "Fourth. That no chronic or incurable diseases shall be admitted. "Fifth. That no children under six years of age shall be admitted until a special ward for children be added to the hospital. "Sixth. That only such cases as are sick enough to be con- fined to bed, or whose cases require operation shall be admitted. "Seventh. Severe accident cases only shall be admitted on sight, day or night, without a previous examination by the medical director. "Eighth. That out-door patients applying to the dispensary shall receive treatment only on the regular days and hours of the different clinics. Emergency cases only will be treated at irreg- ular hours. "Object Second. — To provide a true Christian home for the sick, where spiritual food may be administered unto the soul as well as medicine to the body. To conduct the hospital on purely Christian principles, and have it surrounded by exemplary Chris- tian influences, non-denominational. "Object Third. — To train young women of good moral stand- ing and common school education to nurse the sick, and thus educate them to a position of honor and great usefulness in the community in which they may afterwards live. For this purpose a training school for nurses will be established in which women of the required qualifications may receive a full course of clinical and didactical instruction in nursing, besides practice in nursing in the hospital. Upon completion of their studies, they will be examined upon the subjects taught, and if satisfactorily passed, will be awarded a diploma of proficiency, entitling them to regis- tration in the nurses' register. Further particulars regarding the The Temple University 361 school will be announced by circular as soon as the plans are completed. ENDOWMENTS, DONATIONS. ETC. "The first donation day was held at the Temple, Christmas of 1891, at which time there was a generous contribution of mis- cellaneous articles. The donation day, hereafter, will be held at the hospital on Christmas, and we earnestly ask our friends to remember us on that occasion, and contribute whatever they can to the cause. A number of beds in the hospital are supported by friends, who pay $250 each year for one bed, which the benefactor has the privilege of naming after any one he chooses. This form of gift is highly recommended as being one which gives entire satisfaction to the giver, as he naturally takes interest and pride in his own bed if in none of the others. Other friends have con- tributed in various ways, such as money gifts for the general fund or special purposes, furniture, instruments and surgical appliances, linen, cooking utensils, flowers for the sick, fruit, etc. Others, again, have volunteered their services in carpentering, plumbing, painting, and so on, in the different departments of the house. BENEFITS FOR THE HOSPITAL "A number of concerts, teas and other entertainments have been given in aid of the Samaritan, all of which. were generously patronized. MANAGEMENT OF THE INSTITUTION "The hospital is under the management of a Board of Trus- tees, divided into committees, so that each department has its representative body to superintend the work. An auxiliary com- mittee of ladies supervise the domestic affairs of the house. "This hospital, although limited in its present capacity to twenty beds, compares favorably in relative proportion with the work of the larger institutions of its kind throughout the city, and has from the beginning been encouraging. The problem, the solution of which has seemed so difficult to many, i.e., whether another hospital was needed in Philadelphia, has been solved in the affirmative, and to-day even those who were opposed to its founda- tion on the grounds of its inexpedience, must admit that they were in error, and acknowledge its great usefulness in that section of the city." 362 Medical, Pharmaceutical and Dental Colleges GROWTH OF THE HOSPITAL PROPERTY The building purchased January 18, 1892, was soon overtaxed and popular subscriptions were solicited for improvements to the operating room and for the building of an addition. Aided by the Ladies' Auxiliary and others benevolently inclined, these improvements and an ambulance were secured. The annex, affording a ward capable of containing about six or eight beds, was built in the rear of the hospital building, and was opened September 26, 1906. The demand for more room resulted in the addition of the sister building at the corner of Ontario Street, which was purchased November 2, 1898. For a time a part of this building was used for patients or as a maternity, while the rest of the building served as a home for the nurses. Later it was only used as a nurses' home. A large vacant lot north of the hospital and ground east of the hospital have been purchased to provide for the future growth of the institution. An appropria- tion with which to erect new buildings was granted by the Legislature in 1901, and one story of an administration building and a north wing having three stories were completed in 1903. On August 8, 1903, the collapse of a balcony at the Philadelphia Base Ball Park resulted in seventy persons, more or less, seriously injured being brought to the hospital within an hour. To accommodate forty victims of this accident, who could not well be moved from the hospital, it was necessary to at once use the new wing, although this was not formally opened until the early part of 1904. With a second State appropriation, received in 1903, a laundry building and power house were erected to the east of the administration building. In 1905, the State appropriated fifty thousand dollars additional; with this money there was erected a new kitchen and dining building, an addition to the power house and a south wing containing two stories, and a base- ment supplying much needed larger wards, and also a place for the rapidly growing dispensary service. To provide room for the erection of the south wing the rear portions of the original dwell- ings were removed. This gave the hospital a capacity of one hundred and ten beds. In 1907, a brick home for nurses was erected upon the east side of the hospital lot with the frontage on Park Avenue, and during 1908 the old building at the corner of Broad and Ontario Streets, which had previously been used as ^Jl NURSES' TRAINING SCHOOL DENTAL ROOM. Temple University, The Temple University 363 a nurse's home, was renovated and refurnished and connected with the south wing to supply the urgent need of additional rooms for private patients. The original hospital building is now used for laboratory purposes and for housing the resident staff and certain of the hospital officers. None of these additions have kept pace with the growth of the hospital. Hardly has an addition been made before the institution has again been overtaxed. At the present time many patients are refused admission from lack of room. The wards are overcrowded, and there is frequent requisi- tion for cots which are inserted between the ward beds that the emergency cases brought to the hospital be not turned away. The rapid growth of the hospital is indicated by the number of patients admitted on successive years. In 1892, there were admitted 87 patients; in 1896, 350; in 1897, 413; in 1898, 519; in 1899, 506; in 1900, 572; in 1901, 605; in 1902, 526; 1903, 710; in 1904, 1,141; in 1905, 1,257; in 1906, 1,459; from June, 1907, to June, 1908, 2,008 were admitted. The following shows the growth of the dispensary service: — In (six months) 1892, 1,448 total visits were made to the dis- pensary; in 1896, 7,420; in 1897, 10,370; in 1898, 13,539; in 1899, 13,951; in 1900, 14,363; in 1901, 15,775; in 1902, 17,774; in 1903, 15,980; in 1904, 17,970; in 1905, 21,043; in 1906, 24,349; from June, 1907, to June, 1908, 26,717. During the six months' service of 1892 seventeen operations were done. In 1902, it is estimated that about two hundred and fifty operations were performed. In the year ending June, 1908, over eighteen hundred operations were performed upon over twelve hundred patients, an amount of operative work exceeded by but few hospitals in the State of Pennsylvania. As the hospital has continuously suffered from an insufficient number of beds to meet the demands of patients seeking relief, and as it has been essential to take care of surgical emergencies, the surgical department has outgrown the medical department of the hospital. At the Samaritan Hospital the surgical service embraces the most diverse forms of operative work. A large number of difficult modern operations in obstetric, gynsecologic, ophthalmic and orthopedic surgery as well as all types of opera- tion in general surgery, have been successfully performed, while the hospital is sought by physicians and patients for the solving 364 Medical, Pharmaceutical and Dental Colleges of the most complicated or difficult surgical problems. The num- ber of Caesarian operations has been unusually large for a general hospital. The amount of surgical work done for the operations peculiar to women exceeds that of many hospitals devoted entirely to this branch. One of the modern operations for perineorrhaphy was first developed at the Samaritan Hospital. One of the first, if not the first, operation ever done for the removal of one of the larger lobes of the lung for tuberculosis was done in this hospital. A valuable and new operation for the removal of varicose veins and for the relief of many ulcers and inflammatory conditions of the leg was devised in this hospital. The relief of certain forms of paralysis by carrying nerve trunks from one side of the spine into opposite paralyzed extremities probably originated at the Samaritan Hospital, and opened the way for giving relief for forms of paralysis hitherto considered incurable. The very ex- tensive work done in connection with spinal anesthesia at the Samaritan Hospital exceeded, perhaps by no other Eastern hos- pital, has developed important principles relating to this pro- cedure, which, in some instances, may be of a life-saving character. Narcotic anaesthesia, for the patient the most comfortable of known methods of narcosis, has perhaps nowhere been more fully studied or more fully developed than at the Samaritan Hospital. At the Samaritan Hospital there have also been devised new methods of skin grafting, and for the transference and rebuilding of lost tissues, and for the correction of malocclusion of the jaw and deformities of the face. Investigations of the cerebrospinal fluid, a study of the influence of various drugs as affecting the coagulation time of the blood, special work relating to the opsonic treatment of disease and other forms of study also indicate that the Samaritan Hospital is striving, not only to do its routine work of relieving those in the community, but is endeavoring to aid the progress of medicine by the development of safer, better and more scientific methods of practice. The Hospital Staff for 1892 consisted of Samuel W. Morton, M.D., and Judson Daland, M.D., as Physicians ; W. Frank Haehn- len, M.D., and T. W. Broackbank, M.D., Surgeons; W. Frank Haehnlen, M.D., as Gynecologist ; Samuel Wolfe, M.D., Neurol- ogist ; G. Oram King, M.D., Ophthalmic Surgeon. The Consulting Staff consisted of William Pepper, M.D., and Horatio C. Wood, M.D., as Physicians; J. William White, M.D., as Surgeon; Wil- The Temple University 365 Ham Goodell, M.D., as Gynaecologist; and William Morris, M.D., as Ophthalmic Surgeon. In 1900 the staff consisted of W. Frank Haehnlen, M.D., as Physician-in-chief, Gynaecologist and Obstetrician ; Jas. M. Anders, M.D., Samuel Wolfe, M.D., Howard S. Anders, M.D., and Levi J. Hammond, M.D., as Physicians; Ernest Laplace, M.D., Harry C. Deaver, M.D., J. A. Boger, M.D., and Levi J. Hammond, M.D., as Surgeons ; and G. Oram King, M.D., and W. W. Moorhead, M.D., as Ophthalmic Surgeons. With the affiliation of the Samaritan Hospital with the Med- ical Department of the Temple University a rule was passed that only those teaching in the Medical School should be eligible to positions on the hospital staff. The staff was therefore reor- ganized in 1903, and included Samuel Wolfe, M.D., as Physician- in-chief, and I. Newton Snively, M.D., and Boardman Eeed, M.D., as additional physicians; Edmund Holmes, M.D., as Surgeon; John Welsh Croskey, M.D., as Ophthalmic Surgeon. In February, 1903, Dr. W. Frank Haehnlen, M.D., having resigned as Gynae- cologist and Obstetrician, Dr. W. Wayne Babcock was elected in his place. Later in the year Dr. J. C. Applegate was made Obstetrician, and in November, Dr. Holmes having resigned, Dr. W. Wayne Babcock was made Surgeon-in-chief, and later Dr. Wil- mer Krusen was made Gynaecologist. Dr. A. Eobin was made Pathologist. In 1905, Dr. Eeed resigned; Dr. Wendell Eeber succeeded Dr. Croskey as Ophthalmologist; Dr. J. C. Attix was elected Chemist; Dr. J. Thompson Schell Pediatrician, and Nathan G. Ward, M.D., Laryngologist and Otologist. The changes during the past three years include the resig- nation of Dr. Schell and the appointment of Dr. James H. McKee as Pediatrician; the appointment of Dr. Collier F. Martin as Proctologist, and William A. Steel, M.D., as Genito-urinary Surgeon. History of the Philadelphia Polyclinic and College for Graduates in Medicine By R. MAX GOEPP, M.D. IN addition to her six undergraduate medical schools, Philadel- phia possesses in the Philadelphia Polyclinic and College for Graduates in Medicine a postgraduate school and hospital where graduated physicians can obtain special instruction in all branches of medicine. It has been conclusively proved by experienced teachers that it is unwise to endeavor to combine the teaching of undergraduate medical students with that required by physicians who have already passed through this course and, perhaps, also several years' experience in actual practice. The Philadelphia Polyclinic receives only students who are graduates of legally recognized medical schools, and is the only postgraduate medical school in the State of Pennsylvania. Occupy- ing a distinct field of its own, it does not compete in any way with other teaching institutions in the city, but has graduates from all of them amongst its students, as well as from every State of the Union, from Canada and elsewhere. The physician whose practice obliges him to live at some dis- tance from medical centers of thought finds it a great mental stimulus to confer occasionally with his colleagues and discuss with them the newest methods of treatment and the practical effect of the latest scientific discoveries. Perhaps also the needs of the com- munity in which he practices lead him to specialize. It has been the custom for the graduate physician seeking further clinical study to obtain this in Europe ; but physicians are beginning to appreciate the fact that they can frequently obtain what they need in their own country with great saving of time and money. The idea of establishing a post-graduate school in Philadelphia originated toward the end of the year 1882 with a group of physi- cians, Dr. Eichard J. Levis, Dr. Thomas G. Morton, Dr. John B. Eoberts and Dr. J. Solis-Cohen. At a meeting of these gentlemen, held on December 21, 1882, it was decided to organize an institution for giving advanced instruction in medicine and surgery. The pur- pose of the founders — to provide instruction in every branch of (366) Philadelphia Polyclinic 367 medicine — is expressed in the name which they adopted for the new enterprise and which, as we are told by Dr. John B. Eoberts in an address, entitled "A Eetrospect," delivered by him on the occasion of the laying of the corner-stone of the new Polyclinic building, was the result of a compromise. Some of those present at the inaugural meetings desired the institution to be called a "College" while to others the appellation "Polyclinic" seemed especially appropriate, as the institution was designed to be a hospital for the treatment of many, indeed, all forms of disease. To the public this odd-sounding name was for a time meaning- less, as evidenced by an early bill, which states that "Polly Mc- Clintock" is debtor to so-and-so for so much. Gradually, however, the meaning and mission of the institution became known, and now its friends, even its enemies, if it have any, call it the "Polyclinic." Much criticism was called forth by its christening; many thinking it had been intended to call the newcomer after the German "Poli- klinik," or City Hospital, and that the name had been misspelled. The first step towards the realization of the project was the opening of a dispensary, on March 12, 1883, at the southeast corner of Thirteenth and Locust Streets. The first student matriculated on March 26th, and the charter incorporating the institution "for the purpose of furnishing gratuitous medical services and advice to the sick poor and affording physicians facilities for study in special branches of practice" was granted March 19, 1883. The first trustees of the institution, who were to be five in number, were : Eichard J. Levis, M.D., J. Solis-Cohen, M.D., Henry Leffmann, M.D., Thomas G. Morton, M.D., James C. Wilson, M.D. During the three years that the Philadelphia Polyclinic con- tinued at Thirteenth and Locust Streets, over 9,000 patients received medical relief, and 159 physicians were matriculated as students. Soon, however, larger accommodations became necessary, both for the care of the patients and for the proper instruction of the students who visited the Institution, and accordingly, in 1885, two houses, situated at Broad and Lombard Streets, were leased, and small hospital wards were added to the dispensaries. These new quarters were occupied early in the year 1886. Again, in 1889, the accommodations of the temporary building proved inadequate to meet the demands of the largely increased number of physicians seeking the peculiar opportunities for study and research furnished at the Philadelphia Polyclinic. It was 368 Medical, Pharmaceutical and Dental Colleges found necessary to lease two rooms at the northwest corner of Fifteenth and Lombard Streets to provide quarters for the Path- ological and Physiological Laboratories. During this year eighty- six physicians were in attendance, representing nineteen States of the Union and graduated from twenty-one medical schools. A Sick Diet Kitchen, a School of Massage and Swedish Move- ments (attended by eight nurses), and the nucleus of a Nurses' Training School were organized by the faculty. Finally, on November 4, 1889, the corner-stone of the present Main Building was laid with Masonic ceremonies on a lot situated on the south side of Lombard Street, between Eighteenth and Nineteenth Streets. On this occasion a fund, which had been raised to endow a free bed in the name of Dr. Eichard J. Levis, was presented by Mr. Charles B. Baeder, and accepted on behalf of the Trustees, by Hon. William N. Ashman; and a short retrospective address, giving the history of the institution, was made by Dr. John B. Boberts, Secretary of the Board of Trustees. CONTENTS OF THE CORNER-STONE The programme and Masonic ceremonies at the laying of the Corner- stone. The Keystone of October 26, 1889. The announcements and reports of The Philadelphia Polyclinic and College for Graduates in Medicine, from its organization in December, 1882. The first number of The Poly- clinic medical journal. Report of the State Board of Public Charities for 1889, recommending an appropriation of $50,000 to The Philadelphia Poly- clinic and College for Graduates in Medicine. A copy of the Appropria- tion-Bill for the Polyclinic passed at the last session of the Legislature. Proof set of silver, copper and nickel coins of 1889, presented by Henry Leffmann, M.D. Appeal of the committee having charge of the Dr. R. J. Levis Testimonial Free Bed Fund, with list of subscribers to the same, and the presentation address of Charles B. Baeder, Chairman. Invitations to the laying of the Corner-stone, and to the reception given by the Ladies' Aid Society. A set of adopted plans furnished by Baker and Dallett, architects. "The History of the Institution," by its founder, John B. Roberts, A.M., M.D. The forty- third annual announcement (for the year 1882) of the Philadelphia School of Anatomy, where the Polyclinic originated. The "History of the Philadelphia School of Anatomy," by W. W. Keen, M.D. The last issue of the Medical and Surgical Reporter, Medical News, American Journal of Medical Sciences,, Times and Register, University Medical Magazine; The Press, The Times, The Record, The Inquirer, The North American, The Telegraph, The Bulletin, and The Public Ledger, with a facsimile of its first issue and biography of Mr. Geo. W. Childs. Philadelphia Polyclinic 369 With the opening of the new Polyclinic building on December 29, 1890, the institution entered upon a new life in the attractive quarters belonging to it and built for its uses. The hospital is situated in a densely populated district, extending in three direc- tions, east, south and west, and easily reached by several car lines. The nearest general hospital is about three-quarters of a mile distant. It is constructed of brick and heated by indirect radiation (hot air) . All the corners of the building are rounded according to the most modern principles of sanitary architecture. The Polyclinic Medical Society, the membership of which consists of the faculty, clinical staff, students and alumni of the college, came into existence about this time. The society held meet- ings every Tuesday evening except during July and August, at which lectures were delivered by members of the faculty on clinical as well as on scientific subjects. One meeting each month was devoted to the therapeutic section, which had for its object the investigation of drugs and remedial agents. The Ladies' Aid Society, which was organized November 14, 1888, contributed not a little to the funds of the institution. The object of this society was "to further the prosperity of the Phila- delphia Polyclinic Hospital by obtaining money to aid in the care of the sick poor, by providing necessities and luxuries of hospital life, by providing reading-matter, toys and games, by sewing and entertaining, by the furnishing and care of the wards of the only institution in the State of Pennsylvania devoted entirely to pro- viding practical instruction to graduates in medicine." This society continued to take an active interest in the fortunes of the Polyclinic by organizing "Donation Day," teas, bazaars and the like, as well as by individual efforts of its members and, besides supplying comfort and entertainment to the inmates, greatly assisted in the material prosperity of the institution. Early in the year 1883, with the idea of bringing the work of the institution more generally to the attention of the medical pro- fession, and oifering so much of the teaching as could be given in this way to those who were unable to attend the courses given at the institution, a medical journal entitled The Philadelphia Polyclinic, under the editorial care of the faculty, was established. Appearing at first quarterly, it was soon changed into a monthly, and in the beginning of 1894 into a weekly journal. As such it continued to appear until 1898. 24 370 Medical, Pharmaceutical and Dental Colleges About this time the practice was begun of offering special courses, of one week each, upon subjects in which busy practitioners are particularly interested, and since then this has become an estab- lished feature of the institution. The year 1898 saw a radical change in the management of the institution. By an almost unanimous action of the faculty, the business control of the college department was handed over to the trustees on the first of January, 1899, and Dr. J. B. Boberts, after a long and efficient service, resigned his office as president of the board of trustees. This policy has been continued since that time. During this year the Polyclinic shared with other hospitals in the city in taking care of the disabled soldiers who returned from the Spanish War. Forty-four of these soldiers were admitted as patients to the Polyclinic. The greater number were regulars from Porto Bico and Santiago, brought by the hospital ship "Belief"; there was also one assignment from Camp Meade. The hospital sent out no hospital train, as it already had all the patients it could care for properly, and, to the great regret of the house surgeons and nurses, no more soldiers could be admitted when the ship "Belief" came for the third time, as all the beds were full. The cases received were practically all typhoid fever, malaria, and a severe form of dysentery. Although the patients when received were far advanced in the disease, there was only one death to report; a record which, it is not too much to say, was not surpassed by any hospital in the city. At this time of need the many offers of gratuitous service received from citizens of Philadelphia showed that it is still the City of Brotherly Love. One of the volunteers was a janitor of a neighboring school who offered to go errands, to come and wash dishes, or do anything else free of charge. He explained he was too old to go to war, and also had a family dependent upon him, but he "could wash dishes for them as had gone"; and, be it remembered, one does not wash dishes, at least in the Polyclinic, to the sound of beating drums or other inspiring surroundings. The laboratory department of the institution had long been a source of anxious care to the faculty and board of trustees, chiefly for want of funds, and but little progress was made until, in 1898, Dr. Thomas S. Kirkbride, Jr., was appointed director of the labora- tories. His work was of the highest order and its effect was felt in many directions. He soon placed the laboratories on a sound work- Philadelphia Polyclinic 371 ing basis, demonstrating that under proper management a laboratory can be made not only practically self-supporting, but a most valuable feature of the work of a medical institution, both from the educa- tional and medical standpoint. The severe loss sustained by medical science in the death of Dr. Thomas S. Kirkbride, Jr., was felt with special severity by the Philadelphia Polyclinic. An unusually complete and thorough medical education begun in this country and continued in Europe, combined with great natural gifts, had equipped him so well for his chosen work that, when the opportunity came, no one could have been more thoroughly prepared for it. When he assumed charge of the laboratories, the work of that department was prac- tically at a standstill. It was impossible to perform satisfactorily the pathological work of the hospital, to say nothing of providing satisfactory courses in pathology for students. Dr. Kirkbride resolutely set to work and, by devoting an enormous amount of time and energy to the task, soon made himself master of the situation. Since his death, in July, 1900, the work has been carried on along the lines laid down by him, and the wisdom of his methods is shown by the steady progress which has been made in that department of the institution. In March, 1902, a department of Phototherapy was established and, a new X-ray machine to replace the one which had been in use up to that time, was equipped with a London Hospital type of lupus lamp, or Finsen light, the first apparatus of its kind put in operation in the State. A small quantity of radium was purchased abroad at the same time and added to the resources of the photo- therapeutic department. Over 1,000 light treatments were given during the first year in this department. The most recent addition to the laboratory equipment is a new Eoentgen-Eay machine, of the newest and most powerful type now in use, which was purchased in 1908. As the Polyclinic was one of the first hospitals in this country to install an X-ray outfit, the acquisition of this new type of apparatus is in line with its former policy. An important feature of the Philadelphia Polyclinic is its Nurses' Training School, which was begun on a small scale during the early years of the institution and thoroughly re-organized in 1894, when it was placed in the charge of Miss Maud Banfield, the present superintendent of the hospital. Under her able manage- ment the School speedily attained a high degree of efficiency and 372 Medical, Pharmaceutical and Dental Colleges now ranks among the best in the country, combining the advantages of a general hospital training with instruction and practical ex- perience in special departments of medical practice. The term of instruction is three years and the curriculum includes courses of lectures by members of the faculty on medicine, surgery and special branches, as well as the usual hospital training. In 1903, the Training School was comfortably housed in a new nurses' home, a model of its kind, connected with the main hospital building by a bridge across Naudain Street. It is called the "Kay House" in grateful recognition of a bequest by the late J. Alfred Kay, the bulk of which was devoted to the erection of this building. The latest addition to the plant of the Philadelphia Polyclinic is the new Dispensary Building, erected in 1908 and now awaiting completion. It is a three-story brick structure and, when completed, will be entirely devoted to the dispensary service and college depart- ment of the institution. It is hoped that the necessary funds for its internal equipment will soon be available so that the difficulties under which teachers and students are laboring in our present crowded quarters may be relieved in the near future. In the mean- time the front part of the roof of the building has been converted into a pleasant solarium for the use of convalescents, and the remainder fenced in with a high and strong wire netting and utilized for a children's playground. At the present time, twenty-seven years after its beginning in a half dozen rooms in a building at Thirteenth and Locust Streets, the Philadelphia Polyclinic occupies a half-block of ground, and its plant includes the following buildings : The Main Hospital Build- ing (with a capacity of 108 beds) ; The Dispensary Building (com- pleted, but not equipped) ; the Laboratory Building; the Nurses' Home or Kay House; the Laundry; the Boiler House; the Mortuary Chapel; the Ambulance Station; the Isolation Building and Superintendent's Residence. Even with this extensive plant the institution is hampered for lack of space, and the coming quarter century is likely to see further extensions, made necessary by the growth of the institution's activities. The members of the faculty, thirty in number, are men who are actively engaged in the practice of their respective specialties, and are assisted in the work of teaching by a staff of nine associates and twenty-six instructors, besides a large number of clinical assistants. Instruction is given in the dispensaries and wards of the Hospital NURSES' HOME, KAY HOUSE Philadelphia Polyclinic 373 in all branches of clinical medicine, and the Polyclinic Laboratories offer, in addition to regular courses in general and clinical pathology, anatomy and operative surgery, opportunities for independent research work. During the past year the number of patients treated in the Hospital was 1,617. The patients came from 32 different counties in the State of Pennsylvania, not including the county of Phila- delphia; and from 18 States other than Pennsylvania. In the Dispensaries 21,670 new cases and 76,850 return visits were re- corded, making a total of 98,520 visits. In the Accident Ward there were 7,313 new cases, with 1,045 referred for further treat- ment, making a total number of visits for the year 106,878. The number of students matriculated during the year was 130, which is less than the usual number. These students came from 27 different states of the Union and 3 foreign countries, nearly one-half being from Pennsylvania. The average stay of these students at the institution was a fraction over six weeks. BOARD OF TRUSTEES President, Francis B. Bond; Vice-President, John P. Ander- son; Secretary, Thomas S. Gates; Treasurer, C. S. Newhall; J. E. Sterrett, Franklin B. Kirkbride, George T. Lippincott, Nelson Z. Graves, John Scott, Jr., James Crosby Brown, J. Somers Smith, Jr., Sidney F. Tyler, Herbert L. Clark, C. Howard Clark, Jr., W. Hinckle Smith, Henry M. Moore. HOUSE OFFICERS Superintendent of Hospital, Miss Maud Banfield; Superin- tendent of Nurses, Miss F. Freese; Assistant Superintendent of Nurses, Miss Dora Lyon ; Instructor to Probationers, Miss Winifred Atkinson; Night Superintendent of Nurses, Miss E. A. Elliott Smith; Housekeeper and Dietitian of Hospital, Miss Kathryn M. Wood; Dietitian and Matron of Nurses' Home, Miss Leonora B. Clark; Chief Resident Physician, Willis E. Eobert, M.D. ; Resident Physicians, Frederick C. Hyatt, M.D., Wm. Garrison Marks, M.D., Carl E. Koenig, M.D., John Berry, M.D. ; Apothecary, E. H. Ging- rich; Assistant Apothecary, Miss Eose Gabriel; Bookkeeper, J. F. Snyder; Secretary to Superintendent, Mrs. A. M. Johnson; Office Assistant, Miss Bessie Goehring; Foreman of Buildings, Isaac Connelly. 374 Medical, Pharmaceutical and Dental Colleges COLLEGE DEPARTMENT Emeritus Professors. J. Solis-Cohen, M.D., Emeritus Professor of Diseases of the Throat. C. B. Nancrede, M.D., Emeritus Professor of General and Orthopedic Surgery. George C. Harlan, M.D., Emeritus Professor of Diseases of the Eye. J. Henry C. Simes, M.D., Emeritus Professor of Genito-Urin- ary Surgery. Arthur Van Harlingen, M.D., Emeritus Professor of Diseases of the Skin. H. Augustus Wilson, M.D., Emeritus Professor of Orthopedic Surgery. Edward Jackson, M.D., Emeritus Professor of Diseases of the Eye. Henry Leffmann, M.D., Emeritus Professor of Clinical Chem- istry and Hygiene. Charles K. Mills, M.D., Emeritus Professor of Diseases of the Nervous System. Samuel D. Eisley, M.D., Emeritus Professor of Diseases of the Eye. Thomas S. K. Morton, M.D., Emeritus Professor of Surgery. Howard F. Hansell, M.D., Emeritus Professor of Diseases of the Eye. Max J. Stern, M.D., Emeritus Professor of Surgery. Walter J. Freeman, M.D., Emeritus Professor of Diseases of the Throat and Nose. Harris A. Slocum, M.D., Emeritus Professor of Gynecology. Professors. John B. Eoberts, M.D., Professor of Surgery. B. F. Baer, M.D., Professor of Gynecology. Lewis W. Steinbach, M.D., Professor of Surgery. Arthur W. Watson, M.D., Professor of Diseases of the Throat and Nose. J. Montgomery Baldy, M.D., Professor of Gynecology. Lewis H. Adler, M.D., Professor of Diseases of the Rectum. James K. Young, M.D., Professor of Orthopedic Surgery. Augustus A. Eshner, M.D., Professor of Clinical Medicine. Philadelphia Polyclinic 375 Eugene L. Vansant, M.D., Professor of Diseases of the Throat. and Nose. Addinell Hewson, M.D., Professor of Anatomy. Joseph S. Gibb, M.D., Professor of Diseases of the Throat and Nose. Theo. B. Schneideman, M.D., Professor of Diseases of the Eye. G. Hudson Makuen, M.D., Professor of Defects of Speech. William G. Spiller, M.D., Professor of Diseases of the Nervous System. David Eiesman, M.D., Professor of Clinical Medicine. Jay F. Schamberg, M.D., Professor of Dermatology and Infec- tious Eruptive Diseases. James Thorington, M.D., Professor of Diseases of the Eye. William Campbell Posey, M.D., Professor of Diseases of the Eye. Francis B. Packard, M.D., Professor of Diseases of the Throat and Nose. Samuel McC. Hamill, M.D., Professor of Diseases of Children. James H. McKee, M.D., Professor of Diseases of Children. Hiliary M. Christian, M.D., Professor of Genito-Urinary Sur- gery. Francis T. Stewart, M.D., Professor of Surgery. E. Max Goepp, M.D., Professor of Clinical Medicine, Dean of the Faculty. William M. Sweet, M.D., Professor of Diseases of the Eye. Morris B. Miller, M.D., Professor of Surgery. Walter Eoberts, M.D., Professor of Diseases of the Ear. Clifford B. Farr, M.D., Professor of Diseases of the Stomach and Intestines. William E. Nicholson, M.D., Professor of Gynecology. George M. Coates, Professor of Diseases of the Ear. Consultants. William W. Keen, M.D., Consulting Surgeon. George E. DeSchweinitz, Consulting Ophthalmologist. John B. Deaver, M.D., Consulting Surgeon. POLYCLINIC LABORATORIES. James A. Kelly, M.D., Pathologist to the Hospital. John M. Swan, M.D., Instructor in Clinical Pathology and Tropical Medicine. 376 Medical, Pharmaceutical and Dental Colleges Francis B. Jacobs, M.D., Assistant in Clinical Pathology. John J. Gilbridge, M.D., Assistant in Clinical Pathology. Eose Hirschler, M.D., Instructor in Pathology of the Skin. A. A. Sargent, M.D., Instructor in Pathology and Bacteriology of the Eye. Seymour D. Ludlum, M.D., Instructor in Pathology of the Xervous System. Norman B. Gwyn, M.D., Instructor in Bacteriology. Addinell Hewson, M.D., Professor of Anatomy. Morris Booth Miller, M.D., Professor of Surgery. George M. Dorrance, M.D., Instructor in Operative Gynecology. William M. Sweet, M.D., Professor of Diseases of the Eye. Ealph Butler, M.D., Instructor in Operative Surgery of the Ear and Mastoid. Jay P. Schamberg, M.D., Professor of Diseases of the Skin. W. Estelle Lee, M.D., Eadiologist to the Hospital. Miss Mary B. Kirkbride, Eegistrar. The Philadelphia College of Pharmacy 1 By GEORGE M. BERINGER, A.M.. Ph.M. EARLY AMERICAN PHARMACY DURING the period of the early settlements and throughout the colonial period in America, pharmacy was not prac- ticed as a distinct art and calling. Every well-organized family had its collection of household remedies, consisting largely of cultivated and indigenous plants, and in each community the "herb garden" for the cultivation of plants for culinary uses and as domestic remedies became an established feature. The practice of medicine in these early days was carried on by men who, pos- sibly, because of the prevailing good health of the colonists, usually devoted a large portion of their time to other vocations. They universally dispensed their own remedies or directed their preparation at the home of the patient mainly from such simples as herbs, roots, barks, leaves and flowers. With the development of the colonies and the growth of their commerce the establishment of chemists' stores and apothecary shops became more common. The stock in trade of these com- monly included paints, dyes, teas, spices and numerous sundry items of use and adornment along with the medicines and chem- icals needed in domestic treatment, household duties and the limited mechanical and manufacturing industries. As time pro- gressed several of the more successful medical practitioners in Philadelphia opened apothecary shops, as sort of dispensaries for supplying their patients, where the mixing was usually entrusted to an apprentice or beginner in the study of medicine. About 1765, Dr. John Morgan introduced in Philadelphia the practice of writing prescriptions, or, as he called it, "the regular mode of practicing physic." He strongly advocated the separa- tion of pharmacy and of surgery from the practice of medicine proper, and argued, "We must regret that the very different employment of physician, surgeon and apothecary should be l The data contained in this sketch have been mainly compiled from the minutes of the College and numerous biographical memoirs and his- torical papers published in the American Journal of Pharmacy, and the writer acknowledges his indebtedness to their authors. (377) 378 Medical, Pharmaceutical and Dental Colleges promiscuously followed by any one man; they certainly require different talents. Let each cultivate his respective branch apart, the physician, surgeon, apothecary, etc.; the knowledge of medi- cine will be then daily improved, and it may be practiced with greater accuracy and skill. Practitioners in general business never do, or can do, the business of an apothecary in this place themselves. They have apprentices for the purpose. After visiting the sick, do not their apprentices make up their pre- scriptions? I should ask, is not an apothecary thoroughly acquainted with the art of compounding and making up medicines as skilful in it as an apprentice? Is not a man educated in the profession to be trusted in preference to one who is only learning the business." This sound advice and logical presentation slowly gained recognition, and the differentiation between the duties of the diagnostician and the prescriber and those of the compounder and dispenser gradually became an established principle, and to this must be accredited much of the accomplished progress and eleva- tion of medicine and pharmacy in America. The early part of the nineteenth century may be considered as the formative period of pharmacy on this continent. The seed sown by Dr. John Morgan was disseminated and bore fruit, and the importance of the duties of the apothecary became better understood and his position was assured, and the necessity for his professional education was recognized. About this time a few sporadic attempts were made to introduce into the medical schools lectures on the preparation of medicines, and public lecture courses on chemistry and botany were arranged for during the winter months. These appear to have been largely private ventures, and not coordinated into a definite systematic plan of education. While the apothecaries' apprentices could, through these channels, have obtained a considerable amount of valuable information, but a limited number availed themselves of the opportunity. The majority were content to obtain their special training from their preceptors and the theoretical knowledge by reading the limited number of books on materia medica, chemistry and botany that were found in the shop, and consulted in the discharge of their duties. It is greatly to the credit of the early apothecaries of Phila- delphia that many of them were men of good families, who had, The Philadelphia College of Pharmacy 379 before engaging in business, acquired a good academic schooling and were well grounded in the natural sciences as known at that time and accomplished in mathematics and belles leitres. A number were men of social prominence and possessed of great energy and forethought, and had considerable influence in shap- ing the financial and commercial interests of the city. They took an active part in the problems associated with public welfare, both political and philanthropic, and they were looked up to and re- spected as prominent citizens and influential business men. THE FOUNDING OF THE PHILADELPHIA COLLEGE OF APOTHECARIES On the recommendation of the medical faculty, the Trustees of the University of Pennsylvania, on February 21, 1821, adopted a resolution "instituting the degree of Master of Pharmacy to be conferred on such persons exercising or intending to exercise the profession of an apothecary, as are, or shall be, duly qualified to receive the same." The resolutions further provided "that the applicant must have served a regular apprenticeship of three years with a respectable apothecary, and that he pass an examina- tion by the Professors of Chemistry and Materia Medica and Pharmacy, and also present a certificate of good moral character." It was also provided "that in the future the candidate shall have attended at least two courses of lectures on chemistry, materia medica and pharmacy in this University." It will thus be seen that the medical faculty and trustees of the University of Pennsylvania had become convinced that the time was fully ripe for the special training of men who should not practice medicine, but devote their entire time to the duties of an apothecary. This action of the University, looking toward the establishment of a course in pharmacy, however, was the spark that was needed to arouse the dormant pride and self-respect of the druggists. It is not unlikely that this project of the medical faculty had been noised about and discussed prior to the action of the trustees. Immediately, Peter Lehman, whose store was located on the south side of Market Street, below Tenth, began an agitation in opposition. Calling on his friend, Henry Troth, who was a thriving wholesale druggist, he gave vent to his indignation. "Henry, this don't do," said Lehman, "the University has no right to be taking our boys away at noon to make them M. P's." Henry Troth was a man of practical ideas and enterprise, and becoming 380 Medical, Pharmaceutical and Dental Colleges enthused by the indignation of his friend at this assumption of the doctors to teach, examine, and perhaps in some degree, to suborn the independent guild of druggists and apothecaries, replied: "Why can't we have an institution of our own, train our own apprentices and ourselves supervise the qualifications of those seeking admission to our rank?" The suggestion seemed both timely and wise, and these two representative druggists proceeded at once to make it effective by calling on the druggists, and in person presenting the subject. On February 23, 1821, but two days after the aforesaid action of the University of Pennsylvania, a meeting of the druggists and apothecaries of the city and liberties of Philadelphia was held at the historic Carpenter's Hall. Stephen North was chairman and Peter Williamson was secretary. Eesolutions offered by Henry Troth were adopted. These objected to the University institut- ing a school of pharmacy, and set forth that "the method pro- posed by the trustees of that body was not suited to correcting the alleged abuses in the drug and apothecary business." A com- mittee of nine was appointed to prepare a plan for organizing the Philadelphia College of Apothecaries. This committee, remark- able for the personnel and ability of its members, was composed of Samuel Jackson, Daniel B. Smith, Robert Milnor, Peter William- son, Stephen North, Henry Troth, Samuel Biddle, Charles Allen and Frederick Brown. This movement of the University of Pennsylvania, although so distasteful to the apothecaries, had a certain ground of rea- sonableness, and had the happy effect of calling the attention of those most directly interested to the needs and requirements of the drug trade. Previous to 1821, in this new country, with its sparse population and vast territorial extent, the occasion had scarcely arisen to put in practice the systematic education fitted to the calling and profession of pharmacy; but now, the time evidently had come. The intelligent apothecaries of Philadelphia fully appreciated this, but they also knew that the instruction that might be considered suitable for the student preparing for the practice of medicine would be only partially fitted for one who was to assume the widely different responsibilities of the drug store and dispensary. "The calling of the apothecary involving peculiar responsibilities, and being inseparably connected with chemical processes, and with many delicate manipulations con- CARPENTERS' HALL, 1828 Nllteasry. HENRY TROTH. PETER LEHMAN. The Philadelphia College of Pharmacy 381 nected with the preparing and vending of potent medicines, is one demanding scientific and practical education of a peculiar kind." At the next meeting, held on March 13, 1821, this committee reported that "the best way to remedy the existing irregularities would be by the interposition and active agency of the druggists and apothecaries themselves, and to this end the formation of a college of apothecaries was recommended/' the attention of the college to be constantly directed to the qualities of articles brought into the drug markets, in which also subjects relating to the busi- ness and its objects can be discussed, and information beneficial and instructive to the trade communicated. It was also proposed to erect a school of pharmacy, in which lectures designed espe- cially for the instruction of druggists and apothecaries should be delivered. They also proposed a constitution for the college, which was approved and signed by those present. Sixty-eight of the representative druggists and apothecaries became charter members of the new college. The history of pharmaceutical education and of pharma- ceutical progress in the western hemisphere dates from these meetings held in Carpenter's Hall in 1821. Thus was established the first college of pharmacy in America, the pioneer whose pre- cepts and examples have been closely followed by many of the schools of pharmacy that have been established in more recent years. The principles and objects declared in the organization of the Philadelphia College of Apothecaries are worthy of special consideration. The primary demand that the teaching of phar- macists should be specialized and practical so as to be suited to the needs and applicable to the store practice of the apothecary, and that to attain this it must be controlled by those engaged in and acquainted with the actual condition and wants of the trade, was established as one of the distinctive features of this college. This principle has become thoroughly grounded in its history, and is recognized in pharmaceutical circles throughout the civilized world, and has established its reputation as the most practical school of pharmacy that graduates men and women capable of the proper conduct of the business of apothecaries and chemists. The successful career of many of its graduates has amply demon- strated the correctness of this principle. 382 Medical, Pharmaceutical and Dental Colleges The declaration "that the attention of this College was to be constantly directed to the qualities of articles brought into the drug market^' was the earliest movement for pure drugs, and has borne fruit in the recent enactment of pure food and drug laws. It is to the credit of the College that she has persistently and consistently worked in the direction of pure medicines, and that, true to the precepts of her teaching, many of the members have been quite active in shaping legislation destined to obtain this object. Another object then announced was that the college was to be the place for discussion of subjects relating to the business and the communication of beneficial and instructive information to the trade. The pharmaceutical meetings, with the discussion of the problems of trade and legislation, the innumerable verbal communications, the scientific and practical papers presented, the publications of the College, all attest that this object has been a prominent and ably sustained part of its work. A permanent organization was effected at a meeting held March 27, 1821, with the election of Charles Marshall as President; William Lehman, First Vice-President ; Stephen North, Second Vice-President; Wm. Heyl, Treasurer; Daniel B. Smith, Secretary; and sixteen prominent druggists as Trustees. The trustees promptly assumed their duties and organized with Samuel P. Wetherill as chairman and Daniel B. Smith as secretary. On April 9th by-laws for the government of the Board of Trustees were adopted, and the Committee on School of Phar- macy reported a plan for a course of instruction, which was approved, consisting of lectures three times a week; those on Materia Medica and Pharmacy to be given from November 1st to March 1st, and on Pharmaceutical and General Chemistry from March 1st to June 1st. Two weeks later Samuel Jackson, M.D., was elected Professor of Materia Medica and Pharmacy, and Gerard Troost, M.D., Pro- fessor of Chemistry. At the very commencement of its career, the Philadelphia College of Pharmacy adopted the policy of selecting as teachers men of the highest ability and possessing more than a local reputation. GERMAN HALL ZANE STREET BUILDING. The Philadelphia College of Pharmacy 383 INCORPORATION OF THE PHILADELPHIA COLLEGE OF PHARMACY When the college was incorporated, March 30, 1822, the title, Philadelphia College of Apothecaries, was changed to the more appropriate Philadelphia College of Pharmacy, and this change in the Act of Incorporation is said to have been made at the sug- gestion of William Lehman. COLLEGE BUILDINGS AND LABORATORIES The German Hall, situated on the east side of Seventh Street, below Market Street, was secured as a lecture hall at an annual rental of $200. This was the first home of the college, and its instructions were given here until 1833. The German society desiring the rooms occupied by the col- lege, and the members feeling that the time had now arrived when the college should own a permanent home, a committee was ap- pointed to secure a permanent situation. A lot on the south side of Zane Street (now Filbert Street), adjoining Six's sugar house, was secured for $4,500, and here, in 1833, the college erected a four-story building with a frontage of 30 feet 9 inches and a depth of 46 feet. The first and second stories were built with high ceil- ings for lecture rooms, with an amphitheatre arrangement. This modest home of the college was erected at a cost of $8,323.74. As the reputation of the college grew, the classes increased and the accommodations became insufficient for the needs of the institution, and so, in 1866, a committee was appointed to con- sider the subject of increased accommodations and the propriety of selling the Zane Street property. The following year this com- mittee reported recommending the purchase of the property No. 143 North Tenth Street, with the lots in the rear of Nos. 139, 141, 143 North Tenth Street. Early in 1868 the college acquired these properties and disposed of its Zane Street building to J. B. Lippineott. A contract for a new building was entered into, the corner-stone being laid June 24, 1868, and the building opened on October 7th following. The cost of this improvement was $34,650. ADVANCES AND CURRICULUM The policy of the Philadelphia College of Pharmacy has always been to carefully note and study the advances taking place in the practice of medicine and pharmacy, and in the chemic and biologic sciences, and to anticipate the needs of the rising gener- ation of pharmaceutical chemists by continuous advances and 384 Medical, Pharmaceutical and Dental Colleges extensions of its curriculum. Consequently, it has always been the leader in pharmaceutical education whose every announcement is critically watched and followed by other schools of pharmacy. One of the earliest changes was the separation of Pharmacy from the chair of Materia Medica in 1846, and the establishment of a distinct Professorship of the Theory and Practice of Phar- macy and the election of William Procter, Jr., to fill same. The newer methods of drug extraction, the improved processes of manufacture and the mechanical aids thereto, the increased knowl- edge of drug constituents and actions, and the more exact and elegant forms of administering medicines, were all then in their infancy; but, as anticipated by the trustees of the college, were destined to influence and perhaps to revolutionize the modern practice of the calling and demanded special instruction by one versed in the duties of a pharmacist. In 1870, the trustees fitted up a room in the College for a laboratory for the teaching of Practical Pharmacy and of Analy- tical Chemistry, and Professor John M. Maisch was placed in charge. This was the first laboratory established, and the first laboratory instruction given in a school of pharmacy in America. Here, again, the pioneer of pharmaceutical education laid the foundation for laboratory practice, which to-day constitutes a valuable part of the instruction in all well-equipped schools of pharmacy, and which is generally credited as being worthy of as much time and attention as is the purely didactic instruction. In 1877, Prof. Joseph P. Eemington instituted an evening course in pharmaceutical manipulations, and the following year the lab- oratory instruction was divided, he assuming charge of the Prac- tical Pharmacy Laboratory, and Professor Maisch retaining that of the Analytical Chemistry. The Pharmaceutical Laboratory has been recently enlarged by two sections, one devoted to practical compounding and dis- pensing of prescriptions, and the other to research work. In 1874, the College purchased two adjoining properties on Tenth Street on the south, and the one adjoining on the juorth, and in 1880, four small houses on Elwyn Street, in the rear of the college buildings, were acquired. On the latter site, in 1881, was erected an extensive chemical laboratory, equipped with apparatus and facilities for individual instruction in analytical chemistry. The teaching of analytical chemistry now became a separate LABORATORY ANNEX. FIRST LABORATORY. Philadelphia College of Pharmacy, The Philadelphia College of Pharmacy 385 and required branch, and this laboratory was placed in charge of Prof. Frederick B. Power. Professor Power remained in charge for two years, when he resigned. Since then he has held important positions abroad as research chemist, and is now in charge of the Wellcome Chemical Eesearch Laboratories of London, England. He was succeeded by Prof. Henry Trimble, and since 1899, this laboratory has been in charge of Prof. Frank X. Moerk. In 1886, an addition was built to the Chemical Laboratory and fitted up for students desiring to undertake original chemical research. About this time the necessity for again increasing the accom- modations of the college in the near future became apparent, and a committee was appointed to consider ways and means of increas- ing the college buildings. Although plans were directed to be prepared in 1888, actual building operations were not undertaken until 1892, when the Board of Trustees decided that it was neces- sary to build, and the meeting of the college approving their action, the present building fronting on Tenth Street was built and the rear buildings remodeled. By February, 1893, this opera- tion was completed, at a cost of over $75,000, and since then the Philadelphia College of Pharmacy has enjoyed the distinction of having the largest and best equipped building in the world devoted solely to pharmaceutical education. In 1894, the College established the Microscopical Laboratory at an initial expenditure of over $5,000. This was the third lab- oratory to be fully equipped as part of the necessary curriculum, and is devoted to the study of plant histology and pharmacognosy and the application of the microscope to pharmaceutical and chemical problems. For a number of years prior to this, the Alumni Association had established in the college a microscopical laboratory, and an optional course in microscopy, under the instruction of Albert P. Brown, and later under George M. Beringer. In 1897, it was decided to divide the teaching of materia medica into two full professorships. Dr. C. B. Lowe was assigned to the chair of Physiology and Pharmacology, and Henry Kraemer, Ph.D., was elected Professor of Botany and Pharmacognosy, and Director of the Microscopical Laboratory. In recent years the instruction in the pharmacy course has been extended by the addition of minor branches, such as com- mercial training, chemical mathematics, Latin of pharmacy. 25 386 Medical, Pharmaceutical and Dental Colleges SPECIAL AND POST-GRADUATE INSTRUCTION The reputation of the Philadelphia College of Pharmacy as an institution of learning and the standing of the members of its faculty as learned specialists and teachers has, for years, attracted students who desired special instruction or post-graduate work in any field, and this has resulted in the formation of classes in Practical Botany, Urine Analysis, Bacteriology, General Micro- scopy, Water Analysis, etc. The college encourages post-graduate study, and provides ample facilities for individual and special instruction in any of its departments. For those desiring to acquit themselves as public analyists or professional chemists, a most comprehensive course of chemical instruction has been mapped out covering fully the qualitative and quantitative methods as applied to a host of natural products and their technical applications, and manufactures of all kinds. The graduates of this course are thorough technical chemists and receive a certificate of proficiency in chemistry. The demands for chemists in the arts and manufactures is growing rapidly with the development of our natural resources and industries, and a num- ber of our graduates are holding excellent positions as industrial chemists or public analysts. COURSE FOR FOOD AND DRUG CHEMISTS The passage of the national and State food and drug laws has created a demand for men specially equipped as food and drug analysts. This demand is extensive, and comes not only from the government, national, State and municipal authorities, but also and in still greater degree from the manufacturers whose products now have to comply with legal standards, and at present is far in excess of the supply of competent and able men; and this condition will probably prevail for some years. To meet this demand the Philadelphia College of Pharmacy arranged a special course of instruction for food and drug analysis, covering carefully and systematically all the accepted methods for chemic and microscopic analysis of such products. In addition, the course provides for a thorough drilling of the students in the basic sciences. The needs of these special and post-graduate students has again compelled the college to extend its laboratory facilities. In PHILADELPHIA COLLEGE OP PHARMACY, 1868-1892. The Philadelphia College of Pharmacy 387 1907, another large Microscopical Laboratory, fully equipped, was opened for such students. In 1889, the College acquired the property on the north side of Cherry Street, east of Tenth, that had for many years been occupied by the "Aimwell School," a private institution supported mainly by Friends. This property formed an L, extending south from the college building 54 feet and having a frontage 42 feet 7!/2 inches on Cherry Street. During the past year this has been razed, and on the site an annex Chemical Laboratory of two stories and a basement has been erected. This has been fully equipped with special rooms and apparatus, many pieces of which were especially imported, to carry on all forms of analysis, either food, drug or technical. The roof of this annex has been converted into a botanical garden and conservatory, and is a source of supply of many typical specimens of drugs and plants. COLLEGE LIBRARY Soon after the incorporation of the College, the trustees decided to establish a library for the use of members and students, and in 1822, issued an earnest appeal for assistance "for forming the nucleus of a library." The following year a loan of $1,000 was made, to be applied to the library and cabinet. The Com- mittee on Library select works of reference, and all new books relating in any way to pharmacy, chemistry and botany, and the reports of this committee show that the library is annually aug- mented by the purchase of several hundred volumes. In addition, the pharmaceutical and chemical journals, as well as the impor- tant technical journals, are systematically preserved and bound. In 1865, the College received, by the will of Algernon S. Roberts, a bequest of $200 annually for five years to be applied to the purchase of books and scientific apparatus. Prof. William Procter, Jr., when abroad in 1867, purchased for the library a number of rare valuable foreign books of reference. In recent years the College has received a large number of volumes from private libraries. Among these may be mentioned the extensive collections of Prof. John M. Maisch, Prof. Henry Trimble, Prof. E. S. Bastin, Charles Bullock, Charles Zeller and Dr. W. S. W. Euschenberger. From the latter library Mr. Howard B. French presented to the College 2,000 volumes. The library now contains over 13,000 volumes, and an im- 388 Medical, Pharmaceutical and Dental Colleges portant collection of pamphlets. It is considered the most valu- able collection of books on pharmaceutical and allied subjects in this country, and is very frequently consulted by authors and investigators. MUSEUM AND HERBARIUM One of the most valuable adjuncts to the teaching facilities of the Philadelphia College of Pharmacy is the extensive collec- tion of specimens contained in the Museum and Herbarium. At the very commencement of the College a cabinet of rare and typical specimens was started, and by continuous addition has grown into immense proportions, requiring the largest room in the main building with ceiling two floors high and arranged with a gallery, extending around the entire room. Here are found specimens of crude drugs, raw materials and manufactured drug and chemical products from all over the world; likewise many articles of historic value, illustrating apparatus and methods that have been used abroad, as well as many that are now obsolete in our own country. The collection has been enriched by the gift of numerous specimens of raw materials received from Dr. William P. Wilson, Director of the Philadelphia Commercial Museums. The extensive private collections of the late Prof. John M. Maisch, consisting of over 3,800 specimens, illustrating commercial varieties and sources of drugs, rare principles, and type specimens of pure, spurious and adulterated articles that have at times entered commerce, have become the property of the College. Likewise, the excellent private collection of the late Professor E. S. Bastin. The Philadelphia College of Pharmacy really possesses two distinct botanical collections. The older, or original college herbarium, was largely the results of the herborizing of that talented French pharmacist, Elias Durand, and his associates. Mr. Durand had a store at Chestnut and Sixth Streets, where the Public Ledger building now stands. He was very active in the botanical work of the Academy of Natural Sciences and was neces- sarily brought into close contact with the erratic Eafinesque and Thomas Nuttall, and the other noted botanists of that period. Not a few of the specimens in this collection bear the tickets of these celebrated writers and students. Dr. Joseph Carson and his successors in the chair of Materia Medica added many specimens, and Dr. Thomas C. Porter made The Philadelphia CoUege of Pharmacy 389 several valuable and extensive contributions. In later years Pro- fessor John M. Maisch added his personal collection, made in numerous private excursions, as well as in field excursions with his students. In 1894, the College was presented, by Mr. Howard B. French and the Smith, Kline & French Company, with the extensive botanical collections of the late Isaac C. Martindale, of Camden, K J. This superb collection of more than 80,000 dried plants was considered the most valuable and extensive private herbarium in America. It represents the life work of Mr. Martindale as a collector and active student of systematic botany, and also of his close personal friend, Charles F. Parker. Mr. Martindale's studies and correspondence brought him in contact with the botanical authorities and teachers, and his specimens were fre- quently consulted by monographers and specialists, and not a few of these bear the labels and notations of such eminent botanists as Prof. Asa Gray, John M. Coulter, Sereno Watson, Dr. N. L. Britton, B. L. Greene, Dr. George Vasey, L. M. Underwood and Thomas C. Porter. Numerous correspondents and exchangers in Canada, Brazil, England, France, Germany, Austria and Scandinavia all added the flora of their countries. He likewise obtained, by purchase, the best collections offered. ~No collector, at home or abroad, sub- mitted a list of desirable plants without being gratified by an order from Mr. Martindale, who was also a liberal contributor to every botanical expedition. Among the many noted American collectors here represented may be mentioned Parry, Garber, Lemmon, Eothrock, Eusby, Curtis, Howell, Eeynolds, Austin, Pal- mer and C. G. Pringle. The Martindale Herbarium is preserved intact as a valuable authority and scientific work of reference. WORK OF THE PHILADELPHIA COLLEGE OF PHARMACY IN BEHALF OF THE PHARMACOPOEIA OF THE UNITED STATES The first edition of the United States Pharmacopoeia was published December 15, 1820. The early and active interest shown by the members in having correct formulas and national standards for drugs and medicines was evidenced by the report of the committee appointed by the College to examine the Phar- macopoeia of the United States, submitted June 26, 1821. This report recommended a continuance of the committee to institute 390 Medical, Pharmaceutical and Dental Colleges a further examination of the book, with a view of correcting the errors it contained. The first revision, following the Pharmacopoeial Convention of 1830, was published in 1831, and was edited by Dr. George B. Wood and Dr. Franklin Bache, both Professors in the Philadel- phia College of Pharmacy, and reflected the views and suggestions for improvements made by its members. The convention of 1840 authorized the Committee on Revi- sion to request the cooperation of colleges of pharmacy. In response to that request a committee of the Philadelphia College prepared a voluminous and valuable report. Pending the receipt of the report from the College the Committee on Eevision had prepared its review and was ready to report by October, 1840, but concluded to defer all action until the Philadelphia College of Pharmacy should present its report. This communication was sent to them near the end of the year 1841, and the preface to the Pharmacopoeia of 1840, refers to it as follows: "A committee of that body, charged with the work of revision, had, in the mean- time, been zealously engaged in prosecuting the objects of their appointment, and the result of their labors, having received the sanction of the College, was transmitted to the committee of the convention. This contribution from the Philadelphia College of Pharmacy consisted of a revised copy of the Pharmacopoeia, elab- orated with ability and great industry, and presenting along with numerous individual additions and alterations, some new features in the general plan. It, therefore, required close attention and deliberate examination on the part of the committee who found themselves under the necessity of going over the whole ground which they had recently traversed." The Pharmacopoeial Convention of 1850 was the first to which the incorporated colleges of pharmacy were invited to send delegates. The Philadelphia College of Pharmacy responded, and since then duly accredited delegates have attended the decennial conventions, and have been influential in the deliberations thereof and in shaping the revisions. For many years the College con- tinued a standing committee on United States Pharmacopoeia, which prepared and submitted to each convention voluminous reports containing the results of investigations, formulas for new preparations and descriptions of new remedies that claimed recog- nition, corrections, eliminations, etc. The reports of such com- PHILADELPHIA COLLEGE OF PHARMACY. The Philadelphia College of Pharmacy 391 mittees to the conventions of 1860, 1870, 1880, and 1890, were highly appreciated, and outlined many of the improvements that have been made in our national standards. Members of its faculty have always been on the Kevision Com- mittee, and active in the work thereof. Among those who have thus contributed to the labor of developing our national phar- macopoeia and placing it on the high legal and scientific position, which it now occupies, must be mentioned Dr. George B. Wood, Dr. Franklin Bache, Dr. Eobert Bridges, Prof. William Procter, Jr., Prof. John M. Maisch, Prof. Samuel P. Sadtler, Prof. Henry Kraemer, and Prof. Joseph P. Eemington, who now has the dis- tinction of being chairman of the National Convention Committee of Eevision. CONTRIBUTIONS TO SCIENCE AND LITERATURE EMANATING FROM THE PHILADELPHIA COLLEGE OF PHARMACY Not content with simply teaching students, the Philadelphia College of Pharmacy, from its earliest career, has taken an active part in disseminating literature relating to pharmacy, thus aiming to impart knowledge and improve the usefulness and professional standing of the entire calling. In 1826, The Druggists' Manual was issued by the Board of Trustees. In 1825, the publication of the American Journal of Pharmacy was commenced, and has been continued ever since. It is the oldest periodical devoted to phar- maceutical science published in the English language, and is recognized as the ethical pharmaceutical journal, both in this country and abroad. The literary and scientific productions, emanating from its faculty have been numerous and authoritative. GRADUATES OF THE COLLEGE The Philadelphia College of Pharmacy commenced its labors in a very modest way, and the success that has attended its efforts and its influence on pharmaceutical education and the progress of professional pharmacy, must be attributed to the wisdom of the founders, the solidity of the principles of foundation, the integrity of its members and the faithfulness of its teachers. For a number of years the classes were small and the com- pensation of the faculty meagre indeed. The records show that for the session of 1826-1827 but twenty-four tickets were sold for 392 Medical, Pharmaceutical and Dental Colleges the course of lectures on Chemistry by Dr. George B. Wood, and thirty for the Materia Medica lectures by Prof. Samuel Jackson. The first graduates of the College were declared by the Board of Trustees, August 23, 1826; the class consisted of but three. The following January the first diplomas were issued, and these were entirely engrossed by hand, but in March, 1828, a copper plate was ordered for diplomas. By 1834, the College had so grown in importance and the classes in size, that the Trustees decided that a public commencement for the conferring of degrees upon the candidates who had been recommended should be held each year. The introduction of music in this public function was an innovation first adopted in 1851, but it was not until 1867, that the College felt warranted in engaging the Academy of Music for its annual commencement. The Philadelphia College of Pharmacy has matriculated more than 18,000 students, and its diplomas and certificates have been conferred upon nearly 6,000 graduates. These students have come, not only from every State and territory of the Union and from our insular possessions, but also from many foreign coun- tries. The reputation of the College has attracted many grad- uates from other schools who desired to complete their education with a post-graduate course and obtain their degree from the leading and oldest college. The field of pharmaceutical application has in recent years so broadened out as to permit of specialization, and the number of our students that are applying themselves to special studies is constantly on the increase. The American Pharmaceutical Association held its first meet- ing in the Philadelphia College of Pharmacy in 1852, and from its organization the graduates of this College have been prominent in its work, and have been repeatedly elected to fill its executive offices. In the various State and local pharmaceutical societies the activity of its graduates is always manifested. The thoroughness of its tuition is attested by the fact that its graduates are found in many of the faculties of the younger schools of pharmacy. It is also greatly to the credit of their alma mater that in commercial circles we find its former students at the head of the principal pharmaceutical and chemical manufac- turing houses in America and in England. The Philadelphia College of Pharmacy is typical of the con- The Philadelphia College of Pharmacy 393 servatism that marked the institutions of the Society of Friends. The Quaker element preponderated in its inception and organiza- tion and the influence of the members of that society for many years decided its management, and has extended throughout its entire honorable career. It holds to-day a unique position among the professional schools of Pennsylvania, in the fact that it has never received any financial aid from the Commonwealth, but has always been dependent upon the contributions of its members and the tuition fees of its students. An ample endowment fund is needed, and should be provided to permit the extension of the facilities for technical education which its trustees are contemplating. While its management has always been conservative, it has, nevertheless, been characterized by a dignified progress that has maintained the Philadelphia College of Pharmacy in the foremost rank and the peer of any school of pharmacy in the world. THE PRESIDENTS OF THE PHILADELPHIA COLLEGE OF PHARMACY. The history of any institution is very largely dependent upon the wisdom and ability of its executive officers, and this sketch would be incomplete without short biographical notices of those who have been entrusted with its management, and who have suc- cessfully steered its course for nearly a century. It is regretted that the space at the command of the writer will permit of includ- ing only those who have been presidents of the society, and the many eminent men who have served as vice-presidents, treasurers, secretaries and trustees cannot be here given the consideration they merit. Charles Marshall (1744-1825), the first President of the Col- lege, was the son of Christopher Marshall, who had established his apothecary on the south side of Chestnut Street, above Second Street, in a two-story building, from the roof of which was sus- pended a large gilded ball and the store was commonly designated by its sign. 2 Christopher Marshall was prominent in business and in public affairs during the stirring events of the Eevolution- ary period. Charles Marshall received a good English and class- 2 An old advertisement read, "Imported and sold by Christopher Mar- shall at the sign of the Golden Ball near the Three Tun Tavern opposite Strawberry Alley on Chestnut Street." 394 Medical, Pharmaceutical and Dental Colleges ical education prior to entering the store of his father. On attaining his majority, he entered into partnership with his father and elder brother, and later became sole proprietor. He enjoyed a reputation for skill in preparing many of the remedies then in use, and his store was the resort of the leading physicians and citizens. He was a consistent and lifelong member of the Society of Friends. His contemporaries regarded him as possessed of scrupulous probity of character, combined with great urbanity of manner. Frederick Brown, who had learned the business in the Marshall store, and who had seryed as its chief clerk for a num- ber of years, eulogized him with the assertion, "that few nobler men ever lived than Charles Marshall." William Lehman (1779-1829), the second President of the College, serving in that capacity from 1824-1829, was descended from Godfryd Lehman, who came to this country from Saxony and settled in Germantown in 1731. He was a cousin of Peter Lehman, who inaugurated the movement that resulted in the founding of the College. He was educated at the University of Pennsylvania, graduating in both the literary course and in medi- cine. He did not, however, practice the profession of medicine, but entered the drug business with his father, George Lehman. About 1802, he opened his own apothecary store at 97 South Second Street, and a few years later removed to 76 South Second Street (old numbers), below Chestnut Street. He was associated in partnership, under the firm name of William Lehman, William Smith & Son, and later as Lehman & Smith. This partnership was dissolved in 1819, and he continued the business alone till 1822, when he entered into partnership with Algernon S. Roberts. William Lehman was a studious and industrious man, who appeared to have inherited from his grandfather, Christian Leh- man, who was an accomplished linguist, a fondness for languages, and is said to have been a Latin, French and German scholar. He was elected to the Pennsylvania Legislature in 1814, and con- tinuously reelected for fifteen years. He was a strong advocate for internal improvements, and very active in furthering many of the great works and progressive undertakings of the State. Daniel B. Smith '(1792-1883), the third President of the Col- lege, was remarkable for the versatility of his attainments. While characterized by a quiet and unostentatious manner, he was, never- theless, a happy combination of business man, philanthropist, CHARLES MARSHALL. CHARLES ELLIS. DILLWYN PARRISH. CHARLES BULLOCK. Philadelphia College of Pharmacy. The Philadelphia College of Pharmacy 395 literary and scientific scholar, teacher, editor and author. In all of these channels of his personal application he established an enviable reputation, and won the respect and admiration of his contemporaries. The ancestors of Daniel B. Smith were among those who established the early settlements in Burlington County,' N. J. He was the son of Benjamin and Deborah Morris Smith, and was born in Philadelphia. His father died when he was but one year old, and the mother removed to Burlington, N. J. His early education was acquired at the school of John Gris- com, a highly esteemed educator of that time, and whose reputa- tion attracted scholars from Philadelphia, New York and portions of New England. In this Quaker school, in Burlington, in the fall of 1808, John Griseom gave a course of lectures on chemistry, and this was probably the first teaching of chemistry in the com- mon schools in this section of the United States. The influence of a teacher so enthusiastic and endowed with such natural qualifi- cations and gifted with a conversational ability that was magnetic, must have been a potent factor in deciding the choice of a busi- ness career for Daniel B. Smith, which would bring him into close association with scientific studies. After leaving school, he entered the store of John Biddle on Market, between Fourth and Fifth Streets, to learn the drug busi- ness. After completing his apprenticeship, a partnership existed with his preceptor, under the firm name of Biddle & Smith for about one year. In 1819, Daniel B. Smith established his store on the northeast corner of Arch and Sixth Streets. At this time this locality was the quiet secluded residential section occupied by many of the most prominent members of the Society of Friends. He was one of the originators of the movement to establish a public library for supplying wholesome instruction and useful reading to boys learning a trade, which resulted in the organiza- tion of the Apprentices' Library in 1820. The following year he was active in founding the Philadelphia College of Apothecaries, and was elected Secretary. After serv- ing as Secretary for seven years, he was elected Vice-President in 1828, and President in 1829. For a period of twenty-five years he held this position, resigning in 1854. This was probably the most trying period in the history of this College. At a meeting held June 28, 1825, a committee on publication 396 Medical, Pharmaceutical and Dental Colleges was appointed, with Daniel B. Smith chairman. As a result of their efforts the first number of the American Journal of Phar- macy appeared in December, 1825, with Daniel B. Smith as editor, and he contributed the initial original article in the issue, a paper on "Epsom Salt and Magnesia." To him belongs the credit of having established, from the very beginning, a high, scientific and ethical plane for this publication. He contributed a number of articles to the first edition of the United States Dispensatory, and it was the intent of the authors, Drs. Wood and Bache, that Daniel B. Smith should be associated with them in its preparation, but his removal to Haverford at this time rendered this program im- practical. Dr. George B. Wood has permanently recorded his tribute of appreciation of the attainments in science and litera- ture, as well as the services rendered by Daniel B. Smith in behalf of pharmacy. In 1828, William Hodgson, Jr., became associated with him in business, and the firm of Smith & Hodgson continued to extend their manufacturing and wholesale business. The erection of a new four-story addition but temporarily met the demands for increased room for manufacturing purposes, and the firm of Smith & Hodgson decided to engage exclusively in the manufacturing line at their new laboratory, which they had erected on Grays Ferry Eoad and to dispose of their drug business which was trans- ferred to Bullock & Crenshaw in 1849. Daniel B. Smith took an active interest in the notable dis- coveries of the English and French physicists and chemists that were published in the early part of the nineteenth century, and repeated many of their experiments. While science claimed much of his time, achievements in the field of general literature were equally attractive. He became a member of the Franklin Institute immediately after its organization in 1824. In 1829, he was elected a member of the American Philosophical Society, and was also a member of the Academy of Natural Sciences. He was one of the incorpora- tors of the Historical Society of Pennsylvania, and that society's first Corresponding Secretary. He was one of the incorporators of the Philadelphia Savings Fund, and served as manager from 1819-1835. He was likewise one of the corporators of the institu- tion known as the House of Eefuge, In 1834, he accepted the chair of Moral Philosophy, English The Philadelphia College of Pharmacy 397 Literature and Chemistry in Haverford School (now Haverford College), and removed to Haverford. During his residence here for twelve years he issued "The Principles of Chemistry," a text- book that went through two revisions. His lectures on "Ethics and the Lives and Doctrines of the Early Members of the Society of Friends" are spoken of as literary productions of great merit. In 1846, he resigned from Haverford and gave his attention to his increasing drug and manufacturing drug business until 1853, when he retired from active business. When the American Pharmaceutical Association was organized in 1852 he was elected President. The last years of his long and useful career were spent in quiet and rest at his home in Germantown, where his life ceased on March 29, 1883, in the ninety-first year of his age. Charles Ellis (1800-1874), the fourth President of the Col- lege, was the son of William Ellis, one of the Quaker emigrants from Wales who settled in Lycoming County, Pennsylvania. Charles was the fifth son in a family of eleven children. His father's death occurred when he was but six years old, thus leav- ing the responsibility of rearing this household upon the mother, Mercy Ellis, who was highly esteemed as a preacher in the Society of Friends. This faithful parent instilled into his character that love for truth and the spirit of brotherly kindness and gentleness that characterized and ennobled the man in his mature years. From his sixth to his fifteenth year, he was carefully taught at home under a competent teacher, and then finished his school- ing at a private school at Manhattanville, N. Y. At the age of seventeen, he became an apprentice to Elizabeth Marshall, the talented daughter of Charles Marshall, the first President of the College, who, at that time, had assumed the management of this renowned store at 56 Chestnut Street (old number). In 1825, Charles Ellis and Isaac P. Morris, another apprentice, formed a copartnership and purchased the business. After continuing in business for five years the firm of Ellis & Morris was dissolved, Mr. Ellis retaining the drug business. Mr. Morris entered the iron industry, in which his family had become extensively inter- ested, and established the Port Eichmond Iron Works, which sub- sequently became part of the Cramp's shipbuilding plant. In 1832, William Ellis, a nephew, became associated in the business, and the firm title became Charles Ellis & Co. The firm rapidly extended into the wholesale and manufacturing business, 398 Medical, Pharmaceutical and Dental Colleges first establishing a laboratory in a building on VidalPs Court, to the east of the main store building. Later a stone building was erected at Sixth and Morris Streets for laboratory purposes, and the drug business removed to more commodious quarters at 724 Market Street. In 1863, there was a division of the firm, William Ellis continuing business at 724 Market Street and the reor- ganized firm of Charles Ellis, Son & Co. opening up a store at the northeast corner of Seventh and Market Streets. Subsequently Charles Ellis erected a building at Tenth and Market Streets, which was occupied by the Ellis & Co. drug firm until it ceased business in 1875. Charles Ellis was one of the sixty-eight original members of the College and was active in its affairs for over half a century, and was associated in some official capacity for more than forty years. In 1828, he was elected Eecording Secretary, and served in this capacity till 1842, when he was chosen First Vice-President. When Daniel B. Smith resigned the Presidency in 1854, he was elected to the highest office of the College. As President he faithfully served its interests for fifteen years, resigning in 1869. He was a member of the Publication Committee for forty years, the greater part of the time holding the position of Treas- urer. Charles Ellis, William Procter, Jr., and Alfred B. Taylor were the three Philadelphians that attended the meeting in New York, in 1851, to consider the subject of the proper inspection of drug imports, and out of this representative meeting grew the organization of the American Pharmaceutical Association the fol- lowing year in Philadelphia. He was active in this organization, and was elected Second Vice-President in 1855-1856 and President 1857-1858. Dillwyn Parrish (1809-1886), the fifth President of the Phila- delphia College of Pharmacy, was the son of Dr. Joseph P. Parrish, in his day one of the most accomplished and best-known physicians and surgeons of Philadelphia. His parents were leading members of the Society of Friends. He received the usual classical educa- tion at the Friends' School, that was then considered essential to the mental training and the proper foundation for a professional career. He was apprenticed to learn the drug business at the cele- brated Marshall drug store about the time of its transfer to Ellis and Morris. He matriculated at the Philadelphia College of The Philadelphia College of Pharmacy 399 Pharmacy, and was graduated therefrom in 1830. A short time after graduation, he embarked in business at Eighth and Arch Streets, where he remained a successful and honored pharmacist for more than twenty years, retiring from all active business pur- suits in 1860. He became a member of the College in 1831, and throughout his life devoted himself in its behalf, serving faith- fully on many important committees. He was elected Becording Secretary continuously from 1843 to 1854, when he became Second Vice-President. In 1868, he was elected First Vice-President, and in 1869, was made President. He remained at the head of the institution until ripe old age with its infirmities made his resigna- tion a necessity. Dillwyn Parrish was associated actively with many of the worthy charitable organizations of Philadelphia, and served as officer or director in a number of these. He was always calm and dignified in manner, wise and discreet in judgment, unwavering m integrity, and his views and counsels were greatly appreciated by his associates. Charles Bullock, Ph.M. (1826-1900), the sixth President of the Philadelphia College of Pharmacy, was a direct lineal descendant of John Bullock, a member of the Society of Friends, who emigrated from England in the early part of the eighteenth century, and settled in Burlington County, N. J. On the old homestead, near Arneytown, N. J., John Bullock, the father of Charles Bullock, was born in 1785. He was wont to relate anecdotes of these early days and experiences, and as indicating the peaceful conditions of the surroundings related that the doors were not barred at night, and that it was no unusual thing for him in his boyhood days, on coming down stairs in the early morning, to stumble over the prostrate forms of their Indian neighbors slumbering around the kitchen fire. He was a scholarly gentleman, and married Bachel Griscom, the sister of Prof. John Griseom, and became principal of a select school for boys at Wil- mington, Del. To this couple was born a son, Charles Bullock, on February 25, 1826. Charles Bullock obtained his early education at Friends' School and the school presided over by his father, and at the age of fifteen was sent to Haverford College to complete his schooling. In 1844, he was apprenticed to Messrs. Smith and Hodgson at the well-known store, Arch and Sixth Streets, to learn the 400 Medical, Pharmaceutical and Dental Colleges mysteries and arts of the apothecary. He graduated from the Philadelphia College of Pharmacy in 1847. Two years later, he formed a copartnership with a fellow-apprentice, Mr. Edmund A. Crenshaw, and the firm of Bullock & Crenshaw succeeded to the business of Smith & Hodgson. This firm greatly extended their wholesale and manufacturing business, and their products had an extensive sale throughout the United States. They were the first manufacturers in Philadelphia of sugar-coated pills. In addition to their pharmaceutical business, they established a department of chemical apparatus and pure chemicals for analyt- ical and experimental purposes, and supplied many colleges, schools and private laboratories with these materials. From his entrance into the drug business, Charles Bullock lived in an atmosphere permeated by the influence of the Phila- delphia College of Pharmacy. For half a century he was con- nected with the institution, and served faithfully as officer and member. It claimed a larger share of his time than any other interest outside of his business. He was a member of the com- mittee that selected the site of the present College buildings, and served on all the building committees till his decease. For years he was Chairman of the Property Committee and Committee on Instruction, and Treasurer of the Publication Committee, and was a member of nearly every important committee of the College or the Board of Trustees. He contributed many excellent papers to the American Journal of Pharmacy. In 1864, he was elected Eecording Secretary, and in 1874 First Yice-President, and on March 30, 1885, was chosen as President, to succeed Dillwyn Par- rish, who resigned on account of advancing years. He was a member of the American Pharmaceutical Associa- tion, serving for two years as its Eecording Secretary, and in 1876 was elected President. He was also a member of the American Philosophical Society, the Academy of Natural Sciences, and the Franklin Institute. The wide scope of work of the latter appealed strongly to his scientific and mechanical tastes and claimed a large share of his time and attention. In this Institute he did valuable work as a member of the several exhibition committees and of the Publication Committee, as well as in the elective offices of Curator, Manager, Vice-President and President. William J. Jenks, Ph.M. (1822-1904). Among the sturdy pioneers and adherents to the doctrines of "religious freedom" The Philadelphia College of Pharmacy 401 and the "inward light," who accompanied William Penn in his emigration was Thomas Jenks, who settled near Newtown, Bucks County, Pa. "William J. Jenks was a direct lineal descendant of this Quaker pioneer, being the oldest son of Michael Hutchinson Jenks, who had been a Judge of the County Court, and who, in 1844, was elected a member of Congress to represent the district of Bucks and Lehigh Counties. It is a strange, though peculiarly fitting coincidence that on March 30, 1822, the natal day of William J. Jenks, there was issued the charter of the Philadelphia College of Pharmacy, an institution with whose welfare he was to become' so intimately associated, and in whose service he was to devote such a large portion of his life work. His scholastic training was finished at the institute of John Bullock in Wilmington, Del., where he paid particular attention to acquiring a knowledge of the sciences and English and Latin languages. In 1838, he became an apprentice to Messrs. Smith & Hodgson, and graduated from the Philadelphia College of Pharmacy in 1842. After graduating, he continued with Smith & Hodgson as head clerk for about two years. He then embarked in the wholesale and retail business with Charles S. Ogden, under the firm name of Jenks & Ogden, at 160 North Third Street. This firm was succeeded by Jenks & Middleton, and after the dis- solution of the latter firm, Mr. Jenks continued alone in the busi- ness until 1887, when, finding the wholesale business no longer satisfactory, he removed to 4043-4045 Market Street and devoted himself exclusively to the retail trade, being actively engaged therein until incapacitated by his final illness. William J. Jenks became a member of the College in 1846, and was elected as Trustee the same year, and remained con- tinuously for fifty-eight years a member of the Board of Trustees. Shortly after his election as Trustee Mr. Jenks was appointed a member of the Committee on Examination, and was soon made Chairman, which position he held until 1887. He took great pride in the work of this committee, and was especially pleased in noting the increase in the number of students. His smiling, happy countenance and pleasant words of encouragement proved an inspiration to many a student, and have endeared to these the memory of the "Grand Old Man." For a number of years he was Secretary of the College, then 26 402 Medical, Pharmaceutical and Dental Colleges Second Vice-President, and was First Vice-President at the time of his decease. On March 26, 1900, he was elected President of the College, to succeed Charles Bullock. He immediately re- signed, and in eloquent and appropriate remarks expressed his appreciation of the honor intended and the compliment paid by his fellow-members to his years of service, but he was firm in his conviction that the conditions now called for a younger man of energy and aggression, and his interest in the progress of the Col- lege, as well as his increasing years, admonished him against accepting the honor and duties of the office. Howard B. French, the present President of the College, is the son of Samuel H. French, sixth in descent from Thomas French, who came to this country from England about 1677 on account of persecutions against the Society of Friends and became one of the landed proprietors of West New Jersey. His preliminary education was acquired in the Friends' schools, after which he decided to study pharmacy, and served his apprenticeship with the late William B. Webb, a thoroughly practical and reliable druggist at 1000 Spring Garden Street. He was graduated from the Philadelphia College of Pharmacy in 1871. In 1870, he entered the employ of his father's firm, French, Richard & Co., wholesale druggists and paint manufacturers, at the northwest corner of Market and Tenth Streets. In 1883, the two branches of this business were separated; Samuel H. French and his sons, William A. and Howard B. and John L. Longstreth constituting the firm of Samuel H. French & Co., who acquired that portion of the old business relating to paints and their manu- facture and to building materials. After the decease of his father, Mr. Howard B. French and Mr. Longstreth continued the copart- nership for several years. When the latter decided to retire, Mr. French purchased his interest, and is now the sole owner of the extensive business of the firm of Samuel H. French & Co., com- prising paint and plaster factories, cement mills, tilings, etc. He was elected a member of the College in 1871 and a Trus- tee the following year. His deep interest in the work of the College has always been manifest, and it was largely through his earnest efforts that the extensive addition and improvements to the College buildings were made in 1892. He served as Chairman of the Building Committee, and has been Chairman of the Prop- erty Committee for many years. He has supervised the installa- The Philadelphia College of Pharmacy 403 tion of the electric light plant and all of the recent additions of the laboratories and other improvements. He was Chairman of the Committee on Seventy-Fifth Anniversary of the Founding of the College, and the success that attended that celebration was largely due to his efforts. In 1897, he was elected Second Vice-President of the College, to succeed the late Eobert Shoemaker, and following the decease of Charles Bullock, in 1900, he was chosen President. It is noteworthy that the presidency of the Philadelphia Col- lege of Pharmacy has always been fdled by men of marked ability, who have been influential, not only in trade and professional cir- cles, but being men of sterling character and broad experience, have been active in public affairs and assumed their full share of the duties and responsibilities of useful citizenship. The present incumbent of that office is no exception, and it would be difficult indeed to find a more strenuous worker in Philadelphia than President Howard B. French. His executive ability, coupled with his earnestness and zeal and determination, accounts for the enor- mous amount of work that he accomplishes. Besides directing the extensive interests of his own firm, both manufacturing and mercantile, he is President of the Equitable Trust Co., President of the Philadelphia College of Pharmacy, Chairman of the Executive Committee of the Philadelphia Paint Club, an active member of the Philadelphia Bourse, The Trades' League and of the Union League. These are but some of the avenues of his energetic application, and in addition to these more or less business interests to look after, he has found time to take an active part in many of the public movements that have aimed at the betterment of the city and the improvement of its commer- cial interests. Nor has he been neglectful of the charities of the city and State, as he is a Manager of the Home Missionary Society, a Trustee of the Southern Home for Destitute Children, and at present President of the Pennsylvania Board of Charities, a commission that is charged with immense powers and responsibili- ties, and has general supervision over the asylums, charitable and penal institutions of the State, indirectly influences much of the educational work, and annually directs the distribution of large sums of money to the beneficiaries and charities of the Common- wealth. 404 Medical, Pharmaceutical and Dental Colleges THE TEACHERS OF THE PHILADELPHIA COLLEGE OF PHARMACY; PAST AND PRESENT MEMBERS OF THE FACULTY The policy pursued by the Philadelphia College of Pharmacy since its foundation has been to secure the most thorough and expert teaching talent available, and its faculty has always con- sisted of teachers of recognized ability and national and interna- tional reputation. It has indeed been fortunate in this connection and has been blessed with a corps of devoted teachers, whose efforts and sacrifices have been potent factors in determining its success and establishing its fame. The history of this College is largely the history of the eminent men who have devoted their lives to its work, and it is unfortunate that the limitations neces- sarily placed upon this volume preclude biographies that would give a fair conception of the personal history and career of each of these honored and revered teachers. The first Professor of Materia Medica in the College was Samuel Jackson, M.D., who filled this chair from 1821 to 1827. He was a noted and successful practitioner of medicine, teacher and author. He subsequently became a professor in the medical department of the University of Pennsylvania. Gerard Troost, M.D., an educated Hollander, was the first Professor of Chemistry, but served in that capacity for one year only. He was one of the founders of the Academy of Natural Sciences and its first President. Geology and Mineralogy were his favorite studies, and in 1828 he was elected Professor of Chem- istry, Geology and Mineralogy in the University of Nashville, and his valuable reports as State Geologist of Tennessee are consid- ered the best work of his life. Dr. George B. Wood succeeded Professor Troost as teacher of chemistry, serving in this capacity until 1831, when he was transferred to the chair of Materia Medica and Pharmacy, made vacant by the decease of Dr. Benjamin Ellis. This early teaching of materia medica and pharmacology in the Philadelphia College of Pharmacy gave Dr. Wood experience and broadened his knowl- edge, and his success here influenced him to devote his life to this special feature of medical education. In 1835, he resigned his Professorship in this College to accept the Professorship of Materia Medica in the University of Pennsylvania. His medical works rank among medical classics, and he was not only very FRANKLIN BACHB. JOHN M. MAISCH. GEORGE B. WOOD. SAMUEL JACKSON. Phila.ielD.hia College of Pharmacy. The Philadelphia College of Pharmacy 405 influential among his contemporaries in shaping the progress of medicine and pharmacy, but his influence continuing through his publications is still potent. It was during his connection with the Philadelphia College of Pharmacy as a teacher that his most cele- brated work, the "United States Dispensatory," was issued. On the eve of his retirement from the duties of an active Professorship, Dr. George B. Wood published, in 1859, a volume of "Introductory Lectures and Addresses." The very first address is one delivered to the members of the Philadelphia College of Pharmacy when Professor of Chemistry. The object of this address was to arouse the members to an appreciation of its con- ditions, its duties, and its powers, and in what way these should be exerted to fulfil its destiny. He predicted its prosperity and influence upon professional and scientific pharmacy, and "that it would render the City of Philadelphia the center of pharmaceu- tical, as it has long been of medical instruction, to the whole extent of the Union." When Dr. Samuel Jackson resigned the chair of Materia Medica, Dr. Benjamin Ellis was elected his successor, and served in that Professorship till his decease in 1831. He was likewise editor of the American Journal of Pharmacy and author of a medical formulary. Dr. Franklin Baehe was Professor of Chemistry from 1831 to 1841. It is greatly to the credit of this College that early in its career it brought together in its faculty Dr. George B. Wood and Dr. Franklin Bache, two men so eminently qualified to be pioneers in developing those branches of knowledge connected with its peculiar sphere of usefulness. In 1841, Dr. Bache resigned his Professorship in the College, to accept a similar position in the Jefferson Medical College. Dr. Eobert Eglesfeld Griffith, who was editor of the American Journal of Pharmacy and a fluent and scholarly writer on medical and scientific subjects, was elected Professor of Materia Medica, to succeed Dr. George B. Wood in 1835. He delivered but one course of lectures, as the following year he was elected Professor of Materia Medica in the University of Maryland. Dr. Joseph Carson was Professor of Materia Medica from 1836 till 1850, when he resigned to accept the chair of Materia Medica in the University of Pennsylvania. While a professor in this College he edited the American Journal of Pharmacy, and 406 Medical, Pharmaceutical and Dental Colleges two editions of "Pereira's Materia Medica," and in 1847 published his masterpiece, "Illustrations of Medical Botany," in two quarto volumes, illustrated with 100 handsome lithographic plates, the original drawings for which were his own handiwork. William E. Fisher, M.D., was teacher of chemistry for one year only, when he resigned, and was succeeded, in 1842, by Dr. Eobert Bridges, who was a faithful teacher until 1879, when, on account of his impaired health, he resigned and was honored by being elected Emeritus Professor of Chemistry. Prof. William Procter, Jr., who was preeminent among the American pharmacists of his generation, was elected to the newly- established chair of Theory and Practice of Pharmacy in 1846, and for twenty years continued his renowned career of teaching and writing on subjects relating to pharmacy. His own contribu- tions to the American Journal of Pharmacy, exclusive of editorials and abstracts, numbered 550 titles. He was one of the founders of the American Pharmaceutical Association, and one of the most active spirits in promulgating its usefulness. Prof. William Procter, Jr.'s great aim in life was the advance- ment of pharmacy. His heart was devoted to that work, his mind was keenly alive to every opportunity, and his powers of quick observation and judicial selection enabled him with unerring judg- ment to pick the kernels of truth and usefulness. His researches and investigations were marked by scientific accuracy and thor- oughness, and the results were presented in his numerous papers in a clear, convincing way that stamped them at once as the very essence of truth and made his name an authority. The practical value of his labors and contributions to the educational and professional development of pharmacy has endeared his memory to its devotees, and he has been named the "Father of American Pharmacy," and a movement is now well under way in the American Pharmaceutical Association to perpetuate his fame by a monument, to be erected in Washington. In 1850, the chair of Materia Medica became vacant by the resignation of Prof. Joseph Carson, and Dr. Eobert P. Thomas was elected to fill same. This talented teacher succumbed to an attack of spotted fever in 1864, and in the forty-third year of his life, in the height of a career of great usefulness and promise, was called from his earthly labors. Edward Parrish, Ph.C, was elected Professor of Materia The Philadelphia College of Pharmacy 407 Mediea in 1864 to fill the vacancy caused by the decease of Dr. Thomas. After serving in this capacity for several years he exchanged chairs with Prof. John M. Maisch and assumed the chair of Pharmacy. He very successfully taught this department until his decease, in 1872. While engaged as a Federal Commis- sioner to settle certain difficulties with some of the Indian tribes, he fell a victim to malarial fever, and died at Fort Sill, Indian Territory. The death of Professor Parrish occurred just prior to the time for the commencement of the course of instruction, and the Trustees induced Prof. William Procter to again assume the chair of Pharmacy. Professor Procter assented to this as a tem- porary management, and continued to give the lectures in the course till February, 1874, when an affection of the heart suddenly terminated his useful life. The present incumbent, Prof. Joseph P. Eemington, who had served as the assistant of both Professors Parrish and Procter, was then elected Professor of Theory and Practice of Pharmacy, and for thirty-five years has continued his able and popular instruction. In 1866, when Prof. William Procter, Jr., resigned the chair of Pharmacy, John M. Maisch, who had been Superintendent of the United States Army Laboratory, established in Philadelphia during the Civil War, and had, before this, been a teacher in the Few York College of Pharmacy, was elected his successor, and, in 1870, succeeded him as editor of the American Journal of Pharmacy. The exchange of chairs with Professor Parrish, by which he became Professor of Materia Mediea and Botany, was a wise movement, as the new assignment was more congenial to his studies and field of work, and materially enlarged his sphere of usefulness. Professor Maisch retained this chair of tuition until his decease, and more than two thousand students graduated under his careful, methodical and painstaking instruction. His persistent work, profound knowl- edge and retentive and accurate memory made him almost an encyclopaedia of pharmaceutical information. The special trend of his mind toward pharmacognosy is, however, indicated by his many papers on materia mediea. Probably the highest honor that was conferred upon him was the award of the Hanbury Gold Medal for Eesearch in the Chemistry and Natural His- tory of Drugs. This was the only time that this medal had been awarded to an American. This tribute reached him just a fort- 408 Medical, Pharmaceutical and Dental Colleges night prior to his decease, and its presentation was a touching yet peculiarly fitting close to a career devoted to the work that it symbolized. Henry Trimble, A.M., Ph.M., was elected Professor of Analytical Chemistry and Director of the Chemical Laboratory in 1883, and in 1894 succeeded to the Editorship of the American Journal of Pharmacy. In addition to editing and contributing many valuable papers on pharmaceutical, chemical and botanical subjects, he prepared a text-book on "Analytical Chemistry," and was joint author of a pharmaceutical and medical chemistry by Professors Sadtler and Trimble. His researches and investigations into vegetable astringents led to his publishing a unique and valuable monograph on "The Tannins," two volumes of which had appeared at the time of his decease, and a third was in eourse of preparation. Edson S. Bastin, A.M., was elected Professor of Materia Medica and Botany, to succeed John M. Maisch. He was a botanical student, author and teacher of high order. In the short period of lour years that he was spared to continue his life's work in this College his enthusiasm and zeal were demonstrated by the work accomplished. The thorough equipment of a large labora- tory in the College for microscopic and pharmacognostic study, the issuance of a new book, "Laboratory Exercises in Botany," the collection of materials for a proposed elaborate work on materia medica and the numerous extensive researches and papers, attest his indefatigable industry and ability. The present Faculty of the Philadelphia College of Pharmacy is composed of the following eminent teachers and authors : Joseph P. Eemington, Ph.M., F.C.S., Professor of Theory and Practice of Pharmacy, and Director of the Pharmaceutical Lab- oratory, and Dean of the Course in Pharmacy. Samuel P. Sadtler, Ph.D., LL.D., Professor of Chemistry, and Dean of the Department of Technical Instruction. Clement B. Lowe, Ph.G., M.D., Professor of Materia Medica. Henry Kraemer, Ph.G., Ph.B., Ph.D., Professor of Botany and Pharmacognosy, and Director of the Microscopical Laboratories. Frank X. Moerk, Ph.M., Professor of Analytical Chemistry, Director of the Chemical Laboratories. Charles H. LaWall, Ph.M., Associate Professor of Theory and Practice of Pharmacy. The Pennsylvania College of Dental Surgery 1 By HENRY LEFFMANN, A.M., M.D., D.D.S. THE history of the Pennsylvania College of Dental Surgery begins with the establishment, in 1852, of the "Philadel- phia College of Dental Surgery" under authority of an Act of the Pennsylvania Legislature, being the first institution incorporated in the State for such object. Much effort was needed on the part of the profession before this charter was secured, and, even then, the conditions involved in it were such that very soon after the sessions of the College began, serious differences of opinion arose between the Board of Trustees and the faculty. These differ- ences referred principally to the limitations in the conferring of honorary degrees in dentistry. After a few years of operation, successful, as far as classes and professional relations were con- cerned, the faculty and some friends outside of the profession deemed it best to establish an independent organization, and obtained, in the spring of 1856, from the Legislature, a charter which provided, among other important points, that no degree could be conferred except upon the written recommendation of the faculty. As a result, from that time to the present, no dis- pute has arisen concerning the respective functions of the trustees and faculty in the teaching work of the College. Under the authorization of this charter of 1856, by which the corporate title became "The Pennsylvania College of Dental Surgery," the teaching work of the institution was promptly begun, the location being at 528 Arch Street, occupying the same rooms that had been occupied by the original institution. The governing body of the latter did not secure a faculty to carry on the work, and it ceased to give instruction. The following are the members of the Board of Corporators iThe data for the earlier period of this history have been derived principally from an article by W. L. J. Griffin, A.B., D.D.S., in Volume 3 of the Proceedings of the 4th International Dental Congress (St. Louis, Mo., 1904). Data subsequent to 1880 are mostly from the writer's own recol- lection, supplemented by articles by Dr. C. Newlin Peirce (Phila. Dental Times, Vol. 1, No. 1, Oct., 1901; ibid., Vol. 5, No. 9, June, 1906). (409) 410 Medical, Pharmaceutical and Dental Colleges and Faculty, respectively, at the opening of the first session of the Pennsylvania College in 1856 : — Corporators: Henry C. Carey, William Elder, Washington L. Atlee, Elisha Townsend, George Truman, Benjamin Malone, Alfred Stille, Daniel Neall, Thomas Wood, William W. Fouche, John E. McCurdy, and T. S. Arthur. Faculty: Elisha Townsend, M.D., D.D.S., Professor of Opera- tive Dental Surgery; Ely Parry, M.D., D.D.S., Professor of Chemistry, Materia Medica and Therapeutics; Eobert Arthur, M.D., D.D.S., Professor of the Principles of Dental Surgery; J. F. B. Flagg, M.D., D.D.S., Professor of Anatomy and Surgery; Thomas L. Buckingham, M.D., D.D.S., Professor of Mechanical Dentistry. Dr. Eobert Arthur was elected Dean. The faculty was the same as that in the former college, with one exception. The first session was opened November 3, 1856. Thirty- three students matriculated. The first commencement was held on February 26, 1857, in Musical Fund Hall, at which thirteen students received the degree of Doctor of Dental Surgery. Through various causes, changes took place in the faculty, and in a few years Dr. Buckingham was made Dean, and was also made Professor of Chemistry, Materia Medica and Therapeutics. In 1858, Dr. C. Kewlin Peirce became Professor of Operative Den- tistry, and in 1862 was elected Dean. In 1863, several incidents occurred that seemed likely to injure the College seriously. The owners of the building, in which the sessions were held, gave notice of their wish to use the rooms occupied by the College for their own purposes. A charter had been obtained for another dental school, and the persons inter- ested in this new venture used certain important advantages to the detriment of the Pennsylvania College. Among other mat- ters, access to the advertising pages of an influential journal was denied, and the mailing list, according to which the annual announcements were distributed, was also withheld. The faculty of the Pennsylvania College were, however, determined to do everything legitimate to maintain their institution. They suc- ceeded, by addressing the postmasters in different parts of the "United States, in getting lists of dentists in many places. By the lease of the second, third and fourth floors of the building at the southeast corner of Tenth and Arch Streets, more commodious THE PENNSYLVANIA COLLEGE OF DENTAL SURGERY. The Pennsylvania College of Dental Surgery 411 and more convenient quarters were obtained, and the temporary disadvantages turned out to be benefits, for the College, in its new location, entered upon a career which led to its becoming one of the leaders in dental education in the world. It will easily be understood that at this period a large num- ber of persons were practicing dentistry without college training. There being no legal control, it was possible for any one to set up practice. Many of those so practicing were, however, men who had been well trained in their work under other dentists, and still better fitted by reason of long and observant experience. It was thought by some, who were anxious to raise dentistry to the level of a recognized liberal profession, that it would be advan- tageous to afford these non-graduates opportunity to secure the degree of Doctor of Dental Surgery. To this end, the Pennsyl- vania College published in its announcement for the session of 1866-67, that it would grant the degree to those who had been in practice since 1852 ; were at the time of application in good stand- ing in the profession ; and could pass an examination given by the faculty. No attendance on lectures was required, and the fees to be paid were those for matriculation and diploma. Looking back upon this plan with our present knowledge of the require- ments for professional degrees, it seems to be a not very well- advised method; the interests of good education seem not to be properly safeguarded, but it must be borne in mind that at the time the plan was put in operation, general and theoretic training m connection with professional schools, either in medicine or den- tistry, was quite limited. A considerable number of persons availed themselves of this opportunity, but the plan was strenuously opposed by other dental schools, and the discussion of it led ultimately to the Pennsylvania College withdrawing from the Association of Dental Colleges, that had been formed a few years before. In the course of a few years the College ceased to grant diplomas under this rule, substituting a rule which was for some years in force in all American dental colleges, namely, allowing a certain period of practice to count as a first year of lectures, but requiring one year's actual attendance on lectures to entitle the person to apply for examination for the degree. At the session of 1867-8, a woman was admitted to the class at the College. She was Mrs. Henrietta Hirschfeld, of Berlin, 412 Medical, Pharmaceutical and Dental Colleges German}', and was the first woman to undertake the study of dentistry in Philadelphia, and the second in the United States. She conducted herself in a satisfactory manner, and her admission led to the matriculation of other women in subsequent sessions. Much opposition was developed, however, to this co-educational system, and much bitterness was engendered. In 1878 the matter was fully discussed by a committee appointed under authority of the trustees. This committee reported that nothing in the char- ter could be construed to exclude women from matriculating at the College, but that it was within the powers of the College authorities to withhold the privileges of matriculation from those deemed not acceptable for any reason. It was, however, further declared that, having once accepted a person as a matriculate, this person must be allowed to continue the course of study as long as he or she complied with the regulations of the College. In course of years, the opposition to women matriculates declined to mere individual feeling, and they were freely admitted on the same basis as men. The College has, in the course of its existence, graduated over one hundred women, most of whom have secured excellent practices, and have had professional careers creditable to the college and the profession. As might be expected, some have for special reasons, especially marriage, abandoned their professional career at the outset. The constantly increasing classes and the necessity for more extended instruction, especially laboratory facilities, that had become so important in professional schools, led the faculty to seek for a more commodious building, which was found at the northwest corner of Twelfth and Filbert Streets, to which the College was transferred in 1878. In the latter part of 1877 the authorities of the University of Pennsylvania, having decided to establish a dental department in connection with that institution, a formal offer was made to constitute the Pennsylvania College the dental department of the University. After carefully considering the matter, the faculty of the Pennsylvania College was unable to reach a unanimous con- clusion, several members favoring the plan, others opposing it. It was not possible to adjust the conditions, except by unanimous consent, and a formal declinature was transmitted to the representa- tives of the University of Pennsylvania. The University, proceeding with its plan, made offers of pro- PROSTHETIC LABORATORY. READING ROOM. The Pennsylvania College of Dental Surgery 413 fessorships to several of the members of the faculty of the Penn- sylvania College, who, accepting the same, resigned from the latter institution. The chairs thus rendered vacant were promptly filled, and among the newly-elected professors was Dr. C. Newlin Peirce, who, as noted above, had at one time been Dean of the College, but had resigned. Dr. Peirce was again made Dean. The building which had been secured at Twelfth and Filbert Streets afforded greatly increased facilities, as compared with the former location. Two commodious lecture rooms were provided on the second floor, while on floors above were located an operat- ing room, a prothetic laboratory and a dissecting room. This was the first dissecting room established in a college devoted exclu- sively to the teaching of dentistry. Up to this time, dental students had been obliged to secure instruction in practical anatomy at institutions intended for medical students. A chem- ical laboratory was also installed, affording opportunity for in- structions in practical chemistry. At first, this was on optional course, with a special fee, but in 1882 the faculty made the instruction part of the requirements and appointed a professional chemist to take charge. During these years, the College, in common with other Ameri- can dental schools, was accustomed to allow a certain number of years of practice of dentistry to be equivalent to the first course of lectures. A considerable proportion of the classes consisted of those who claimed privileges under this rule. It was probably never a satisfactory system, and as the scope of dental science widened, and the complexity of teaching, especially in chemistry, physiology and biology increased, this class of students, largely, as might be supposed, persons either of limited college training or so long out of college as to derive but little advantage therefore, placed a serious burden upon the teaching staff. Among the members of the profession at large, it was felt that the time had come when no concession should be made to any one desiring to undertake so important a department of professional work. In the early eighties, this and other questions of general interest became so pressing that a conference was determined on, and in pursuance of this, a meeting of representatives of a number of colleges was held in New York City in the summer of 1884. The Pennsylvania College was represented by Drs. Peirce and Leff- mann. Dr. Peirce was elected chairman of the meeting, and later 414 Medical, Pharmaceutical and Dental Colleges the National Association of Dental Faculties was formed. This body began at once to move for higher requirements and better ethical relations. One of the first decisions was to abrogate the rule allowing a term of practice to count as an equivalent for lectures. Thus was removed one seriously disturbing condition in the teaching work of American dental colleges. The classes of the Pennsylvania College continuing to increase, it became necessary for the faculty to secure additional space. This was at first accomplished by renting other portions of the building in which the College was located. Under this arrangement much larger space was available for the chemical laboratory and the dissecting room. The relief thus afforded was only temporary, and it was evident that the College could not maintain its standing without a building specifically adapted to teaching purposes, and under its ownership. After examining several sites, a selection was made of the property at the corner of Eleventh and Clinton Streets. This was purchased in 1893, the title vested in the Board of Corporators, and the work of altering and rebuilding promptly undertaken. A considerable portion of the expense was borne by the faculty of the College; for these subscriptions, second mortgage debenture bonds were issued. The building was first occupied in the session of 1S93-4. The location was convenient, and as the lot had three fronts, two of them on main streets, abundance of light and air was secured. The lecture and dissecting rooms are in a building practically separate from that containing the laboratories and operating room. The latter, located upon the upper floor, is a large, bril- liantly lighted room, excellently adapted to the purpose. Some years prior to the removal to the new building, the principal American dental colleges had agreed to extend the required course for the degree to three years. This change has led to great extension of laboratory work, and now the College provides instruction in bacteriology, modeling, and in the special- ties of operative and prosthetic dentistry. These additions have necessitated considerable addition to the teaching staff, and the list of professors, demonstrators and instructors is a long one. The extension of the course to three years was followed by a lengthening of the courses, so that at present writing, about eight months of each year are occupied in work of instruction and The Pennsylvania College of Dental Surgery 415 examination. These changes have not only affected the general methods of the College, but have profoundly influenced the stu- dent life. In early days, when, at most, two short winter courses were the periods of instruction, the students had but little oppor- tunity to establish personal relations with each other, or with the teaching corps. Indeed, as has been noted, some of the grad- uates had no class relationships, and many others had only one course of lectures. Nowadays most of the graduates spend the better part of three successive years in association with one another, and, moreover, get opportunities in the extended lab- oratory work for conference and exchange of thought. These conditions have led to a large development of the social features. The interest in athletics, while not reaching the dominating posi- tion that it has obtained in the great University foundations, has been an important feature modifying the attitude of the student. In response to the social tendency, many societies have been formed. Some of these are purely for athletic contests; others, such as the glee clubs and mandolin clubs, are expressions of artistic impulses. The College has even had a well organized and meritorious dramatic club. The Greek-letter fraternities are always represented. A branch of the Young Men's Christian Association has been for a number of years in active life. Among the organizations that have promoted fellowship and assisted in the intellectual work of the College are the eponymic societies, which are now so prominent a feature of student life at professional schools. Three of such organizations are in exist- ence at the Pennsylvania College — The C. K Peirce Society, The Wilbur P. Litch Society of Stomatology, The Henry Leffmann Society of Odontology. These societies manifest a reasonable emulation in discussing the accessory questions in the science of dentistry, supplementing the formal teaching work, by encouraging their members to pre- sent communications, resulting from individual study and obser- vation. From time to time the societies, by public meetings, addressed by the members of the teaching body, or by prominent persons outside the College circle, afford the students opportuni- ties for special instruction and advice. The work of instruction has been carried on uninterruptedly since the organization in 1856 to the present. It is apparent from the facts set forth in this historical note, that in all professional 416 Medical, Pharmaceutical and Dental Colleges and teaching relations the prior organization, incorporated as the Philadelphia College of Dental Surgery, must be counted as part of the life of the present College, hut the corporators and faculty of the Pennsylvania College have preferred a more restricted claim, and regard the history as beginning with the granting of the charter on April 3, 1856. In pursuance of this principle, the golden anniversary of the establishment of the College was celebrated by a banquet at the Bellevue-Stratford Hotel on May 31, 1906, at which addresses were made by Dr. Wilbur P. Litch, who acted as toastmaster, Dr. William H. Trueman, Dr. I. Minis Hays, Dr. George W. Warren, Dr. James Truman, Dr. Edward C. Kirk, Dr. Frank G-. Eitter. On this occasion, four of the members of the graduating class of 1854, of the Philadelphia College of Dental Surgery, were present; Drs. C. N. Peirce, James Truman, W. Story Howe, and Eri W. Haines. Another member of this class, Dr. Louis Jack, could not attend on account of illness. In its career of more than half a century, the Pennsylvania College of Dental Surgery has maintained, without lapse, the ideals of an institution devoted to the education of men and women, without distinction of color, creed or nationality, in the science and art of dentistry. Its teaching body has been drawn largely from its alumni, but it has not hesitated to make selections outside of this circle when merit has been evidently in favor of such choice. In accordance with the tendency to specialism that has been developing so steadily in the last forty years, the College has now on its roll many who have been trained in the specialties that have arisen in dentistry, in addition to teachers who have given exclusive attention to the accessory and purely scientific aspects of dental practice. The number of graduates up to the present time (1908) is about three thousand. These include men and women from all parts of the world, who during the course of their practice have been widely scattered, so that those who look to the Pennsylvania College of Dental Surgery as their Alma Mater, are to be found in many countries. In addition to the names borne on the faculty roll at the beginning of the history of the College and those who now con- stitute the teaching body, are many who have in the intermediate years done honor to the dental profession and to the College. Among these are: Dr. John L. McQuillin, Dr. William Calvert, CHEMICAL LABORATORY. CLINIC ROOM. The Pennsylvania College of Dental Surgery 417 Dr. J. Hayhurst, Dr. J. L. Suesserott, Dr. E. Wildman, Dr. George T. Barker, Dr. W. S. Forbes, Dr. James Truman, Dr. Henry Hart- shorne, Dr. James Tyson, Dr. J. Ewing Mears, Dr. Charles J. Essig, Dr. Edwin T. Darby, Dr. I. Norman Broomel, Dr. P. E. Loder. The following is the present governing and teaching staff of the College : — BOARD OF CORPORATORS President. — I. Minis Hays, M.D. Secretary. — Joseph Pettit, M.D., D.D.S. Treasurer. — Charles F. Bonsall, D.D.S. William H. Trueman, D.D.S. ; Emlen Hutchinson, Esq. ; Hon. Samuel Gustine Thompson; W. Atlee Burpee, Esq.; C. 1ST. Peirce, D.D.S.; G. C. Purves, Esq.; William I. Schaffer, Esq.; John Scott, Jr., Esq. FACULTY C. N. Peirce, D.D.S., Emeritus Professor of Principles and Practice of Operative Dentistry; Henry LefEmann, A.M., M.D., D.D.S., Emeritus Professor of Chemistry; Wilbur F. Litch, M.D., D.D.S., Professor of Materia Medica, Therapeutics and Principles of Prosthetic Dentistry; Albert P. Brubaker, M.D., D.D.S., Profes- sor of Physiology, General Pathology and Bacteriology ; George W. Warren, A.M., D.D.S., Professor of Principles and Practice of Operative Dentistry; W. J. Eoe, M.D., D.D.S., Professor of Anatomy, Surgical Pathology and Oral Surgery; J. Bird Moyer, B.S., Ph.D., D.D.S., Professor of Chemistry and Metallurgy; H. E. Eadasch, M.D., Adjunct Professor of Physiology; William H. Trueman, D.D.S., Lecturer on Dental History; V. H. Jackson, M.D., D.D.S., New York City, Special Lecturer on Orthodontia. AUXILIARY INSTRUCTORS Clinical Instructors in Operative Dentistry.— E. Poland Hearn, D.D.S., Chief Instructor; J. T. Yoder, D.D.S.; Louis Britton, D.D.S.; J. W. Adams, D.D.S.; George F. Bonnick, D.D.S.; Wm. C. T. Bauerle, D.D.S.; Frank G. Ritter, D.D.S., Extracting and Anaesthetics. Instructors in Prosthetic Dentistry. — W. T. Herbst, D.D.S. Clarence C. Dougherty, D.D.S.; E. A. Kretschman, D.D.S. William B. Warren, D.D.S., Instructor in Crown and Bridge Work H. L. Cragin, D.D.S., Instructor in Dental Ceramics; Samuel S. 27 418 Medical, Pharmaceutical and Dental Colleges Peck, D.D.S., Instructor in Appliances for Cleft-Palate Deformities and Maxillary Fractures; W. K. Thorpe, D.D.S., Instructor in Operative Technics; Charles L. Miller, D.D.S., Instructor in Appliances for the Correction of Dental Irregularities. Special Instructors. — H. H. Shepler, B.S., D.D.S., Chemistry; E. E. Huber, D.D.S., Metallurgy; Justin E. Nyce, D.D.S., Anatomy; W. E. Eoe, D.D.S., Surgery and Bandaging; P. P. Rutherford, Ph.G., D.D.S., Bacteriology. Hospitals ANb allied Institutions Under Municipal Management The Philadelphia General Hospital The Medical History of the Philadelphia Almshouse and Hospital, from their Inception to the Consolidation of the County and City of Philadelphia in 1 854 By ROLAND G. CURTIN, M.D. IT seems rather presumptuous for me to attempt to write the history of the Philadelphia Almshouse and Hospital from its commencement until the consolidation of the city in 1854, as I had been in Philadelphia but twice before 1854; but when I remember that Watson, the author of Watson's Annals of Philadelphia, was a Jerseyman, that Washington Irving never saw Astoria, that Camp- bell, the author of Gertrude of Wyoming, was never in America, that General Lewis Wallace had never visited the Holy Land until after he had written Ben Hur, and Longfellow never saw Acadia, I take courage. Still I enter upon the task with some trepidation, know- ing from past investigation, how little information can be obtained from the early history of this neglected subject. Having passed through the various stages of student, resident physician to the insane department, resident physician to the hospital, clinical clerk or externe and finally serving twenty-six years as visiting physician to the Philadelphia Hospital, I feel that I could best write a history of the institution during the years of my service and subsequent thereto. I have not, however, been so fortunate as to be called upon for information in regard to the latter period, but instead have been asked to write a history of the period one hundred and twenty-two years before 1854. This history must, therefore, of necessity be gleaned from others. The first thing that confronts us is the settling of the date of the inception of the medical function of this time honored institu- tion. There has been much controversy upon this point for the destruction of records from vandalism, the "dust of ages," the "eat- (419) 420 Institutions Under Municipal Management ing tooth of time," leaves us little official information as to the exact time when the Philadelphia Almshouse began its medical depart- ment. This institution has suffered greatly from the loss of the official and historical records in olden times, as well as in the near past, a loss which makes it impossible for me to give an uninter- rupted medical history since the incipiency of the medical depart- ment. It is quite reasonable to suppose that an infirmary is the natural outgrowth of an almshouse, for in an almshouse are collected inmates among whom are those who are degraded, aged, degenerate, frail, deformed, crippled, and diseased as the result of their own acts as well as of accidental injuries, and perhaps also of a bad inheritance. In the early history of the City of Philadelphia the people who came here to settle were largely from England, and of such a high grade as not likely to require charitable assistance. Later on commerce brought emigrants of the poorer class, seafaring men, and penniless adventurers, those restless spirits who usually flock to a new country to seek their fortunes, thinking that more money can be made easily "somewhere else." Commerce was very brisk at that time, and the ships brought many waifs into the city from foreign countries. From 1609, when Henry Hudson discovered the Delaware Bay and Eiver (first called South Kiver), up to the time when the subject of a city almshouse was first considered there was no seeming need for such a charity in Philadelphia. It was about 1700 that an almshouse and hospital became a necessity. The Quakers took the first initiative in the benevolent work and gave to Philadelphia its first almshouse which was intended solely for the poor of their own denomination. In 1713, the Quaker Alms- house was opened, the first to be established in Philadelphia and having no connection with the city government. This house was located on the South side of Walnut Street between Third and Fourth. The main front was built in 1729, the wings or cottages having been built between 1706 and 1713. Latterly it was more like an old ladies home; it is generally stated that it took in only females, and it was often facetiously called the "Quaker Nunnery." John Martin, a tailor, who died in 1802, gave the land to three Quakers, Thomas Chalkely, Ralph Jackson and John Michener, on, condition that they should support him for the rest of his life, and these gentleman turned it over to the aforesaid :■' -' The Philadelphia General Hospital 421 use, which was probably agreed upon previously with Mr. Martin. The front building was torn down in 1841. The last of the smaller buildings of the Quaker Almshouse were demolished in 1876. It had been latterly occupied only by a few old Quakeresses. It was a popular belief in some quarters that this was the first meeting place of Evangeline and Gabriel after leaving Acadia, but as we have no knowledge of any medical history of this interesting charity, and as historians state that it had no medical department, and further as we are led to believe that only Quakeresses were admitted, the story seems altogether mythical. In a brief history of the "Philadelphia Almshouse and Hos- pital," Vol. I, Philadelphia Hospital Reports, page 78, Dr. C. K. Mills informs us that "One of the first acts for the better pro- vision of the poor in Pennsylvania was passed in 1700, and repealed by the Queen's Council in 1705. In 1706, the Assembly directed that the Justices of the Peace should annually appoint two overseers of the poor for each township, and also that a levy of one penny (2 cents) a pound should be made upon all real and personal estate of the citizens, and four shillings a head not other- wise ratified." FRIENDS' ALMSHOUSE. 1713-1841 In the minutes of the Common Council for July 9, 1712, there is an entry reading: "The poor of the City daily increasing, it is ye opinion of this Council that a workhouse be immediately hired to employ poor persons, sufficient persons be appointed to keep them at work, and the house and persons be provided by the Overseers of the Poor, the rent of the house and the salary of the housekeepers to be agreed for by the Mayor, Alderman Hill, Alderman Carter, Joshua Carpenter, William Hidson, Pentecost Teague, or some three of them report their doing therein at the next Council." After some delay, on September 1, 1713, Alder- men Carter and Preston were ordered to treat with Dr. Owen "as to the sum mentioned in his petition, and that an order be given upon the Overseers of the Poor to pay the same, and they are desired to take the person's bonds for the repayment thereof in six months." This was probably the first house of employment. Where the house was located is not positively known. The fore- going is all that is known about this city institution. This was probably the first house for the poor of the City of Philadelphia, if such existed. 422 Institutions Under Municipal Management This provision was necessary, for many idle persons were coming to the city, and the good people demanded that this class should he set to work, and that all should pay a share of the expense for their support. In 1717, the Assembly passed an ordinance giving permission to Philadelphia, Chester, and Bristol, Pennsylvania, to erect a workhouse, but the permission was not acted upon. As will be stated in more detail in the history of the first period of the almshouse, on a plot of ground called "The Green Meadows," between Third and Pourth, and Spruce and Pine Streets, an almshouse was erected in 1732. This was outside of the built-up portion of the city at that time. In 1742, a pesthouse, or contagious hospital, was erected upon Fisher's Island, located near the mouth of the Schuylkill Eiver. On the western shore of the island buildings were erected for the accommodation of the sick. Later this island was called "Province Island," and still later "State Island." This was used as a refuge for those having contagious diseases, and was the first quarantine station for the port of Philadelphia. To go back one hundred and sixty-six years and collate the early history of the medical department of the Philadelphia Almshouse is a difficult task, as very little official or other data have come down to us. Since the publication of the Philadelphia Hospital Eeports, beginning in 1890, much recent information has been recorded in the six volumes of these reports. Dr. D. Hayes Agnew, in 1861, collected much valuable medical history which would be now lost to us had it not been for his energy and forethought in looking up and putting in print the important data collected by him. His was the first attempt to write a full med- ical history of the Philadelphia Almshouse. He seems to have collected almost all of the existing material before 1861; and his happy style and well-known painstaking care give his statements great weight. The dearth of historical data is easily explained. The average new official comes into office and finding a quantity of old dusty books and papers, proceeds to "clean up," the evidences of his predecessors' work which often means the destruction of valuable material such as the historian is in search of. The people do not realize that "the rubbish of to-day is the history of to-morrow." Such is one of the disadvantages of the frequent change of officials The Philadelphia General Hospital 423 who have neither experience nor judgment in matters of this kind. I have witnessed two such iconoclastic visitations in "Blockley," and I do not wonder at the great want of continued historical material. We find the remaining records but few, at times not very clear, and more frequently they are lost or destroyed. 1 The little which has been collected and put in printed form is all that we can depend upon in writing the early medical history of the Philadelphia almshouse and hospital. To show how little attention has been paid in • the past to medical affairs, I may state that in 1890, when I was elected Presi- dent of the medical board, the names of the resident physicians had not been placed upon the reports of the managers. Consequently, there were no lists to be consulted. Since that time the residents have been honored by having their names in each yearly report. The history of the Philadelphia Hospital and the Philadelphia Almshouse are so indissolubly blended that it is impossible to com- plete a history of the former without referring frequently to the latter, for they have marched hand in hand under the same adminis- tering board and a single controlling superintendent. For the historical data they have furnished us, we are very thankful to Dr. D. Hayes Agnew, Dr. Alfred Stille, Dr. Charles K. Mills, to the editor of Watson's "Annals of Philadelphia," and of Scharf and Westcott's "History of Philadelphia," and to Captain Lawrence; more especially to the last named for his magnificent "History of the Philadelphia Almshouse and Hospital," which was largely collected from the official records of the governing board of these two institutions. These valuable works give us a general idea of the earlier history of this institution, of which the hospital was an outgrowth. There has been some controversy as to the location of the first hospital in America, and it has been claimed that this was in Philadelphia, but we have reliable data to prove that the Hotel Dieu l To show how valuable records are sometimes needlessly destroyed, I may cite an instance. Miss Anne H. Wharton was writing the history of Martha, the wife of George Washington, and was looking for some letters which she heard were in existence. They were stored in a garret of an old home that had been occupied continuously for many generations by Martha Washington's relatives. When Miss Wharton called at the house she was informed that the letters, of which there were many, con- tained so many misspelled words that they had been burned to conceal the errors! 424 Institutions Under Municipal Management of Montreal was founded in 1642, and that some of the Mexican hospitals are probably much older than that institution. ( See foot- note, volume I, Philadelphia Hospital Eeports.) Eecently it has been claimed that the Pennsylvania Hospital was the first hospital in the United States. We have to acknowledge that it was the first independent hospital in continuous service, but we have proof, seemingly good, that the medical department of the Philadelphia Almshouse antedated this hospital. One recent writer states that there was no hospital connected with the almshouse until 1802, but Dr. Agnew speaks of the varied routine of beneficent functions which it was fulfilling in 1742. He also states that in 1772 it was the most extensive hospital on the continent, containing three hundred and fifty persons. The author of Watson's "Annals" with reference to this subject, in volume I, page 460, says : "The earliest hospital, separate from the poorhouse, to which in early times it was united, was opened and continued for several years in the house known as Judge Kinsey"s dwelling and orchard." Dr. F. P. Henry, in his "Standard History of Medicine in Philadelphia," informs us that clinical instruction began in the Philadelphia Hospital in 1770. It is certain that the Philadelphia Almshouse in 1732, had an infir- mary or hospital for the sick and insane. No one can positively say that the infirmary was not a hospital, but it can be certainly said to be a hospital department of the almshouse. Dr. Agnew tells us that the first resident apothecary was appointed on June 6, 1788, one hundred and twenty years ago. John Trust was his name. He dispensed the prescriptions of the attending physicians. He also took short histories of the patients and kept a record of the obstet- rical patients, for which he received his board and lodging. John Davidson was made an additional apothecary and house pupil in 1789, and, in 1802, a third resident was found necessary and was appointed. A visiting physician with a resident apothecary would seem to indicate that there was a drug department, and a drug department would necessarily imply sickness and disease, which, together with one or more resident physicians would suggest a hospital department. The official name of Philadelphia Hospital was first given to the medical department in 1835. At this time the hospital department had grown to such proportions that it was believed best that it should have a separate designation. There was no great change at The Philadelphia General Hospital 425 this time in the conduct of affairs in the institution, matters remain- ing about the same. It is true that at times eases of a contagious nature were refused in order that the health and lives of the other inmates should not be imperilled. At one time it was the custom to refer all venereal cases with constitutional syphilis and the violently insane to the Pennsylvania Hospital. In regard to the first it was deemed necessary, in accordance with the current medical opinion on the subject, to subject every syphilitic case to a mercurial course carried to the extent of salivation. In the Pennsylvania Hospital the facilities for this treatment were larger and more complete than those of the almshouse hospital. In addition to the ordinary expense of board and nursing, a fee was always charged against the almshouse by the physician under whose care the case had been treated. There is a record of two guineas being paid to John Morgan 2 for such medical attendance. The fact that these cases were transferred to the Pennsylvania Hospital has been given as proof that there was no hospital in the Philadelphia Almshouse. We will leave it to the reader to decide for himself as to the justness of this claim. The almshouse could not be called a place of confinement, for those who did not require restraint did not receive it. There- fore, it was not a prison. Necessary rules had to be made to restrain the mentally unbalanced, the viciously inclined, the weak-minded, and those addicted to alcohol; in short, the ordi- nary restricting rules that are required in hospitals generally, even at this date. Indeed, the conditions were about the same as those which exist at the Philadelphia Almshouse and Hospital at the present time, that is, there were two institutions under the same board of managers, and with an officer, the superintendent, as the directing head and administrator. On February 8, 1766, the governing board of the Philadelphia Almshouse and Hospital, then located at Third or Fourth and Pine Streets, was entitled The Contributors to the Eelief and Employment of the Poor within the City of Philadelphia. This body was composed of a membership of persons who contributed each year ten pounds to the support of the almshouse. It was empowered to erect a commodious building for the use of the poor. A square lot was purchased at Tenth and Eleventh and 2 One of the two gentlemen who established the first medical school in the United States. 426 Institutions Under Municipal Management Pine and Spruce Streets, for which eight hundred pounds ($4,000) were given. During the Eevolution the contributions were greatly reduced in number, and the income diminished to such an extent that in 1781 a law was passed investing the overseers of the poor with all the powers of a corporation, under the title of Guardians of the Poor of the City of Philadelphia. In 1803 the Assembly ordered that an election should be held annually for guardians. This plan continued in force until the time of the consolidation of the city in 1854. These guardians elected their own officers, who reported to the City Councils annually a statement of their expenses and receipts. Within the time limits accorded me (1732 to 1854), the his- tory of the Philadelphia Hospital can be conveniently divided into a general introduction and three periods: The first period (1732- 1767), comprises a history of the original city almshouse, at Third and Pine Streets; the second (1767-1834), a history of the second almshouse, at Tenth and Pine Streets; and the third (1834-1854), the first twenty years of the third almshouse and hospital ("Blockley"). The Philadelphia Hospital, in the one hundred and sixty-six years of its existence, has been the scene of many of the battles of scientific medicine. It has assisted in the deciding of many important medical questions that have come before the world in that time. Valuable original investigations have been made in this hospital; new theories have been reported and tested, those which were found to be erroneous having been discarded and the correct ones, being established, recorded as worthy of the credence of medical men. For example, the labors of Drs. Gerhard and Pennock in the dead house of Blockley, finally settled the ques- tion of the pathological diagnosis between typhus and typhoid fever. Other examples might be given. THE FIRST PERIOD-THE FIRST ALMSHOUSE AND HOSPITAL 1732-1767 The erection of this almshouse was the result of a petition which was sent by the overseers of the poor to the Assembly in 1729. This petition was responded to favorably by the Common- wealth which, in 1730, granted the permission to erect an alms- house, and the Councils of the City of Philadelphia obtained the money. The Mayor, Alderman Plumstead and James Steel were The Philadelphia General Hospital 427 appointed a commission to select a piece of land, prepare plans, and proceed with the work. The commission decided to purchase a site on a piece of land called "Green Meadows," which was owned by Mr. Aldran Allen. They purchased the land, which was bounded by Third and Fourth, and Spruce and Pine Streets, on March 3, 1731. In 1732, a brick building was completed on this property for the aforesaid use, and was occupied by the paupers at this time. This was Philadelphia's first almshouse and infirmary for the use of the poor of the city. The style of architecture was said to be very similar to that of. the old Quaker Almshouse. This is all we know about its appearance, as no illustration of it is known to history. The main front of the building was towards the east, or Delaware Elver, and was approached by a stile on Third Street. On Spruce Street, the north side of the house, there was a great gate for vehicles and other general uses. Encir- cling this building was an ample piazza. We are told that it had an infirmary, or hospital, for the sick and the insane. If such were the case, there must have been physicians in attendance, but we have no knowledge who these physicians were until 1768 (one year after the removal to Tenth and Pine Streets), at which time we are informed that Drs. Cadwalader Evans and Thomas Bond were re-elected as visiting physicians. It is not known whether the infirmary was a separate build- ing, or a portion of the building set aside for hospital purposes. It is generally conceded to be the oldest infirmary and hospital in continuous service in the United States. At the opening of the first almshouse and hospital the Board of Management was called the Overseers of the Poor, and this management continued until 1766, when the title of the body was changed to that of the Contributors for the Eelief and Employment of the Poor within the City of Philadelphia. Dr. Agnew says, "In 1742, it was fulfilling a varied routine of beneficent functions in affording shelter, support and employment for the poor and indigent, a hospital for the sick, and an asylum for the idiotic, the insane and the orphan. It was dispensing its acts of mercy and blessing, when Pennsylvania was yet a province and her inhabitants the loyal sub- jects of Great Britain, more than twenty years before a school of medicine was founded in this city, and indeed before most of the great events which have given the American people a historical importance among nations of the earth." 428 Institutions Under Municipal Management Captain Lawrence in his "History of the Philadelphia Alms- house and Hospital," says, "it was a hospital for the accommodation of the sick and insane established in connection with the alms- house, and that was the inauguration of the system which has been continued up to the present time. The Philadelphia Hospital is, no doubt, the oldest hospital in continuous service in this country." A footnote on page 32, in Henry's "History of Medicine in Philadelphia," says "The city almshouse, now the Philadelphia Almshouse, had its first structure completed about 1731, and had a hospital department, the oldest in the colonies." When the first almshouse and hospital were built there were no facilities for the treatment of the violently insane patients and, as has been detailed in the introduction, they were sent to the Pennsyl- vania Hospital to have the benefit of its better facilities for their care and the same conditions existed until December, 1803, at which time underground cells, which have been described as being dark, damp and dismal, were provided at the building at Tenth and Pine Streets and the Pennsylvania Hospital cases were placed therein. This almshouse and hospital were used for thirty-five years. No one knows when the first visiting physicians were appointed to the Philadelphia Hospital, nor who they were, but we do know that, in 1768, Drs. Cadwalader Evans and Thomas Bond were serv- ing as visiting physicians, and that they were re-elected on the eighteenth of January, 1769. How long they had previously served has not been noted in history. Por these services they each received fifty pounds a year, and they were expected to furnish all the required medicines. It is probable that prior to the above date unofficial physicians had at times been in attendance. The institu- tion at this time had two hundred and forty-six inmates. The Dr. Bond referred to, delivered the first clinical lecture in the United States, at the Pennsylvania Hospital on December 3, 1766, and can, therefore, be called the "Father of Clinical Medicine in the United States, if not in America." When we consider the large population of the almshouse and the fact that it must have included the sick and the insane, it seems that physicians were in attendance prior to 1768. This almshouse and hospital sent to the new building at Tenth and Pine Streets two hundred and eighty-four persons. The Philadelphia General Hospital 429 THE SECOND PERIOD— THE SECOND ALMSHOUSE AND HOSPITAL 1767-1834 In the almshouse of this period occurred many of the most important events in the history of the institution. In this building were the first and second clinic rooms for the use of students from the University of Pennsylvania. At an early period when the classes were small, the students were taken through the wards by the visiting physicians when going their rounds, but eventually their numbers increased until it became impossible to teach them satis- factorily in this way. It was then found necessary to have a lecture room. This building was the almshouse during the calamitous visitations of yellow fever and smallpox, and the epidemics of viru- lent dysentery, and malignant typhus fever. It was also the supposed location of the final scene of Longfellow's "Evangeline," and the city's hospital during the trying time of the Kevolutionary war. The land upon which the second almshouse and hospital or "Bettering House" was situated, was four hundred feet square. It was located between Tenth and Eleventh, and Spruce and Pine Streets, and cost eight hundred pounds. The origin of the name "Bettering House," by which it was as well known as is the third almshouse by the name of "Blockley," has not been clearly deter- mined. The name has been supposed to indicate that the house caused a betterment of the condition of the poor and sick inmates. Dr. Agnew tells us that some say it was derived from Bettler Haus, or Beggar House. In time this name came to be used as a con- temptuous appellation. The piece of land on which the Bettering House was built was generally known as the "Society Ground." The work on the building was begun in 1760. The building was in the shape of an "L" and was two stories high, with an attic. The towers, two in number, were placed at the corners. These were four stories high, with an attic. In the center, midway between the towers, was a large building of plain architecture, which was four stories high, with an attic and cupola. An arcade surrounded the lower story. The public were invited to an inspection of the new building in February, 1767. At the opening, in 1767, there were admitted two hundred and eighty-four persons, and during the first year, three hundred and sixty-eight more were admitted. This would seem to be far above the normal number when we take into consideration the population 430 Institutions Under Municipal Management of the city and county. The official name of the institution was the Almshouse for the Eelief and Employment of the Poor. Dr. Agnew states that in 1782 the General Assembly of the State passed an Act permitting the managers to bind out cured venereal cases, so that they could reimburse the institution by their wages. In 1826, the property at Eleventh and Spruce Streets was so crowded that it became necessary to erect a more commodious building on a site with a farm large enough to employ those suffi- ciently well and strong in raising the farm products necessary to supply the wants of the officers and inmates. The building, which had been the scene of so many important events in the seventy years of its existence, was sold on March 2d, for one hundred and thirty thousand dollars, and was finally torn down in 1834 and 1835. THE ALMSHOUSE SHIN PLASTERS I have had in my possession for many years three "Shin Plas- ters," or specimens of colonial paper currency. One is for one shilling, another for two shillings, and a third for half a crown. They all have the same wording, except that designating their values. The one shilling note states that: — No. 12824. One shilling. THIS indented BILL of ONE SHILLING, shall entitle the Bearer to receive of the Treasurer of the Contributors to the Relief and Employ- ment of the Poor in the City of Philadelphia, the like Sum of One Shilling, of equal value with the same Sum, of the Bills of Credit of this Province, now by LAW current, according to the Directions of an Act of General Assembly of Pennsylvania, made in the Ninth Year of the Reign of his Majesty GEORGE III. Dated the Tenth Day of March, 1769. (SIGNED) J. LEWIS. CHAS. THOMSON. SAM'L RHOADS. These notes are three and a half inches long, and three inches wide, with an ornate border, and on each note is a small, almost black, picture, mostly scroll work, in which a heraldic shield is placed, this being of the Penn coat-of-arms. They all number above 12,000, showiDg that if they began at No. 1, the issue must have been a very large one. As these notes are dated March 10, 1769, as has already been stated, it will be observed that they were issued two years after the finishing and opening of the second IsfTwo Shillings. Nq./^/^a ?*£-■ THIS indented Btu. of TfTO SHILLINGS l^fliall entitle the Bearer to re- ^ceive of the Treafarer of the •^Contributors to the Relief andf jJJjEmployment of the Poor in the j^City of Philadelphia, the like tgjSum of TworSmiwifcs, ©f • ^-iqual Value with the fame Sum, ^6f the Bills of Credit of this P - — i Province, now by, aw current, accojsdiirg to the IHteftions of ariji VfeAa of General y >^-> • S? 5£AfiembryofiV*- y&j0Ct4/i/iu^&V Stf WO SHILLINGS St ^s® is® vague® ©»i0s> mg® ©shs® yagll SHINPLASTBR ISSL'ED IX ACCORDAXCE WITH AX ACT OF ASSEMBLY OP 1769 BY THE CON- TRIBUTORS FOR THE RELIEF AND EMPLOYMENT OF THE POOR. The Philadelphia General Hospital 431 almshouse at Tenth and Pine Streets. The currency was issued by an Act of the General Assembly of Pennsylvania, passed in the ninth year of the reign of His Majesty, George III. I have shown these notes to quite a number of persons, including Mr. Perrine, who is an authority on matters concerning the past history of Philadelphia. He and all whom I have ques- tioned, who are well versed in Philadelphia and Pennsylvania his- tory, have not been able to tell me the special object of this issue at the time named. It would seem probable that the contributors were short of funds when the building was finished, and that this shortage resulted in the passing of the Act of Assembly to enable them to pay the debt so incurred, or to help the out-door poor whom they had on their hands. THE PHILADELPHIA HOSPITAL IN THE REVOLUTION The almshouse and hospital and its staff were concerned with many of the important events of the Eevolution which transpired in Philadelphia. Dr. William Shippen, a visiting physician of the hospital, and one of the first faculty of the medical department of the Univer- sity of Pennsylvania, was chief physician to the "flying camp," was promoted to the post of director general on April 11, 1777, was re-elected director September 30, 1780, and resigned January 3, 1781. Dr. Benjamin Push, also a professor in the University of Pennsylvania, and a visiting physician of the Philadelphia Alms- house Infirmary, from which he resigned in 1777, was appointed president general of the hospitals in the middle department, April 11, 1777, and resigned January 30, 1788. Dr. Benjamin Duffield was surgeon in the American army, a member of the American Philosophical Society, and of the Phila- delphia College of Physicians. Dr. John Morgan was also a visiting physician of the alms- house, and was one of the original faculty of the medical depart- ment of the University of Pennsylvania. In October, 1755, he was appointed by Congress physician-in-chief of the American army, and director-general of the hospitals of the United States army. He was dismissed January 9, 1777, but was afterwards vindicated by Congress. 432 Institutions Under Municipal Management Dr. Thomas Bond, one of the earliest known visiting phy- sicians, was made medical purveyor of the United States army. The information in regard to the relations of the almshouse and hospital to the war then is interesting, but meagre. A very few facts have been recorded, and from them we glean sufficient information to show that in 1776 and 1777 the Philadelphia Almshouse and Hospital was the center of considerable military activity and interest. "On the fifth of September, 1776," says Agnew, "the Coun- cil of Safety, through its president, Thomas Wharton, Jr., addressed a note to the managers of the 'Bettering House,' as it has often been styled, asking permission for their quartermaster (deputy) general to quarter in the institution a number of the continental militia who were sick with dysentery. This was strongly opposed both by the managers and medical attendants, as calculated to endanger the health of the house. They had on former occasions suffered greatly from the prevalence of a putrid sore throat and small-pox, and had been compelled to move many of the cases to private houses in order to stay their fatal progress; and in justice to the helpless and infirm inmates — most of whom possessed little ability to resist disease — they naturally objected to the introduction of an element of danger, such as malignant dysentery, the scourge of the camps, would constitute. As all military government points to despotism, the application was merely to maintain the semblance to the legitimate form of pro- priety. This was quite natural and proper, when public interest becomes paramount to personal, and accordingly the Council ordered Col. Francis Gurney, on the twenty-third of October, to take military possession of the almshouse for the sick soldiers. No alternative was left but to make the best of the unpleasant position forced upon them. A number were transferred to the West Building, and the soldiers placed in the southeast wing of the house of employment, arresting entirely the individual opera- tions of the establishment. They retained possession of this apartment until the British took possession of the city in 1777, when they were removed. "This removal, however, in no way relieved the managers from embarrassment, as shortly after, in the month of October, the entire east wing was appropriated for the sick belonging to the king's troops under General Howe. For fear they might, in The Philadelphia General Hospital 433 like manner, appropriate the west wing also, the managers waited on Joseph Galloway to secure his influence with the general to prevent an occurrence which must entail so great disaster on the poor — its inmates being at this time of the most helpless descrip- tion." Joseph Galloway was a lawyer of distinction and wealth, Speaker to the Provincial Assembly. In our struggle he took the Eoyal side of the question, and became, under the sanction of the British community, the general superintendent of the city. When, however, the cause of the colonies brightened, and Howe was obliged to vacate the city, he was compelled to follow his master. His estates were confiscated, his fortune melted away, and he was obliged to accept the secretaryship of the commander-in-chief. It was, therefore, on account of his Eoyal proclivities the man- agers sought his aid. They were referred to him by Dr. Stuart, a surgeon-general of the Philadelphia Hospital, who promised, unless an emergency should arise, to accede to their request. "It was a short time after this, in November, at nine o'clock at night, when the poor were almost destitute of food, the bar- rack master called on two of the managers, ordering them to clear the hospital for the reception of the king's troop. The Board met the next morning, and after short deliberation refused to comply with the cruel request. On hearing their decision the British officials proceeded at once to remove the inmates— about 200 in number— of miserable, decrepit, half-starved creatures. As they were exposed to the rigors of the November air, the man- agers succeeded in securing quarters for them, some in the Free- masons old lodge, still standing on Filbert Street above Eighth, some in the Friends' meeting house; and others in Carpenters' Hall on Chestnut Street above Third. There they were main- tained until the last day of June, 1778; when the invaders left the city they were removed back to their old home. The exposure and deprivation attending their ejectment was followed by heavy mortality, as only eighty-two of the original two hundred survrved to re-enter their former quarters." On September 2, 1776, the Minutes of the Board of Managers state that "The number of troops that are passing through the city and making use of the court-house renders it extremely inconvenient to meet there, and it should hold its sessions at the 'Sign of the Golden Fleece.' 28 434 Institutions Under Municipal Management "In 1776, a number of poor and disabled soldiers were admitted to the house of employment, and the families of the soldiers were assisted by the Board. The times were such as to make it exceedingly difficult for the overseers to secure money for their use, as the people were much poorer than usual, and all available money was wanted for patriotic uses. The Board did not meet between November 26, 1776, and January, 1777, owing to the disturbed condition of affairs in the city. On the latter date George Meade, Benjamin Gibbs, David Sehafer, Samuel Bead and Mordecai Lewis met to see what could be done to help the poor of the City of Philadelphia. "On December 6, 1776, sick soldiers were brought to Phila- delphia by Dr. Bond, Jr., to the Almshouse Hospital and Pennsyl- vania Hospital, Carpenters' Hall, and many other houses. The general Continental army hospital was moved to Philadelphia on March 27, 1777. "The army of Lord Howe left the City of Philadelphia in 1777, retired to Skippack Creek, eighteen miles distant from the city." With regard to the Bevolutionary period, Lawrence, in his his- tory, states as follows : — "The overseers of the poor did not resume their sessions until July 22, 1778. The minutes of the meetings of that date states: 'The British army having at length evacuated this city after having possession of it for about nine months.' On the seventh of Feb- ruary, 1781, Dr. Bond, medical purveyor of the United States army, applied to the managers for the use of the east wing of the building (which had been used by the board of war) for the use of the captured British prisoners who were ill and in jail. The request was granted and the government agreed to pay one hundred dollars hard money each month. Dr. Samuel Duffield, who was the sole physician, consented to give his attention to the inmates and find the medicines for two hundred pounds per annum. "The southeast wing of the house of employment, which had been used as an almshouse, was at this time occupied by wounded soldiers of the continental army. The overseers were not anxious to deprive them of such shelter, but they thought that as the poor of the city were thus excluded from the building erected for their use, rent should be paid, so that it could be added to the relief fund of the board." The Philadelphia General Hospital 435 On March 3, 1790, the city complained to the board that several invalid pensioners had been receiving the benefits of the charity since the Eevolutionary War. It was charged that some of these crippled and diseased soldiers sold their pensions before they were due, and by so doing deprived the institution of any return for their maintenance. This practice was afterwards stopped, by legislative act, so that later the pension money went toward paying for their board. The Eevolutionary War not only interrupted teaching for a time hi the University of Pennsylvania, but also in the wards of the Philadelphia Hospital. In 1803, the teaching by lecture was again resumed under Drs. James and Henry Church, and, in 1807, Dr. James secured the "green room" or dead house which was out- side of the wards of the hospital for the use of clinical lectures. EVANGELINE In 1755, many of the Acadians or "Neutrals," as they were called, came to Philadelphia from Nova Scotia, New Brunswick, Newfoundland and Prince Edward Island, where they had peace- fully lived until the war between the English and Erench, at the end of which the British confiscated their lands and harshly drove them from their homes. They then scattered over the civilized parts of the continent, some coming to the colonies, while others floated down the Mississippi to Louisiana. In September, 1755, a ship arrived in the Delaware with four hundred of these unfortunates, and three hundred more arrived in the sloops "Hannah" and "Swan." They came insufficiently clad, and suffering from want of food, and were landed on Province Island. At first they were not even allowed the privilege of visiting the city, but later on, just before the rigors of winter set in, they were brought to Philadelphia and were comfort- ably housed by Samuel Powell, who built barracks for them far out on some land in the country on a piece of ground on the north side of Pine Street, between Fifth and Sixth. Longfellow's poem tells of the journeying of Evangeline, the heroine, to Louisiana, and her search for her lover Gabriel. When she was old, discouraged and heartbroken, she arrived in Philadelphia searching in the Acadian settlement for her loved one. She became a sister of mercy, and her ministrations during the terrible plague, probably the yellow fever, are described in the poem. 436 Institutions Under Municipal Management "In that delightful land which is washed by the Delaware's waters, Guarding in sylvan shades the name of Penn the apostle, Stands on the banks of its beautiful stream the city he founded. There all the air is balm, and the peach is the emblem of beauty, And the streets still re-echo the names of the trees of the forest, As if they fain would appease the Dryads whose haunts they molested. There from the troubled sea had Evangeline landed, an exile, Finding among the children of Penn a home and a country.'' * * * * "Then it came to pass that a pestilence fell on the city, Presaged by wondrous signs, and mostly by flocks of wild pigeons, Darkening the sun in their flight, with naught in their craws but an acorn; And as the tides of the sea arise in the month of September, Flooding some silver stream, till it spreads to a lake in the meadows, So death flooded life, and o'erflowing its natural margin, Spread to a brackish lake, the silver stream of existence. Wealth had no power to bribe, nor beauty to charm, the oppressor, But all perished alike beneath the scourge of his anger, — Only, alas! the poor, who had neither friends or attendants, Crept away to die in the almshouse, home of the homeless. * * * * "Suddenly as if arrested by fear or a feeling of wonder, Still she stood, with her colorless lips apart, while a shudder Ran through her frame, and forgotten the flowerets dropped from her fingers. And from her eyes and cheeks the light and bloom of the morning. Then there escaped from her lips a cry of such terrible anguish, That the dying heard it, and started up from their pillows. On the pallet before her was stretched the form of an old man. Long, and thin, and gray were the locks that shaded his temples; * * * * "Then through those realms of shade, in multiplied reverberations, Heard he that cry of pain, and through the hush that succeeded Whispered a gentle voice, in accents tender and saint-like, 'Gabriel! my beloved!' and died away into silence." * * * * Vanished the vision away, but Evangeline knelt by his bedside. Vainly he strove to whisper her name, for the accents unuttered Died on his lips, and their motion revealed what his tongue would have spoken. Vainly he strove to rise ; and Evangeline kneeling beside him, Kissed his dying lips and laid his head on her bosom. Sweet was the light of his eyes, but it suddenly sunk into darkness, As when a, lamp is blown out by a gust of wind at a casement. "All was ended now, the hope, and the fear, and the sorrow, All the aching of heart, the restless, unsatisfied longing, All the dull, deep pain, and constant anguish of patience! As she pressed once more the lifeless head to her bosom, Meekly she bowed her own, and murmured, 'Father, I thank thee!' " The Philadelphia General Hospital 437 Scarcely a year passes without some discussion in the news- papers of the hospital scene described in this poem. It has been supposed by some that the hospital in which Evangeline discovered Gabriel was the one at Third and Pine Streets, by others, that at Tenth and Spruce Streets, and by still others the old Quaker Alms- house on Walnut Street. The incident has even been located in the Pennsylvania Hospital. The almshouse at Third and Pine Streets is out of the question, as it was not occupied after 1767, only twelve years after the Acadians arrived in Philadelphia. Evangeline and Gabriel were young when they left Acadia, and are described as old and gray in the poem. It would therefore seem altogether probable that the incident should be placed in the Tenth and Spruce Streets hospital, which was first occupied in 1767. Another question has been discussed, that of the cemetery in which these lovers were buried. The poet says: — "Under the humble walls of the little Catholic churchyard, In the heart of the city, they lie unknown and unnoticed." Different parties have decided in favor of the following churches as the place of sepulchre of Evangeline and Gabriel : St. Mary's churchyard, Fourth and Spruce Streets; St. Joseph's churchyard, Willing's Alley below Fourth Street; and Trinity churchyard, at Sixth and Spruce Streets. Pictures have even found their way into the newspapers of two nameless graves with tombstones from which the inscriptions have been removed by time, with the statement that they were over the graves of the lovers. All these attempts to locate the scene of the death and burial of Evangeline and Gabriel are untrustworthy, for we have evi- dence from Longfellow himself that he had no particular place in view, and that regarding Evangeline and Gabriel, the details are all imaginary, and that the story was wholly the child of the poet's fancy. Appended is a letter from Longfellow to Miss Wills and a statement made to Mrs. Caroline H. Dall by the poet. The first sets at rest all discussion in the matter; the second gives the details of the origin of the poem : — 438 Institutions Under Municipal Management "Cambridge, Mar. 10, 1876. "Deab Madam: "Many years ago, and long before I had ever thought of writing 'Evangeline,' in my rambles through Philadelphia I passed the almshouse of the Friends, and was deeply impressed by its quiet and seclusion. "When I wrote the poem, the image of this place came back to me, and I selected it for the closing scene. The story was not ebnnected with it by any tradition. The expulsion of the Aeadians is historic, the details imaginary. But as many of these unhappy exiles sought refuge in your city, it seemed to me proper that the tale should end there. "Thanking you sincerely for your letter and for the kind way in which you speak of my writings, I am, yours very truly, "Hexby W. Longfellow." Mrs. Caroline H. Dall, writing to correct some mistaken impressions about the origin of Longfellow's "Evangeline," gives the poet's statement made to her, in answer to an inquiry, as fol- lows : — "Some time before I wrote 'Evangeline/ Hawthorne and Sumner were dining with me, and I think there must have been others present. After dinner Hawthorne told us that he had lately become interested in the exile of the Aeadians. It excited his imagination. He fancied two lovers widely separated and wandering for years, meeting only to die, and wished to make a novel of it. He, however, thought the subject too difficult, and fancied he should have to give it up. I waited awhile, heard nothing more about the novel, and finally asked Hawthorne if he were willing that I should make the story the subject of a poem. He gladly consented, and was one of the first to congratulate me on its popularity." The Aeadians suddenly left Philadelphia when the Eevolu- tionary War broke out. No one knew of their intended exodus, or when they left the city. They probably had had enough experience of war in the northern colonies. It was afterward learned that they had settled in Louisiana among their brethren already located there. CHRONOLOGY OF THE VISITING PHYSICIANS DURING THE SECOND PERIOD s In 17G8, Dr. Thomas Bond and Dr. Cadwalader Evans, who was earlier a pupil of Dr. Bond, were the medical attendants, and were re-elected on May 18, 1769. Unofficial doctors had sometimes attended to the patients, 3 This chronology ia mostly taken from the history by Dr. Agnew. The Philadelphia General Hospital 439 but this was stopped by the action of the management, which passed a rule that none but physicians officially connected with the hospital should prescribe. In 1771, Dr. Evans inoculated for small-pox in the house. Seventy-one children were operated upon, and all recovered. In 1772, the staff was enlarged, the salaries of physicians were stopped, and students were admitted to the wards for instruc- tion, the managers paying only for the necessary medicines. On March 25, 1774, Dr. Adam Kuhn, Professor of Materia Mediea and Botany; Dr: Benjamin Rush, Professor of Chemistry in the University of Pennsylvania; Dr. Samuel Duffield, a mem- ber of the first graduating class of the medical department of this University; Dr. Gerardus Clarkson and Dr. Thomas Parke were elected to the staff. In 1777, Dr. Benjamin Push 4 and Dr. Clark- son resigned. The king's troops having taken possession of the almshouse and hospital, the poor were attended outside by Drs. Hutchinson and Wilson. This house visitation was the origin of the poor department, and attendance upon the poor at their homes has been in vogue ever since. One of the most distinguished physicians of the period made a joke upon this subject. He said that in Europe at the latter end of life the successful physician had "court prac- tice;'' 1 the American physician began with it. When Dr. Bond left, in 1779, to become the medical purveyor of the United States army, Dr. Samuel Duffield was the only remaining visiting physician in 1781. In 1788, the medical department of the institution was re-or- ganized by the election of Dr. Samuel Duffield, Samuel P. Griffitts, late Professor of Materia Mediea and Pharmacy in the Medical College of Philadelphia, now the University of Pennsyl- vania; Dr. Caspar Wistar, afterwards Professor of Chemistry and Institutes of Medicine, and still later Professor of Anatomy in the University of Pennsylvania; also Drs. J. E. B. Eodgers, Gerardus Clarkson, Michael Leib and John Morris, making a very eminent medical staff. In April, 1789, Drs. Griffitts and Morris resigned, 4 Dr. Benjamin Rush has been called the American Hippocrates. He was certainly the most eminent American physician. Dr. William Pepper writes, "It has been said that the history of Rush's work is largely the history of American medicine." 440 Institutions Under Municipal Management being too busy to attend to the duties of their positions, and their resignations were accepted with much regret. In 1789, Dr. Eodgers was dropped and Dr. U. B. Waters was elected in his place, together with Dr. William Shippen, the founder of systematic medical teaching in the United States. On March 29, 1790, the managers complimented the medical staff, and begged them to continue for another year. In April, 1790, a month later, the whole body of physicians resigned. Shortly afterwards Drs. Duffield and Leib were re- appointed to attend to the sick of the institution. On August 10, 1795, Dr. Cummings was elected assistant physician without a salary. In February, 1796, the managers purchased the patent for the "Perkins' Metallic Tractor." "Perkinism" was a name given to the metallic tractors of Dr. Perkins called "Perkins' Tractors," which were said to cure by a special action of metallic points. The blind were made to see, the deaf to hear, and the lame to walk. On February 27, 1796, the visiting committee of the hospital, after viewing a demonstration by Dr. Perkins, were satisfied with the success of the remedy. At the next seance the whole board was present, and its members were so impressed with the success of the remedy, that they purchased for the hospital the patent right of Philadelphia. On March 20, 1796, Dr. Samuel Clements, Jr., Dr. William Boyce and Dr. Samuel Cooper were elected with a salary of $100 annually. In the fall of 1797, Dr. Pleasants, whose date of appointment is not known, died, Dr. Cooper dropped out, and Drs. John Church and Thomas James, later Professor of Obstetrics in the University of Pennsylvania, became members of the medical staff. Dr. James belonged to the Quaker meeting and was an amiable and accomplished gentleman. On April 6, 1801, Dr. Boyce resigned, and Dr. Elijah Griffitts was elected. In August of the same year, Dr. Duffield, after twenty-nine years of service, was dismissed for admitting a typhus fever patient. This shows the kind of gratitude accorded a man who had served long and faithfully and had stepped to the front when the hospital was without medical officers. On September 7, 1801, Dr. John Proudfit, Dr. Philip Syng Physick, the father of American surgery, and Dr. Charles Caldwell The Philadelphia General Hospital 441 were elected. They were to receive twenty-five pounds per annum. On January 9, 1804, there was a heated controversy between Drs. Caldwell and James. A new board was appointed, consisting of Drs. Philip Syng Physick, John Church, Elijah Griffitts, John Rush, Thomas C. James, Benjamin Smith Barton and Samuel Stewart, each to receive twenty-five pounds annually. Dr. John Push declined. These men were to attend to the outside patients. On January 19, 1804, Dr. James Reynolds was elected. On the seventeenth of June, 1805, Dr. Physick offered his resignation because of his election to the chair of Surgery in the University of Pennsylvania. Dr. James Hutchinson took his place, served three years and then resigned. In 1805, Dr. Barton, having served a short time, was dismissed for refusing to attend the outside patients. In the spring of 1805, Dr. J. Cathrall and Dr. Peter Miller were elected. Dr. Cathrall was a member of the first staff of Bushhill Hospital in 1793. In 1805, Dr. Church died and Dr. John Syng Dorsey was elected in his place. In a short time, Dr. Dorsey was elected adjunct professor to Dr. Physick, and later, successor to Dr. Chap- man, Professor of Materia Medica, and still later successor to Prof. Wistar in the chair of Anatomy in the University of Pennsylvania. In 1807, Dr. Reynolds having died, Dr. Nathaniel Chapman was elected to fill his place, and Dr. Parrish was added to complete the staff. On the seventeenth of November, 1809, the managers asked the medical officers to form a medical board and to make rules for the government of the hospital. In the following year, 1810, Mrs. Lavender was appointed assistant midwife. Dr. Agnew says she was probably the first female resident physician in the country. In 1810, Dr. Griffitts withdrew and Dr. Stewart died, and Drs. Klapp and Stewart were elected to fill the positions. On September 2, 1811, Dr. Dorsey resigned, and, on the sixth of September, Dr. Thomas Hewson was elected to fill the vacancy. The staff was now divided into physicians and obstetricians, and surgeons. The medical staff was composed of Chapman, Stewart and Hewson. Cathrall, Miller and Parrish were the surgeons. In 1814, Dr. Dorsey was again on the staff as physician. 442 Institutions Under Municipal Management In 1815, Dr. Chapman resigned, and Dr. Joseph Klapp was elected. The obstetrical ward was placed under the care of Dr. James and the duties took so much of his time that on November 2, 1818, Dr. John Moore was elected as Assistant Obstetrician. In 1818, Dr. Dorsey died at the early age of thirty-five, and, on November 26th, Dr. Joseph Hartshorne took his place. On February 28, 1820, Dr. Hartshorne withdrew and the same day Dr. John Ehea Barton succeeded him. In February, 1821, Dr. Moore resigned and Dr. Henry Neill was elected to his place as Assistant Obstetrician and soon after was advanced to an equality with Dr. James. On March 5, 1821, Dr. James resigned, having served twenty- five years, and Dr. Nathan Shoemaker was elected to his place. In 1821, Drs. Parrish and Kush resigned and Dr. William Gibson, Dr. George McClellan, Dr. Samuel Colhoun and Dr. William P. C. Barton were chosen to fill the four existing vacancies. On August 12, 1822, the old medical board having been dis- pensed with, a new body was elected, consisting of Drs. Samuel Jackson, Joseph Klapp, J. K. Mitchell, Richard Harlan, as physi- cians ; Drs. John Rhea Barton, William Gibson, William E. Homer and J. O'B. Lawrance, as surgeons; and Drs. Henry Neill and Nathan Shoemaker, as obstetricians. In September, 1822, Dr. Joseph Klapp resigned, and Dr. Nathaniel Chapman was elected in his place. In the same year, after an exhaustive operation, Dr. Lawrance became exhausted and died. Dr. Hewson was transferred to the surgical staff in his place, and Dr. Hugh L. Hodge was elected to fill Dr. Harlan's position. Dr. Hewson was president of the College of Physicians. During 1827, Dr. Shoemaker declined to serve, and Dr. C. Lukens was elected. In 1827, Drs. Mitchell and Lukens resigned and Drs. Samuel George Morton and William B. Ellis were elected. In 1831, Dr. Ellis died, and, on May 2d, Dr. Beatty was chosen to fill the vacancy. On April 30, 1832, Dr. N. Chapman went out and was suc- ceeded by Dr. Jacob Randolph, who exchanged places with Dr. Horner. The Philadelphia General Hospital 443 THE THIRD PERIOD OF THE HISTORY OF THE PHILADELPHIA ALMSHOUSE AND HOSPITAL-" BLOCKLEY." 1834-1854. In February, 1810, the question of removing the almshouse and hospital to a farm in the suburbs was first broached, and a committee was appointed to look into the matter. The report of the committee stated that the building at Tenth and Spruce Streets was overcrowded, and that one hundred persons capable of working were living in idleness in the house. This was the last heard on the subject, and nothing was done until several years later. An Act of Legislature, March, 1828, authorized the appoint- ment of a commission for erecting larger buildings for the accommodation of the sick and poor, and "to purchase a suitable site (not exceeding two miles distant from Broad and Market Streets) for the erection of buildings suitable for a hospital, and house of employment, and children's asylum." The Board pur- chased a site in Blockley Township, on the western bank of the Schuylkill, consisting of 187 acres. Along the river was a meadow and back of it an elevated plateau, on which the buildings were to be erected. The farm in Blockley Township was purchased from the Hamilton Estate for two hundred and seventy-five dollars an acre. "The "Woodlands" was the country estate of the Hamiltons, who owned the greater part of West Philadelphia. The estate consisted of six hundred acres; the first acquisition on the west bank of the Schuylkill Eiver having been purchased by Andrew Hamilton. James Hamilton, a brother of Andrew, and a colonial governor under the Penns, bought additional adjoining land. Andrew, a son of the before-mentioned Andrew, married a Miss Till, who owned other adjacent land, which was added to the tract of Andrew and James. The fine old mansion now standing in Woodlands Cemetery was built by him, and supplanted the original building erected in 1747. The Woodlands were noted for beautiful landscape gardening, with rare and exotic trees and plants. Prof. Benjamin Smith Barton, of the University of Pennsylvania, was accustomed to take his class in botany to study the plants at the Woodlands. The streets of Hamilton Village, which was located on the north side of Market Street down to Darby Eoad, bore the family names of the Hamiltons. Walnut Street was then "Andrew," Chestnut Street was "James," Fortieth 444 Institutions Under Municipal Management Street was "William," and other streets were called "Mary," "Margaretta" and "Till." The country seat, Woodlands, was purchased by a company in 1840, and was laid out as Woodland Cemetery. The name "Blockley" came from the township in which the third almshouse was situated. Blockley Township was one of the thirteen unincorporated townships within the County of Philadel- phia, and was a portion of the "Liberties," which consisted of so- called free lots, or liberty land. These were lands lying to the north and west of the cit3 r , which were given free to any one pur- chasing land in the colony. The boundary lines of Blockley Township, of Philadelphia County, in which the almshouse and hospital have been situated since 1834, as made by the Act of Assembly, approved April 5, 1848, and May 15, 1850, are given in a recent article by Prof. Lewis E. Harley, of the Central High School, 1908, and published by the Executive Committee of Public Works. BLOCKLEY TOWNSHIP Boundary. "Beginning at a point on the west side of the Biver Schuyl- kill at the mouth of Mill Creek, thence extending northwardly along the center of Mill Creek to the center of Baltimore Avenue (said point being about 100 feet east of Forty-third Street), thence southwestwardly along the center of Baltimore Avenue to the center of Ameaseka Creek (said point .being just west of the line of Fifty-fifth Street), thence along the center of Ameaseka Creek in several courses in a southwestwardly direction to the center of Cobb's Creek, thence in a northwestwardly direction along the center of Cobb's Creek to the center of City Avenue, thence in a northeastwardly direction along the center of City Avenue to a point near the center of Sixty-sixth Street, thence in a southwestwardly direction through and along the lands of Israel Morris and Jesse George estate to a corner-stone, thence west- wardly about 41 feet to a point, then southwardly along the lands of Morris and George to a point, then southwestwardly along the property line dividing the estates of A. J. Pleasonton and Leonard Fraily to a point in the center of Virginia Eoad, thence eastwardly along the center of Virginia Boad to the dividing line between the properties of Lewis Jones and William P. Walters, thence The Philadelphia General Hospital 445 along the several courses of said property line to the center of Merion Eoad, thence southwardly along the center of Merion Eoad to the property line dividing the estates of Jacob P. Jones and George Prentice (said line being south of Lansdowne Avenue, about 50 feet), thence extending eastward along the said property line to the center of Fountain Eoad, thence southwardly along the said Fountain Eoad to the center of Haverford Avenue, thence southeastwardly along the center of Haverford Avenue to the cen- ter of Westminster Avenue, thence eastwardly along the center of Westminster Avenue to center of Mill Creek, thence south- wardly along the center of Mill Creek to the north side of Haver- ford Avenue, to a point opposite the eastern wall of the Pennsyl- vania Hospital for the Insane, thence south along said eastern wall by the several courses thereof to the southern line thereof, thence due south to Mill Creek (about Forty-fourth and Market Streets), thence southwardly along the center of said creek by the several courses thereof to the north side of Baltimore Avenue (said point being about 100 feet east of Forty-third Street), thence eastwardly along the north side of Baltimore Avenue to the west- erly line of Hamilton Village (about 200 feet east of Forty-first Street), thence south along the said west line to the north line of Woodland Avenue (about 100 feet east of Forty-first Street), thence northeastwardly along the north side of Woodland Avenue to the Philadelphia Almshouse property (said point being about 20 feet south of Walnut Street), thence southeastwardly along said property line to the Eiver Schuylkill, thence southwardly along the west side of said river by the several courses thereof at low water line to the mouth of Mill Creek aforesaid and place of beginning." All township lines were abolished at the time when the county was consolidated as the City of Philadelphia in 1854. The almshouse and hospital were placed in this township on the western bank of the Schuylkill Eiver, below Pine Street, and to this day are generally called "Blockley." The buildings were probably begun late in 1830, or in the beginning of 1831, and the work was ended in 1835. In May, 1833, the commission reported that two of the four buildings would be ready for occupancy on October 1, 1833, and that the other two would be finished a year later. The official records show that the final removal commenced on July 7, 1834, and ended 446 Institutions Under Municipal Management July 28, 1834, which was the date of the final closing of the alms- house at Tenth and Pine Streets. In 1866, while the writer was serving as resident physician in the Philadelphia Hospital, one of the old patients who was transferred from the Tenth and Pine Streets house, Mary Cannon, a pauper, informed him that the female paupers were first removed to Bloekley on August 22, 1833. Her card of admission was first dated at Bloekley on August 22, 1833, and not until 1840 was she admitted to the hospital. She said that the card was given to her when she moved from Tenth and Pine Streets to Bloekley. This, if true, gives the date of the removal of the female paupers. We are told that the first buildings to be occupied were the southwestern, on the side next to Woodland Cemetery, and the one on the northwest nearest to the University campus, and finally the northeastern and southeastern buildings. Therefore, it would seem that the paupers were removed to Block- ley on August 22 or 23, 1833, and that the rest were finally removed in 1834. We cannot tell the exact time when work was begun on the Bloekley Almshouse, nor precisely when each building was finished. The statements generally made are that the buildings were occupied in 1833, '34 and '35, but Dr. Carson's "History of the University of Pennsylvania," page 201, informs us that the hospital department was the first building to be completed on the west bank of the Schuylkill, and that it was in sufficient readiness to receive patients at the time of the first visitation of cholera in 1833. 5 Dr. Mills, in 1890, made an investigation of the minute books of the Board of Guardians from 1828 to 1835 inclusive, which seemed to prove that Dr. Carson's statement was erroneous, and that the work was actually begun in 1830 or early in 1831 and was carried on steadily until 1835. The building commissioners reported on May 27, 1833, that two buildings would be ready for the inmates on October 1, 1833, and that the other two would be finished the next season, 1834. On January 19, 1835, the commissioners sent a communication to the guardians that they would surrender the new almshouse building completed on March 1, 1835. The four principal buildings surrounding the quadrangle are 5 Dr. Carson may have confused this first visitation of cholera with the second epidemic. The Philadelphia General Hospital 447 practically the same to-day as they were at the time of the removal from the "Bettering House." They were built chiefly of brick, and then rough casted. The building looking towards the southeast, or towards the Schuylkill river, was then, and still is called, the frontage. This building, in the center, had a high portico backed by a row of columns of the Tuscan order of architecture. The pillars rest upon a platform extending out to the street. The second floor, on which the portico is placed, is approached by steps on each side of the raised platform. The central part of this southwestern building was occupied by the steward and his family and contained the dining-room for the residents, and the meeting room and offices of the governing boards. The room underneath the portico was used as a receiving ward of the almshouse. On the right and left of this central main building were wards for the male paupers. These were large, commodious rooms, sur- rounded by two tiers of small rooms called "cubbies." These small rooms in the second story were approached by a gallery. They were without windows or any means of ventilation, except the small doors. I well remember, while resident physician in 1866 and '67, being called to attend the paupers in these cells. The air was stifling and at night the man in charge, a pauper, would supply the necessary light by a poorly burning tallow candle. The only time I was ever nauseated while attending patients was one mid- night while performing a small operation to relieve a patient in one of these "pigeon holes." On the opposite side, looking toward Darby road, was a build- ing the same size as the one in front, but without the ornate portico. The building on the southwest side of the quadrangle was, at first, used as the hospital. In the center was a magnificent amphitheatre which was usually well filled with a large number of students who were attending the medical colleges of Philadelphia. The end towards the Schuylkill was the men's ward, and the other end was used as a woman's ward. The apothecary store was on the first floor. The lying-in wards were in the northwestern build- ing, and the children's department was in the northeastern end of the same building. The northeastern building was more substan- tially built than the others, and was used at first for a house of employment, or factory. When I was a resident physician there in 1866, the remains of the hoisting apparatus were still to be seen. Dr. Ludlow tells us that this building was first used for medical 448 Institutions Under Municipal Management wards of the hospital in 1861, the building opposite being appro- priated to the insane. The store, washhouse, and bakery, and kitchen of the out-wards, were located in the center. The front or main building facing the Schuylkill was five hundred and twenty-five feet and six inches long by sixty feet wide. The one occupied by the hospital proper was five hundred and forty feet long and sixty feet wide. The northwestern building was five hundred and twenty-one feet, six inches, long by sixty feet wide. The southwestern was two hundred and ninety-eight feet long and its width was sixty-three feet. Since 1861 a great many buildings have been added to those already described. In the third story of the northwestern building or women's out- wards were the rooms of the resident physicians, and in the second story the housekeeping apartments of the matron. The second floor towards the north was used for the nursery, and the third floor for the obstetrical ward. In the attic was "Dandy Hall," the waiting apartment for women awaiting "delivery." Forty-seven years ago the clinic room was transferred from the southwestern building to the place now occupied by the newer clinic room, and the old amphitheatre in the insane department was divided by a floor half way up into two stories, and cut up into rooms for the officers whose quarters were below. The upper portion was used as an entertainment or amusement hall, assembly room, and chapel. The drug store was first placed under the center of the hospital in the building now used as the insane department. In 1861, it was moved to the first floor in the building now used as the hospital proper. It was next in the clinic room on the left side of the main door. When the first suggestion was made to take the hospital to the west side of the Schuylkill river, the medical board thought its removal would abolish clinical teaching in the institution, but we find that, in 1834, two hundred and twenty students were in attendance at the clinics. In 1835, the Philadelphia and West Chester Eailroad paid $5,955 damages for the right to cross the almshouse grounds, pass- ing near the Schuylkill in front of the main building looking southeast. According to Dr. Agnew, "on the twenty-eighth of November, The Philadelphia General Hospital 449 this year (1835), Drs. Gerhard and Pennock suggested to the guardians the propriety of designating the hospital department by some particular name, as that of almshouse could not technically be regarded in the sense of a hospital. When the subject came up regularly before the Board, it was moved by a member, Mr. Hansel, that it should be styled The Philadelphia Hospital. This received the sanction of the majority of the votes, and it has been known under that name ever since/' 6 Dr. Mills will tell of an attempt to change the name in 1892, when James A. Freeman was president of the governing board. The hospital has not an independent organization even to this day, 1908. The hospital department is still often spoken of by the withering name of "Almshouse," which is a stigma to the city and a hardship to the better class of poor. In discussing the second period of the history of Blockley, reference has been made to "Perkinism," one of several great medical follies of the past, in which this institution, like many other institutions and communities, became involved. At an early date in the period now under consideration, animal mag- netism, like Perkinism in 1796, was attracting widespread atten- tion in this country as well as abroad, and the Philadelphia Hospital did not escape the contagion. "The year just past (1837)," writes Agnew, "was remarkable for one of those visitations of folly and ignorance which seem periodically to sweep over the country; providentially, I believe, designed to distinguish the wise from the fools. In the instance referred to it was animal magnetism; and, of course, if a patent medicine was to be tested, or any charlatan maneuver to be prac- ticed, the Philadelphia Hospital was a field in which the trial was to be made, like a barber's head everlastingly pulled for stray hairs to determine the cutting qualities of his instrument. The resident pupils, among others, assiduously labored in the manipula- tion of the patients to determine its value, until the guardians, for fear the remedy should prove too powerful for the constitution of the poor, passed a resolution on the twentieth of June, 1837, disallowing all further operations." 6 On April i, 1903, the name was changed to the Philadelphia Gen- eral Hospital. 29 450 Institutions Under Municipal Management CHRONOLOGY OF VISITING PHYSICIANS DURING THE THIRD PERIOD Thanks to Dr. Agnew we can give a chronology of visiting physicians during the third period. On March 16, 1835, Dr. Henry Neill resigned, and Dr. Caspar Wistar and Dr. Pennock were elected. Dr. Pennock was a cardiologist, and co-worker with Dr. G-erhard in his typhoid fever investigation in the wards of Bloekley. On October 13, 1835, Dr. Wm. H. Gerhard was elected phy- sician. He was the Father of Physical Diagnosis in America. In 1836, he and Dr. Pennock made their important investiga- tions. Dr. Gerhard was a resident pupil in the house from 1828 to 1831. While a resident in 1829, he experimented on the endermie application of medicine, which he made the subject of his thesis in 1829, which thesis was translated into almost every language. On October 7, 1835, Drs. Hodge and Morton resigned, and Dr. Joseph Pancoast and Dr. William Ashmead were elected. Dr. Pancoast was later transferred to the surgical staff, taking Dr. Eandolph's place. In 1837, Dr. Eandolph withdrew, and Dr. M. Stuardson was elected one of the physicians. Dr. Beatt} r , who was one of the obstetricians, resigned, and Dr. W. D. Brinckle was elected in his place. In 1838, Dr. Stuardson resigned, and Dr. Eobley Dunglison was elected. In 1838, Drs. Harlan, Ashmead, Gibson and E. Peace were added to the staff. In May, 1839, Dr. Brinckle resigned, and Dr. Eobert M. Hus- ton took his place. In the fall of 1840, Dr. Gibson resigned, and Dr. James McClintock took the place of obstetrician. On May 3, 1841, Dr. Peace left the staff, and Dr. Ashmead was again elected. In August, 1841, Dr. McClintock left Philadelphia, and Dr. William H. Gillingham took the position occupied by him as obstetrician. In April, 1843, Dr. Meredith Clymer was elected. On August 1, 1845, a chief resident physician, consulting physicians and surgeons and one accoucheur were appointed. The Philadelphia General Hospital 451 From this time there was no instruction in clinical medicine in the institution for almost ten years. On March 6, 1845, Dr. H. S. Patterson was chosen chief resi- dent physician ; William Byrd Page, consulting surgeon ; Meredith Clymer, consulting physician; and William Benedict, consulting obstetrician. In November 9, 1845, Dr. Patterson resigned, and Dr. Bene- dict was put in his place. In 1850, Dr. Benedict resigned. On February 13, 1850, Dr. Wm. S. Haines was chosen chief resident physician. On February 11, 1853, Dr. Wm. S. Haines resigned, and Dr. J. D. Stewart was elected as chief resident physician in his place. He died in April, 1854. The Bevolutionary War greatly disturbed the functions of the almshouse at Tenth and Pine Streets, as has been stated in another part of this history. The War of 1812 was scarcely a disturbing element to the Philadelphia Hospital or the medical profession of the city gen- erally. Commerce was greatly interfered with, but the army and navy did not come near enough to make any history, so far as the almshouse and hospital were concerned, hence the absence of his- torical notes. The Mexican War left nothing to chronicle, for the conflict was largely carried on in Mexico, and being so far removed, it had no perceptible influence upon medical affairs in the institution. Each almshouse building was erected in a situation removed from the built-up portion of the city, and in turn each became surrounded with buildings. The present buildings are now hemmed in on all sides. It seems strange that they should all have been located on Pine Street, first at Third and Pine, second at Tenth and Pine, and now at Thirty-fourth and Pine. Heaven grant that the respectable unfortunate poor of Phila- delphia may soon have a hospital that has not the label of "alms- house" on it, and a place in which the garb of the pauper is ■unknown. I have been on three committees which went up the Delaware Eiver to select a site for an almshouse, and since my last visit another one has gone on the same errand, and still we have the paupers in our midst. On April 28, 1854, it was proposed to have a separate institu- 452 Institutions Under Municipal Management tion for the correction and employment of the able-bodied inmates, but these plans were not carried out until many years later. In 1854, the County of Philadelphia was formed into a con- solidated city of twenty-eight incorporated districts, nine town- ships and thirteen boroughs, which, together with the City of Philadelphia, was called the Consolidated City of Philadelphia. At the time of the consolidation the managers were called the Board of Guardians. RESIDENT-IN-CHIEF AND CHIEF RESIDENT PHYSICIANS The hospital was first placed under a chief resident physician on October 6, 1845, when Dr. H. J. Patterson was elected to this position. At the same time appointments were made of "William Byrd Page as consulting surgeon, Meredith Clymer as consulting physician, and M. D. Benedict as consulting accoucheur. This new method of medical administration was the result of the so- called "Cockroach incident," which is graphically narrated by Dr. Agnew. The resident physicians who were boarded at the table of the steward were thrown into a great frenzy by the destruction of an unfortunate cockroach, which had run across the table instead of going round. They became indignant, and demanded to be transferred to the matron's table. A refusal to comply with this request caused their unanimous resignation, leaving the hos- pital without any resident attendants. Considerable controversy was carried on between the visiting staff and the managers, and finally a committee was appointed by the Board of Guardians to report to the Board upon the expediency of reorganizing the med- ical department of the house. On October 1, 1845, they reported that after that date there would be one chief resident physician with a salary of $1800, one consulting surgeon, one consulting physician, and one consulting accoucheur, each with a salary of $100 a year. A complaint having been made, Dr. Patterson resigned on November 9th, Dr. 1ST. D. Benedict was elected as his successor, and the office of consulting accoucheur was abolished. In November, 1850, Dr. Benedict resigned, and on February 18, 1850, Dr. Haines became chief resident physician, which posi- tion he held until February 11, 1853. He was succeeded by Dr. J. D. Stewart. Dr. Stewart's health soon broke down, and he died in April, 1854. Dr. B. T. Coleman, then an interne of the house, The Philadelphia General Hospital 453 temporarily held the position, serving until May 1, 1854, at which time Dr. Archibald B. Campbell was elected to succeed him. Dr. Kobert K. Smith was made chief resident physician in 1855, holding the position until 1856, when Dr. Campbell was reappointed. Dr. James MeClintock succeeded Dr. Campbell in 1857, serving until 1858, when Dr. Smith was again appointed, continuing in office until 1859. In 1859, the office of chief resident physician was abolished, and the hospital was again placed in charge of a visiting medical board. Dr. Smith was the last incumbent until 1885, when the position was revived by the election of Dr. Thomas N. McLaughlin, and the office still continues. This position, under the present arrangement, is not so important as it was between 1854 and 1859. The visiting staff has greatly increased, and the duties of the chief resident physician have become largely administrative. RESIDENT PHYSICIANS Eesident medical students, or pupil physicians, and resident physicians have been in almost continuous service since 1788, if not longer. As has already been indicated, John Trust, a grad- uate in medicine, was elected apothecary in 1788, and performed the duties of medical resident. The resident pupils and physicians were not as fully appre- ciated in the past as they should have been. The early history of the resident physicians is meagre, and no note was taken of their election until after 1854. A list was commenced by Dr. S. S. Stryker in 1866, which was afterwards added to by Dr. W. A. 1ST. Dorland and Dr. Edward Stone. Before 1854, the list is very incomplete, only a few names having been secured of those serv- ing before that time, and these were mostly obtained from their colleagues who served with them as residents. In the whole recorded history of the Philadelphia Hospital it is only known that 1,350 resident physicians have served. A great many others have been lost to history. Before 1836 the lists have been entirely lost, but Dr. AgneVs history states that up to 1862 the Philadelphia Almshouse Infirmary and Hospital had 350 resident pupils and physicians. The list since 1862 shows about 1,000, in round numbers, making 1,350 residents. Even our lists since 1862 are far from complete. For instance, on the list appear only two residents in 1863, but we are informed by 454 Institutions Under Municipal Management trustworthy persons that in that year five of the residents were drafted into the United States army while serving the hospital. The difficulty at this time of securing medical men for the visit- ing staff was owing to the demand for surgeons in the army and navy. Among the deceased resident physicians may be mentioned Dr. Elisha Kent Kane, Dr. Jason O'Brien Lawrance, Dr. Alfred Stille, Prof. Harrison Allen, Dr. L. P. Bush, of Wilmington, Del.; 'Dr. E. T. Bruen, Prof. W. W. Holmes, of Philadelphia; Drs. Wil- liam V. and John M. Keating, Dr. John L. Ludlow, Dr. William Weidemann, of Reading; Dr. J. K. Lineaweaver, of Columbia, Pa.; Prof. William W. Gerhard, Prof. John W. Biddle, and Dr. William Elmer. Among those living now are Prof. H. C. Wood, Prof. J. Chal- mers Da Costa, Prof. Louis A. Duhring, Dr. Edward L. Duer, Prof. J. William White, Prof. John Guiteras, of Havana, Cuba; Dr. J. J. Black, of Newcastle, Del. ; Dr. Jamar, of Elkton, Md. ; Prof. J. H. Musser, Dr. Oliver P. Eex, Prof. De Eorest Willard, Prof. Allen J. Smith, Prof. Alfred Stengel, Prof. James B. Walker, Dr. Van Harlingen, and many others. The names of the resident physicians now regularly appear each year in the report to the Mayor. As mentioned previously, John Trust and John Davidson were the first and second apothecaries appointed in 1788 and 1789, respectively; a third apothecary was appointed in 1S02. It was at this time that the terms Senior and Junior pupils were intro- duced. The oldest in service were called Senior pupils, the next oldest Juniors, and the last appointed the apothecary. The duties of the Senior were to attend to the sick and obtain histories of the patients. The Junior dressed cases, cupped and bled in the surgical wards, daily inspected the working wards, and made reports of cases of the sick to the Senior student. He also looked after the surgical instruments and operations. The apothecary looked after the medicine, and cupped and bled in the medical wards. The resident pupils were required to pay $80, to serve as Seniors for two years and a half, and for three years and a half in the other two positions. In 1808, one of the rules of the library was that it should be under the care of the Senior resident physician. In 1811, the number of house pupils, or apprentices, as they The Philadelphia General Hospital 455 were sometimes called, was increased to four during the winter, and three in the summer, when the population decreased. At this time they were charged $100, which went into the treasury of the house. The house pupils at this time were required to have been under the instruction of a physician for at least two years, to have attended one course of medical lectures, to pay $100 into the common treasury, and also to give bonded security for faithful service. The Senior moved from ward to ward every month, and the Junior every two months. The Juniors acted as apothecaries, and attended the Seniors while going their rounds. In 1816, the house pupils' fee was increased to $150, and their term of service by twelve and six months. At this time, upon the recommendation of the visiting physician, an apothecary was appointed with a salary of $300 a year. After a trial this position was abolished in 1817, to be resumed in 1818. It has been continued up to the present time. In 1817, eight medical students were appointed. The title of house pupil was changed in 1820 to that of house physician and house surgeon. In the next year, 1821, the residents' fee was raised to $200. In 1822, the number of residents was reduced to six. A difficulty that arose in 1823 between the pupil physicians and the managers caused a change from pupil to graduate physicians, and two men of known ability were therefore elected. In lieu of a salary, an honorarium was to be given — a piece of plate, not to exceed $100 in value. This plate was to have inscribed upon it a testimonial indicative of efficient service, with date of the length of service rendered. Before the year was up the Blockley authorities decided to go back to the old plan. This ended the service of the first resident graduate physician, eighty-five years ago. In November, 1824, the medical board- recommended that all candidates be examined, in order that the best might be selected. They further recommended that two pupil residents should be added to the medical staff. These suggestions were adopted by the Board of Managers. Eighty years ago, in 1828, the Seniors were first called resi- dent physicians; and the Juniors, resident students. The fee which the resident physicians paid for the privilege of giving their services was $250 in 1835. The title of house pupil was changed to house physician and surgeon. The residents numbered six, two 456 Institutions Under Municipal Management graduates and four medical students. They all resided in the house, generally for one year. Medical students paid $10 for attending the practice in the house. These tickets permitted them to attend the infirmary and to use the library, which had at this time three thousand volumes. In 1831, Dr. Rivanus, one of the indoor physicians, catalogued the library. In September, 1839, the fees of the resident physicians were reduced to $50 and the price of board. In 1839, the number of residents was raised from six to eight, and remained so until 1874, at which time it was increased to fourteen. In 1879, about twenty residents were found necessary, and in 1901 the number was thirty-one. In 1903, forty-six resident physicians were on duty during the year. At the present time, 1908, there are thirty-three in the hospital proper, seven in the insane hospital and two dental residents, making forty-two in all. When the writer was a resident physician, in 1866, all resi- dents were obliged to deposit $75, which was held until the end of their term, when it was returned if the full term was served. This practice was continued until 1904, when the money deposited mysteriously disappeared. Since that time no money had been deposited by the residents. While I was resident physician in 1867, a meeting was held of the resident physicians, and we resolved ourselves into a body with the astounding name of Board of Resident Physicians. We passed three resolutions advocating improvements that we thought might be made in the conduct of the hospital, and sent a com- munication to the Board of Guardians, stating that "we, the Board of Resident Physicians," etc. This communication created consternation among the guardians. Mr. Brown, a very dignified member, said : "This is very astounding. I knew we had the Board of Guardians and the Medical Board of the hos- pital, but heretofore I never heard of any Board of Residents." The upshot of the matter was that the Board of Resident Phy- sicians never again communicated with the Board of Guardians. The medical historian has generally been neglectful of the hospital interne, and yet it must be supposed that this important official has been on duty in hospitals since their organization. History furnishes us information as to such officials for the last D. HAYES AGNEW. Philadelphia Hospital. The Philadelphia General Hospital 457 four hundred years, and probably they were known to the world many years earlier. They have always been useful, essential adjuncts to a properly organized hospital. Yet what a life is that of the interne, with the exacting visiting physician on one side, and the critical superintendent, the head nurse, and the pupil nurses on the other, not to speak of the laity in the management. Nevertheless, the resident serves his hospital, and then goes to outside fields of labor with an equipment which he could have obtained in no other way, and which he finds of the utmost value during his entire career. THE CERTIFICATES OR DIPLOMAS GIVEN TO RESIDENT PUPILS AND PHYSICIANS Dr. Agnew has briefly described the older certificates that were given to the resident medical officers. In 1817, the first plate was engraved for a diploma or certifi- cate of service for a resident pupil, for which diplomas or certifi- cates the dispensers of charity charged three or four dollars apiece. Their liberality ( ?) will be fully recognized when it is considered that the laboring resident also paid $250 for the privilege of serv- ing them. In September, 1832, a new certificate was ordered and the plate engraved. This plate was more ornate and artistic, a vig- nette showing the front of the main building looking toward the Schuylkill Eiver. In 1860, a third certificate of a new design was placed upon the tickets, or rather the certificates, which was transferred to a lithographic plate. This gave the front view of the almshouse buildings as they were at that time. This certificate indicated the time and extent of the resident's services, and was signed by the President of the Board of Guardians, the President of the Medical Board, and the Secretary of the Board of Guardians. My certificate, dated 1867, has an oval picture about ten inches long and about four inches from top to bottom. In this picture is a view of the main front with its two wings, and the ends of the two buildings running at right angles to it. It is signed by the three officials mentioned in the preceding paragraph. In 1890, the certificates issued were signed by the whole Med- ical Staff, the Superintendent and the President of the Board of Charities and Correction. 458 Institutions Under Municipal Management At this writing, 1908, the certificates are signed by the Direc- tor of the Department of Public Health and Charities, the Super- intendent of the Almshouse, the Chief Eesident Physician of the Hospital, the President of the Medical Board, the Secretary of the Medical Board, and the head of the Oral Surgical Department. OBSTETRICIANS AND INSTRUCTION IN MIDWIFERY It will be of some interest to glance briefly at the history of midwifery in the Philadelphia Hospital, and in introducing this subject let me quote again from Dr. Agnew: "To Dr. Thomas Bond belongs the honor of inaugurating clinical teaching in this country, while physician to the Pennsyl- vania Hospital, as early as 1T66, but for the Philadelphia Alms- house we may claim the establishment of the first obstetrical clinic. Students of good character were allowed to attend cases of labor, and various stages of the process were explained to them by Dr. Bond or Evans, under whose personal direction these instructions were conducted as early as 17 70, and in all probability much earlier, as may be inferred from the phraseology of the minutes touching the subject." In 1772, students were admitted upon the request of the visit- ing physicians coupled with the offer of gratuitous medical service on the part of the visiting staff. They were allowed to study the cases in the hospital, including the midwifery cases. John Trust, the first resident apothecary, kept a record of the ob.-tetrical cases. This would tend to show that obstetrical patients were admitted early in the history of the hospital. In the History of the Pennsylvania Hospital, 1751-1695, by Drs. Thomas G. Morton and Frank Woodbury, Philadelphia, 1895, p. 231, we are informed that: "It is of historical interest that a lying-in ward was established in 1802, at the almshouse, by Dr. P. Chalkely James, assisted by Dr. Church. Subsequently, after Dr. Church's early death from yellow fever (1805), this work was continued by Dr. James in conjunction with Dr. Chapman. Dr. James gave his annual course of lectures at the citv almshouse in connection with the medical department at the college." In Xovember, 1806, Drs. James and Church were allowed by the managers to deliver clinical lectures twice a week in the "green room" or dead house. It would not now be considered a very asep- tic place for an obstetrical clinic. The Philadelphia General Hospital 459 In 1810, the medical staff was first divided into two portions, the first included medicine and obstetrics ; and the second was the surgical staff. This is the first intimation we have of the medical staff being specialized. "The following year" (1810) writes Dr. Agnew, "furnishes us with the first instance, so far as I know, of a hospital in this country receiving a female resident physician. On the first of July, a Mrs. Lavender made application to be admitted to the institution as an assistant midwife, in order the better to perfect her educa- tion. Such a charming name as 'Lavender' so overcame the phys- ical senses of the members of the board, that they lost their intel- lectual senses and granted her petition." In 1813, a new rule was made that permission would be given to any student taking out the hospital ticket to attend a case of labor. On May 8, 1815, the obstetrical department was placed under the exclusive control of Dr. James, but the duties took up so much of his time that upon his request, on November 2, 1818, Dr. John Moore was elected associate obstetrician. We have every reason to believe that the obstetrical department began with the hospital in 1732, although no positive statement to that effect has come down to us in history. "In February, 1821, Dr. Moore resigned and Dr. Henry Neill was elected, first as assistant obstetrician to Dr. James, and after- ward, in March, to equal rank with his colleague. Very shortly after, Dr. James, whose services to this charity extended over twenty-five years, declined any longer to discharge the duties of obstetrician, and on the fifth of March, 1821, Dr. Nathan Shoemaker assumed the labor of this department" (Agnew.) On August 12, 1822, all the visiting medical staff was dispensed with, and on the 26th Drs. Neill and Shoemaker were elected obstetricians. "In 1827, Dr. Shoemaker declined acting as obstetrician, and on the 3d of September was succeeded by Dr. C. Lukens" (Agnew) . In 1854, Dr. McClintock became one of the obstetricians. On October 6, 1845, under the newly arranged plan of having a chief resident physician, Dr. M. D. Benedict was elected consult- ing accoucheur, out the office was abolished when Dr. Benedict was elected chief resident physician. On the 30th of October, 1854, Dr. E. A. P. Penrose was elected obstetrician, but probably did not serve until he was re- elected in 1858. 460 Institutions Under Municipal Management EPIDEMICS In such an institution as the Philadelphia Hospital it might naturally be expected that contagious and infectious diseases would find conditions favorable to their propagation; such has been the case. As early as 1776, we learn from Dr. Agnew that there were two epidemics, small-pox and "putrid sore throat." Since that time the hospital has been visited by such scourges as yellow fever, cholera, whooping-cough, typhus fever, relapsing fever, influenza, "malignant intermittent fever," dysentery, and others. By far the worst epidemic in the history of the institution and of the city was that of the year 1793, when yellow fever claimed over 5,000 victims. Unfortunately want of space precludes the possibility of giving a more detailed account of this side of the hospital's history. Thanks to the improved condition of the world, the city and the hospital, there has been nothing like an epidemic since 1890. BLOCKLEY PREJUDICES Blockley has its medical prejudices as well as its medical super- stitions. These continue from one generation to another of resi- dent physicians, nurses, and patients. Down about Seventh Street, in the Seventh and Fourth Wards, from which district most of the patients of the lowest class formerly came, the people all thought that when a patient in Blockley was beyond hope of perfect cure he was gotten rid of by poisoning. Even a few months ago a very old man said : "Don't send me there ; they will give me that little black drop." This idea dates back to 1834, and probably earlier. I have heard the same story a hundred times. When jaborandi was first used at Blockley it was given to two colored men, who both died of edema of the lungs, so that later on it was considered fatal medicine in colored males. The residents used to say "Don't give jaborandi to colored men." At one time "Clutterbucks" elaterium was too freely used in cardiac dropsy, and so fell into disuse on account of the seeming fatal result. A patient dying after its use was said to have died of "Clutterbucks disease." In the "drunk wards" the resident physicians and nurses were always on the alert to prevent the delirium which came from using tobacco. It was supposed that the use of tobacco would cause an immediate return of the delirium. The Philadelphia General Hospital 461 THE BLOCKLEY SMELL The older men can tell about the smells of Blockley. They were locally as noted as the smells of Cologne, which were said to be seventy-two in number. Samuel Taylor Coleridge has written the following verses on the stench of Cologne : — ■ "In Koln, a town of monks and bones, And pavements fang'd with murderous stones, And rags, and hags, and hideous wenches, I counted two-and-seventy stenches, All well-defined and several stinks! Ye nymphs that reign o'er sewers and sinks, The river Rhine, it is well known, Doth wash your city of Cologne; But tell me, nymphs ! what power divine Shall henceforth wash the river Rhine?" The Blockley smell has disappeared. This disappearance was accomplished by opening the sewers. When Dr. James William White was president of the Department of Charities and Correc- tion, it was found that when the sewers were made, they had been carried outside of the walls and there ended abruptly without any outlet. The Blockley smell came from the accumulated drainage of Blockley for about fifty years. SOME OF THE MARTYRS TO DUTY It is not surprising that death should have sometimes visited members of the visiting and resident staff while on duty. So far as I can glean, the following physicians have contracted disease in the hospital and died therefrom : — Dr. Jason O'Brien Lawrance, a member of the surgical staff of the hospital, died of typhoid fever August 19, 1823, an epidemic of this disease having prevailed during this and the preceding year. He was attending patients in the hospital at the time, was taken sick and completed an operation, after which he was taken home, went to his bed, and soon afterward died. The record of the pro- fessional life of Dr. Lawrance is worthy of mention. He was born in New Orleans in 1791, graduated from the University of Pennsylvania in 1815, practiced in New Orleans, but returned to Philadelphia in 1818. He founded the Philadelphia School of Anatomy in March, 1820. In the same year he became the assistant to Dr. Gibson, professor of surgery in the University of Pennsyl- vania. He was the first to practice vivisection, and early in his 462 Institutions Under Municipal Management work made upwards of ninety experiments on animals. Later he made over one hundred similar experiments to prove the correct- ness of Magendie's theory that absorption took place by other chan- nels than by the absorbent vessels, especially by the veins. While in New Orleans he performed autopsies on the bodies of victims of malignant yellow fever, which was then considered and pronounced a reckless act. Dr. Lawrance, with Dr. Samuel Jackson, was the first to describe the ulceration of the intestine in the fever epidemic which prevailed in the Schuylkill Valley in the early winter. Dr. Massenburg, a resident physician at the hospital, whose home was in Hampton, Virginia, took the cholera and died in 1849. Dr. Pendleton Tutt, like Lawrance, fell a victim to typhus fever. He was one of the visiting physicians on duty during the years 1864 and 1865. During an epidemic of typhus fever, having made a post-mortem on a very malignant case of a few days subse- quently, he took the most virulent form of the fever, and died a few days after in great suffering. Dr. Edward Khoads was indefatigable during the epidemic of relapsing fever which prevailed in 1869 and 1870. In this epi- demic between two and three hundred cases were treated. He con- tracted the fever, and being already affected with disease of the heart, his death was thereby hastened. j } WHAT PHILADELPHIA OWES TO MEDICAL, EDUCATION We have some disconnected data as to the number of students and physicians that have attended the clinics in the Philadelphia Hospital, but we can, I think, make an approximate calculation of the attendance through the figures given to us here and there in the various histories of the hospital. For the past forty-six years I have had the opportunity of judging the exact number during that period. Pestilence, war, and other interferences have disturbed the usual attendance, and make any estimate before that time uncertain. When I made my address at the opening of the new clinic amphitheatre on October 8, 1892, I calculated that the number of students and physicians that had been in attendance in the old clinic room from the previous opening on September 19, 1861, was from 18,000 to 20,000. An approximate estimate of the number of students who The Philadelphia General Hospital 463 have been in attendance upon the Almshouse and Hospital since its opening is as follows: — From 1772 to 1834—62 years, 100 per year 6,200 From 1834 to 1851—17 years, 500 per year 8,500 Omitting ten years when instruction was omitted. From 1861 to 1902—41 years, 700 per year 28,700 From 1902 to 1908— 6 years, 800 per year 4,800 48,200 We feel certain that the above is an underestimate. The students have come from every part of the world, and have been male and female, and from regular, homoeopathic and eclectic schools. They have been drawn from the following Philadelphia medical schools: — University of Pennsylvania, Jefferson Medical College, Woman's Medical College, Hahnemann Medical College, Medico-Chirurgical College, Pennsylvania Medical College, Philadelphia Dental Colleges (five), Penn Medical University (coeducational institution), Phila- delphia University of Free Medicine, Franklin Medical College, Philadelphia University of Medicine and Surgery, Eclectic Medical Colleges (two). , We can say that probably one-sixth of the 48,200 students were from Philadelphia, and that they would probably have left the city to study medicine had not the medical colleges been here, and would have spent their money in the city in which they were pursuing their studies. Forty-eight thousand, two hundred, less one-sixth, leaves 40,167 students from outside the city. Each student's expenses would average about $800, including his tuition, which would male $32,133,600, a nice sum to be brought to any city. The students are attracted by two things: First, the teachers; and second, the clinical advantages afforded. Blockley teaching has been of great value in the past to the colleges and city, as well as to the shop- keepers, theatres, boarding-house keepers and instrument-makers. In addition to this, the graduates come back year after year to visit the clinics, and replenish their stock of medicine, instruments, and other necessary supplies. More than this, thousands of patients come here annually upon the recommendation of the graduates to receive treatment, leaving behind much money for medical treat- 464 Institutions Under Municipal Management ment, board, nursing, etc. All this shows how important is clinical teaching to the city, and all good citizens ought to assist in cherish- ing it. Care should be taken to deal generously with medical educa- tion, for in the past much injury has been done by those who do not seem to understand or value it properly as a source of municipal revenue, as well as a factor in adding to our population ; for many of the graduates, more especially the hospital residents, settle in the city, and very often later on attract their families to it. Our future reputation as a medical center largely depends upon our offering unequaled clinical facilities for the instruction of students and physicians. It would pay any municipality which could offer proper clinical advantages to endow one or more medical schools simply on the ground that it would be a good paying investment to the city. At the present time the teaching in the Philadelphia General Hospital is all that can be desired. The clinics are reg- ularly held, and all the colleges are having ward class demonstra- tions, as well as clinical conferences, and the patients, as well as the teachers and students are thereby benefited. This is espe- cially true of the patients, for they are more carefully examined and prescribed for by the teachers who are critically watched by the resident physicians and students. The Philadelphia General Hospital 465 The Philadelphia Almshouse and the Philadelphia Hospital from 1854 to 1908 By CHARLES K. MILLS, M.D. However much differentiation into departments has taken place in the lapse of time, the Philadelphia Almshouse has always had three great subdivisions which have usually been known as the outwards or home for the indigent, the insane department, and the Philadelphia Hospital. At various times changes have been made or have been attempted in the names applied to the Philadelphia Almshouse as a whole and to its subdivisions. The first almshouse at Third and Pine Streets was commonly spoken of as the "Green Meadows," and the second at Tenth and Pine Streets as the "Bettering House." After its removal to the west side of the river it soon took the name "Blockley" or Blockley Almshouse after the old township in which it was located. The recognition in nomenclature of the hospital element was, however, early. The almshouse had its infirmaries or hospital wards for the sick and the insane and its physicians and surgeons almost from the time of its establishment. About 1804, in a memorial to the Legislature of the State asking for an appropriation, the institution is spoken of as com- prising a poorhouse, a house for the reception of the aged and infirm whose condition incapacitates them from earning a subsistence, an orphan and foundling hospital, a ward for lying-in women, apart- ments adapted for the treatment of the insane, workshops for those who are capable of exercising every species of industry, and an extensive hospital. This memorial, by the way, referring to the Pennsylvania Hospital, says that it had, on various occasions, received assistance from the State Legislature, although not admit- ting patients free. It speaks also of the relatively much greater importance of the almshouse and its hospitals or infirmaries to the cause of medical education, as the Pennsylvania Hospital had at this time usually not more than sixty to eighty patients, while the alms- house had an average of from six to seven hundred. In 1892, an effort was made by the President of the Board of Charities and Correction and the Superintendent of the almshouse 30 466 Institutions Under Municipal Management to abolish the name Philadelphia Hospital. This name, for many- years placed over the gateway, was effaced and that of Blockley Almshouse substituted, and similar steps were taken with regard to the designations on the ambulances, the official paper, and where the name appeared in other connections. This attempt to get rid of the name, hospital, aroused much adverse criticism in the community. One of the objects of applying the designation, hospital, to those parts of the almshouse where the sick and insane are cared for and treated is to render these departments less repellent to those who are compelled to seek their ministrations. Good and ancient authority exists for the use of the term, hospital, in connection with some of the departments of the almshouse. The hospital feature appears in many ways in connection with the history of the institu- tion before the removal to Blockley township. The act passed by the Legislature in March, 1828, providing for the erection of the almshouse at Blockley, authorized the pur- chase of a site and the erection of buildings suitable for a hospital and an almshouse, house of employment, children's asylum, and other departments. As recited in "Agnew's History," in accord- ance with the suggestion of Drs. Gerhard and Pennock in December, 1835, the Board of Guardians adopted the name "Philadelphia Hospital" for that department of the almshouse which was concerned with the care of the sick. From that time until 1902 this term was continued as the official designation of the hospital department, except during the very brief period in 1892 when the abortive effort was made to abolish the term, hospital. In 1902, during the administration of Mr. Samuel Ashbridge as Mayor, and of Dr. John V. Shoemaker as President of the Board of Charities and Corrections, it was officially determined that the department of the almshouse known as the outwards and con- taining the indigent, not sick, should be designated as the Phila- delphia Home or Hospital for the Indigent ; the insane department, the Philadelphia Hospital for the Insane ; and the hospital proper, the Philadelphia General Hospital. These terms have been since officially retained. In the sketch which follows, in order to avoid confusion when speaking of the hospital departments of the almshouse, I shall usually use the terms Philadelphia Hospital and Insane Department of the Philadelphia Hospital. The Philadelphia General Hospital 467 A GLANCE AT THE BUILDINGS AND GROUNDS AT DIFFERENT PERIODS A visitor to Philadelphia in 1854 would have found the acreage of the farm surrounding the city almshouse not greatly curtailed from the 187 acres and 60 perches comprised within it when it was bought by the city commissioners from the heirs of William Ham- ilton in 1829. Across the meadow land, between the river and the rising ground on which the buildings of the almshouse stood, ran the just completed trestle work and tracks of the Philadelphia and West Chester Kailroad. The Philadelphia, Wilmington and Balti- more Eailroad then entered and left the city by way of Gray's Perry bridge further down the river, and the junction road which connected this railroad with the Pennsylvania system was not laid until nearly ten years later. In the winter the meadows were sometimes flooded and turned into a skating park. Woodlands Cemetery, founded in 1840 from a part of the Hamilton estate, bordered the city farm to the south and southeast, and was then, as it still remains, a place of great natural beauty, although some of its charms have disappeared with the destruction of trees and the invasion of tombs. The vicinity of the almshouse was distinctly rural. West Philadelphia was sparsely settled. The old Market Street bridge on the site of the more ancient middle ferry was the chief means of getting across the Schuylkill to the almshouse and hospital, although there was some ferriage from the east side to a wharf or landing on the almshouse grounds. Here and there near the almshouse farm were a few buildings for private business or public purposes, and a few wharves were located on both sides of the river. In 1854, the city's poor were housed almost entirely in the four massive buildings erected of brick and roughcast, and, in some parts, of stone brought from the old Falls of Schuylkill quarry in the years between 1830 and 1834. A high board fence then surrounded these buildings and the grounds bordering them. The quadrangle within contained only one or two old wooden buildings. The insane department was then without its extensive wings. Many curtailments of the almshouse farm of 1854, and many additions to buildings occurred before 1890, when the writer described the appearance at that time presented by the almshouse, its annexes and its surroundings, in the first volume of the Phila- 468 Institutions Under Municipal Management delphia Hospital Reports, which description will be here repro- duced with some condensation and alteration. For a short distance from Thirty-fourth Street the almshouse enclosure was then bounded on the north and northeast by Pine Street and Guardian Avenue, running from Pine Street to the eastern border of Woodlands Cemetery. A street called Cleveland Avenue was not opened, but was marked on the city plan between Woodlands and the almshouse. From Pine Street, for about a block, Thirty-fourth Street bounded the enclosure on the east, Vintage Avenue running from Thirty-fourth Street to Woodlands Cemetery (or Cleveland Avenue) in a line parallel with the front or southeastern building. Beyond Vintage Avenue stretched a large field — riverward as far as the railroads, eastward as far as Almshouse Lane, and south- ward to Woodlands. On the city plan was Meadland Street, parallel with Vintage Avenue and intended to run along the bluff above the railroad tracks. Between these tracks and the river was a large area, once meadow and swamp which had become under city ordinance a dumping ground, and was eventually intended for a riverside park; this design has never been consummated. A lane lined on both sides by old trees, ran from Vintage Avenue near Thirty-fourth Street to the almshouse wharf. To the east or left of this lane, not far from Thirty-fourth Street, was an old frame building still standing and then occupied by the clerk of the almshouse; and to its right, facing and close to the railroad tracks, was an ancient stone building two stories and a half high. Between Thirtj'-fourth Street and the river, and east of Alms- house Lane, were an old farm house and barn with connected stables, sheds and buildings. This farm house, well built and roomy, stood on a knoll, and was used as the children's asylum. On the southeast corner of Thirty-fourth and Spruce Streets was a frame house of comparatively recent date, occupied by one of the officials of ihe almshouse. Between Almshouse Lane and South Street, beyond the barn and old frame house was a large lot, used by the water department for the storage of pipes and other materials. A large free city bathhouse was situated along the approach to the South Street bridge. Between the almshouse grounds, as just described, and Wood- land Avenue or Darby Road, much of the old almshouse farm was in the possession of the University of Pennsylvania. At the apex of the triangle bounded by Thirty-sixth Street, Spruce Street and is g a The Philadelphia General Hospital 469 Woodland Avenue, was and still is a city police station. On another part of this lot, facing Spruce Street, stood in good condition an old farm house with dormer roof which was for a long time the residence of the physician-in-chief of the insane department. For many years the Potter's field connected with the present almshouse was situated on a part of the grounds which would, as the streets have been laid out, be between Locust and Spruce Streets and Thirty-fourth Street and the railroad. The cemetery, in 1890, was situated between the southeastern end of the insane department and the railroad. It covered about an acre; was surrounded on three sides by a close board fence, and on one, the east, by a pale fence in the center of which was a gateway. Great have been the changes in old Blockley and its neighbor- hood, not only during the fifty-five years which have elapsed since the city and county consolidation, but even in the last eighteen years. During this time many and important additions have been made to the buildings of the University of Pennsylvania. The campus of the university now covers about sixty acres, and scattered over it are numerous buildings, some of them the finest for their purposes in the world, notable among these being the archaeological museum, the gymnasium and athletic training quarters, the medi- cal laboratories, Houston Hall and the dormitories. Many addi- tions to and improvements of other university buildings have been made since 1890. The Drexel Institute, founded in 1891, and opened in 1892, another educational institution of which Philadelphia is justly proud, stands at Thirty-second and Chestnut Streets, just on the outskirts of the old farm. Many important manufacturing and commercial plants occupy the low grounds which skirt the river from above Market Street to below the Walnut Street bridge. In every direction from the almshouse, except along its river front, a new city has arisen since 1854, with its hotels, business houses, churches, schools, colleges, eleemosynary institutions and splendid private residences. The grounds now used by the city for almshouse and hospital purposes have been reduced to less than twenty acres. The four massive original buildings still stand apparently as indestructible as the pyramids. Lengthwise through the center of the enclosed quadrangle runs a series of two story buildings, with others at right angles at each end, these being used for shops, stores, bak- 470 Institutions Under Municipal Management ery, dining-rooms, kitchens and other purposes; while outside the original buildings, between the southeastern side and the stone wall, along Thirty-fourth Street and between the northeastern side and the wall along the University campus, have been gradually erected many useful additions and annexes to the hospital, such as the women's wards for tuberculosis and for nervous diseases, the nurses' home, the maternity building, the morgue and museum, the brick pavilion and glass houses for men tubercular patients, the enlarged and improved laundry and the isolation buildings. On the moderately elevated ground between the imposing front of the quadrangle and the lowlands bordering the river, stand the buildings of the Philadelphia Museums. On June 27, 1895, an ordinance was passed by Councils and later other ordinances trans- ferring part of the almshouse grounds to the trustees of these museums. The first buildings for museum purposes were erected in 1899. One of them has been recently given over temporarily to the housing of the overcrowded inmates of the almshouse. Above the network of tracks in the low ground an unsightly railroad, elevated to a height to allow of traffic over the river bridges, has been constructed. One who knew this region in the last century would be able to recognize it only by the original build- ings enclosing the quadrangle. Although the almshouse grounds have shrunken so much, its population has steadily increased, this being one of the causes of the distress which the best administrations have not been able fully to overcome. CHRONOLOGICAL LIST OF IMPORTANT BUILDINGS AND IMPROVEMENTS SINCE 18S4 1860. Stone building in the center of the quadrangle for shops, fire apparatus, etc. 1861. New receiving vault; clinic hall. 1870. Two wings to the buildings of the insane department. 1875. Wooden pavilions for medical and other patients; later used for nervous wards and replaced by brick pavilions. 1883-84. Maternity pavilion. 1885-86. Portion of the insane department destroyed by fire rebuilt. 1886. New kitchen from the Mary Shield's Legacy, now a mattress shop; new post-mortem room or "dead house" and morgue. The Philadelphia General Hospital 471 1887. Nurse apartments and the quarters of the resident physicians renovated ; general laundry enlarged. 1888. Additional fire escapes. 1890. Pathological museum. 1890-91. New wards for the insane department, by building two-story T-shaped extensions to the wings. 1892. Associated dining-room and kitchens, and laundry for the insane department ; isolation building for contagious diseases ; clinic hall remodeled. 1894. Nurses' home. 1895. Addition to the maternity wards. 1897. New wards for insane department, by adding third story to wing on women's side, and main building on men's side. 1899. Summer pavilion for the female insane department. 1900. Koentgen ray laboratory. 1901. Electric plant. 190.2-03. Children's Hospital; venereal building or wards, later made infirmary for male tuberculous patients; Maternity Hospital. 1903. Six new steel and glass pavilions for tuberculous patients; roof garden for consumptives. 1904. Operating and sterilizing room for hospital; steriliz- ing apparatus and a minor operating room for the insane depart- ment. 1906. One of the Philadelphia Museums' buildings fitted up to receive male indigent; outwards remodeled for the male insane patients and the men's nervous wards; hydrotherapeutic plant. 1908. Additional isolation building ; receiving ward enlarged and remodeled; yard pavilions remodeled into wards for noisy and disturbed insane bed patients. In most of the reports of the governing boards of the alms- house and hospital for the years from 1890 to 1908 accounts are given of much needed repairs, improvements and additions to the hospital and other departments besides those just tabulated. Any detailed account of these is necessarily passed by in a con- densed historical statement of the progress of the institution. In this category should be mentioned many valuable improve- ments consummated during the administration of the present Director, Dr. Joseph S. Neff, and the present Chief Eesident Physician, Dr. Henry Sykes. These include, as stated by Dr. 472 Institutions Under Municipal Management Neff in his remarks at the reunion of the visiting and resident staffs of the hospital during Founders' Week, "a handsome tiled receiving ward replacing the old worm-eaten wooden rooms, the remodeled and renovated men's nervous pavilions accommodating the tuberculous women and permitting their removal from the main wards, and the rearrangement of the second floor of the main building, allowing the removal of the venereal from the old attics, which will now be permanently abandoned." SALES AND TRANSFERS OF LAND The manner in which the original Blockley farm has been curtailed until it now contains about one^ninth or one-tenth as many acres as at the time of the original purchase is a matter of considerable interest to the student of municipal affairs. For- tunately, much of this ground has gone to the greatest of our State and city educational institutions, the University of Pennsylvania. One of the first invasions of the almshouse grounds was by the Philadelphia and West Chester Eailroad, which was completed in 1853. About ten years later the junction road was built, and from that period to the present many railroad tracks and exten- sions have been made along the river front. A few sales have been made to private individuals or corporations for business pur- poses, as that of a part of the ground on which the Allison Department of the National Tube Company stands. Much of the property which has been sold or transferred has been under the provisions of an Act passed May 1, 1861. The accessions of property by the University summarized have been as follows : The ground between Woodland Avenue and Spruce Street, and Thirty-fourth and Thirty-sixth Streets, on which the College Hall and some of the most important buildings of the University stand, was granted to the Trustees of the Uni- versity of Pennsylvania in May, 1872, for the nominal sum of $500. In 1882, the city, under an agreement with the Trustees of the University, deeded to this institution fourteen acres more of the almshouse land, in consideration of which the city was to be paid $10,000, and was to be entitled to fifty free scholarships in the University forever. These free scholarships have since been distributed among the pupils of the public high schools of Phila- delphia, those being selected who have passed best in competitive examinations. In 1888, the city gave to the University three- The Philadelphia General Hospital 473 fourths of an acre opposite Medical Hall, on Thirty-sixth Street, on condition that a free library of reference be erected there. In 1889, the University purchased of the city another large tract of almshouse ground, chiefly situated between Thirty-fourth Street, the Philadelphia and West Chester Eailroad, and Locust and South Streets, paying for this property $149,000. This was, in the main, the ground on which the gymnasium, the training quar- ters, athletic grounds and laboratories between Thirty-third and Thirty-fourth Streets, north of Spruce Street, are situated. Other moderate accessions of ground were obtained subsequently by the University — as a small piece of ground at the northeast corner of Thirty-fourth and Spruce Streets, on part of which the Chemical Laboratory has been built, and the land in the space between Thirty-fourth and Meadland Streets, and south and west of South Street, and its continuation as Spruce Street, and a portion of the almshouse grounds, in which the beautiful archaeological museum has been erected. Two transfers of lands were made to the Trustees of the Philadelphia Museums for park, botanic garden, museum and exposition purposes, the first of eight acres in 1895, the second in 1896 of seven acres. 7 THE BYBERRY PURCHASE While the old Blockley farm has been so much reduced in size, steps have recently been taken to compensate for this cur- tailment of the grounds originally intended for the indigent, the insane, and the sick poor, through the purchase of a large tract of land at Byberry, on the northern border of the city. In 1906, during the administration of Mayor John Weaver and Director Coplin, after numerous efforts, this tract containing in all 874 1 Those interested in the details of the Act of Assembly of 1883 and the ordinances of Councils passed at various times after this date, regarding the transfers of land to the Trustees of the University of Pennsylvania and to the Trustees of the Philadelphia Museums, are referred to a pamphlet issued by the Philadelphia Museums, containing the same. Other acts and ordinances relating to the transfers of ground to the University of Pennsyl- vania and to other corporations and private individuals are described in Lawrence's "History of the Philadelphia Almshouse," etc. It is only intended here to give a brief sketch of the manner in which the land formerly included in the Blockley farm has been granted for purposes not connected with the administration of the almshouse. 474 Institutions Under Municipal Management acres, was secured by bringing together a number of purchases of farms and other properties. Probably nowhere else within the city limits could the same amount of ground have been secured for the purposes for which it is intended. On November 15, 1906, an ordinance of Councils was passed appropriating $261,000 for this purchase. Director Coplin, in his annual report to the Mayor for the year 1906, speaking of this purchase, says this tract "is splendidly located, well suited to farming and possesses a surface contour adapted to the erection of buildings for the reception of the insane at present crowded into the insufficient space afforded by anti- quated buildings long out of date and no longer capable of alteration to meet modern requirements." MOVEMENT TO CONSOLIDATE THE OUTLYING POOR DISTRICTS UNDER THE DEPARTMENT OF HEALTH AND CHARITIES While this article is in course of preparation a movement has been set afoot which contemplates the relief of overcrowded Bloekley. This movement, which is receiving the earnest support of Mayor Eeyburn, Director NefE and others deeply interested in the welfare of the city's poor, although opposed by many citizens of the localities under discussion, is one which looks to the con- solidation of the almshouses and farms in the outlying districts of Germantown, Koxborough, and Oxford and Lower Dublin. Under the Act of Consolidation of 1854, these were permitted to continue under the independent control of the people of the town- ships or boroughs in which they were situated. On the whole, they have been satisfactorily managed, but it is believed by those who advocate the centralization of all the almshouses of the city under one department, that this will result greatly to the benefit of the poor of the entire city. A bill now before the Legislature has for its design this centralization. If these farms could be placed under one management, it would then be possible to realize, once and probably for all time, a project in every way to be approved, that of separating topographically the institutions in which are cared for the indigent not sick, the epileptic, the insane and the tuberculous. Modern medicine altogether favors the idea of large tracts for the care and treatment of the sick of these classes. With the 874 acres at Byberry, the 152 acres in the dis- trict of Oxford and Lower Dublin, and the 42 acres at Eox- The Philadelphia General Hospital 475 borough, and with the present buildings and grounds at Blockley renovated and rehabilitated for a modern hospital, the problem of properly earing for the poor of Philadelphia would be solved. CHANGES IN METHODS OF GOVERNMENT AND IN INTERNAL ADMINISTRATION The methods of governing the Philadelphia Almshouse, in- cluding its constituent parts, and its administration by internal officials, have varied considerably since 1854. The manner in which the controlling boards have been elected or appointed, the character of these boards, and the personal and political considera- tions connected with their appointment, have at certain periods in the history of the almshouse done much on the one hand to cause confusion or even retrogression, and on the other hand to bring about reforms and advances in the interests of the poor, as well as of the medical profession in its relation to the hospital. About the time when the Act of Consolidation went into effect, the almshouse was under the control of a board, which because of abuses, was frequently spoken of in the community as the "Board of Buzzards," a term, however, which was not only used at this particular period, but was afterwards applied to other boards. While the accusations of shortcomings and even of mal- feasance, including the trafficking in dead bodies, were in some instances justified, it remains true that in every board which has had control at Blockley some good men have been found. After consolidation the guardians were elected, one by the voters of each ward, except in certain boroughs in the outskirts of the city, and excepting also that no election was held in wards Twenty-one, Twenty-two and Twenty-three. The board thus constituted was abolished by an Act of Assembly of April 7, 1859, which directed that the Board of Guardians should thereafter be appointed, three by the District Court, three by the Court of Com- mon Pleas, and three by the Common Council. By an Act of June 2, 1871, the election of the guardians was placed entirely with City Councils. They elected four persons annually to serve three years; the minority party being repre- sented in the board, which was to be a department of the city, subject in the matter of contracts and appropriations, to the appointing body. The management of the Almshouse and Hospital continued 476 Institutions Under Municipal Management under the Board of Guardians thus elected until the Act entitled "An Act to provide for the better government of cities of the first class of the Commonwealth," familiarly known as the Bullitt Bill, came into force on the first Monday of April, 1887. Under this Act the executive power was vested in a Mayor and certain departments, one of which was known as the Department of Chari- ties and Correction, which was under the charge of a president and four directors, to whom were confided the care, management, administration and supervision of the Almshouse, Hospital, House of Correction and other similar institutions, the government of which was entrusted to the city, except the Municipal Hospital, the Lazaretto, and institutions under any city trust then existing. During the tenure of the Board of Guardians much of the work of the almshouse, including the supervision of the hospital and of the insane department, was entrusted to standing com- mittees. The Hospital Committee, in particular, was vested with great power, and was practically the Executive Committee for the control of medical matters in general. Under the Bullitt Bill the Board of Charities and Correction was divided into two bureaus, one having charge of the almshouse and the other of the House of Correction. The State Legislature, April 8, 1903, passed an Act amending the Bullitt Bill, providing for a Department of Public Health and Charities in lieu of the Department of Charities and Correction. An ordinance was passed putting into effect this Act of Assembly after May 1, 1903. The almshouses, hospitals and allied institu- tions were placed under the control of the new department, which had for its head a director receiving a salary of $10,000 a year. The House of Correction and other interests confided to the old Bureau of Correction were transferred to the Department of Public Safety. The Department of Public Health and Charities, since the passage of the above amendment to the Bullitt Bill, has been one of the co-ordinate departments of the city government, and its director a member of the Mayor's cabinet. The first director of the department was Dr. Edward Mar- tin, who was appointed by Mayor Weaver in 1903, and served until 1905. The second was Dr. W. M. L. Coplin, also appointed by Mayor Weaver, and holding this position until the expiration of the Mayor's term, when he was succeeded by Dr. Joseph S. Neff, who was appointed by Mayor Reyburn. The Philadelphia General Hospital 477 The administration and general supervision of the affairs of the almshouse and of the general and the insane hospitals under the Directors of the Department of Public Health and Charities have been highly efficient, the interests of the poor and the sick receiving the closest attention and consideration. For many years the chief executive officer of the almshouse was known as the Steward. According to the rules of 1861, under the direction of the board, he was to have entire supervision of the institution in all its various departments, except those under the immediate charge of the Medical Board and resident physician of the insane department. In 1876, the office of Steward was abolished, and that of Superintendent, with some enlargement of powers, was substituted. Mr. Marshall Henzey served in the capacity of Steward from 1858 to 1873, and on his resignation Major Ellis P. Phipps was unanimously elected to fill the vacancy. Major Phipps was the first Superintendent, his title having been changed from that of Steward. Major Phipps continued in office until 1882, when he was succeeded by Mr. Thomas B. Scarborough, who continued until Mr. George H. Smith was appointed in 1884. Mr. Smith served until 1886, when he was succeeded by Mr. George Eoney, who con- tinued to hold the office until 1891, when he was appointed by the Mayor, Mr. Edwin S. Stuart, as Director of the Department of Public Safety. This vacancy was filled by Mr. Charles Lawrence, formerly President of Common Councils and a veteran of the United States Navy during the Civil War. He served until May 15, 1900. Those who have held this office since have been : Will- iam M. Geary (May 15, 1900, to July 29, 1902) ; Eobert H. Smith (July 29, 1902, to July 19, 1904); William E. Defrates (August 15, 1904, to some time in 1905); Samuel Laughlin (1906 to the present time). The chief medical position in the Philadelphia Hospital until 1885 was that of Hospital Warden, which was in this year abol- ished, and in its place that of Eesident Physician-in-Chief was created. The first to hold this position was Dr. Thomas N. McLaughlin, who served until after the Bullitt Bill went into effect, when he was succeeded, April 12, 1887, by Dr. George M. Wells, who continued to serve until February 15, 1890. On March 24, 1890, Dr. Daniel E. Hughes was chosen to fill the place of Dr. Wells. He held the position until the time of his death, 478 Institutions Under Municipal Management October 27, 1902. Dr. George I. MeKelway, who had been ap- pointed Assistant Chief Eesident Physician, became Acting Chief Kesident Physician, and on May 16, 1903, Dr. M. H. Biggs was elected. The term of service of Dr. Biggs extended to April 1, 1906, when he was succeeded by Dr. Henry Sykes, who has con- tinued in the office until the present time. Much of interest might be said about the medical men who have occupied paid official positions, and about the personnel of the governing boards, but I shall say only a few words about some of these, wishing it to be understood that others worthy of com- ment or commendation must be passed by because of the limita- tions of this article. Dr. Bobert K. Smith, who held the position of Besident-in- Chief in 1855-56 and in 1858-59, was evidently a man of much force of character. Dr. J. W. Lodge, who was Eesident Physician at Blockley in 1859, knew Dr. Smith very well. He says of him that he was a man of much ability, a fluent and forcible speaker, earnest and painstaking in his work. He had general charge of all hospital affairs, and besides this routine work, lectured at times in the amphitheatre. Dr. James McClintock, who served as Besident-in-Chief 1857- 58, was a striking personality, thoroughly equipped as a physician. He was, however, alleged to be engaged in the manufacture of medicinal preparations whose contents were not known, and for this, among other reasons, he was frowned upon by the Medical Board, and because of his appointment the entire visiting staff resigned, as did also six of the resident physicians. Dr. Daniel E. Hughes, who died October 27, 1902, after a service of twelve years as Besident Physician-in-Chief, both of the hospital and of the insane department, was an efficient and zealous official, whose untiring work in behalf of the sick, poor and insane will long be gratefully remembered. He had great executive ability, and was also blessed with an insight into character, which enabled him to get the best out of the resident physicians and others who worked under him and with him. He was graduated from Jefferson Medical College in 1878. He was the author of a compend of the Practice of Medicine, which passed through numerous editions. He filled his difficult position not only to the satisfaction of the Bureau of Charities, but at the same time he won the respect of the medical staff, and by the patients he was The Philadelphia General Hospital 479 universally regarded as their friend and helper. A tablet in bronze, commemorative of the worth of Dr. Hughes and of his services to the Philadelphia Hospital, was placed in the hall of the administrative building on December 27, 1904, with suitable exercises. After the Bullitt Bill went into effect' in 1887, the presidents of the Department of Charities and Correction were, without exception, men who deserved the respect and esteem of their fel- low-citizens for the manner in which they administered the affairs of one of their most important institutions. Dr. James W. White, who served as president of the department 1887-88, brought about many changes and reforms, and will be particularly remembered for the emphasis which he laid upon the hospital idea in the man- agement of almost the entire institution. Mr. Eobert Laughlin gave the closest attention to the duties of the position, working harmoniously and in the best interests of the institution with both the Medical Board and with the non- medical officials. Mr. James A. Ereeman served with zeal and efficiency as- president of the board during his short tenure of office. He was appointed early in 1892 and was compelled to resign because of ill health, in September of the same year. Major William H. Lambert showed in his official position the same high qualities displayed in the service of his country during the Civil War, and in the business and civic affairs with which his name has been identified. He was alike watchful of the interests of the poor, of the medical staff, and of the institution as a whole. He co-operated in every way with Captain Lawrence and Dr. Hughes in the erection of necessary buildings and in the furthering of numerous material improvements. Dr. John V. Shoemaker during his term of service gave his hearty co-operation to every good work advised by the Medical Board, and was assiduous in his attention to all the duties of his position. He was instrumental in the erection or equipping of cer- tain buildings or departments which were much needed, such as the Eoentgen-ray laboratory, the new children's hospital, and the new maternity hospital. He took especial interest in furthering clinical teaching, both in the amphitheatre and in the form of ward or bedside instruction. Dr. Edward Martin, Dr. William M. L. Coplin, and Dr. Joseph S. Neff, who have been successively the Directors of the Department 480 Institutions Under Municipal Management of Public Health and Charities since the creation of this depart- ment in 1903, like their predecessors the heads of the Department of Charities and Correction, have rendered service of the highest value. To Dr. Martin were due numerous improvements in the facilities for surgical practice, such as new sterilizing and operating rooms, as well as a roof garden for consumptives and the completion of the glass houses for the treatment of tuberculosis, which were begun by his predecessor. During his term of service a rule was adopted which permitted each member of the Medical Board to have an official assistant to be appointed by himself and confirmed by the director. This addition to the medical staffs has advanced the interests of the patients, of the often overworked members of the Medical Board, and of clinical teaching. The great work done by Dr. Coplin and Dr. ]STeff in improving conditions in the hospital and insane department, in securing the B} r berry tract, in preparing or erecting buildings on this tract, and in many other ways, is fully detailed in several parts of this histori- cal sketch. During several of the administrations, physicians were selected for positions in the department, serving always on the Bureau of Charities. Among those who did notable service in the interests of the hospital were Drs. Richard Cleemann, James W. Walk, C. S. Middleton and Ellwood E. Kirby. The experience of many years has shown that it is of great advantage to a city hospital to have physicians either at the head or in the membership of its governing board, and the wisdom of the Mayor in making such appointments has always been justified. THE HOME FOR THE INDIGENT The Philadelphia Almshouse, like any almshouse or poor house, was of course primarily designed to take care of the indigent, whether well or sick, who for some reason, presumably not because of their own faults, were unable to care for themselves. At first in the history of the institution the general care of the indigent, or paupers as they were commonly termed, received most consideration, it becoming necessary very soon however, to make particular pro- vision for the sick, the decrepit and the insane. The reader is referred to the sketches of Dr. Curtin and Dr. Agnew, and to the municipal and other histories of Philadelphia for the account of the manner in which the poor, both within and outside of the alms- The Philadelphia General Hospital 481 house, were looked after from 1731 to 1854, which marks the begin- ning of the period with which this article is concerned. When the four massive stone structures at Blockley were com- pleted in 1834 the inmates were subdivided in such manner at first that all the hospital cases including the insane, were placed in the southwestern, the female indigent or outwarders in the northwest- ern and the male indigent in the southeastern building; while the vagrants and others who were required to work occupied the north- eastern building. So far back as my own memory and the recol- lections of men older than myself who have been on the Medical Board at Blockley, extend, the male and female indigent, until a recent period, have been quartered in the southeastern and north- western buildings. The entire southeastern structure, with the exception of the central administration quarters, was reserved for the male outwarders, but on the female side only one-half of the northwestern structure was for the most part necessary. The other half had been given over during many years to other depart- ments of the hospital, as for instance, to the obstetrical wards on the third floor, the womens' wards for nervous diseases on the first floor, and the wards for tuberculous women. The central portion of this southeastern building has long been the residential quarters for the physician-in-chief of the hospital and the resident physicians on duty. At various times in the history of the Philadelphia Almshouse earnest efforts have been made to separate the indigent or pauper element from the hospital department. On June 2, 1882, a special committee of Councils which had been appointed to investigate the conditions at the almshouse, urged the separation of that portion of the institution containing the indigent presumably not sick, from the hospital. It was advocated to take the pauper element elsewhere, leaving the almshouse build- ings for hospital purposes alone. After the great fire which destroyed a portion of the insane department in 1885, there was again much agitation of the ques- tion of the removal of the insane and the indigent to the out- skirts of the city. The newspapers took up the subject which was discussed by Councils, meetings were held at various places, and committees of councilmen, physicians, guardians and interested citizens visited Holmesburg to see if it were possible to locate a new insane department in this neighborhood. It looked for a time as if 31 482 Institutions Under Municipal Management something might be accomplished, but before long the matter was again neglected and the buildings of the insane department were rebuilt and rehabilitated and matters went on as usual, the hospital, insane department, and outwards becoming more and more crowded as years progressed. Other spasmodic efforts were made from time to time. In 1902, the money necessary for the purpose was set apart, and an effort was made to remove the indigent and the insane to the House of Correction grounds and to other tracts which it might be possible to obtain in the immediate vicinity. Fortunately, perhaps, this effort failed, although it was advocated by men actuated by the best motives who were greatly worried and depressed by the over- crowded and dangerous condition of the buildings in West Phila- delphia. It perhaps, fortunately failed because the grounds avail- able were not sufficient, although they were the only land within the city limits which could be utilized at that time. The much more desirable site at Byberry has since been obtained. The establishment of the House of Correction did much not only for the relief of the overcrowding at Blockley, but also much that was desirable towards the separation of the vagrant and semi- criminal class from the inmates of the almshouse. The House of Correction at Holmesburg was opened January 15, 1874. "At that time there were 4,597 inmates in the almshouse, according to the reports, 1,150 of whom were classed as vagrants. At the end of the year the number dropped to 3,972 with 421 vagrants." — Lawrence. In December, 1905, and early in 1906, steps were taken by Mayor Weaver and Director Coplin for immediately relieving the overcrowding of the hospital and of the insane department. Councils made a liberal appropriation for the purpose and one of the buildings and a connected corridor of the Philadelphia Museums was fitted up to receive the male indigent. It took more than a year to accomplish the changes necessary to bring about this object, but on September 15, 1906, the male indigent were removed to comfortable quarters which had been prepared for them, and which were in most respects highly satisfactory. Immediately after the removal of the paupers to their new quarters work was begun on the old male outwards. They were thoroughly renovated, many addi- tions and changes being made. The old toilet rooms were newly equipped, additional toilet rooms were built, an elevator was The Philadelphia General Hospital 483 installed, new floors were laid, much cleaning and painting were done, and a hydrotherapeutic plant thoroughly up to modern requirements was installed. This work, after some unexpected delays, was finished in April, 1907, and soon afterwards 300 insane persons were transferred to the wing next to the insane depart- ment, 8 while the wing on the other side of the administration department was fitted up for the men's nervous wards, and the male psychopathic ward. The male nervous wards and the psychopathic wards together, December 31, 1908, contained no less than 267 patients. These changes furnished much needed relief, but as was everywhere recognized, were not sufficient to long put off the day for the final separation of the hospital from the other departments of the almshouse. DRUNK WARDS OR WARDS FOR ALCOHOLICS Very early publications regarding the almshouse make some reference to the drunkards' wards or department for drunkards. This department was referred to, for instance, in the memorial to the Legislature in 1804, already cited, and doubtless such wards have existed ever since the almshouse has contained a few score of inmates. During a long period, reaching down to 1890 in the administration of Mayor Pitler, the drunk or alcoholic wards were a part of the medical department, under the direction of the visiting physicians. After the establishment of the neurological department, the visiting neurologists were not infrequently called in to see cases of delirium tremens, alcoholic insanity, multiple neuritis, or some other form of alcoholism, but had no special supervision of alcoholic eases until 1905, when the new alcoholic and psychopathic wards were established. The drunkards' wards were always, as may be presumed, a 8 The history of the insane department of the Philadelphia Hospital or of the Philadelphia Hospital for the Insane, as it has been known officially since 1902, formed a part of this history as it was originally pre- pared, but owing to the limitations of apace it has been found necessary to omit it, although no part of the Philadelphia Almshouse furnishes more interesting data for the local historian. The sketch of the insane depart- ment was presented in the form of an address before the semi-annual meeting of the association of superintendents and trustees of the State and incorporated hospitals for the feeble-minded and insane of Pennsylvania, held at the Philadelphia Hospital for the Insane, May 14, 1909, and will be published in pamphlet form as a part of the proceedings of this associa- tion. 484 Institutions Under Municipal Management most important feature of an institution which housed hundreds or even thousands of the poor, disorderly and degenerate class. Their population, was from the nature of the cases admitted to them, often transient, although the wards for the most part con- tained a large number, which, before the establishment of the House of Correction, was probably at times considerably larger than after this period. To these wards many patients who did not properly belong to them were sent from time to time, chiefly through the police department of the city — cases, for instance, of doubtful mental state or cases in the early stages of different forms of insanity. In 1890, during the administration of Mayor Fitter and that of Mr. Eobert Laughlin as President of the Bureau of Charities and Correction, as the result of a suggestion to the Mayor and Dr. Daniel E. Hughes, the Chief Eesident Physician, by Dr. Thomas H. Andrews, then Surgeon to the Bureau of Fire and Police, a detention or observation ward, separate from that for drunkards, was established. To this newly-created ward, cases in which alcoholism or insanity or both were doubtful, were now sent to remain under observation until their true nature could be deter- mined. If, in the judgment of the physician-in-charge and the examiners for admission to the insane department these eases proved to be instances of insanity, the patients were transferred by proper legal process to the insane department, while cases of recovery were discharged, and those properly belonging to some department of the general hospital were sent to it. This was a praiseworthy innovation, and one the great value of which has been frequently demonstrated. For the most part, after the estab- lishment of the detention wards, these as well as the wards for drunkards, remained under the immediate control of the Chief Eesident Physician or his assistant, members of the visiting staff being often called upon in consultation. In 1906, during the term of Dr. Coplin as Director of the Department of Public Health and Charities, the drunkard and detention wards were reorganized under the form of the psycho- pathic and alcoholic wards, which were now placed in charge of the visiting neurologists. The rules applying to these wards, which were adopted soon after their organization, required them to be visited at least twice a week by the visiting neurologists on duty and the same number of times by their assistants. The Philadelphia General Hospital 485 These wards have since continued under this organization. One of the duties of the visiting neurologists is to indicate to the committing physicians the eases to be transferred to the depart- ment for the insane. Internes are assigned by the Chief Eesident Physician to serve in the wards. Few, if any, hospitals in the country afford equal opportuni- ties for the study of all forms of alcoholism and the disorders in which insanity is doubtful. The routine duties devolving upon the physicians are somewhat onerous, owing to the number of cases admitted and the attention which must be immediately given to them. It is the duty of the Assistant Chief Eesident Physician to take charge of these wards during the absence of the visiting staff, a provision which is absolutely necessary, owing to the frequency of admissions, which take place at almost any hour of day or night. The same individuals are admitted again and again. One alcoholic recently admitted had been in the wards more than one hundred times, and the records show many instances of victims of the drink habit who have been admitted twenty, thirty, and more times. The patients in these wards can be used for teaching purposes, but students are not permitted to enter the wards, the instruction being given either in the amphitheatre or in suitable rooms adjacent to the wards. THE FEEBLE-MINDED The care of the feeble-minded, under which broad designa- tion all of the idiot and imbecile classes are often officially grouped, is a problem of much importance to municipalities. During a very long period many feeble-minded children were cared for at Blockley, in large part in the children's asylum, although persons of this class were not infrequently found in the medical wards, and after their organization in 1877 in the nervous wards. "An ordinance was passed and approved December 31, 1862, which provided for sending the feeble-minded children from Blockley to the Training School at Media. Twelve children were sent in 1863, and since then the number has been increased from time to time, until now there are more than one hundred and sixty in that institution, for whose maintenance the City of Phila- delphia defrays the expense." — La whence. The institution at Elwyn, under the contract, is only expected 486 Institutions Under Municipal Management to take a certain number, and it has its choice of the character of those it takes. In consequence of this, a number of feeble- minded children are always to be found in the wards of the Phila- delphia Hospital, usually in the nervous wards or in the children's asylum. Since the opening of the State Institution for Epileptic and Feeble-minded at Spring City, Montgomery County, arrangements have been made for the transfer of some cases to this institution. THE SUBDIVISION OF THE HOSPITAL INTO SPECIAL DEPARTMENTS In 1854, as stated in Dr. Agnew's history,, the medical officials of the almshouse consisted of the Besident-in-Chief and a Board of Lecturers on Clinical Medicine and Surgery — this board being also the medical staff of the institution. The manner in which the Philadelphia Hospital was organized at this time and a little later may be seen from the report which was made by Dr. Archibald B. Campbell to Mayor Bichard Vaux, who was the second Mayor of our city under the Act of Consolida- tion, and was elected in 1856. In this report Dr. Campbell describes the hospital as comprising "a small-pox hospital, a lunatic asylum, a children's asylum, a lying-in department, a nur- sery, a hospital for medical, surgical, venereal and mania-a-potu cases, besides the almshouse properly so-called." — Lawrence. These different portions of the hospital were not, as some of them became many years later, under the supervision of specialists. The only medical officers besides the Besident Physician-in-Chief were the three staffs of physicians, surgeons and obstetricians or accoucheurs. Exactly how the different departments of the hos- pital were assigned to these staffs does not appear, but it is prob- able that the assignments were similar to those which prevailed until the seventies or to some extent even later — the small-pox hospital which was also used for other contagious diseases, the lunatic asylum, and the wards for medical diseases in general com- ing under the visiting physicians, the surgical and venereal wards under the surgeons, and the obstetrical wards, children's asylum, and nursery under the obstetricians. According to the rules of 1861, the Medical Board of the hospital consisted of four physicians, four surgeons and four accoucheurs, the hospital being divided into three departments, medical, surgical and obstetrical, and the term of each physician, The Philadelphia General Hospital 487 surgeon and accoucheur being three consecutive months, each staff regulating the order in which its different members served. At various periods since 1861, efforts have been made to increase or decrease — usually to increase — the number of mem- bers of the different staffs. Four on each staff remained the con- stitution of the board until 1874:. During this year the surgical and obstetrical staffs were increased from four members to five, the medical staff practically remaining at four, although the superintendent of the insane department was regarded officially as a member of this staff. A sudden jump was taken in 1875. The physicians and sur- geons were increased to eight each, while the accoucheurs remained at five. In 1876 and 1877, important changes were made. The staff of obstetricians was increased to eight members to correspond with the surgical and medical staffs. Specialism began to assert itself in medical practice in this country about 1865 to 1870, but no specialists were recognized in the organization of the Philadelphia Hospital until 1877. In September of this year three new special departments were added to the hospital, namely, the neurological, ophthalmological and dermatological. Dr. Charles K. Mills was appointed to organize and take charge of wards for nervous diseases; Dr. E. 0. Shake- speare was made ophthalmologist, and Dr. L. A. Duhring, derma- tologist. Since this time the changes in the organization of the medical board have been many, as will presently appear. From 1880 to 1884, the medical and surgical staffs numbered nine. One reason for this abnormal increase was probably the great pressure brought to bear upon the governing board. At a meeting of the Board of Guardians, October 27, 1884, a rule was adopted reducing each of the main staffs to six. The rule in full was, that the Medical Board should consist of a medical, surgical and obstetrical staff, not exceeding six members each; also of a neurologist, a dermatologist, a pathologist who should serve as curator, a microscopist, and a physician to the insane department. In December, 1889, numerous changes were made in the per- sonnel of the Medical Board, in consequence of a controversy which arose between the Mayor and the Department of Charities and Correction. The rules for 1890 divided the hospital into four depart- 488 Institutions Under Municipal Management merits — medical, surgical, obstetrical and neurological; the med- ical including the medical wards only; the surgical, the surgical, venereal, eye and skin wards; the obstetrical, the maternity, gynecological and convalescent wards, the nursery and the chil- dren's department; the neurological, the nervous wards and the insane department. In addition, special wards were under the care of ophthalmologists, dermatologists and laryngologists. The terms of service of the visiting medical officers were fixed by their respective staffs. The Medical Board, under the rules prevailing at this time and down to a recent period, was elected annually in December, by a vote of a majority of the members of the Board of Charities and Correction, and vacancies on the board were filled by a similar vote for the unexpired term, at the nest stated meeting of said board, following the one at which the vacancy was declared. Since the creation of the new Department of Public Health and Chari- ties, the medical appointments have been made by the director of the department. The medical, surgical and obstetrical staffs were composed of eight members each; the neurological staff of four; in addition, the board consisted of two ophthalmologists, two dermatologists, two laryngologists, a pathologist with two assistant pathologists, and a bacteriologist. In the period which has elapsed since 1890, several new and important departments of the hospital have been created, and some of the staffs in existence before this time have been increased in number. I shall next briefly sketch the history of each of the separate special departments, in doing which, use will be made of the his- tories of these departments already published in the first and other volumes of the Philadelphia Hospital Eeports, also of the original material obtained from various members of the special staffs and of the annual statements or reports of the governing boards. Before doing this, however, the history of the children's asylum and of the pathological department will be given, these antedating the special departments as usually considered. THE CHILDREN'S ASYLUM AND PEDIATRIC DEPARTMENT The Children's Asylum may, in a sense, be regarded as the first of the separate departments, although the pediatric staff was not appointed until 1900; the organization of the Children's Asylum probably dated back to the eighteenth century. The Philadelphia General Hospital 489 The first location of the Children's Asylum was on Fifth Street, between Pine and Federal Streets, at the house of Joseph J. Wharton. This property was afterwards purchased by the Guardians of the Poor. Among the earliest physicians were Drs. J. G. Nancrede, William Price, Benjamin Coates and C. D. Skerrit. In 1835, Joshua H. Wallace was elected resident physician to the asylum. The obstetricians were also required to attend the asylum, but in April, 1835, Dr. H. L. Hodge, then obstetrician to the hospital, declined longer to attend the children, and a visiting physician was appointed for the asylum, with an assist- ant, who had to be a graduate and resident of the house. Dr. Hodge recommended other important changes, most of which were adopted. The original asylum was sold in 1835, and the children were removed to the institution west of the Schuylkill. When they were first brought to the new almshouse they were placed in the southeastern end of the northwestern range of buildings. In 1884, the asylum was removed to the old farmhouse on the east side of the present Thirty-fourth Street. This building was torn down and gave place to a new children's hospital, which was erected in 1902-03 — a brick and stone building, situated on Thirty-fourth Street, opposite the former line of Pine Street. It is forty-six feet high, and consists of three stories and an attic. In the year 1900, a pediatric staff of four was appointed, and the Children's Asylum placed under its charge. The first mem- bers of this staff were Drs. E. E. Graham, J. P. Crozer Griffith, William C. Hollopeter and J. Madison Taylor. THE PATHOLOGICAL DEPARTMENT As early as 1814, according to Dr. Agnew, an effort was made to establish a hospital museum. In 1860, a resolution was passed by the Board of Guardians to found a pathological museum, and, in 1861, Dr. Agnew was appointed curator. The museum, in 1864, contained one hundred and seven prepared specimens. On May 14, 1866, Dr. James Tyson was elected microscopist to the hospital, the creation of such position having been pre- viously strongly recommended by members of the medical and surgical staffs, who also endorsed Dr. Tyson for the position. Dr. Tyson made many valuable reports of his examinations of speci- mens, some of which were published in the annual statements of the Board of Guardians. 490 Institutions Under Municipal Management Dr. William Pepper succeeded Dr. Agnew as curator on October 4, 1867, and Dr. Tyson was succeeded as microscopist by Dr. E. M. Bertolet, on February 26, 1872. On November 22, 1871, Dr. Pepper resigned as curator, and Dr. Tyson was ap- pointed curator and pathologist. In March, 1872, Dr. Tyson was elected one of the visiting physicians of the hospital, but con- tinued also as curator and pathologist until 1875. In 1874, a catalogue of the specimens in the Pathological Museum was prepared, conjointly by Drs. Tyson and Bertolet, the task being one of unusual difficulty. The total number of speci- mens was three hundred and twenty-two. In 1875, Dr. Thomas B. Eeed was made microscopist, Dr. Bertolet during the same year having succeeded Dr. Tyson as curator. Dr. Joseph Berens, who was appointed curator and pathologist in 1876, continued in this position until 1879. In 1880, Dr. B. 0. Shakespeare, already ophthalmologist to the hospital, was made curator, and Dr. H. P. Pormad micro- scopist. In 1882, Dr. Shakespeare was made pathologist, the office of curator disappearing as a separate position. Dr. Formad continued microscopist until 1886. In 1887, Drs. Shakespeare and Formad were both appointed pathologists, each taking half the year. Dr. Shakespeare was appointed bacteriologist in Decem- ber, 1889, his duties as defined being to make investigations of infectious diseases in the hospital, and of hygienic questions sub- mitted to him by the Bureau of Charities or the medical staff. Since 1892, those who have served in the position of patholo- gist have been Dr. John Guiteras (1892-1899) ; Dr. William M. L. Coplin (1893-1895) ; Dr. B. B. Sangree (1895) ; Dr. Wil- liam M. L. Coplin (1896 to the present); Dr. Henry W. Cattell (1899-1900); Dr. Joseph McFarland (1900 to the present); Dr. Simon Flexner (1900 to 1903) ; and Dr. Allen J. Smith (1903 to the present) . Although allowed at one time to degenerate, the Pathological Museum has during recent years received much attention from the pathologist and members of the medical staff. For many years the pathological specimens were kept in cases placed around the walls on the upper floor of the clinic hall, the dead house or post- mortem room and connected morgue being at this time in a build- ing adjacent to the clinic hall. A new dead house was erected in its present location in the space between the northwestern build- The Philadelphia General Hospital 491 * ing of the quadrangle and the enclosing fence in 1885. A new museum building, adjoining the dead house, was erected in 1890. The Pathological Museum was recatalogued by Dr. John Guiteras for Volume II of the Philadelphia Hospital Eeports, published in 1893, the list as prepared by him showing a total of six hun- dred and twenty specimens. In the fifteen years which have passed since, large and valuable additions have been made to the specimens. A large central space in this museum is sometimes used for the assembling of classes in pathology, which are drawn from the different medical schools of Philadelphia, and are taught during the college year. Post-graduate instruction is also given, both in the dead house and in the museum. The first classes instructed separately in pathology in the Philadelphia Hospital were taught by Dr. J. P. Tutt in 1865. Dr. Tyson first taught classes in microscopical and pathological his- tology in the spring of 1871. Dr. Formad for many years gave instruction in the hospital to the students of the University of Pennsylvania. Owing to the great population of the hospital, the insane department, and w r ards for the indigent, many opportunities for post-mortem investigation occur, and this, notwithstanding the fact that necropsies are not held except with the permission of the kindred or friends of those dying in the institution when these can be reached, and also notwithstanding the fact that many of the bodies pass, under the State laws now in force, to the anatomical rooms connected with the medical, dental and other schools. The positions of visiting and resident physicians at Blockley carry with them large opportunities for making necrop- sies. These necropsies are often made or supervised by the pathologists and members of the staff who have distinguished themselves in the literature of pathology. From the pathological laboratory at Blockley comes most of the material exhibited at meetings of medical societies in Philadelphia. CHRONOLOGICAL LIST OF SPECIAL DEPARTMENTS ESTABLISHED FROM 1877 TO 1908 INCLUSIVE 1877. Neurological Department, or Nervous Wards; Oph- thalmologieal Department; Dermatological Department. 1884. Training School for Nurses. 492 Institutions Under Municipal Management 1889. Bacteriological Department. 1890. Laryngological Department. 1892. Isolation Department. 1900. Pediatric Department; Orthopaedic Department; Eoentgen Laboratory. 1901. Oral Surgical Department. 1903. Clinical Laboratory. 1904. Venereal and Genito-iirinary Department; Tuber- culosis Department. NEUROLOGICAL DEPARTMENT The neurological department or nervous wards of the Phila- delphia Hospital were organized by the writer in 1877, he having been appointed neurologist in September of this year, this being the first position of this kind in Philadelphia, and probably the earliest in the country. At that time a number of roomy wooden pavilions, almost entirely unoccupied, were standing on each side of the driveway between the clinic hall and the clinic gate. In this space are now (1908) the nurses' home, the maternity pavilion and the brick pavilions, which are, in part, occupied by the women's nervous wards and in part by the women's tuber- culosis wards. The wooden pavilions were built in 1875 for fever and other patients. The first patients, male and female, placed in the nervous wards were less than twenty in number, and were brought from the outwards, where at this time were many cases of organic nervous disease, most of them receiving little or no attention. Besides the cases in the wooden pavilion, the room known as the "paralytic ward," in the third story of the men's outwards, was also placed under the charge of the neurologist. Later the occupants of this ward were transferred to the nervous wards. Although the wooden pavilions were in poor condition, they furnished plenty of room for expansion, and the number of patients in the wards, both for men and for women, steadily increased. An extensive addition was made to the wards in 1885 by the transfer to them of a large number of epileptics, who had up to this time been cared for in the insane department, a work which was brought about through the efforts of Drs. Mitchell, Wood and the writer, who were at this time consultants to the insane department. The manner in which the wards have increased will be seen The Philadelphia General Hospital 493 by a study of the following table, which is taken from an article by Drs. Weisenburg and McCarthy, on the history of the nervous wards, in Volume V of the Philadelphia Hospital Keports : — Year 1877 Male Patients Treated Remaining No record Female Patients Treated Remaining 11 11 1878 24 17 52 18 1888 503 156 182 65 1898 477 187 215 74 Since 1898 the nervous wards have continued to increase even more rapidly than before this time, until the census of the wards for 1908 shows for the men's nervous wards 403 patients remain- ing at the end of the year, and for the women's nervous wards 115 patients remaining, these numbers including the patients in the recently organized psychopathic and alcoholic wards, male and female, which are now under the supervision of the neurologists. The location of the nervous wards has changed several times since their organization in 1877. The old wooden pavilions were grad- ually torn down to make way for new brick pavilions and for the nurses' home. For many years, until 1907, these brick pavilions, which were at first of one story and later of two, were occupied by the men's nervous wards. The women's nervous wards were removed to the lower story of the women's outwards in 1884. During the administration of Director Coplin, in 1906, the male indigents were removed from the outwards to one of the buildings erected for the Philadelphia Museums, and after the rehabilita- tion of these male outwards, one-half of them was fitted up for the men's nervous and the male psychopathic wards. The women's nervous wards, in 1908, were again moved, this time from the women's outwards to the brick pavilions formerly occupied by the nervous wards for men. The history of the changes which have taken place in the number and in the personnel of the neurological staff cannot be given here in detail. An account of these changes will be found in the history of the neurological department in Volume I and in Volume V of the Philadelphia Hospital Keports. From hav- ing had at first only one neurologist, the staff has increased, until the neurologists now number eight, each of these having an assistant neurologist. In addition, there are two neurological registrars. ' 494 Institutions Under Municipal Management The facilities offered by the nervous wards of the Philadel- phia Hospital for the study of organic diseases of the nervous system are unsurpassed in the country and scarcely equaled abroad, and the literature of American neurology is largely indebted to the work done in these wards or on material furnished by them. Almost every member of the neurological staff has taken a considerable part in teaching neurology in the Philadel- phia Hospital, those taught including students from the University of Pennsylvania, the Jefferson Medical College, the Medico-Chir- urgical College, the Woman's Medical College of Pennsylvania and, the Philadelphia Polyclinic; and in addition special undergrad- uate and post-graduate classes made up of students not receiving instruction under the authority of any medical school. For several years from 1887, the neurologists of the hospital were also visiting physicians to the insane department; later they were made consultants to this department. These connections largely increased the facilities of the staff, giving special oppor- tunities for the investigation of the symptomatology and pathology of insanity, and for teaching general and special classes in mental diseases. The history of the neurological departments by Drs. Weisenburg and McCarthy gives in considerable detail an inter- esting account both of the teaching done in the nervous wards and of the literature which has resulted from investigations pursued in them or through them. The pathological material furnished by these wards has, in many cases, been studied in the Pepper Laboratory and the Laboratory of Neuropathology of the University, and in the laboratories connected with the Jefferson and the Medico-Chirurgical colleges. THE OPHTHALMOLOGICAL DEPARTMENT The ophthalmologic^ department of the hospital had its origin with the appointment, in 1877, of Dr. E. 0. Shakespeare as ophthalmologist, although prior to this, eye wards were under the charge of the surgeons. In the address delivered in 1855 by Dr. Eobert K. Smith, to which reference has already been made, men- tion is made of the eye wards as one of the recognized portions of the hospital. In 1877, one hundred and eleven cases are recorded as having been treated in the men's eye wards, and wards for both men and women are referred to in the annual statement for the year 1878. Dr. Shakespeare had the sole charge of this The Philadelphia General Hospital 495 department until June, 1887, when Dr. George E. de Schweinitz was made an additional ophthalmologist. In the summer of 1888, Dr. Charles H. Thomas served temporarily during the absence of Dr. Shakespeare. The men's eye ward continued to occupy a room on the second floor of the main building next to the venereal ward, until 1888, when it was transferred to the second story of one of the brick pavilions built for the men's nervous wards. This ward was provided with a dark room, an operating room and other suitable arrangements for the study and treatment of ophthal- mic affections. The women's eye ward has always been on the women's surgical floor. In 1887, the occupants were moved into the women's surgical dining-room, and a little later were transferred into the children's ward. In November, 1888, the cases were moved once more to the quarters on the women's surgical floor, which they occupied until 1903. This was especially prepared for eye cases. One-half of the ward was devoted to the reception of patients suffering from diseases of the skin. From June, 1887, to December, 1889, Dr. Shakespeare and Dr. de Schweinitz were the ophthalmologists to the hospital, each serving alternate terms of three months. In December, 1889, Dr. Shakespeare was succeeded by Dr. G. M. Gould. On the resigna- tion of Dr. Gould in 1894, Dr. Charles A. Oliver was appointed in his place, and subsequently the ophthalmic staff was enlarged by the appointment, in 1900, of Dr. Howard F. Hansell, and in 1901 of Dr. John W. Croskey. The term of service of each of the ophthalmologists is three months. Dr. T. B. Holloway was appointed ophthalmic registrar. In 1903, the eye wards were removed to the second floor of the main building, and now consist of one ward for male patients, containing twenty beds, and one ward for female patients contain- ing sixteen beds with room for additional beds. In the center of the male ward is a large dark room suited to ophthalmoscopic examinations, and directly outside of it the ward can be converted, when necessary, into an operating room, well lighted from the north by a tall window. In 1907, certain notable additions to the ophthalmic equip- ment of the hospital were arranged for by Dr. Henry Sykes, the Chief Resident Physician, with the permission of Dr. Joseph 496 Institutions Under Municipal Management S. Neff, the Director, namely, an isolation ward for cases of ophthalmia neonatorum and gonorrheal ophthalmia, containing ten beds; a ward for women afflicted with trachoma, containing at present five beds, but with room for additional cots. These two wards adjoin the regular eye wards already described. On the third floor of the main building, Dr. Sykes has converted the old detention room into an admirably appointed ward for the reception and treatment of male patients suffering from trachoma. This ward contains at present ten beds, with room for additional ones when necessary, which stand upon a polished floor, while the walls and ceiling of the room are covered with enamel paint, which can be kept scrupulously clean. The addition of these trachoma wards to the hospital has been of the highest impor- tance, and enables the ophthalmic surgeons on duty properly to isolate these patients and at the same time to take care of the numerous immigrants who are from time to time detained by the immigrant inspectors, and sent to the hospital either for treatment or for diagnosis. Insofar as completeness of equipment, satisfactory ward accommodations and nursing are concerned, the eye wards of the Philadelphia Hospital are unsurpassed by any in the city. In addition to the work which the ophthalmic department does in connection with those who suffer from various ocular dis- orders, the heads of the department and their assistants make numerous examinations of patients in the other wards of the hos- pital, when the attending physicians believe that ophthalmoscopic examinations or investigations of disturbances of the ocular motility would be useful to them in their study of the cases. This is particularly true so far as the neurological department is concerned, and in no hospital in this city, or indeed, perhaps in any other American city, is the opportunity for practical ophthal- moscopy so great as in the Philadelphia General Hospital. 9 THE DERMATOLOGICAL DEPARTMENT Previous to 1887, there was no special dermatological depart- ment, but cases in the skin ward, as those in the eye ward, were apportioned to the members of the visiting staff. In 1870, Dr. P. F. Maury had charge of this ward, and from that date to 1877 9 I am indebted for moat of the facta contained in this sketch of the ophthalmic department to Dr. de Schweinitz. The Philadelphia General Hospital 497 Dr. L. A. Duhring was practically in charge, becoming full derma- tologist in this year by election by the Board of Guardians. Dr. Duhring continued in sole charge of this service until June, 1887, when an additional dermatologieal position was created, and Dr. Henry W. Stelwagon was chosen to conduct the service. From this time Dr. Duhring and Dr. Stelwagon were the dermatologists of the hospital until December, 1889, when Dr. Duhring was suc- ceeded by Dr. J. A. Cantrell. In 1900, Dr. M. B. Hartzell and Dr. E. S. Gans were made dermatologists, and Dr. Cantrell resigned. The dermatologieal cases were at first divided according to the sexes into two wards, the ward for the male patients being on the second floor of the hospital building. The diseases of the skin occurring among women were for a long time treated in half of the ward on the women's surgical floor, which is set apart for diseases of the eye. At present (1908), the dermatologieal staff consists of three dermatologists, Drs. BE. W. Stelwagon, E. S. Gans and M. B. Hart- zell, and one assistant to each dermatologist. There are two men's wards, one containing eighteen, and the other twenty beds, situated in the northwestern end of the northeastern building on the third floor, to which the skin cases were moved in June, 1904. The women's and children's ward is on the third floor of the same building and contains sixteen beds. The dermatologieal staff is frequently asked to see cases in all the other wards of the hospital chiefly for the purposes of diagnosis. The opinion of the mem- ber of the staff on duty is often requested in cases of suspected exanthemata. The wards have been fully utilized for teaching purposes, classes of ten to twelve being taken into them twice or three times a week for practical instruction. The material is usually ample for this purpose and affords opportunities nowhere else obtainable in Philadelphia. Dr. Hartzell informs me that at the time of writing, while the men's wards contain thirty-eight beds, there are fifty-seven patients in those wards. THE TRAINING SCHOOL FOR NURSES Training schools for nurses and well trained nurses are now so numerous in all parts of our country that it is difficult for the physician of to-day to realize the conditions which prevailed twenty-five years earlier. Then, while training schools were not 32 498 Institutions Under Municipal Management unknown, they were few in number and the courses given in them were short and much less thorough than those of the last decade. The Training School of the Philadelphia Hospital was founded in 1884. Trained nurses were, however, not unknown at Blockley even before this time. A corps of such nurses from the Training School of the Woman's Hospital of Philadelphia served, in 1876, 1877 and 1878, in the wooden pavilions which were erected in 1875 in the space just outside of clinic hall. This service had been brought about through the application made from the authorities of the AV Oman's Hospital to allow their nurses to take part of their training at Blockley. I well recall these nurses as they were on duty at the time of my appointment as neurologist in September, 1877. They took charge of the wards for nervous diseases when they were first organized in addition to the surgical and medical work which was assigned them. They were efficient, enthusiastic and faithful. To this corps of nurses I gave a course of lectures on massage and the use of electricity by nurses, one of the early courses of this sort. From the time when their service at Blockley ceased until 1884, the nursing throughout the hospital was done in the main by men and women untrained and in many instances unfit for such work. Often these nurses had formerly been patients, and in other cases, especially among the men, they held their positions by virtue of influence of the politicians who had them appointed. The new Board of Guardians appointed after the sensational exposures in 1881, with Mr. Edward Hoffman as its President, was persistent and energetic in its efforts to improve conditions at Blockley, and as one of those most calling for such improve- ment was the state of the nursing in the hospital, there was soon much discussion as to what should be done in this direction. As early as September 24, 1883, at the meeting of the Board of Guardians, a special committee was appointed to consider a proposed training school for nurses, but it was not until several disappointing efforts had been made that on July 28, 1884, Miss Alice Fisher, a lady of refinement and culture, who had held several important positions in training schools at Oxford and Birmingham, was invited to organize a new school. The services of this lady were secured through the efforts of two of our most prominent citizens, Mr. George AV. Childs and Mr. Anthony J. Drexel. Miss Fisher brought with her from England Miss Edith The Philadelphia General Hospital 499 Horner, who had been associated with her in several hospitals, and who had a fine record of service during the Zulu war. It might be stated here in passing, that, after several years Miss Horner married General Joseph E. Hawley, United States Senator from Connecticut. The great work done by Miss Fisher and her asso- ciates and pupils, not only for the Philadelphia Hospital, but for the cause of trained nurses throughout the United States, need not be dwelt upon here. The nursing became of a character to challenge comparison with that in any hospital, either here or abroad. Besides the practical instruction given in the wards, which was steadily improved, courses of lectures, both by the heads of the Training School and the members of the staff, were instituted, and have been continued until the present time. Many of the training schools founded in America since 1884 have been organized by women who received their training in the Philadelphia Hospital. Miss Fisher died June 3, 1888, lamented by everyone who knew her. She was succeeded July, 1888, by Miss Marion E. Smith, who had served one year in the Birmingham Hospital with Miss Fisher, and had graduated at the Philadelphia Hospital Training School after eighteen months of attendance, and for two years had been chief nurse at the Pennsylvania Hospital. Miss Smith continued as head nurse, doing excellent work, until 1903, when she resigned to take the superintendency of the hospital of the University of Pennsylvania. She was succeeded in July, 1903, by Miss Margaret F. Donahoe, who was a graduate of the Massa- chusetts General Hospital Training School, and also of the Sloane Maternity Hospital. Miss Donahoe has continued to the present time as chief nurse. The quarters for the Training School, until 1893, were in the southeastern extremity of the northeastern building of the four original structures. These quarters were in contiguity with the children's asylum and the drug store, and were much cramped and badly suited for their purpose. It was not until 1893 that the new home for the nurses was built to the right of the roadway to the clinic hall. The Training School has advanced steadily since its inaug- uration, doing more and more efficient work. The course, which was at first only one year, was made two years in 1894 and three in 1898. The discipline of the school is of the highest character. The first class which graduated numbered thirteen; the last 500 Institutions Under Municipal Management class, in 1908, twenty-two; the total number which has graduated since the school was begun is seven hundred and eighty-seven. Among the changes and improvements in recent years worth noting, it might be mentioned that the Nurses' Home has had a number of rooms added to it, that the number of head nurses has been increased from twelve to twenty, that an added appropria- tion of $30 a year has been given for nurses' uniforms and books, and that a reference library has been established, and that the infirmary for nurses has been enlarged and improved. THE BACTERIOLOGICAL DEPARTMENT AND THE CLINICAL LABORATORY The Clinical Laboratory was established in 1903, and was placed under the directorship of Dr. Eandle C. Eosenberger, who has since remained in charge. Before this time practically the only examinations for clinical purposes -made in the hospital were of the urine and sputum. When other work of this kind was deemed necessary, or was desired, it was done by or for members of the visiting staff in laboratories outside of the hospital. Imme- diately after the opening of the Clinical Laboratory the examina- tions made in it began to extend over a wide range, including investigations of milk, of gastric and intestinal contents, of tumors, of the constituents of the blood and of the secretions of the throat. Serodiagnoses, inoculations, and the study of spreads of discharges became part of the regular routine of the laboratory, which is now not only one of the most useful departments of the hospital, but also one from which important scientific results have already emanated. The total number of specimens examined in the laboratory during the year 1908 was twenty-seven thousand eight hundred and eighty. The number of autopsies held during the year was four hun- dred and twenty-four, and the number of histological examina- tions five hundred. THE LARYNGOLOGICAL DEPARTMENT Early in 1890 the medical staff was increased by the appoint- ment of two laryngologists, Dr. C. Jay Seltzer and Dr. George Morley Marshall. A small ward was soon established for laryngo- logical cases. This ward now contains about ten or twelve beds and has partitioned off at one end a clinic or examining room equipped with the appliances necessary for the examination and The Philadelphia General Hospital 501 treatment of diseases of the throat and nose. This room is also used to instruct small classes. Laryngologieal material at the Philadelphia Hospital is now the richest to be found in any spe- cial or general hospital, illustrating especially all varieties of syphilitic, tubercular and malignant disease of the throat, func- tional diseases, like hysterical aphonia and affections of the vocal cords, palate and connected parts, associated with chronic nervous diseases. The laryngologists, in addition to their ward duties, have as an important part of their work the examination and reporting on cases referred to them by members of the medical, surgical and special staffs. Dr. Marshall, who was one of the first appointees, is still a member of the staff; Dr. Seltzer served from 1890 to 1900; in 1901 Dr. Charles P. Grayson and Dr. E. B. Gleason were appointed members of the staff, the latter resigning in 1904; Dr. Walter Eoberts became a member of the staff in 1904. The present members of the staff are therefore three in number, Drs. Marshall, Grayson and Eoberts, each of these under the rules formulated in 1902, having an assistant. THE ISOLATION DEPARTMENT Although in recent years, Philadelphia, like all great cities which properly care for their poor and sick, has established municipal hospitals for the treatment of contagious diseases at a distance from the general hospitals, it sometimes happens that the sudden outbreaks of contagious or infectious diseases which are likely to occur in the large population of these hospitals may be a source of great danger and often cause an epidemic. The Philadelphia Hospital has been visited by not a few of such epidemics, which have been discussed by others, especially by Dr. Poland G. Curtin. Every city hospital should have its isola- tion building, to which the victims of contagious disease can be immediately transferred either to be treated or to be temporarily cared for until they can be sent to the municipal hospital for such diseases. In the early part of the period beginning with 1854 a wooden structure, known as the Small-pox Hospital, was located in what was then a large field, between Vintage Avenue and the railroad, not far from that part of the almshouse grounds which were bor- dered by Woodland Cemetery. Just when this building was 502 Institutions Under Municipal Management erected I have not been able to learn. Dr. Curtin informs me that when he was resident physician at Blockley, in 1866, he was familiar with this rough pine building, whose boards were appar- ently changed by the weather, indicating that the building was some years old. During the epidemic of cholera in 1866, one hundred and four patients were treated in this building. As one walked by he could see through the cracks between the boards the patients within. On the outside were always to be seen a large supply of rough pine coffins, too many of which were soon to be put into use. This building probably disappeared soon after the time the old Municipal Hospital for Contagious Diseases was opened at Twenty-second and Lehigh Avenues, on April 18, 1865. The Philadelphia Hospital was not provided with any suit- able isolation building until 1892, when one was built under the direction of Captain Charles Lawrence, Superintendent of the Almshouse, who was also the designer of the building. This building is situated west of the laundry in the space between the northwestern of the main buildings and the wall of the enclosure. This building, which has proved one of the most useful and satisfactory of the many which have been built as annexes to the hospital, not being sufficient for the many demands made upon it, an additional isolation building was erected in 1908. This is a small building, so arranged by a corridor running lengthwise through the center of it and three crosswise partitions as to divide the place into eight individual rooms. By means of these isolation buildings it is now possible not only to separate the cases of contagious diseases breaking out in the hospital from the patients in the general hospital, but also to isolate the different forms of contagious disease from each other. THE ORTHOPAEDIC DEPARTMENT The orthopsedic department of the hospital was established by the election of Dr. H. Augustus Wilson, on December 29, 1899, as the first orthopaedic surgeon officially recognized by the gov- erning board. Previous to this time, during the service of Dr. A. Sidney Eoberts, on the surgical staff from 1881 to 1887, at the request of Dr. Eoberts he was allowed to confine his work during a considerable portion of his term of service to orthopsedic sur- gery, his colleagues on the surgical staff referring such cases to him for operation and treatment with apparatus. The Philadelphia General Hospital 503 The orthopaedic surgeon, under the rules adopted when the department was created, was to receive for orthopaedic treatment only such cases as were referred to him by the surgeons on duty, the latter retaining the privilege of using orthopaedic cases for their clinical lectures. Separate wards were not set apart for the orthopaedic cases, but these were allowed to remain in wards for men, women and children in various departments of the hospital. On January 24, 1901, the orthopaedic staff was increased to three, by the addition of Dr. J. P. Mann, Professor of Orthopaedic Surgery in the Medico-Chirurgical College of Philadelphia, and Dr. G. G. Davis, Associate Professor of Applied Anatomy in the University of Pennsylvania. As Dr. Wilson was the Professor of Orthopaedic Surgery in the Jefferson Medical College, three of the regular medical schools of Philadelphia were now represented on the staff. Excellent work, both operative and mechanical, has been done by the orthopaedic department, which has been unusually active during the short period of its existence. Clinical lectures and demonstrations are given by its different members at various periods of the college year. THE ROENTGEN LABORATORY The Eoentgen laboratory of the hospital was established in 1900 by Dr. Daniel E. Hughes, Chief Eesident Physician, who received most valuable assistance from one of the pioneers and most distinguished exponents of Eoentgen ray work in this country, Dr. Charles L. Leonard, who was at this time anaesthetist to the hospital. Dr. Leonard gave much time and attention to the organization of the new laboratory. After its establishment the work done in it was under the supervision of Dr. George E. Pfahler, then Assistant Chief Eesident Physician. Dr. Pfahler has since become widely known, both for his diagnostic and thera- peutic skiagraphic work. After the resignation of Dr. Pfahler. on October 1, 1902, he was succeeded by Dr. Mihran K. Kassabian, instructor in electrotherapeutics and skiagrapher in the Medico- Chirurgical College of Philadelphia, and author of a valuable treatise on "Electro Therapeutics and Eoentgen Eays," published in 1907. The work done by Dr. Kassabian has been of the great- est value not only to the hospital, but in furthering the develop- ment of Eoentgen methods in medicine and in surgery. 504 Institutions Under Municipal Management About two years after the laboratory was established, no less than eight hundred X-ray examinations were made. The writer, in connection with Dr. Pfahler, located the second case of brain tumor ever diagnosticated by the Eoentgen method, and subse- quently other cases of the same disease were similarly located. Important original investigations have been made on diseases of the aorta, of the viscera of the thorax and abdomen, pelvis and affections of the joints. The treatment of cancer and of diseases of the skin has been carried out in this laboratory with much success. Between 1900 and 1908, important changes were made in the laboratory and its equipment, these all being in the direction of keeping the work in line with that done in other parts of the world. THE ORAL SURGICAL DEPARTMENT The oral surgical department of the hospital was established in January, 1901, through the interest taken in the matter by Dr. John V. Shoemaker, then President of the Department of Charities and Correction, who during his term of service as Sur- geon General of the National Guard of Pennsylvania, had observed the great need of dentists and oral surgeons in the military service. The first oral surgical staff was composed of four members — Dr. M. H. Cryer, Professor of Oral Surgery in the Department of Dentistry in the University of Pennsylvania ; Dr. Robert H. Nones, Dean and Professor of Mechanical Dentistry in the Medico- Chirurgical College of Philadelphia; Dr. I. X. Broomell, Professor of Dental Anatomy and Prosthetic Technics in the Pennsylvania College of Dental Surgery; and Dr. Thomas C. Stelwagon, Jr., Lecturer on Physiology and Physical Diagnosis in the Philadel- phia Dental College. Oral surgical internes were appointed to assist in the work of the visiting staff. Dr. Cryer, from the first, took an active interest in the development of the oral surgical department, and to him we are indebted for a history of its inception and progress published in the Philadelphia Hospital Reports, Volume Y, 1902, from which the facts for this sketch have been obtained. The duties of the staff and internes as defined by the gov- erning board are to take care of the teeth and maxillary bones of the patients in the hospital, and also to give public clinics for the students attending the various colleges in Philadelphia. The Philadelphia General Hospital 505 A well-equipped operating room and a mechanical laboratory were soon established and arrangements were soon made for the delivery of clinical lectures on oral surgery, the first of which was given March 9, 1901. From the first these lectures were largely attended. Gathered at one lecture would sometimes be found undergraduates and post-graduates, representatives of almost every civilized country. Work done by the oral surgical staff, both in the general hospital and in the insane hospital, has been most valuable, and some record of it has been made in reports and papers of much interest. THE GENITO-URINARY DEPARTMENT From a very early period in the history of the Philadelphia Almshouse, wards for the treatment of venereal diseases were set apart in the hospital, these being under the jurisdiction of the surgical staff. For a short time, until 1904, the women's venereal wards were included in the obstetrical and gynecological depart- ment. It was not until this year that a special department for the treatment of venereal diseases and genito-urinary affections in the male was created by Dr. Edward Martin, at that time Director of the Department of Public Health and Charities. Dr. H. M. Christian, Dr. E. H. Siter and Dr. Henry Tucker were the first appointees to the new staff. For many years the women's venereal wards were loca'ted on the third floor of the women's department of the hospital and the men's wards first on the second floor and later on the fourth or attic floor of the northeastern or hospital building. In 1902 a building was erected just west of the museum building, in the space outside of the northwestern wing of the main building, the intention being to use this new structure for venereal wards. It was a fireproof building consisting of two stories and a basement, of brick and stone construction, and granolithic floors. Exter- nally it had the appearance of one building. A solid brick wall divided it in half however, one portion being intended for male and the other for female patients. Communication from one part to the other was made by an iron passageway outside of the build- ing. Soon after its completion female venereal cases were placed in one part of this building and in the other women and children suffering from various forms of skin disease. In August, 1903, the skin cases were sent to the medical ward, and some time dur- 506 Institutions Under Municipal Management ing 1904 the venereal cases were returned to their old quarters on the fourth floor of the eastern end of the northwestern building. The building was then transferred to the department of tuber- culosis, to be used as an infirmary for male patients. Until 1908, the male venereal patients, sometimes as many as eighty or ninety, were crowded together in an attic on the fourth floor of the hospital. The special interest which Dr. Neff took in these unfortunates resulted in their being housed on the third floor in their present greatly improved quarters. The department now has a special operating room with tiled floor and walls and sterilizers. The floor has four wards in all, one for genito-urinary cases, another for active secondary syphilis, a third for acute gonorrhoea and its complications, and a fourth for miscellaneous cases. THE DEPARTMENT FOR TUBERCULOSIS In Blockley, as in all great city hospitals, tuberculosis vies with syphilis and alcohol in adding to the census of the hospital. Until recently cases of tuberculosis were commingled in the same wards with other medical and surgical patients, and with the insane, but thanks to those who have led the movement for the eradication or better control of the white plague, these cases now have their special quarters, which, while not adequate, represent a great advance. In the near future, with the removal of tuber- culosis eases to the suburbs, the problem of their municipal care will be largely solved. In 1904, a department for tuberculosis was created. The first staff consisted of Dr. Lawrence F. Flick, Consulting Phy- sician, Dr. Joseph Walsh, Dr. W. B. Stanton, Dr. H. B. M. Landis and Dr. H. S. Anders. Others who have served on the staff since are Drs. Ward Brinton, T. Y. Ullom, Samuel Bhoades, A. C. Morgan, A. P. Francine, Chas. M. Montgomery, Chas. J. Hatfield and Daniel M. Hoyt. During the year 1903, six glass pavilions for the treatment of consumptives were erected on the slightly elevated ground between the northeastern building of the quadrangle and the wall enclosing the grounds of the institution. These buildings were so designed that their sides and roofs could be opened at pleasure, allowing free entrance and egress of air. Iron or steel was used in the construction of the supports or framework so as to prevent The Philadelphia General Hospital 507 the vitiation by germs which often takes place in wooden struc- tures. One of the reasons for making the pavilions of glass was • that they might act as sun parlors. For a full account of the construction and method of using these pavilions the reader is referred to an article by Dr. John V. Shoemaker in Volume V of the Philadelphia Hospital Eeports, published in 1902. These pavilions, with various additions and improvements, made since their erection, have been continuously in use, and in 1908 accommodated as many as two hundred men patients at one time. Arrangements have been recently made to put up shacks or temporary wooden buildings for the use of the tuberculosis cases on the Byberry tract. Besides about three hundred men patients in the tuberculosis department there are about seventy women patients, these being housed in one of the brick pavilions adjoining the present women's nervous wards. WOMEN PHYSICIANS AND WOMEN STUDENTS The first woman physician in the Philadelphia Hospital was Sarah Adamson, appointed May 25, 1851. She made application to the board to witness the methods of practice in the hospital, which was granted by the Board of Guardians in a resolution requesting the resident physician to assign her such position as would best enable her to obtain the knowledge which she desired. Dr. Adamson married Dr. Dolly, and is still living at an advanced age in Bochester, New York. Dr. Clara Marshall was the first woman appointed as visiting physician to the Philadelphia Hospital. On October 27, 1882, at a meeting of the Board of Guardians, on motion of Mr. John Huggard, Dr. Clara Marshall was elected one of the physicians of the obstetrical staff, and on motion of Mr. William McAleer, Dr. Hannah T. Croasdale was given a position on the same staff. Dr. Croasdale declined the appointment, but Dr. Marshall accepted and served until 1895. During her term of service she delivered clinical lectures in the amphitheatre to mixed classes, and also gave ward class instruction to students of the Woman's Medical College of Pennsylvania, and met private classes. On her resig- nation in September, 1895, Dr. Elizabeth L. Peck was chosen to fill her place, and is still a member of the staff (December 31, 508 Institutions Under Municipal Management 1908). Like Dr. Marshall, she has also given instruction both in the clinic hall and at the bedside. Dr. Mary Panline Boot, a graduate of the Woman's Medical College, in 1883, was the first woman to receive an appointment as Kesident Physician. The residents, then as now, were chosen as the result of competitive examination, Dr. Eoot being the sixth in the list of twelve who received the appointment. Since 1883 the resident staff has usually had at least one woman on its list, and at some periods there have been two, or even three. Women students attended the clinical lectures at the Phila- delphia Hospital at least as early as 1868 or '69. Since that time they have been in frequent attendance at the general clinics on Wednesdays or Saturdays, and numerous ward and amphitheatre classes have been instructed by members of the faculty of the Woman's Medical College, who have also been on the Medical Board of the hospital. REGISTRARS The position of registrar, as it now exists in the Philadelphia Hospital, is of comparatively recent origin, although as early as 1824, and again in 1851, efforts were made by the Medical Board to have recorders appointed. Some useful work is done by the registrars of the various staffs, but their duties and privileges are probably not as important as those of holders of similar positions in foreign hospitals, especially in London. In 1885, the Board of Guardians, on the recommendation of the Medical Board, created the position of registrar, and four registrars were elected, one for the medical wards, one for the surgical, venereal, skin and eye wards, one for the obstetrical, gynecological and children's wards, and one for the nervous and insane wards. The number of registrars in the different wards has since been increased, in most cases doubled. The registrars record their names and the time of their arrival and departure from the hospital, but have no fixed hours of attendance. The office of registrar carries with it some privileges, as for instance, that of studying the cases, and with the permission of the visiting physicians, of giving instruction to ward classes. The office has frequently proved a stepping-stone to the higher positions of assistant physician, visiting physician or surgeon. As defined in the last printed rules of the Bureau The Philadelphia General Hospital 509 of Charities (1908) the duties of the registrars are mainly to go through the wards at least once a week, sometimes accompanying the visiting physicians, to examine histories before they are bound in reference to diagnosis, to check the histories in the wards or in the record room before they are bound ; to remind the internes of any carelessness or neglect in taking histories, and to see that the histories are in proper shape for patients who are to be taken before the clinics. RESIDENT PHYSICIANS The reader is referred to the historical sketches of Dr. Agnew and Dr. Curtin for an account of the first resident pupils and apothecaries, an apothecary having been first appointed about 1788. From 1823, the resident physicians have always been grad- uates in medicine. The number of those serving has varied con- siderably, but on the whole has gradually increased. The list of former resident physicians at Blockley who have become distin- guished as physicians or surgeons is now a long one, and is worthy of a special article. Dr. Curtin has made some reference in this connection to those who served prior to 1854. It might be of interest to glance at the number of residents serving at a few separated periods. During the Civil War almost the entire visiting staff of the hospital went into the medical service of the army or navy, and those who continued on duty served in the military hospitals in and around Philadelphia. Even the resident staff was reduced in numbers because of the exigencies of the war time. In 1863, four of the resident phy- sicians on duty were drafted into the army. In 1866, the resident staff numbered nine, which included the resident to the insane department. In 1890, the theoretical number of residents was twenty, six- teen of whom were elected annually. The term of service was fifteen months. The position of resident physician at the Philadelphia Hos- pital is one of great value, especially for the study of chronic diseases of acute and chronic forms of alcoholism, of cases usually classed as psychopathic representing the affections in which insan- ity is doubtful or imminent, and for the opportunities to make pathological investigations, including necropsies and bacteriolog- ical examinations. The internes have also special advantages m 510 Institutions Under Municipal Management their opportunities to follow the instruction, both in the clinical amphitheatre and at the bedside, of men connected with the teaching staff of the great medical colleges of Philadelphia. THE PHILADELPHIA HOSPITAL MEDICAL SOCIETY The Philadelphia Hospital Medical Society was first organ- ized in 1867, through the efforts of Drs. J. Ewing Mears, S. S. Stryker, William F. Jenks, M. B. Musser, Poland G. Curtin and Charles Orvis. The object of the society was to advance the knowledge of the interne by reading medical histories, accounts of dissections, necropsies, epidemics and diseases observed in the hospital. This organization was continued for some years, but lapsed into desuetude. In 1886, it was reorganized, its object being the advancement of medical science and the promotion of good fellowship among the resident physicians in the hospital. The activity of the organization and the interest taken in it by its members have varied somewhat at different periods, but it has, on the whole, proved a valuable auxiliary to the work of the internes. At its most active periods its meetings were held once a week in the evenings, and at intervals of a month or more it was addressed by some physician not a member of the society, usually some member of the visiting medical board. An association called the Association of ex-Resident Phy- sicians of the Philadelphia Hospital was organized November 16, 1887, after a preliminary meeting held in October. This associa- tion, which consists of ex-resident physicians and resident phy- sicians on duty, has remained in existence ever since, and has become an active and influential body. It holds an annual ban- quet, at which addresses, reminiscences, etc., constitute interesting features. This banquet, which takes place in the evening, is usually preceded by a meeting in the afternoon and a general inspection of the hospital by those in attendance. Some of the most interesting of the addresses have been published, as for instance, that by Dr. J. Chalmers Da Costa on "The Old Blockley Hospital: Its Characters and Characteristics/' delivered at the meeting held November 12, 1907. On October 8, 1908, the association departed from its usual method and a reunion of the former and present members of both the visiting and resident staffs was held in the afternoon at the hospital, followed by a smoker at the Bellevue-Stratford in the The Philadelphia General Hospital 511 evening. An account of this reunion is given in the introductory chapter of this volume. OFFICIALS OF THE MEDICAL BOARD For a period of which there is no record, but which probably extends back to some time in the eighteenth century, an organiza- tion known as the Medical Board of the Philadelphia Hospital has been in existence, and at various times has exerted an important influence on the welfare of the almshouse and its hospital. In Volume I of the Philadelphia Hospital Eeports, some account of those who have held official positions in this organization is given. The President of the Medical Board has, as a rule, been chosen from its older members. The minute book now in the hands of the Secretary, begins in 1859, but for several years no minutes appear. At a meeting of the board, held August 13, 1859, Dr. Samuel D. Gross was nominated and unanimously elected Chairman, and Dr. John Wiltbank was appointed Secretary. Dr. Edward L. Duer subsequently became Secretary; March 30, 1867, he re- signed, and Dr. William Pepper was appointed in his place. January 15, 1868, Dr. Alfred Stille was elected President, and was re-elected for several years, resigning March 8, 1872, when Dr. J. L. Ludlow was elected. January 4, 1869, Dr. Pepper resigned the secretaryship, and was succeeded by Dr. John S. Parry, who continued in this position until February 17, 1871, when he resigned, and Dr. Harrison Allen was elected. Dr. Allen was succeeded by Dr. John Guiteras, October 7, 1878. The next year Dr. Guiteras having resigned to go into the Marine Hospital Service, Dr. E. T. Bruen was elected Secretary, and continued to serve as such until his death, in 1889. Dr. Ludlow was succeeded as President by Dr. James Tyson, March 10, 1885. Dr. Roland G. Curtin was elected President January 6, 1890, and was suc- ceeded by Dr. Charles K. Mills, January 15, 1906. Since the death of Dr. Bruen, Dr. L. W. Steinbach has been Secretary. CONTRIBUTIONS FROM THE PHILADELPHIA HOSPITAL TO MEDICAL LITERATURE A valuable historical monograph dealing with important addi- tions to the literature of medicine— in some instances additions which have incorporated original discoveries— might be prepared from a study of the published work based upon observation and 512 Institutions Under Municipal Management investigation in the Philadelphia Hospital; hut the space allotted to this historical sketch will only permit of the briefest reference to this subject. Dr. Curtin, in his papers on "Clinical Teaching and Clinical Teachers," and on "Epidemics in the Philadelphia Hospital/' has called attention to the well-known contributions of Gerhard and Pennoek on the differential diagnosis between typhus and typhoid fever, and to the work of Stille on cholera and epidemic cerebrospinal meningitis; to that of Pepper and Parry on relapsing fever, and that of Parrish on puerperal septicemia, and to other contributions which have become almost classics in the history of the subjects which they discuss, but these striking productions are only a few of a multitude, the fruit of work done at the Philadelphia Hospital, especially during the past thirty or forty years. Almost every phase of chronic disease has had its delineator in those who have served on its medical boards. As I have said elsewhere: 10 "On pathology the hospital has furnished contributions without number, and some of great value, partic- ularly during the last fifteen years. The medical societies of Philadelphia: the College of Physicians, the County Medical, the Pathological, Obstetrical, Neurological Societies, etc., have drawn largely from this hospital for their material as a search of their transactions will at once make evident. The record of the Pathological Society of Philadelphia, as indicated in its volumes of transactions, would be meager indeed, if the material supplied by the Philadelphia Hospital were omitted." If this was true in 1890, how much more could be said to- day, when one considers how, during the eighteen years since then, the hospital has continued to afford a constantly augmenting volume of valuable contributions. These have not been confined to material furnished from the domain of what is commonly spoken of as general medicine and surgery, but every recognized medical specialty — ophthalmology, dermatology, neurology, laryn- gology, pediatrics, orthopasdic surgery, and all the rest — has fur- nished valuable contributions to the journals, text-books, and treatises which have been issued in the last twenty-five to thirty years. Bacteriological investigations, and researches in radio- graphy, original in character and of much practical importance', have come from the laboratories of this hospital. 10 Philadelphia Hospital Reports, Vol. I, 1890, pp. 80-81. The Philadelphia General Hospital 513 The clinical and pathological literature of neurology, a mat- ter of special interest to the writer, has been more enriched from the nervous wards of this hospital than from any other institution in this country. HISTORICAL, DESCRIPTIVE AND BIBLIOGRAPHICAL LITERATURE The literature, historical and descriptive, of the Philadelphia Almshouse and Hospital has had considerable additions since reference was made to it by the writer in 1890 in the first volume of the Philadelphia Hospital Reports, in which is given a list of the works and sources of information which proved of value to him in the preparation of his historical memoranda for this volume. This list will first be cited with some additional notes, and then the con- tributions which have appeared since its publication will be reviewed : — Lecture on the Medical History of the Philadelphia Almshouse. Delivered at the opening of the Clinical Lectures, October 15, 1862. By D. Hayes Agnew, M.D. Philadelphia: Holland & Edgar, printers, 54 North Eighth Street. 1862. A History of the Medical Department of the University of Pennsylvania. By Joseph Carson, M.D. Philadelphia: Lindsay & Blakiston. 1889. In this well known work of Dr. Carson, the references to the Philadelphia Hospital are taken chiefly from Dr. Agnew J s pamphlet, but a few additional facts of interest are mentioned. Introductory lecture to the clinical course of the Philadelphia Hospital for the winter of 1855-56. By Eobert K. Smith, M.D. Published in pamphlet form, Philadelphia, 1855. Sum m er Medical Teaching in Philadelphia; an Introductory lecture, delivered before his class in pharmacy, April 13, 1857. By Edward Parrish, M.D. The Picture of Philadelphia, giving an account of its origin, increase, improvement, etc., with a compendium of the societies, police, institutions, etc. By James Mease, Philadelphia, 1811. Picture of Philadelphia, or a brief account of the institu- tions and public objects in this metropolis. Being a guide for strangers. With addenda of all the improvements to the present time. E. L. Cary and A. Hart, 1835. Annals of Philadelphia and Pennsylvania in the Olden Times. In two volumes. By John P. Watson. Philadelphia, 33 514 Institutions Under Municipal Management 1857. A recent edition of this work in three volumes with many- additions and revisions was published in 1905, by Edwin S. Stuart. History of Philadelphia, 1609 to 1884. In three volumes By J. Thomas Scharf & Thompson Westcott, Philadelphia, 1884. A History of Municipal Development, Philadelphia, 1681 to 1887. By Edward P. Allison and Boies Penrose. Baltimore and Philadelphia, 1887. In the Philadelphia Library are eight volumes of Poulson's Newspaper Cuttings, search of which will reveal some notes relat- ing to the almshouse and hospital. Kev. C. F. Pearson published a volume in 1875, religious in tone, entitled Sparks Among the Ashes, including reminiscences of nineteen years of labor in the Philadelphia Almshouse, with an introduction by Mrs. Dr. Bell. Among other sources of information are the published Annual Statements or Keports of the Board of Guardians of the Poor, and since 1887 the annual reports of the Department of Charities and Correction and the Department of Public Health and Charities. At various periods, rules for the government of the Board of Guardians, of the Medical Board, and of the Department of Chari- ties and Correction have been published, and afford much informa- tion. Among these are the following: — Eules for the government of the Board of Guardians, 1828; laws for the relief and employ- ment of the poor, 1844; rules for the Guardians of the Poor, 1861; rules for the Guardians of the Poor, 18GS ; rules for the Medical Board, 1870; rules for the Department of Charities and Correction, 1890 ; rules governing the Bureau of Charities, 1908. In the five volumes of Philadelphia Hospital Eeports which have appeared between 1890 and 1903 are to be found much valuable material for the making of a complete history of the Alms- house and Hospital, which are the subjects of this sketch. This material includes articles historical and reminiscent by Dr. D. Hayes Agnew, Dr. Alfred Stille, Dr. Lewis P. Bush, Dr. Mills (alone or in collaboration with Dr. Curtin), Dr. Curtin, Dr. J. L. Ludlow, Dr. Landis, Dr. T. H. Weisenburg and Dr. D. J. McCarthy, and others. Here and there in these volumes are found excellent descriptions of new buildings, which have been erected since 1890, and new departments and laboratories which have been established from time to time since 1890. In volume II and volume IV are given chronological lists of the visiting and resident staffs from an early period. The Philadelphia General Hospital 515 Captain Charles Lawrence, who was superintendent of the Philadelphia Almshouse from 1891 to 1900, has published the most consecutive history of the Philadelphia Almshouses and Hospitals which has appeared up to the present time. Valuable in many ways, it is especially so with regard to the methods of administering charities in Philadelphia since the earliest times, and in the history of the gradual development of the entire almshouse system. The title of this book is : "History of the Philadelphia Almshouse and Hospitals from the beginning of the eighteenth to the ending of the nineteenth centuries, etc." Compiled and published by Charles Lawrence, Superintendent from 1891 to 1900. Published in 1905. Valuable information regarding the manner in which the land included in the old Blockley farm was acquired and has been sold or transferred may be obtained from the following pamphlets : — Organization and By-Laws of the Board of Trustees of the Philadelphia Museums. May 1, 1904. Act of Assembly and Ordinances of Councils affecting that Part of Blockley Farm Transferred for Park Purposes to the University of Pennsylvania and the Philadelphia Museums. (No date.) Annual Eeport of the Philadelphia Museums for the Year 1907. Another publication affording some information of historical value is: "Boundaries of the Incorporated Districts, Boroughs and Townships of Philadelphia County, included in the act of con- solidation of February 2, 1854." Edited by Lewis E. Harley, Ph.D. Published by the Executive Committee of Founders' Week, 1908. In this connection it would be well to say a few words about the Philadelphia Hospital Eeports, six volumes of which have been published since 1890. About 1887 or 1888 Dr. Curtin, the writer, and one or two other members of the Medical Board began to discuss the question of the desirability of publishing annually or occasionally a volume of hospital reports similar to those issued by Guy's, St. Bartholomew's, St. Mary's, and other hospitals of London and also by some of the great hospitals of Paris and other continen- tal cities. Efforts were made to obtain an appropriation but these were not successful until the matter was taken up, during the administration of Mayor Edwin H. Fitler, by Mr. Eobert Laughlin, then President of the Board of Charities and Correction. On the matter being presented to him, Mr. Laughlin became much inter- 516 Institutions Under Municipal Management ested and invited Dr. Curtin, President of the Medical Board, and the committee of this board, to appear with him before the finance committee of City Councils, of which Mr. Edwin S. Stuart, later Mayor of Philadelphia and Governor of Pennsylvania, was then Chairman, to present the arguments in favor of the publication of the reports. This was done and Mr. Stuart, giving his assistance, funds were secured for the publication of the first volume, which appeared in 1890, edited by the writer. In this, as in every volume which has since appeared, in addition to the scientific contributions, some historical data have found a place, and much of this material would have been entirely lost if it had not had this vehicle of publication. 11 11 A section on "Clinical Teaching and Clinical Teachers in the Phila- delphia Hospital Since 1854, With Some Account of the Personnel of the Medical Board at Various Periods," was written for this article, but as it has outgrown somewhat the space allotted to it, these notes will be pub- lished as a separate paper in the University of Pennsylvania Medical Bulletin. A reason for this place of publication is found in the fact that the history of the Medical Department of the University of Pennsylvania, especially as regards clinical teaching, is interwoven with that of the Philadelphia Hospital, where so many university students have received practical instruction from those members of the teaching staff of the nniversity who have held positions in the city hospital. The Municipal Hospital for Contagious and Infec- tious Diseases 1 By WILLIAM M. WELCH, M.D. THE Municipal Hospital, for the isolation and treatment of persons afflicted with a contagious or pestilential disease, has always been an important agency of the Board of Health, or health authorities, whose function it has ever been to exercise general supervision over the sanitary affairs of the city. In order to give anything like an intelligent account of the history of this Hospital, it is necessary to refer briefly to a few of the legislative enactments relative to the public health of this municipality. According to Allison & Penrose's History of the Municipal Development of Philadelphia, in 1774 an Act was passed with the object of preventing the introduction of infectious diseases into the Province. Twenty years later, in 1794, an Act establishing a health office in Philadelphia was passed. This office was located at State Island, where there was also established a hospital for "Pestilential and Contagious Diseases," under the charge of a health officer, a resident physician and a consulting physician. The Act, however, shows that this was mainly a quarantine station. By the Act of April 11, 1799, the Board of Health of Phila- delphia was originally created and incorporated, with corporate powers, to be composed of twelve members. 2 It is provided in this Act that "the messuages and lots commonly called the City Hos- pital, situated on the north side of Sassafras (now Eace) Street and east side of the Eiver Schuylkill, are hereby vested in and shall be under the management of the Board of Health," etc. By the Act of 1806, the Board of Health received more permanent form and its powers were greatly increased, but its membership was reduced to five citizens — three from Philadelphia, one from the Northern Liberties and one from Southwark, to be appointed by the Governor. 1 The last portion of this article, entitled The New Philadelphia Hos- pital for Contagious Diseases, is contributed by Joseph S. Neff, M.D. 2 If any Board of Health existed prior to 1799, it must have been organized under municipal authority. (517) 518 Institutions Under Municipal Management By the Act of 1818, the appointment of the members of the Board of Health, now eleven in number, was vested in City Councils and the District Commissioners. This Act has always been regarded by the health authorities of the city as highly important. While there have been many changes in the health laws of the State since then, in this Act the Board of Health still finds authority for the enforcement of many sanitary measures. In the Act of 1818 I find distinct reference to a hospital which had been located in another part of the city for the treatment of contagious diseases. The section of the Act authorizing the maintenance and defining the special purpose of the hospital reads as follows : — "The buildings and lot of ground situate to the northwest of Bush Hill, in the County of Philadelphia, shall be, and continue a public hospital for the City of Philadelphia, the township of the Northern Liberties, and the districts of Southwark, Moya- mensing, and Penn ; and all persons other than persons on board of any ship or vessel, and liable to be sent as aforesaid to the Lazaretto, residing within the City of Philadelphia, the district of Southwark, the townships of Northern Liberties, Moyamensing, and Penn, who shall be afflicted with any pestilential or con- tagious disease (the measles excepted), may, upon the advise and order of the port physician, or any other physician or person authorized by the board of health to grant such an order, be removed by the health officer, and such assistance as he shall for that purpose employ, to the said hospital, or to such other place as the physician or board of health shall approve, if the person afflicted with any contagious or pestilential disease cannot be properly and sufficiently attended at home, there to be lodged, nursed, and maintained, and kept until duly discharged by a permit in writing, signed by a physician of the said public hos- pital: (a) Provided always, nevertheless, That each and every patient, and his or her estate, real and personal, shall be liable to pay, satisfy, and reimburse all charges and expenses on his or her account incurred in the said public hospital, unless the board of health award that he or she shall be exonerated and exempted therefrom." A. 29, Jan., 1818, S. 22, P. L. 52. Under the Act of 1818, the Board of Health had the power to appoint the clerks and servants necessary to perform the duties of the health office, the Lazaretto, and the City Hospital for The Municipal Hospital 519 Contagious and Infectious Diseases, as well as the physician to this hospital, but the Governor appointed the health officer, the port physician, lazaretto physician and quarantine master. By the Act of 1849, the Board of Health became a quasi- independent body, clothed with a great deal of power, and amenable only to State authority, whence its funds were derived. By the Act of 1854 (The Incorporation Act), the Board of Health estates were vested in the city, and all appropriations of money to the Board were made by Councils. The buildings on Bush Hill were again declared to be a public hospital for persons infected with contagious diseases. By the Act of 1859, the Board of Health was increased to twelve members, each one appointed for the term of three years : Three were appointed by the Judges of the District Court, three by the Court of Common Pleas, three by the Supreme Court of the State, and three by a conjoint meeting of Select and Common Councils of the city. This method of appointing the board was continued for twenty-eight years. A board selected in this manner was free to make appoint- ments to all subordinate positions quite independently of political influence. Indeed, it was the boast of the Board of Health in those days that all appointments were made solely with regard to an applicant's fitness to fill the position. By the Act of 1885, known as the "Bullitt Bill," which went into effect in 1887, the membership of the Board of Health was reduced to five in number, to be appointed by the Mayor. The Board of Health was incorporated into the Department of Public Safety, and the Director thereof was ex-officio a member and the President of the Board. He was invested with authority to appoint, supervise and control all subordinate officers and employees attached to the board. This Act, of course, brought the Municipal Hospital under the jurisdiction of the Director of the Department of Public Safety, while the general supervision over it was left to the Board of Health. This dual government of the hospital continued until 1903, when, on April 8th of that year, the Governor signed an Act passed by the Legislature creating a new department in the municipal government, to be known as the Department of Public Health and Charities, with a director in charge. This, of course, had the effect of transferring the government of the Municipal 520 Institutions Under Municipal Management Hospital from the Department of Public Safety to this new department, with power to appoint and control all officials vested in the director. ORIGIN OF THE MUNICIPAL HOSPITAL In seeking to learn at what period in the early history of our municipality the first hospital was established for contagious and infectious diseases, I find the following passage in the Act of 1794:— "Section 1. Be it enacted, etc., 'That the messuage, tene- ments and lot of ground situated and being in the Eiver Dela- ware, commonly called State Island, which have heretofore been reserved, occupied and employed for the purpose of a 'public hos- pital or pest house,' " etc. The best reference I can find to the earliest hospitals of this character in the city is contained in the remarks of the late Dr. Wilson Jewell, on the occasion of the opening of the present Municipal Hospital, Twenty-second Street and Lehigh Avenue, in the year 1865. Dr. Jewell at that time was a member of the Board of Health, and Chairman of the Sanitary Committee. He said : — "Up to the year 1743 there had not been a single hospital organized in our city. In 1826 the small-pox broke out in the city, and a house located near where Ninth and South Streets intersect was used as a pest house. The victims of this epidemic in those days were taken to farm houses. In the year 1843, the merchants, as a safeguard, took the subject of making provision for the sick into consideration, because the small-pox was increas- ing as emigrants came upon our shores from Germany. The Colonial Assembly became alarmed, and they built a pest house on State Island, at a later period called Fisher's Island, near the mouth of the Schuylkill Biver. This remained in use for sick emigrants until the year 1800, when the Lazaretto, on little Tini- cum Island, in Delaware County, was built. The calamitous necessity, in 1793, so alarmed the inhabitants that it was then considered absolutely necessary to establish some measures to insure the public safety of this city. The Guardians of the Poor had already refused to receive small-pox or fever patients into the almshouse, then located on Spruce Street between Tenth and Eleventh Streets. The Pennsylvania Hospital was closed at that The Municipal Hospital 521 time. The Guardians of the Poor took the old circus on Chestnut and Sixth Streets, but the residents of the vicinity threatened to burn the place down unless the sick were removed. Application was then made to the magistracy of the city, and finally a place was selected on Bush Hill. "The Board of Health was organized in 1794, and purchased the Pish Tavern, on the west side of the Bridge, now occupied by the Pennsylvania Bailroad Company. This was used for a time for hospital purposes. The first hospital established by the city was in 1796 or 1797. This was the Wigwam Hotel, at the foot of Race Street, on the Schuylkill Biver. It was then a somewhat celebrated tavern, to which gentlemen resorted to eat perch, the same as they now (1865) do at the Falls of Schuylkill, where catfish and coffee are popular. This hospital retained the name of the Wigwam Hotel for several years; the sign that used to swing there is in Germantown, but being defaced by the ravages of time, has been painted over. In 1805 the citizens in the vicinity of the Wigwam Hospital entered complaints against the institution. It was finally removed to other ground, on the Wissahickon Boad, near where Ridge Boad and Wallace Street now intersect each other. This place was occupied for two seasons only, when the citizens again rebelled and demanded its removal. For a time the city was again without a hospital for contagious diseases. The people settled down in the opinion that if the epidemic should again visit the city, buildings should be put up at respectful dis- tances to meet the emergency. "In the year 1810, a hospital for infectious diseases was erected on Bush Hill, where it remained until 1855, when it was removed. Since that time Philadelphia has been without a city hospital. This was a subject much to be regretted. The Board of Health opened the Lazaretto Hospital, and patients had to be removed twelve miles from the city; and no one can form any idea of the amount of suffering the poor creatures had to undergo. Now, we have a hospital with all the conveniences needed for the present era, and we would be very happy, indeed, to allow any gentlemen an opportunity to visit the wards, to witness the good treatment to the sufferers from small-pox." It is seen that the experience of the Municipal Hospital is somewhat like that of "The Wandering Jew/' Moved by feelings of hostility, engendered by fear, citizens have constantly demanded 522 Institutions Under Municipal Management its removal whenever city improvements have approached at all near its locality. It remained the longest time at what is known as the Bush Hill site — from 1810 until 1855. Next to this, in point of time, is its present location, where it has remained for the past forty-four years. But, naturally, it is always regarded as an undesirable neighbor, and tends to depreciate the value of property in its neighborhood. It has been my experience that the danger of the spread of such diseases as scarlet fever and diphtheria from the hospital is not great, but as regards small- pox, particularly when a large number of cases are collected together, the danger is considerable. The Bush Hill hospital is said to have commanded a promi- nent position on a lot of ground bounded by Nineteenth and Twentieth, and Wallace and Coates Streets (now Fairmount Ave- nue). According to Dr. John Bell, this hospital, more often spoken of as a hospital for yellow fever, was rented by the man- agers of the almshouse in the latter part of 1823 for the reception of cases of small-pox. No less than 176 cases were admitted within a period of four months. After this time the epidemic declined so rapidly, and the number of cases in the hospital was so greatly reduced, that an old building called the "Sugar House," on the west side of Eleventh Street, just south of Spruce Street, and opposite the old almshouse, was opened for their reception. Prom January until June, 1824, Dr. Bell had the medical charge of the small-pox hospital at Bush Hill, and afterwards of the provisional one just mentioned. ISLINGTON LANE HOSPITAL After the sale and demolition of the Bush Hill hospital, which occurred somewhere between 1855 and 1858, a temporary and somewhat inconvenient building was secured as a substitute on Islington Lane, which locality at the present time is in the vicinity of Nineteenth and Dauphin Streets. The ground sur- rounding this building was later designated "Humboldt Park." As it was not obligatory upon the Board of Health to main- tain a hospital other than the Lazaretto for the care of contagious diseases, which, with the approbation of medical opinion, were commonly admitted into general hospitals, the city authorities felt it was unnecessary to make provision for patients who could be received into such hospitals, or, in the event of their being The Municipal Hospital 523 paupers, into the hospital at Blockley. This opinion was enter- tained by some members of the Board of Health, and a resolution was offered to consider the propriety of removing the city hospital to the Lazaretto. After giving the subject due consideration, and advising with the City Solicitor, the Sanitary Committee of the Board of Health reported adversely to the removal of the hospital as proposed, but for some reason offered the following resolu- tion : — "Resolved, That under the advise of the City Solicitor, whose written opinion, forming part of this report, is herewith sub- mitted, this board declines providing for any patients not strictly embraced in the class for which ample accommodation is secured at the Lazaretto, for a longer period than April 1, 1861; and in view of the large outlay for the support of the city hospital, so disproportionate to the results, authorizes such modification of the Lease upon the premises as will enable it to be vacated by giving the Lessor three months notice." This resolution was adopted by the Board of Health, having previously been sanctioned by the corporate authorities. The board justified this action by the remarkable statement that "henceforward the city will be saved an annual outlay of several thousand dollars, the cost of maintaining a hospital which can safely and properly be dispensed with, and without the least degree of inhumanity to the suffering sick." After this action had been taken by the Board of Health and City Councils, it happened that there was an unusual increase of small-pox cases, "mainly," as the board stated, "subjects for and inmates of the Blockley Almshouse and the County Prison, for the treatment of whom no suitable and proper accommodations existed within those institutions;" hence, City Councils passed a resolution in February, 1861, requesting the Board of Health to continue the city hospital for another year. This request was promptly complied with, and fortunately, too, inasmuch as shortly afterwards, upon the breaking out of the war, small-pox, measles and other contagious diseases appeared among the large bodies of troops, seamen and marines that were in the city, and as no proper place had been prepared by the city or general government for such infected persons, they were all cheerfully admitted into the temporary hospital at Islington Lane. In reporting upon the work of the hospital for the year 1861, 524 Institutions Under Municipal Management Dr. Bell, the physician in charge, said the number of admissions during the year exceeded that of any similar period in the history, not only of this building, but also of the original one at Bush Hill, so far as existing records enabled him to speak. He complained of the scanty accommodations for the large number of patients under treatment, stating that at one time there were fifty persons lodged in rooms whose greatest capacity would not permit of thirty being properly accommodated, and that the air space to each patient was at times not above 340 cubic inches. At the time of leasing the building on Islington Lane for a temporary hospital, it was not anticipated that the demands upon it would be so great. ISTot only was small-pox more prevalent in the city than usual, but the managers of all general hospitals and infirmaries, no longer feeling that it was safe to treat the disease in such institutions, closed their doors against it, and even when the disease broke out in hospitals and infirmaries, the cases were removed to the small-pox hospital. This experience led the Board of Health to see the necessity of establishing, as soon as possible, a permanent and commodious hospital for the care and treatment of contagious diseases. Accordingly, the Board of Health, in conjunction with the Board of Guardians of the Poor, called the attention of City Councils to the subject. A special committee was appointed, and, after carefully considering the matter, made an able and favorable report to Common Councils, presenting at the same time an ordinance to provide for the erection and man- agement of a new municipal hospital. This ordinance was passed by Councils in the latter part of 1862, and duly approved by the Mayor. The supervision of the erection of the hospital was entrusted to a commission of eleven citizens appointed by the Mayor, Honorable Alexander Henry. The names of the men who were appointed on the commission are as follows: Dr. John B. Biddle, Dr. Bene LaBoche, Dr. William Shippen, Dr. James A. McCrea, Dr. Thomas Stewardson, and Messrs. William H. Keich- line, George Erety, Henry Haines, Arthur Hughes, Frederick A. Server and William Neal. The temporary small-pox hospital at Islington Lane was con- tinued until the end of September, 1862, having been occupied for the past four years. Absence of small-pox in the city led to the belief that it was unnecessary to continue the expense of sup- porting an unoccupied hospital, and therefore it was abandoned by The Municipal Hospital 525 the Board of Health, with the approval of Councils, on the first day of October, 1862. TEMPORARY HOSPITAL AT THE LAZARETTO In February, 1863, nearly five months after the abandonment of the hospital, small-pox reappeared in the city. In the absence of any provision for the care of such cases, the Board of Health, in view of the emergency, directed an unoccupied building at the Lazaretto to be prepared for their reception. This building, now a hospital, was placed under the charge of Dr. J. L. Forwood, of Chester. This temporary hospital was continued for a little over two years, until the new hospital, then in course of erection, was com- pleted. During that period, every small-pox patient in the city was conveyed in an ordinary vehicle to the Lazaretto, a distance of twelve miles. Anyone who knows anything about the pain and suffering experienced by a small-pox patient when the eruption is developing can appreciate, I am sure, the remark of Dr. Jewell in this connection, namely, "no one can form any idea of the amount of suffering the poor creatures had to undergo." On June 1, 1865, this hospital was closed. Four hundred and nineteen patients were sent there for treatment during its occupancy, since February, 1863. In his report to the Board of Health for the year 1861, Dr. John Bell presented a synoptic table of the cases of all diseases treated in the Municipal Hospital during a period of twenty years, or from 1840 to 1859, both inclusive, with the remark that it might prove "useful for historical reference, if the record book of the hospital should be lost — a mischance which has occurred with the registered reports of cases previous to those of the year 1840." Dr. Bell's fears have been realized, for no reports can now be found previous to 1860. I have supplemented this table of Dr. Bell by a continuation of the record of all diseases treated each year until the opening of the present hospital at Twenty-second Street and Lehigh Ave- nue, in the year 1865, as follows: — 526 Institutions Under Municipal Management M o a a 00 co — CD >i a) — CD >! CD CO co a 7^ cd 03 > CD CG&4 a) CD O -a O O O) a> a> >> 5J a QJ co P CO CD a? © — co 00 eg o to Q> S3 o 31 175 56 18 ,3 03 oj Q 6 34 4 4 ca 1 CO si eS CD P 1 (A CO OS CO a» CO a> to 03 1 .a S3 a) O ca CD CO 03 1 co a « CD O CO CD CO S3 O co XI a> O CO cd CO X! "S O) Q CO a> CO EC) O CO XJ « P ca co co XI "3 Q 1841 ! 3 4 1842 ....!-... .... 1 1843 1844 t ! 1845 62 199 1 186 168 22 47 85 16 27 117 163 7 64 "35 27 8 8 13 2 4 17 21 7 j ' 1 1847 4 55 74 1 2 11 34 4 2 4 13 15 1 4 1 3 3 1848 9j 3 1 1 34 21 1850 1 ! 1 1851 9 : 1852 "■ 1 ....|....j :.... 1853 3 12 1 6..J '.... 1854 12 1 1 ' 1855 J 3 1856 ! 1 j 1857 46 5 1 — i 1 ; 1858' 17 1 1 , 1869J 6 2 3 60 21 5 28 * 380 5 1 1 1860 67 2 .... 1 1 1 1; 1861 ! 296 91 1 7 .... 6 1 .... 1862 124 1 5 1 1863 48 170 196 2343 1 1 * 195 1 1 1864 * 47 2 1 1865 To- tals 39 * 12 * 3 * 37 l! 10 * * 28 * 17 * 7 * 7 * 4 * 14 * 2 * There is no record of the number of deaths that occurred among the 196 cases of smallpox during the first five months of the year 1865. NEW HOSPITAL ERECTED BY THE CITY The new Hospital, as it was then styled, erected under the supervision of the eleven Commissioners already named, in pur- suance of an ordinance of Council approved November 2-1, 1862, was completed and formally handed over to the care of the Board of Health on April 27, 1865. The first patient— Annie Still, colored, aet. 18 years, servant; nativity, New Jersey; residence, Sergeant Street between Ninth and Tenth Streets; disease, variola; — was admitted May 31st. The plans and specifications of the building were drawn by Samuel Sloan, Architect, and the builders were Messrs. Balderston and Albertson. The location of the building was determined by Councils. It was in an unimproved suburb, then known as Lamb Tavern Eoad and Heart Lane (now Twenty-second Street and Lehigh Avenue). The site upon which it was erected was level ground having an area of a little over ten acres. Municipal improvements, such as The Municipal Hospital 527 the opening of streets, the laying of water pipes and gas pipes, were yet far away from this locality. The formality of the dedication of the Hospital took place in a large room of the Main Building on the 27th of April, 1865. 3 There were present the members of the Board of Health, the Build- ing Commission, Inspectors of the County Prison, the Guardians of the Poor, and a number of public-spirited citizens, among whom was ex-Governor David E. Porter. In passing the hospital over into the possession of the Board of Health, Dr. John B. Biddle, President of the Building Commission, gave a description of the building, from which I glean most of the following facts : The main building (officer's quarters), is fifty feet square, with a basement, two stories, and an attic covered with a slate mansard roof. On each floor there are four rooms, 18 x 20 feet in dimensions, with a hall 10 feet wide connecting with a stairway extending from the basement to the attic. Prom this hall there are cross entries on each floor connecting with the corridors of both wings of the building. Each wing contains on either floor of the two stories two large wards each 26y 2 x 42 feet in area, and 14 feet in height, thus fur- nishing the hospital with eight wards. The wards on each floor are separated by a room twelve feet wide which was provided with bath tubs and water closets. Through this apartment convalescent patients pass to the corridors where they could enjoy a sheltered walk in the open air. The corridors, twelve feet wide, extend along the south side of each wing its entire length, on both the first and second stories. They were protected on the outside exposure by Venetian blinds. In each wing there is an attic extending over only one-half the length of the wing. This attic was divided into sleeping rooms for accommodation of the hospital attendants. Each attic, how- ever, contained one large room which, in certain emergencies, was occupied by patients. Between the center building and the wards of each wing, a wide stairway for the use of patients and employees extends from the cellar to the attic. 3 A full account of the proceedings is contained in the Evening Bulletin, Philadelphia, April 28, 1865. Also, in the report of the Board of Health for the year 1865. 528 Institutions Under Municipal Management The center building was heated by fire-board stoves placed in the first story, which supplied hot air to the chambers in the second story. There was no provision for heating the attic. The wards and bathrooms were heated by hot air furnaces in the cellar ; but each ward had besides a large open grate, materially improving the ventilation. The only means of lighting the building originally was by oil lamps. The supply of water was from a thirty thousand gallon cistern, and from a well in the cellar. The water was pumped by a caloric engine into a large iron tank located in the loft of the center build- ing, whence it was distributed by iron pipes throughout the hospital. The drainage ran to a nearby cess-pool which required to be emptied from time to time. This condition continued for many years until the city's sewerage system was extended to the limits of the hospital grounds. At the time the hospital was built it was supposed that each ward would readily accommodate twenty beds. It was found, how- ever, that while twenty children might be accommodated fairly well, no more than fifteen adults could be treated in a ward without overcrowding. The capacity of the hospital originally was, there- fore, from one hundred and twenty to one hundred and sixty beds, according to the ages of the patients. But it must be remembered that a hospital of this character is required to improvise accom- modation for patients whenever there occurs a great epidemic of some dreaded contagious disease. A building containing a stable, carriage house and laundry was also erected on the grounds. The stable accommodated four horses, and the carriage house, two ambulances. The laundry was fitted up in ordinary style, containing boilers, stationary washtubs, and washboards and flat irons. Both buildings were constructed of stone, quarried near the Palls of Schuylkill. "The cost of the erection of the main building, awarded by public advertisement to the lowest bidder, was forty- five thousand, nine hundred and thirty-two dollars, ($45,932)." The stable, including the laundry, grading, fencing, etc., cost ten thousand, eight hundred dollars, ($10,800). The heating and cooking apparatus, two thousand and eighty-four dollars and fifty cents, ($2,084.50). The fee of the architect was one thousand dollars, ($1,000). Thus, it is seen that the entire cost of the The Municipal Hospital 529 erection of the present Municipal Hospital and fitting it for occupancy was only fifty-nine thousand, eight hundred and sixteen dollars and fifty cents, ($59,816.50). When it is remembered that it was built during the period of our Civil War, when gold was at a premium, and the price of labor and all building material unusually high, the building commission surely deserved much credit for giving the city such ample return for the amount of money expended. In accepting the hospital in behalf of the citizens of Phila- delphia, Dr. James A. McCrea, President of the Board of Health, said: "As President of the Board of Health, I am authorized, on behalf of my colleagues, to accept the future charge of the Municipal Hospital now tendered in conformity with the provisions of the ordinance under which it has been erected. In the conduct of this important element of sanitary regime, every effort will be made to secure the fullest advantages to be derived from a judicious and economic administration of a well-organized hospital, such as a great city like Philadelphia requires, and has at length obtained. "If adequate provision for its support be made by Councils, we may reasonably hope to establish for it the character of a model institution for the treatment of contagious and infectious diseases." Dr. Wilson Jewell, Chairman of the Sanitary Committee of the Board of Health, then offered a resolution, which was adopted, as follows: — "Resolved, That the thanks of this community are due to the Board of Commissioners for the judgment and taste they have displayed in the plan and general arrangement of the hospital, with a view to the convenience and comfort of those who are so unfortunate as to require its protection, as well as for the able and honorable manner in which they have accomplished the trust confided to them by the authorities of the city." The dedication exercises closed with the announcement by the Board of Health that Dr. Samuel P. Brown was elected attending physician to the hospital, and Miss Lydia Tomlinson matron. The latter had served as matron for a number of years in the hospital at Bush Hill. The hospital was under the medical management of Dr. 34 530 Institutions Under Municipal Management Brown for only five months, when, on November 1, 1865, he was succeeded by Dr. J. Howard Taylor. CHOLERA IN THE CITY In 1866, cholera prevailed in Philadelphia to a considerable extent. There were 910 deaths in the city from that disease during the year. Believing that it was detrimental to cholera patients to transport them over rough streets to the Municipal Hospital, a distance of four miles from the center of the city, the Board of Health directed its Sanitary Committee to prepare and hold in readiness a temporary hospital more conveniently located. Accordingly, "Moyamensing Hall," which was known subsequently, during the Civil War, as Christian Street Hospital, was opened for the reception of patients on August 1st; but within twenty-four hours it was fired by incendiaries and completely destroyed. The Board of Health state that application was made to his Honor, the Mayor, Morton McMichael, "for a sufficient police force to prevent a similar occurrence on this site in the event of rebuilding, as well as at other contemplated hospitals," but, this request, they further state, "was declined, as an important political convention was in session requiring all the available force in attendance thereat." The board then had no other resort than the Municipal Hos- pital. It is stated that in all attempts to remove cholera patients thereto they died, either on the way or immediately upon arrival. Consequently, the board made no great effort to remove persons who suffered from this disease to the hospital. There were, in all, only fifteen admissions during the year, and of these, four- teen died. It should be stated that during the prevalence of the disease many cholera patients were treated in Blockley Hospital. Even the general hospitals of the city did not refuse to admit such patients. INADEQUATE WATER SUPPLY The new hospital had not been in use long until it was found that a very serious difficulty arose from the inadequate provision for supplying the building with water. The tank into which the water was pumped for distribution was located in an attic far beyond and inaccessible to any heating apparatus, and, conse- quently, when the temperature fell below the freezing point the flow of water ceased as perfectly as though its fountains were dry. The Municipal Hospital 531 This made' it necessary not infrequently to carry from the pump in the kitchen all water that was required in the wards, bath- rooms and water closets. Under the conditions existing, this inconvenience had to he endured until the city's system of water supply was brought sufficiently near the hospital to permit of connection therewith being made. This did not occur until about the year 1881. In 1870, an apparatus was introduced for generating illumi- nating gas from gasoline, but the result was so unsatisfactory that oil lamps were again resorted to. It was a great improvement and convenience to the hospital to be supplied with gas from the city mains, which became possible about the year 1887. RELAPSING FEVER EPIDEMIC In the early months of the year 1870, relapsing fever appeared in Philadelphia. In a short time the cases began to multiply to such an extent that, by April, it was apparent the disease was rapidly assuming the form of an epidemic. It is remarkable that the infection was in good part limited to a cer- tain locality in the city. The boundaries of the infected district were from Lombard Street to Catharine Street, and from Fifth Street to Eighth Street. The most pestilential parts were Alaska Street, and the various courts and alleys opening on this street, whose inhabitants were among the most degraded of our popula- tion, such as vagrants, tramps, and alcoholic habitues. This locality became familiarly known as the "Alaska District." The Municipal Hospital was now thrown open for the recep- tion of relapsing fever patients exclusively. The first admission was on April 30th, and thereafter all who were removed from their homes for treatment were sent to this institution. It was evident by August of this year that the epidemic had spent its force, and that the disease was under control. The number of cases that occurred during the epidemic was estimated at five thousand. One hundred and sixty-two deaths from this disease are on record in the registration office of this city for the year 1870. The statistics of the Municipal Hospital show that five hun- dred and twenty-five cases were admitted during the epidemic. The disease was vastly more fatal among negroes. Two hundred and sixty-eight white patients were admitted; of these, four died, 532 Institutions Under Municipal Management a death rate of 1.4 per cent. Two hundred and fifty-seven colored patients were admitted, of which number sixty-four died, a death rate of 24.9 per cent. In the month of May of the following year (1871), three cases of relapsing fever were admitted to the hospital. They all were brought from a tenement house in Mayland Street, in the vicinity of Sixth and Eace Streets, where there occurred in all about a dozen cases. Fortunately, the disease did not assume an epidemic form. Eelapsing fever is undoubtedly communicable, but not so highly contagious as are some other communicable diseases. A resident physician, who served a greater part of the epidemic, fell ill with the affection in the fall while on a short visit to his home in the interior of the State. It does not seem possible that so slight a change of climate could have excited or precipitated the attack. YELLOW FEVER AT THE LAZARETTO During the summer of 1870, yellow fever made its appear- ance at the Lazaretto. The quarantine physician, Dr. William S. Thompson, and a number of others at the station and its imme- diate neighborhood fell victims to the disease. Dr. J. Howard Taylor was appointed by Governor Geary to fill the vacancy caused by Dr. Thompson's death. Consequently, Dr. Taylor resigned the position of physician in charge of the Municipal Hospital, and the writer, Dr. William M. Welch, was elected by the Board of Health as his successor, to commence the work September 1, 1870. I should not omit recording the fact that during the outbreak at the Lazaretto, yellow fever made its appearance in the city. The disease was limited to a single locality, called the "Swanson Street District." There were perhaps in all not more than seventeen cases, and four of these were treated in the Municipal Hospital. MALIGNANT EPIDEMIC OF SMALL-POX An epidemic of small-pox commenced in Philadelphia in the autumn of 1871, and progressed rapidly, reaching the culminating point by the following January. After remaining stationary for a while, it then gradually declined during the following spring months, and became quite extinct by the middle of summer. Within this period of time (less than a year), over fifteen thousand The Municipal Hospital 533 eases of small-pox occurred in the city, with a mortality of 4,464. This was one of the severest and most malignant epidemics of small-pox that ever visited our city. The epidemic was not confined to one locality, nor one country, but was world-wide, and wherever it prevailed it was marked by the same malignancy. The President of the Epidemiological Society, at a meeting held in London, in 1872, in speaking of this epidemic, said it "had been present in Europe and Africa, from south of the Equator to the Arctic Ocean; in Asia, from Southern India to Siberia; in America, from Chile to Canada." During the prevalence of the disease in Philadelphia the Municipal Hospital was taxed far in excess of its ordinary capacity. In order to meet the extraordinary demand arising from the emer- gency, additional accommodations for patients had to be quickly provided. This was done by enclosing the corridors on the upper floors of the building, and fitting them up with sash, so as to exclude the weather and admit light. Large double army hos- pital tents were set up on the grounds, and by these means we were enabled to furnish fairly comfortable quarters for an inde- finite number of patients in the shortest possible time, and with the least possible expense. The number of patients admitted to the hospital during the epidemic was 2,377. Of this number, 743 died, giving a death rate of 31.25 per cent. The extreme malignancy of the disease put vaccination to the severest possible test, but it came out of the trying ordeal with its reputation unimpaired. The unvaeci- nated perished to the extent of 64.83 per cent., while those who had been vaccinated in infancy or early childhood and showed good vaccine scars, yielded a mortality rate vastly less— 10.26 per cent. The efficacy of vaccination was more conclusively proven by the protection it afforded the physicians, nurses and other employees of the hospital, as not one of these persons who had been properly vaccinated before entering upon duty took the disease. The difficulties attending the management of the hospital at this time were not small. An insufficient water supply was a cause of serious embarrassment. Fully one-half of all the water used in the wards was carried by buckets from a well located near the stable. There was also much inconvenience arising from the 534 Institutions Under Municipal Management use of oil lamps. The hospital was not provided with a steward; it had only a superannuated matron. There was no one to look after the provisions, the culinary department, the laundry, etc. All this devolved upon the physician in charge. His recent experience in large military hospitals during the war helped to make comparatively easy what would otherwise have been a diffi- cult task. It should be stated, too, that trained nurses were not then available. The nursing was done by men and women who simply showed some aptness for the work. They were obtained in good part from among the convalescent patients. This was the situa- tion, I am sure, in all hospitals of the city at that time. As the hospital was not yet provided with facilities for dis- infecting clothing, the patients, when ready to be discharged, were required to have, as far as possible, clean clothing sent in from their homes. Where this was impossible, the discharged patients were obliged to dress in the clothing that was worn on entering the hospital. It should be added that no attempt was made at that time to disinfect the houses, bedding or clothing of the thou- sands of patients who were treated at their homes. FIRST DISINFECTING PLANT Eealizing the great need of a disinfecting plant in connection with the hospital, the physician in charge called the attention of the Board of Health to the matter in his annual report for the year 1872. In speaking of some of the requirements of the hos- pital, he said: "There is one other improvement which I think should be made, and that is the erection somewhere on" the hospital grounds of a suitable building furnished with all the necessary appliances for conducting artificial disinfection. It is for the disinfection of woolens, bedding and clothing which can- not be washed that such an apartment is more especially required. It should be provided with a close chamber where such articles as named could be subjected for some hours, either to proper fumi- gation or to temperature sufficiently high to destroy "fomites," as for instance, 210° to 250° P. To make this building complete, it should contain bathrooms supplied with an abundance of hot and cold water. It should also contain dressing rooms, where the patients' clothing, after being properly disinfected, could be placed ready for use when the patients are discharged from the hospital. The Municipal Hospital 535 In order, however, to introduce this improvement and make it operative a better supply of water is essential." This recommendation received the support of the Board of Health, but in the absence of any available appropriation, disin- fecting facilities were not introduced until the latter part of the year 1875. A small stone building was then constructed for the purpose, the plans and specifications for which were drawn up by two members of the Board of Health, Dr. William H. Ford, Chair- man of the Sanitary Committee, and Dr. Samuel Ashhurst. The building was located next to the laundry where hot water could be obtained for bathing purposes. It contained a hot-air chamber, a fumigating chamber, and a bathroom and dressing room for the use of patients ready to be discharged. The hot- air chamber was 8 x 11 feet in area, and 8 feet high. The heat was generated by a furnace located immediately under the floor, which was laid in tiles of stone supported on an iron framework. A temperature of 280° F. could be maintained for a long time. But it was never allowed to exceed 250° F., as this temperature was regarded sufficient for all practical purposes, and, besides, it was found that a higher degree of heat was liable to scorch the articles that were being disinfected. This was almost sure to occur if the clothing or bedding came in contact with the walls, floor, or metal. To avoid such an occurrence all articles were suspended from the ceiling. The temperature of the chamber could be seen at any time by examining a thermometer which hung in an aperture in the wall covered by glass. The fumigating chamber, 6 x 11 feet, was made perfectly tight, so as to completely confine the gases liberated for the pur- pose of disinfection. The bathroom was 6x8 feet in dimensions, and communicated with a dressing room 8 x 10 feet. Not only was a disinfecting plant needed for the sanitary treatment of patients' clothing and articles in use at the hospital, but it was also needed by the Board of Health for the proper treat- ment of infected clothing, bedding, etc., in private dwellings in the city. COMMUNICATION WITH THE HOSPITAL During the great epidemic of small-pox in 1871-72, the only way by which the Board of Health could communicate with the hospital, excepting by mail or a special messenger, was by means of an instrument consisting of a dial with the letters of the 536 Institutions Under Municipal Management alphabet at its circumference. An indicator revolved upon this dial, pausing for a moment at each letter of a word that was being spelt, so that by close attention one could in this way receive a message. This was very tedious and required the resident phy- sicians to give it a good deal of their time. Moreover, it was unreliable and frequently out of order. There were but two resident physicians employed, and one clerk. As there was no druggist at that time connected with the hospital, the residents, besides their other duties, were required to compound all medicines. It can be readily seen that they had but little time for recreation, especially when there were as many as 300 patients in the hospital. I would add that each resident physician received as compensation $50 per month. In 1874, the old dial instrument was abandoned and a print- ing telegraph instrument introduced in its place. This required less attention, and was much more satisfactory. It was a great convenience to the Board of Health, and was constantly brought into requisition. It was found to be particularly useful in facilitating the prompt removal of patients, and in furnishing information to their friends, who would otherwise seek such information at the hospital at the risk of infection. This instru- ment was replaced by the telephone system as soon as that system was brought into general use. APPOINTMENT OF A STEWARD For many years the only person in authority who resided at the hospital was the matron. The Board of Health concluded that the time had come when there should be a more responsible person constantly on hand ; one whom they could hold accountable for the behavior of the employees, and the preservation of the property. Accordingly, in the spring of 1873, the board elected James S. Ha}Ties as steward, and his wife. Mrs. E. M. Haynes, as matron. The steward was obliged to furnish a bond for $1,000. Mr. Haynes filled this position until 1887, when he resigned and removed to California. He and Mrs. Haynes were succeeded by James Paul as steward, and his sister, Miss Paul, as matron, both of whom served for nine years. William Bobinson was then chosen, but he held the position for only a few months, as likewise did his successor, L. J. Gouffe. The next man who was appointed to fill the position was the present incumbent, J. The Municipal Hospital 537 William Morgan. His appointment as steward was dated Novem- ber 6, 1897. The title of this office was changed from Steward to Superintendent of the Hospital on July 1, 1901. A few months after the resignation of Miss Paul as matron, Miss Emma Gillians, a trained nurse, was appointed as her suc- cessor. She served until 1903, when the position was abolished, and, in lieu thereof, a head nurse and a housekeeper were ap- pointed for each department of the hospital. SMALL-POX IN CENTENNIAL YEAR After the epidemic of 1871-1872, the next outbreak of small- pox in the city that spread to the extent of constituting an epidemic was in 1876. In the early part of the year the cases gradually increased, and, singularly enough, were most prevalent at the time of the opening of the Centennial Exhibition, which occurred on the tenth of May of that year. An effort was made to promptly search out the cases and remove as many as possible to the hospital, especially those that occurred in hotels, boarding- houses and parts of the city thronged with guests. The Board of Health was apprehensive that the dreaded consequences of an epidemic, such as occurred in Vienna during the year of the great International Exhibition, might be experienced in Philadelphia. The board conducted an active warfare against the disease in a very quiet manner, so quietly, indeed, that but little was said in the newspapers about the presence of small-pox, and consequently, but few of the multitude of visitors to the great exposition ever heard there was a case in the city. Fortunately, the disease began to decline when the summer months were reached; but in the fall there was an increase again, reaching its maximum in November, but secondary in point of number to that of May. Excepting the years of 1871-72, small- pox had not been so prevalent in the city since 1865. The number of cases reported to the Board of Health during the year was 1,263, with a mortality of 407, a death rate of 32.22 per cent. The number admitted to the hospital was 262, of which 84 died, a death rate of 32.06 per cent. YELLOW FEVER IN PHILADELPHIA As yellow fever is but seldom seen in Philadelphia, I may mention that in 1878, three eases were admitted to the hospital. These cases occurred among a number of refugees who had fled 538 Institutions Under Municipal Management from Vicksburg, Miss., where the disease was prevailing with con- siderable mortality. Fortunately, both cases recovered. Again, in 1879, two seamen were admitted with the disease, and both died. In 1888, a man who had left Jacksonville, Fla., two days before, where the disease was present, was admitted as a yellow fever suspect. The diagnosis in this instance was accepted with some reservation. In neither of these years did the disease spread in the city. THREE GREAT EPIDEMICS OF SMALL-POX During the decade from 1871 to 1881, Philadelphia appears to have been singularly unfortunate in being obliged to sustain the burden of three great epidemics of small-pox. The third epidemic began in 1880 and continued over a period of five years (1880-1884 inclusive). Within this period the number of cases in the city amounted to 9,375, with 24.34 per cent, mortality. Of this number the Municipal Hospital received 1,894 cases, and the mortality rate was 30.57 per cent. During the series of epidemics just referred to, it was a mat- ter of regret to the Board of Health that a larger proportion of the persons who suffered from the disease could not be induced to go to the hospital. At that time there was no quarantining of residences, no placarding of houses, nor any severe restrictive measures enforced, such as often determine persons suffering from a contagious malady to seek the hospital in perference to remaining at home. It is true, in some instances, when circum- stances seemed to justify the procedure, patients were forcibly removed from their homes to the hospital. The advantages to the community of an institution for the isolation and treatment of contagious diseases are fully recognized and appreciated by all sanitarians. Such an institution is more especially appreciated when a disease like small-pox prevails extensively in a large and densely populated city, as it may be made to serve the double purpose of affording accommodation for the unfortunate sick, and of safeguarding the public against the dread disease. In speaking of the advantage afforded to the city by our Municipal Hospital in one of his annual reports to the Board of Health, Dr. John Bell said: "A small-pox hospital is made to serve the double ends; first, of an infirmary in which persons afflicted with this painful and loathsome disease receive careful nursing and medical attendance, which they could not procure The Municipal Hospital 539 themselves; second, of a quarantine establishment, in which the infected persons are kept apart from the general community and prevented from holding contaminating and dangerous intercourse with it. Looking to the amount of disease and its attendant mortality thus prevented, the second, or protective, is the most beneficent feature of a small-pox hospital. At a moderate esti- mate, each patient received into the hospital would, if allowed to remain at a house, or, it may be, hovel, in the city, have trans- mitted the poison of the disease, either from his own person or from his body and bedclothes, to three individuals among the whole number of those in the house, and of visitors and others brought into chance intercourse with him, or with her, as the case may be. Each one of these parties who would have been thus afflicted would constitute a fresh source of contagion, and so on to an indefinite extent." Of course, such communication of the disease could only happen where there was great neglect of vaccination. But one can always count upon a certain amount of such neglect. In the year 1888, small-pox again prevailed in the city to a considerable extent. As many as eighty deaths were caused by the disease. Two hundred and one patients were treated in the hospital, and of these fifty-three died, a death rate of 36.26 per cent. THE HOSPITAL HAS "OUTLIVED ITS USEFULNESS" In view of the great amount of service the city had received from the hospital in the years of its existence, it is amusing to ' read the views of a layman as to its importance. William S. Stokly, Director of Public Safety, in his annual report to the Mayor for the year 1889, said: "The Municipal Hospital, located at Township Line and Lamb Tavern Koad, used for the retention of persons having contagious diseases, and to assist the authorities in preventing its spread, has outlived its usefulness." It is a part of the history of the hospital that in the intervals of extensive epidemics, when but few patients sought admission thereto, objections to supporting the institution were so great, especially by those who controlled the finances of the city, that it was impossible to obtain what was needed for its proper mainte- nance. No one realized this fact more fully than Dr. "William H. Ford, who for nearly twenty years was President of the Board of Health, and for a longer time the able Chairman of its Sanitary 540 Institutions Under Municipal Management Committee. On one occasion, when much disheartened, he ex- pressed himself as follows: "Objection has been made to the hospital, or rather to the expense of keeping the hospital open, because so few persons have recently been treated there. None but the ignorant and prejudiced could support such an objection. If the hospital were crowded with contagious diseases, such as small-pox, relapsing fever or other dangerous communicable dis- eases as every now and then happens, these conditions would mean high mortality, a great amount of severe illness and suffering, and immense loss of money in the community at large. The great advantages of such an institution have been demonstrated beyond all peradventure. It is just for such occasional demands that the Municipal Hospital is indispensable. This everyone admits, but it does not occur to the mass of people that, by having an institu- tion of this kind always in readiness at a momenta notice to receive contagious diseases, an epidemic may be prevented. "The institution has a two-fold object: the prevention of epidemics and the lessening of their ravages, if perchance, they happen to gain sway. There can be no doubt that epidemics have been prevented by the prompt and intelligent use of this institu- tion. Every cent the city expends in keeping the hospital in a state of preparedness, and in providing a place for the isolation and treatment of cases of contagious diseases, otherwise unpro- vided for, is most profitably invested. It should be a subject for congratulation whenever the hospital treats but a few cases in a given year, for it indicates a favorable condition of the public health. It is amazing that people in an intelligent community should advance the argument that there is no use for a hospital for contagious diseases because at any one time but few cases were treated in it. It would be more creditable to the intelligence of the community to assign some other reason for this occasional opposition, and perhaps it would be nearer the truth." Since the time that Director Stokley declared the hospital "has outlived its usefulness," it has rendered a far greater service to the city than in all the preceding years of its existence. Even now its capacity is taxed to the utmost, and it has been consider- ably enlarged since the remark just quoted was made. Since then, too, there has been a remarkable change of sentiment in regard to the usefulness of the hospital. It is now not only more liber- ally supported, but the city is erecting in another locality much The Municipal Hospital 541 larger and vastly more expensive buildings for the isolation and treatment of contagions diseases. DISEASES OTHER THAN SMALL-POX Up nntil the early nineties there were comparatively few admissions to the hospital of persons suffering from diseases other than small-pox. The institution, therefore, became known as the "Small-pox Hospital," sometimes, indeed, as the "Pest House." These names were stigmas upon the reputation of the institution, and tended to create a prejudice against the hospital, which has always been very difficult to overcome. Previously to the year 1890, no effort whatever was made to secure admission to the hospital of cases of diphtheria and scarlet fever. The few cases that were received now and then came from hotels, boarding-houses, and the like. In the nineties the prac- tice of placarding houses went into effect, and immediately the number of admissions of scarlet fever and diphtheria patients increased immensely. During 1899, as many as 1,373 persons were admitted with diphtheria, and during 1901 the number of scarlet fever patients amounted to 1,115. TRAINED NURSES INTRODUCED The system of nursing in the hospital was changed as soon as it was possible to obtain trained nurses. The first trained nurse to enter the hospital for service — July 1, 1884 — was Earnest d'Erlach. He had received his training in the German and Bellevue Hospitals, New York City, and in the English Army Hospital Corps, London. It was not until 1888 that female trained nurses were employed. In 1896, Earnest d'Erlach was discontinued as nurse and assigned to the position of disinfector. Since then the nursing has been done exclusively by trained female nurses. DEATH OF AN INTERNE FROM DIPHTHERIA The experience of the hospital in regard to the transmission of infectious diseases to resident physicians, nurses and other employees is interesting. All such persons are protected against small-pox by vaccination. There is no exception to this rule. But the case is very different with regard to diphtheria and scarlet fever, against which there is no protection. It is not at all unusual for a resident physician or nurse to fall ill with one 542 Institutions Under Municipal Management of these diseases. In 1894, Dr. Frank H. Carman, 27 years of age, came to the hospital as resident physician. He had not been on duty long before he took diphtheria, and succumbed to the disease after five days illness. It should be added that this occurred before the hospital was supplied with antitoxin. LEPER BUILDING The records show that nine lepers have come under observa- tion in the hospital. For a time two or three of the number occupied an apartment in the main building, but it was found desirable to remove them to some other place in order to throw open to use a section of the building which could be utilized for no other purpose while a portion of it was thus occupied. Hence, it was decided to erect a small frame building on the grounds for the use of lepers exclusively. This was brought about in the year 1892. The building which was constructed accommodated comfortably four patients and an attendant. It was provided with a kitchen, laundry, water closet and everything necessary for comfort, so as to make communication with the main hospital unnecessary. Concerning the disposition of these nine lepers, I would say that two (mother and daughter) were returned to their home in South America, one was sent to a neighboring county in this State, where he belonged, and has since died. One, I am informed, is in a leper colony in Louisiana, one returned to his home in the West Indies, three died in the hospital, and the destiny of the remaining one is unknown. It is remarkable that one of the lepers was a Philadelphian by birth, and had never resided anywhere else. The source of the infection was unknown. It may be of interest to some readers to note that, while sev- eral of the lepers were inmates of the hospital for many years, there was no instance of communication of the disease to their attendants. COMMISSION TO SELECT NEW SITE The question of removing the Municipal Hospital to some more distant locality having been frequently discussed in City Councils, the Board of Health, in 1889, took occasion to say in their annual report to the Mayor that it was their opinion the hospital should remain where it is because of its central and accessible loca- The Municipal Hospital 543 tion. The board recognized, however, that there was a growing popular sentiment in favor of its removal, that building improve- ments were rapidly extending out toward the limits of the hospital grounds, and that it would not be long before its removal would be demanded. Therefore, the board felt it would be wise to take some steps towards selecting a suitable site, rather than leave the matter to the chance of some unwise action. This question remained in abeyance until 1893, by which time so strong a sentiment had been created against the continuance of the hospital at its present site that the board felt constrained to take some further action. The board again put itself on record as believing that the hospital is well located, and that under an effi- cient administration the danger of communicating disease from the institution to the surrounding neighborhood is very slight, yet the board recognized that the people desired a change and it must be effected. Consequently, the following preamble and resolution were adopted by the board on January 26, 1893, and transmitted to City Councils: "Whereas, The Municipal Hospital, which was originally intended mainly for the treatment of small-pox, is now the only institution in the city maintained for the reception of contagious and infectious diseases; and, "Whereas, The necessity exists for the provision of several pavilion hospital buildings for the isolation, care and treatment of contagious and infectious diseases, each variety of disease to be isolated in a building by itself; and, "Whereas, The opposition to the continuance of the Munici- pal Hospital at its present location, on account of the rapid increase in population in its vicinity, precludes the idea of making any permanent additions upon the grounds adjoining it ; and, "Whereas, The removal of the Municipal Hospital is contem- plated at an early day ; therefore, "Resolved, That City Councils be, and they are hereby respectfully requested to authorize the appointment by the Mayor of the City, of a commission, which should be empowered to select a site, or sites, 'for at least four pavilion hospital buildings, an administration building, disinfecting chamber, crematory, reception ward, stable, etc., to prepare plans and specifications, advertise for proposals and award contracts therefor, subject to the approval of City Councils, and the making of an appropriation therefor, and 544 Institutions Under Municipal Management when completed to transfer the buildings and property to the Board of Health for their use in the treatment of contagious and infectious diseases, agreeably to Act of Assembly ; said commission to consist of two physicians well versed in preventive medicine, one member of the Board of Health, the physician in charge of the Municipal Hospital and one architect." In accordance with the purport of this resolution an ordinance was adopted in March of the same year by City Councils authorizing the Mayor to appoint a commission to select a site, or sites, and to report to City Councils with their recommendation. Accordingly, the Mayor, Hon. Edwin S. Stuart, appointed as members of this commission, Dr. William H. Ford, Dr. William M. Welch, Mr. John T. Windrim, Dr. Judson Daland and Dr. Joseph E. Clausen. The commission convened and organized by electing William H. Ford, M.D., Chairman and John T. Windrim, Secretary. The commission entered upon the work committed to them with a due sense of the responsibility which it involved. They visited almost every locality in the environs of the city, and, after giving the question careful and deliberate consideration, made a report to his Honor, the Mayor, early in the fall of 1894. 4 It was the opinion of the commission that if a single site must be selected for the hospital, then such site must be centrally located. If this were impossible, then two sites should be chosen at opposite sides of the city. The commission called attention to the fact that Philadelphia is a city of enormous area, and that its population is spread out over miles of territory in many directions. If the hospital were located on one side of the city in a sparsely inhabited neighborhood, such as of necessity would have to be selected, the distance from City Hall would be scarcely less than five or six miles, and every mile away from this center in the opposite direction would increase the risk to the sick in their transportation to the hospital. Hence, the commission felt that for humanity's sake, as well as because of the popular demand, and the safe and satisfactory management of contagious diseases, two distinct and opposite locations would have to be selected if the idea of a central location is to be abandoned. After surveying the question of location in every possible 4 See annual report of the Board of Health for the year 1S94, page 117. The Municipal Hospital 545 light, the commission concluded that the very best solution of the problem was to retain the present site and add to its area from available and vacant land adjoining, and perfect the organization and equipment of the hospital, so as to avoid all objections except those advanced by the property owners in the immediate vicinity, who would be expected, for pecuniary reasons, to urge the removal of the hospital. Attention was directed to the fact that the pre- sent site is easily accessible to the mass of the population, and that viewing the site as a whole it is geographically central. The available land referred to consisted of a triangular plot of about two acres at the southern boundary of the hospital prop- erty, together with about three-quarters of an acre upon which was the Chapel of St. John the Divine. It was the opinion of the commission, emphatically expressed, that with the purchase of this adjoining land the present location would be peculiarly well adapted for hospital purposes for many years to come. Besides the reasons already given in support of this view of the question, the commission pointed out that the present site is bounded on two sides — east and south — by the Pennsylvania connecting railroad, which is separated from the hospital grounds by a broad strip of unimproved land belonging to the Kailroad Company; that beyond the railroad are lumber and coal yards and industrial establishments, the residences being still further distant; that on the north was an open common, part of which was owned by the city, so that it would be easy to provide against the building of residences on this side of the hos- pital; and that it was only on the west side of the hospital grounds that it was possible to erect dwelling houses. In 1898, Dr. George Woodward, then a member of the Board of Health, purchased the church property referred to above, and practically presented it to the hospital. It was, however, stipu- lated in the transaction that if at any time the hospital shall be removed to another locality, the church property reverts to Dr. Woodward. In 1899, the city purchased the vacant land on the southern boundary, as recommended by the commission, and enclosed it, together with the hospital grounds; so that the hospital property at present includes an area of about 12y 2 acres. I feel it should be stated that it was the opinion of some members of the commission, if not all, that small-pox should not 35 546 Institutions Under Municipal Management be treated in the same locality with persons suffering from other diseases. While the present location is admirable for diphtheria and scarlet fever patients, the small-pox patients should be treated in some more distant and less populated part of the city. DIPHTHERIA PAVIUON ERECTED Quite extensive additions were made to the hospital in the year 1893. For a number of years it had been the strong desire of the Board of Health to improve the accommodations at the hospital, not so much with regard to capacity as to the facilities for properly separating the various communicable diseases that are treated therein. Up to this time all cases were, of necessity, placed in the original stone building, as it was the only one on the grounds. The writer has seen as many as seven different infec- tious diseases under treatment in this building at one time. Under such circumstances the danger of intercommunication of diseases was of course very great, and proved a constant source of anxiety to the official head of the hospital. Asiatic cholera had been prevailing in epidemic form for sometime in Hamburg, Germany, and early in 1893 our Board of Health became apprehensive that it might be transported to this country and find its way into our city. Hence, they believed it was wise, not only to make preparations to ward it off, but to treat it should it unfortunately appear in the city. For the latter purpose the Board of Health secured from City Councils in the spring of 1893 an appropriation of $16,000 to erect a temporary frame building one story high on the hospital grounds. Plans and specifications were at once prepared, and the building was completed early in the fall of the same year. Its capacity was about seventy- five beds, having besides a few private rooms for pay patients. It was connected with an annex for cooking, laundry work and the like. Should cholera have threatened the city it was within the power of the Board of Health to have had the building sufficiently advanced for occupancy at short notice. It was their intention, in case the disease should occur and assume considerable propor- tions, to utilize not only this building, but also the general hos- pital for the time being, even to the exclusion of all other patients, so that the entire accommodation for the emergency would have amounted to 300 beds. Fortunately, the cholera did not make its appearance, and when all probability of an outbreak had passed, The Municipal Hospital 547 the building was set apart for the treatment of eases of diphtheria, and has since been continuously used for that purpose. This hospital, built on the pavilion plan, is well lighted, thor- oughly heated and ventilated. It is supplied with all necessary appurtenances and conveniently fitted up for its present use. It was cheaply erected, and is now considerably out of repair. On account of the great increase of diphtheria patients about the time this pavilion was built, it was soon found to be inade- quate to the demands made upon it by this class of cases. This increase was perhaps not on account of greater prevalence of diphtheria in the city, but because there was less difficulty in get- ting patients to make use of the advantages of the hospital, and also, doubtless, for the additional reason that the restrictive meas- ures of the Board of Health were more rigidly enforced. During the year 1896, this diphtheria pavilion was enlarged. With the additions that were made the building could accom- modate 110 patients. There are six large wards and twelve pri- vate rooms for pay patients. The Administration Building, three stories high, contains sixteen rooms for nurses and female servants, a bathroom on each upper floor, and other necessary apartments. In describing this pavilion hospital in the Annual Beport of the Board of Health for 1896, Dr. Ford, who wrote the report, said : "While these buildings are not imposing structures of stone or brick, they are unsurpassed in their practical utility and in advantages for the treatment of patients suffering from diph- theria. The system of heating and ventilation is complete. The drainage and fixtures are of standard construction. The furnish- ing is of the best quality and specially adapted to its use. Con- venience and simplicity have been carefully studied. These pavilions are the largest and among the best adapted for the pur- pose of any similar hospital in the United States." On account of the great interest displayed by Dr. Ford in planning and supervising the erection of this pavilion, Director A. M. Beitler, on the occasion of declaring the building open for the reception of patients, named it "The William H. Ford Pavilion Hospital." TEMPORARY BUILDING FOR SMALL-POX In 1893, a small, though convenient, portable building was purchased and set up on the grounds for the accommodation of sporadic cases of small-pox. Its capacity was only twelve beds. 548 Institutions Under Municipal Management Six years later this gave way to a much larger temporary structure capable of accommodating from sixty-five to seventy-five patients. This building still stands, and is sometimes used, though it is scarcely habitable now. STEAM DISINFECTING PLANT The apparatus for disinfection by means of chemical fumes and dry heat, previously described, was for many reasons unsatis- factory. Early in the year 1893, money was appropriated to con- struct a new disinfecting plant on a larger scale at the hospital grounds. The process of disinfection at this plant is by super- heated steam under pressure. The building is divided into three compartments: First, the receiving room for infected articles is 33 feet 4 inches long, and 26 feet 8 inches wide; second, the dis- infecting chamber, constructed of steel, is 8 feet 1 inch by 8 feet 4 inches and 15 feet long; third, the room for receiving the arti- cles after they have been disinfected, having the same dimensions as the receiving room. The infected articles are loaded on a car 13 feet long and 6 feet 6 inches wide, which is rolled upon a track of steel rails into the chamber where, after the large double steel plate door is tightly closed by clamping bolts, the air is partly exhausted from the chamber and the steam turned on. There is no difficulty whatever in bringing the degree of heat up to 230° to 250° F., which is sufficient for all practical purposes when continued for twenty minutes with a pressure of about twenty pounds. If deemed necessary the temperature may be raised to 270° to 280° F. After the process of disinfection is completed, the large steel door on the opposite side is opened and the car rolled out into the clean room where the articles are unloaded. The car is then returned to the infected end of the plant by means of a track on the outside of the building. Both doors of the chamber are never open at the same time; hence, there is at no time direct communication between the two ends of the building. Not only was this plant of great service at the hospital for the purification of infected bedding and clothing, especially the clothing of patients about to be discharged, but the Board of Health found it to be exceedingly useful as a means of purifying infected articles in private homes and public institutions through- The Municipal Hospital 549 out the city. For many years the board made strenuous efforts to induce the citizens to accept the advantages of this sanitary measure, and in order to popularize the work it was done gratui- tously for the rich and the poor alike. As a result of these efforts the plant was for a long time taxed to its utmost capacity. The responsibility for its manage- ment devolved upon the officers of the hospital, and the cost of carrying on the work was included in the expenses of the hospital. During the period of the most active operations of this plant, it was necessary to keep in the stables at the hospital more than thirty head of horses for ambulance service and for collecting from various parts of the city infected bedding, clothing, etc., for disinfection, and the subsequent delivery of these articles. LODGE HOUSE In 1894, a lodge house was erected at the main entrance to the hospital grounds. This became necessary for the reason that in the last few years the great increase of patients in the institu- tion brought to the entrance gate at all hours of the day a large number of inquiring friends. It was seen that by the employ- ment of a gatekeeper such persons could be kept off the grounds and out of danger of infection. It was evident, too, that by issu- ing passes to the employees who were obliged to pass in and out through the lodge house better discipline could be maintained. STEAM HEAT INTRODUCED In 1898, the old system of heating the main building by hot- air furnaces and stoves was supplanted by the more modern method of steam heating by propulsion, or the forcing of warm air into all apartments by means of rapidly revolving fans. The advantage of this system is that it not only supplies heat to apart- ments which before could not be heated, but also provides better ventilation, or change of air, by constantly forcing into the wards either warm or cool air in large quantity and free from pollution. A central steam heating plant was installed in 1901. This, of course, was designed to supply heat in every building on the grounds. APPOINTMENT OF A PHARMACIST For a long time efforts had been made to secure the appoint- ment of a pharmacist to the hospital; this was brought about July 550 Institutions Under Municipal Management 18, 1898. Up to this time the compounding of medicines was done by the resident physicians. ADDITIONS AND IMPROVEMENTS TO THE HOSPITAL The recent success in obtaining a few of the many pressing needs of the hospital led to greater efforts to secure others, with encouraging results. Certain improvements, which had long been needed in the main building, and to which attention had been fre- quently called, were begun in September, 1898, and completed in the fall of 1899. They consisted in changing the long, open corridors on the south side of each wing of the hospital into sun rooms, erecting a toilet tower in each wing, sanitary in all its appointments. The Solaria have been found to be exceedingly advantageous to all patients, but especially to the convalescents during the cold weather months. They also afford better opportunities for venti- lating the wards. They are warmed by steam radiators, as well as by the heat derived from the sun's rays. The toilet towers were constructed of gray stone, similar to the main building. They are two stories high, so as to accommo- date the wards on both the upper and lower floors. Each tower is 25 x 25 feet, and the height of the ceiling of the lower room is 13 feet, and of the upper room 12 feet. In each toilet room there are two bathrooms and six closets; three of the closets were con- structed for the junior, and three for the senior patients. There is also in each toilet room a slop hopper. The fixtures are open set, and the hopper in each closet is provided with ventilation in accordance with the latest method of sanitary plumbing. The floors are made of brick arches between iron beams and covered with broken pieces of marble about one inch square, laid between strips of marble, and the whole laid in cement. Each room is wainscoted with white Italian marble slabs one inch thick. The bathrooms are enclosed with the same quality of marble on both sides of the partitions, which are capped with heavy strips of marble. This description shows that the toilet rooms are absolutely fireproof, and that it is possible to keep them at all times in a sanitary condition. Of course, in the construction of the towers due regard was paid to ventilation. In the year 1900, the laundry was completely transformed. The Municipal Hospital 551 The old-fashioned washboards and sad-irons were forced to give way to the more modern implements for laundry work. The building was enlarged and fitted up with a steam washer, cen- trifugal wringer, a mangle, and drying room. Steam supplied the power for running the machinery and heating the drying room. In the same year a long shed was built in front of the laun- dry, the stables and the ambulance apartments. This afforded shelter while harnessing and unharnessing the horses. Also, in 1900, a house for the dead was erected — the first one ever built on the hospital grounds. Hitherto all dead bodies were conveyed to an old, dilapidated building in Potter's Field, adjoining the hospital. CLINICAL INSTRUCTION It is noteworthy that in the year 1900, the doors of the Municipal Hospital were thrown open to medical students for clinical instruction in contagious diseases. This new departure was brought about through the Philadel- phia County Medical Society passing a resolution to the effect that the unusual facilities which the hospital afforded for such instruction should be made available to the medical students of this city. A committee was appointed by the society to present the matter to the Mayor, the Director of Public Safety, and the Board of Health. These city authorities approved of the project, and the Board of Health adopted a code of rules governing the attendance of students, as follows: — 1. No discrimination shall be made in favor of or against any medical college in the city. Each college must have equal rights and privileges, according to the number of students who may wish to avail themselves of the opportunity of clinical instruction. 2. The instruction must be limited to either the third or fourth-year class of each college, as the faculty may consider best; and as it is necessary to conduct the teaching in the wards of the hospital, the number of students in attendance at one time shall not exceed ten. 3. The day of the week and the hour apportioned to each col- lege for the attendance of its students must be arranged by the faculty and Dr. Welch, the physician-in-charge of the hospital, who will conduct the teaching. 4. Each college must provide its students with suitable caps 552 Institutions Under Municipal Management and gowns, the latter being sufficiently large to cover all clothing as low down as the shoe tops, and these shall be worn during the visits to the wards. 5. After each visit the gowns must be left in a place which will be designated, and they must be disinfected before they are worn again. This will be attended to by the hospital authorities. 6. Before leaving the hospital each student must carefully wash his hands, face and hair, and observe such other precau- tionary measures as may be deemed necessary by the physician- in-charge. 7. Any student who does not conduct himself with becoming propriety, or disregards the rules of the Board of Health, or of the hospital, shall be excluded from further attendance. 8. Patients who are seriously ill must not be subjected to prolonged examinations. In all such eases it is advisable that the examination should be made only by the clinical demonstrator. 9. On entering the hospital for instruction it must be under- stood that each student assumes the risk of contracting a con- tagious disease. In the event of such an accident the Board of Health or the hospital authorities will not be held responsible. 10. The Board of Health reserves the right to discontinue clinical instruction in the hospital at any time, if it be found detrimental to the patients or prejudicial to the public health. This movement was warmly welcomed by all medical colleges in the city, and each one has sent a large proportion of the more advanced students for clinical instruction. The records show that up to the present time, May, 1909, 2,499 students have taken advan- tage of this opportunity to study contagious diseases at the bedside. The risk that the students assume in taking up this work is not as great as one might suppose. Nor, with proper precautions, does there appear to be much danger of their spreading disease. So far as I know no student has contracted diphtheria. The same is quite true with regard to scarlet fever; though I must say one young man returned to the hospital with the disease eighteen days after he had been there for clinical instruction. If infection occurred at that time the incubation period was greatly prolonged beyond the usual limit. I am, however, much surprised that some of the students do not take scarlet fever, as but few — about one-fifth or one-sixth — of those who attend the clinics are able to say they ever had the disease. The Municipal Hospital 553 The experience of the students with regard to their immunity to small-pox is very interesting. Of course it was understood that the colleges would attend to the vaccination of their students who came to study that disease, and there was every reason to believe that this was in good part faithfully carried out. However, it happened that about two weeks after a section of students from a certain college had visited the hospital for instruction, one of the number returned as a patient with severe small-pox. An examination revealed the fact that the young man was unvacci- nated, and, furthermore, that he had not availed himself of the opportunity to be vaccinated because he did not believe in the prophylactic power of vaccination. This student was the only one unvaccinated out of the large number who came to the hos- pital to study small-pox during the epidemic, and he w£s the only one who fell ill with the disease. He recovered, but bears upon his countenance the marks of his sin of unbelief. The last improvement or addition to the hospital was made in 1901, and it consisted in enlarging the main building in order to provide accommodation for pay patients, and also more comfortable quarters for the nurses. Up to this time there were no private rooms for scarlet fever patients. The best that could be done for a patient in affluent circumstances was to place him in a general ward and surround his bed with screens. This addition was brought about mainly through the efforts of Col. J. Lewis Good, then President of the Board of Health. With the object of supplying this long-felt want, an annex was erected at the east end of the main building and was con- structed of gray stone so as to harmonize with the original struc- ture. It is three stories high, with a basement. The first and second stories each contain five rooms for pay patients. These rooms are quite large, well heated and ventilated, and have high ceilings. They open into a hall 8 feet wide on each floor, and this hall communicates with the sun rooms of the hospital. The third story is within a mansard roof, and contains two bed rooms for nurses, and a store-room. The basement contains a large din- ing-room for the scarlet fever nurses; also a dining-room for the female servants of this department, and a large store-room. Hitherto, the nurses were obliged to dine wherever they could find a vacant place to set their table. While this addition to the hospital was being made, the 554 Institutions Under Municipal Management mansard roof, which covered only one-half of each wing, was extended the full length of the wings. This extension provided twenty additional dormitories for the employees. The dormi- tories of one wing were set apart and specially fitted up for the nurses. Among the important acquisitions to the hospital in 1901, I would mention the appointment of Dr. Jay F. Schamberg as assistant physician. The physician-in-charge asked for the ap- pointment of Dr. Schamberg in order that the pathologic and bacteriologic work of the hospital, heretofore much neglected, might receive the attention it merits. IMPORTANT EPOCH IN THE HISTORY OF THE HOSPITAL The period from 1901 until 1904 marks an important epoch in the history of the hospital. During this period the manage- ment of the hospital was changed, the question of its removal to another locality was definitely determined, and it was forced to meet an extraordinary demand incident to a great epidemic of small-pox. During the latter part of the summer of 1901, small-pox, which had been present in the city from time to time for the past two or three years, began to spread, and the number of cases multiplied so rapidly that it was evident the disease was about to assume an epidemic form. As the accommodation at the hospital for such cases was limited, not permitting of more than seventy- five patients under treatment at one time, it was necessary to take some steps to meet the situation. As there was constantly on hand in the hospital a large num- ber of diphtheria and scarlet fever patients, many of whom were unprotected by vaccination, and as the vicinity of the hospital was becoming quite densely populated, it was deemed wise by the physician-in-charge that provision should be made for the small- pox cases in some other locality. This was brought to the atten- tion of the Department of Public Safety, through the Board of Health, and if was decided to erect temporary barracks for the emergency at Twenty-ninth and Somerset Streets, extending westward as far as Mt. Peace Cemetery. Considerable work had been done in preparing and underdraining the ground, and enclos- ing the plot with a fence, when the citizens of that locality, learning what was contemplated, applied for and obtained from The Municipal Hospital 555 the Court an injunction. Nothing then remained but to increase the accommodations at the hospital by the construction of tem- porary buildings or barracks. An extension was made to the original pavilion already in use, and two other temporary struc- tures — one, 329 feet long, and the other 175 feet long — were speedily constructed, making the entire capacity of the small-pox buildings somewhat over 300 beds for patients. While this work was proceeding there was a large number of small-pox patients on hand, and this number was rapidly increas- ing. The original pavilion was filled, and the overflow occupied tents nearby. As the workmen — fifty to sixty in number — were obliged to come in close proximity to the patients, they were requested, before commencing work, to come to the General Administration Building and get vaccinated. They all complied with this order except two, and these two took small-pox, while the others escaped. In regard to the two workmen who fell ill with small-pox, it is deemed worthy of remark that one was a Christian Scientist, and that he preferred to trust to the teaching of this sect rather than submit to vaccination. Poor fellow! He paid the penalty by death for relying upon a false protection against a disease which respects nothing but vaccination. Later, as the small-pox cases increased, it was found neces- sary to make still further additions to the barracks, and a new set of workmen were employed. For some reason, that was never understood, two of these workmen failed to avail themselves of the opportunity to get vaccinated before entering upon the work, and they both fell ill with small-pox. Here, again, all those who were vaccinated enjoyed complete protection. It should be mentioned that all those who worked on this operation were obliged to come sufficiently near the patients and the infected atmosphere of the wards to insure infection if they were not safeguarded by vaccination. Some of them, especially the plumbers and gasfitters, frequently entered the wards and bathrooms to make repairs to the gas and toilet fixtures. It may be worthy of record that the total number of patients admitted to the hospital in 1901 was greater than in any previous year — the number being 3,186. At the beginning of 1902, the small-pox epidemic appeared to be at its height, and it continued unabated throughout the 556 Institutions Under Municipal Management winter, but commenced to wane during the spring months. The comparatively small number of patients on hand during the sum- mer and fall led to the belief that the epidemic would soon sub- side. We were, however, doomed to disappointment, for in the following year there was a recrudescence of the disease and the epidemic continued two years longer. In 1902, after many years of agitation for the removal of the Municipal Hospital, principally on the part of the residents and property owners in the Twenty-eighth Ward (the present location of the hospital), it was definitely decided that it must go to another locality. A new site, known as the "MacAllister Farm," in the Thirty-third Ward, was found and its purchase authorized. The exact location of this site is between the new Cathedral and Green- niount Cemeteries, and east of the line of Xorth Second Street. It contains 58.251 acres, being sufficiently large to allow of ample separation of the buildings for the various classes of contagious diseases. An Act was passed by the Legislature of Pennsylvania, and approved by the Governor April 8, 1903, supplementary to the Act of June, 1885, known as the "Bullitt Bill." By this Act a new department in the city government was created and designated the Department of Public Health and Charities, under a Director. This Act had the effect of transferring the government of the Municipal Hospital from the Department of Public Safety to this new department. In the work of reorganization it was the pleasure of the direc- tor, Dr. Edward Martin, to make certain changes in the management of the hospital. The changes that were made and the reason there- for were stated by Dr. A. C. Abbott, Chief of the Bureau of Health, in his annual report of 1903, to wit : "After carefully considering conditions at the Municipal Hospital, it was deemed advisable to make certain modifications in the organization of the staff. For a number of years the hospital had been under the direction of Dr. William M. Welch, whose knowledge of contagious disease and conscientious devotion to the work is too well known to require comment at this time. Dr. Welch could not, for a number of reasons, reside in the hospital, and for the best interest of internal discipline it was decided to appoint a physician-in-eharge, who would live permanently in the institution. At the same time arrangements were made whereby the hospital The Municipal Hospital 557 would retain the advantages of Dr. Welch's professional skill and interest in the work. On September 1, 1903, Dr. B. Franklin Boyer was appointed Chief Eesident Physician, to be held account- able for the administration of the hospital, while Dr. Welch acted for a time as ' consultant. By the approval of Councils, and His Honor, the Mayor, Dr. Welch was subsequently made one of the two diagnosticians of the hospital and of the board, a position he now holds with credit to himself and to the great advantage of our service. "Dr. Jay F. Schamberg, who had rendered valuable assistance to the hospital as assistant to Dr. Welch, resigned that position when the new order went into effect (September 1, 1903), but it is a pleasure to state that the City is, from January 1, 1904, to have the benefit of Dr. Schamberg's professional skill, for with Dr. Welch he is now one of the two duly authorized diagnosticians." This new department was more fortunate in obtaining, for the time being, at least, a larger appropriation of money for internal improvements of the hospital than was possible under the Depart- ment of Public Safety. For the small-pox pavilion, screens and window shades were at once provided; greater refrigeration and storage facilities were introduced to preserve the food; the nurses and servants were provided with a separate building wherein their street clothing could be protected against infection; provision was made to sterilize all milk cans before returning them to the dealer, and two comparatively air-tight apartments were constructed wherein the ambulances could be disinfected by means of a steam autoclave rapidly discharging formaldehyde with steam into the apartment. The number of resident physicians has since been increased. Heretofore, except during small-pox epidemics, the hospital was allowed only three residents. At the present time there are three salaried and three non-salaried resident physicians. Under the former regime there was no provision for a clerk or telephone operator. This work was done by the resident physicians and the pharmacist. Now the hospital is supplied with a clerk, and four miscellaneous helpers. Under the latter heading is included an assistant clerk, a stenographer, telephone operator and a messenger. This increase of office force is of great advantage to the hospital and should have been allowed long ago. As there is constantly under treatment a large number of 558 Institutions Under Municipal Management diphtheria and scarlet fever patients, the occurrence of an epidemic of small-pox is sure to greatly increase the census of the hospital. During the recent epidemic (1901-1904), there were frequently on hand at one time 500 patients, and this number was sometimes exceeded. During these four years 11,175 patients were admitted to the hospital; this number is unparalleled in any similar period of the hospital's history. In point of numbers, the year which exceeds all others in the entire experience of the hospital is 1903. During this year 3,204 patients were conveyed to the hospital for treatment, which exceeded 1901 by only 18 patients. The small-pox epidemic of 1901 to 1904 was remarkable in that so large a proportion of the cases in the city drifted to the hos- pital. In view of this fact it is surprising that the epidemic was not more speedily brought under control, as it continued for four years. The total number of cases that occurred was 5,025, with 894 deaths, a death rate of 17.79 per cent. Of this number 4,074 were treated in the hospital, with 803 deaths, a mortality rate of 19.71 per cent. It may be of interest to note that the death rate was much less during the recent epidemic than in the great epidemics which have preceded it. Doubtless the disease was of a milder type. As in all previous epidemics, so in this, the reputation of vaccination was well maintained. The mortality among the unvac- einated was 32.73 per cent, while of the vaccinated patients who showed good marks the mortality was only 3.81 per cent. As strong as this evidence is in support of vaccination, there is still stronger evidence to be found in the fact that no person who had been successfully vaccinated within a period of five years was admitted to the hospital with small-pox. It may be worthy of mention that in the last few years a large number of cases of cerebrospinal meningitis and anthrax were received. The former disease appears to have made its appearance in the city in a pronounced form in the early spring of 1905, and has since been more or less prevalent. Prom 1905 to 1908, inclusive, 163 cases were admitted to the hospital. These cases yielded a mortality rate of 57.57 per cent., which is certainly not high. It may be that the comparatively low death rate is due to the use of Flexner's serum in many of the cases. In regard to the anthrax cases — 19 in all with four deaths — the records of the hospital show no admissions prior to 1905. The Municipal Hospital 559 I have yet to record the last change that was made in the medical management of the hospital. On March 15, 1908, Dr. Eoyer resigned the position of chief resident physician, and, on April 1st, Dr. Samuel S. Woody was appointed his successor. In concluding this historical sketch of the Municipal Hospital, I feel it can be safely said that the institution has thoroughly ful- filled its mission as a place for the isolation and treatment- of con- tagious and infectious diseases. With the exception of bubonic plague, it would be difficult to mention a communicable disease that has not been treated in this hospital. Following the example set by Dr. Bell, with the same object in view, I have had Joseph J. Griffin, clerk of the hospital, prepare a table, giving a synopsis of the work of the hospital since it was erected at its present site, in 1865. (See page 560.) No history of this hospital would be complete that did not contain some reference to the long and faithful service of an old and trustworthy employee, George Oldham. "Uncle George," as he is now familiarly called, was appointed to the position of gard- ener on April 4, 1870. During his long connection with the hos- pital, to which he has ever been loyal and true, he has cheerfully served in almost every capacity from nurse to gravedigger. Even now as general utility man his services are invaluable. THE NEW PHILADELPHIA HOSPITAL FOR CONTAGIOUS DISEASES The hospital is located in the Thirty-third Ward of the City of Philadelphia, on a plot of ground containing 58.251 acres, and generally known as the "MacAllister Farm." It is bounded on the north by Hunting Park Avenue, on the south by Luzerne Street and Nicetown Lane, on the east by C Street and farmlands, and on the west by Second Street. There are two level plateaus — one at the northwest and the other at the southeast corners of the property, which together, represent about one-half of its area. The property is bisected by a well-wooded ravine running diagonally from northeast to southwest. The northern plateau is occupied by a group of modern buildings, consisting of an administration building, storehouse, nurses' home, exit building, refectory building, private ward building, four public ward build- ings and a receiving and observation ward building, for which Wilson, Harris & Eiehards were the architects. All of these buildings are connected by an open corridor. These buildings, 560 Institutions Under Municipal Management para io • eoeM co CM - - IN :'- ">J« - - CM rtNOJM - - ■ toco-* CO »H tO i-H CM tOCO i-H S to to CO en S33B3SKI I31U0 W K en .H 25 CM CMi rH ^H C0NVTl— • ^H HCJMlNHHH CO f-f Tft eo para f-tr-lCM ■ •«" XEiinay cm -weo ' en para : w :** : : :"* eo AsoidaT -CN rf •CO (H • ■ jH i-H i en j para 2J rt o BJ9JOII0 iC w to para CM ■ N m J8A3J aionai CO CO CM " : cn para - 1 rt ^ '•rHrH - 1 ■NHH • -0C r- i>t*-CM CM •snaaajn •S'O : rt ' H CM rH *.-tcM " ■CMtHt-1 ■ -c CifliOtO to •MrtOrt rH i-t CM pa'd :" ■ CN M rt :^ ^ 00 I8A3J smqdA'i , • o ^CM ^ t- rtr-. ^ • meoco •r-t'[>-05tOlOOtOr«l>COMCMCQ O CO CO iaAa.ii H3IJB0S ■TfCMiH C*OONHWWC v t(0'*Wt»iOO)(OC»HINW0500»WWQOQ^'(DlOOTtOOO>tOW01 • HHHHlN00»(0«0HtO00t"»Ol0fOlO CM a en para : ;- -:- :- ■"■ 'i-HCM '.** HHHcoi~-oi^Hco'^"iocototo r HCNCCrHtOOtOOJCNt>tOCOOCQ-«'COCOtOin MCN^I^COCMCMCOCOOOtOt>r^CnCMCMtO o o en para r-iCN 3555 h«« . CM CM to CM CO .-f ' HOTOlOH ■ CM •CO ■ w -* • USOH '• '• '. 1-tCO • • • • .th eotocR ■ -tOOS tHCO ; ;HH(NH eo xoa -Iltmig CO tO iO i* to to t» © to tO 00 CM CO i-H •«• O 00 i-l to Oi CM lO to >-l eo ■ Ol "* T* HHCllOOSH^tDO) QPi-H-WtrHCO O r-l CM rH CM CO O CM CM CM i-icoeor-to • -r-o i-» COOOfH • ■ O CM • • r JNt-MOffl H 4 OiO tP QO 00 JB3J « ■; (o t- 2 tO 'X Occa 00 c 8S 3 r DO - r- Id "5 a H U - 1 DC 3« 3 r -r 33 -00 - 1- DcO CT. C CO c 3 a 3 Ci H C DO 1 3 JO 33 St 33 !S to r Co a coo - a 30 3? i-H CM CO-> ■■■■ SS 3tor*ccc » Cn Cn Cn C »OHC 30 oc •^ c 3 C 3 - 5C fir |1 3 r -O0 5 O as The Municipal Hospital 561 exclusive of the administration and storehouse buildings, are for the accommodation of scarlet fever patients. It is contemplated in the near future to erect at the east of the administration and storehouse buildings a group of buildings similar in type and design of construction for the accommodation of diphtheria patients. To the south of the observation building are six build- ings intended for isolation. The same number are contemplated in connection with the diphtheria group. On the southeastern plateau is the building originally designed for small-pox patients, but which will be used for the treatment of diphtheria patients until the diphtheria group mentioned is completed, after which this building will be used for measles patients. To the south of the scarlet fever group lie the power plant, laundry, employees kitchen and dining-room buildings, and garage and stables. Philip H. Johnson was the architect for these buildings, as well as the building to be used for measles. The cost of the hospital has been as follows : — Ground $116,000.00 Scarlet Fever group, including Storehouse and Administration Building 679,382.00 Laundry, complete 77,200.00 Stable and Garage 41,000.00 Dining-room and Kitchen for help 18,500.00 Power House, original cost 117,700.00 Completing Power House, additional machinery, boilers, sewers, drainage, etc., estimated 42,580.00 Coal Pocket 4,730.00 Measles Building, original cost 142,700.00 To finish same — build exit building, grade and sod. 74,645.00 Duct from Power House to Scarlet Fever group.. . . 32,467.00 « « " " Measles Building 38,362.50 « " " " Laundry B'ding group. 7,500.00 Isolation Buildings =H!o'?o Architects' commission not included in above „t'Lknr.n, Equipment, estimated • 75,000.00 Total $1,583,800.60 The cost to complete the institution is estimated:— Diphtheria g.rou P of buildings $600 000.00 Isolation Building ■ • • • • • • ■ • ■ • ' nn Gate Houses, Mortuary, Laboratory and Chapel. . . 4°,0UU.uu Grading, sodding, planting, etc 10,000.00 WallS , f, QQQ QQ Additional grounds os'nnoOO Sewage Disposal Plant *n nnnOO Water Stand Pipe and Pump ?'o0000 Siding Total $839,000.00 '"'"' 36 562 Institutions Under Municipal Management 1909. Mayor of Philadelphia, Hon. John E. Keyburn. Director Department of Public Health and Charities, Joseph S. Neff, M.D. Assistant Director Department of Public Health and Chari- ties, Joseph L. Baldwin. Chief of the Bureau of Health, Alexander C. Abbott, M.D. Chief Medical Inspector, Andrew A. Cairns, M.D. Diagnostician, William M. Welch, M.D. Assistant Diagnostician, Jay P. Schamberg, M.D. Chief Besident Physician, Samuel S. Woody, M.D. Superintendent, J. William Morgan. Architects, Philip H. Johnson and Wilson, Harris & Bichards. The Development of Public Health Work in Philadelphia By A. C. ABBOTT, M.D.. Sc.D. THE beginning of organized effort toward the protection of the public health in Philadelphia may be said to date from the passage of an Act by the Colonial Assembly in the year 1794, and to have been made necessary through the terrible experience incidental to the outbreak of yellow fever that occurred in the city in the preceding summer and autumn. Public health questions had received attention, however, at odd times prior to that date. At the session of the Assembly in 1774, a bill was passed that aimed to prevent the introduction of infectious diseases into the Province by appointing a "Keeper" of Hospitals on Province Island, and by directing the inspection, cleaning and detention of all incoming vessels. It further provided for the removal to the hospital and the treatment of all sick found on incoming ships. The cleaning of the vessel and the care of the sick were to be charged against the consignee. Still earlier in the days of the colony, the records show irregular and intermittent consideration of questions properly relating to the public health. For instance — at the time the colony was founded, doctors were indispensable, since in addition to colds, consumption and "constant malarial disorders," the Province was visited by three or four severe epidemics: one of a fatal influenza, another of a pleurisy, and in 1699, a plague of yellow fever, while small-pox was a "regular and terrible visitor." In 1701, the City Charter directs that the Mayor, Recorder and Alderman .... are to hold a Court of Eecord quar- terly They are to abate nuisances They are to appoint a market clerk, who shall have the assize of bread, wine, beer, etc. The Sheriff shall act as water bailiff on the Delaware. The Grand Jury, in 1702, found that butchers were killing daily in the streets, and allowing blood, dung and "gargdish" to accumulate', to the hurt of the health of the inhabitants. "Multi- tudes of dogges needlessly kept in the city cause great damage to the inhabitants by the great loss of sleep." (563) 564 Institutions Under Municipal Management In 1704, Common Councils took up the question of forbidding the boiling of tar and heating of pitch on the wharf, or within twenty feet of a building, both because of the nuisance arising therefrom and the danger of fire. In 1712, Councils, by ordinance, obliged owners to pave in front of their tenements. In 1714, Councils took steps to encourage the erection of pumps by permitting the person putting in the pump to charge water rent to his neighbors, provided he kept the pump in repair. In 1718, by ordinance of Common Councils, Thomas Kedman was appointed Inspector of Water Courses. At the same time the pump of Benjamin Morgan and Edward Church, in the middle of Front Street, opposite Ewers' Alley, was strongly condemned as "being now, as it always has been, a public and common nuisance." In 1719, we find the first steps taken toward the organization of quarantine. The Governor appointed Patrick Baird, Chirur- geon of Philadelphia, Health Officer, and directed him to board all incoming vessels, and ascertain the condition of those on board. This move was deemed necessary because of the great increase of immigration. By Act of Assembly, in 1721, butchers were forbidden to slaughter animals in the streets or market stalls. In 1729, the community was greatly excited over the arrival of an immigrant ship, having many passengers ill of a malignant disease, probably ship fever. The ship "Dorothy" was boarded by the authorities and forbidden to come within a mile of the city, or to land goods or passengers, until the Sheriff selected some safe place on shore for the sick. The location selected was the "Blue House Tavern" at Tenth and South Streets. All sick were taken there and kept under quarantine until the ship was cleaned and disinfected. The statistics for the following year (1730) reveal the fact that Philadelphia had assumed some, at least, of the characteristics of a city: 171 vessels cleared; 161 entered port; 622 votes were cast at election, and 227 deaths weTe recorded. In 1738, the Grand Jury declared Front, Sassafras and High Streets impassable, and ordered them underdrained and paved, directing that the underdraining be "by arched culverts." In 1739, sanitary questions were conspicuously before the citizens. An effort was made to remove from the heart of the Public Health Work in Philadelphia 565 city slaughter houses, tanyards, limepits and skinners' yards, the offal of which polluted the dock, on the margin of which it was customary to deposit it. This move was defeated by the tradesmen, who rejoiced at their success in frustrating "such a daring attempt on the liberties of the tradesmen of Philadelphia." The year 1741 was one of distress. There was a serious epi- demic of yellow fever, causing 785 deaths. Efforts to check it and to maintain quarantine were obstructed by a quarrel between the Governor and the Assembly. A bitter controversy arose as to the origin of the fever, some insisting that it developed from local causes; others that it was imported. In the meantime, the epidemic continued unabated. Because of the large number of immigrants from the Palatinate, who suffered from the disease (206 in all), it was called "Palatine Fever." The quarantine arrangements were pronounced defective, and Health Officer Graeme's bill for twenty years' service was refused payment, because he was adjudged "derelict in his duties." His suspension caused another political squabble. When harmony was finally established, a petition was presented by the German citizens pray- ing for the institution of a pest house. A committee of the house, in consequence, selected a low lying island, of 342 acres in extent, on the west side of the Schuylkill, near its mouth, known as Province Island, as a site for the pest house. The cost, with buildings and negro slaves belonging to it, was 1,700 pounds sterling. The buildings and six acres of land surrounding them were given over to hospital purposes. The Governor or any two Justices of the Peace were author- ized to send any sick immigrant to the island, and collect all cost incidental to his care from the owners of the vessel that brought him. The patient was not permitted to leave the island without a permit, and any one harboring him, if he escaped, was liable to a fine. Between 1742-44, there was considerable municipal activity in the way of paving and otherwise improving the streets. In 1744, the population is estimated as 13,000, and the number of houses as 1,500. In 1746, the city experienced a severe epidemic of "angina maligna" or "putrid sore throat" (now known as diphtheria). The disease existed at the same time in New York and New Jer- sey, and its widespread was attributed to atmospheric influences. 566 Institutions Under Municipal Management In 1747, another outbreak of yellow fever led the inhabitants to believe it due to the vile conditions of the dock and the swamps along Dock Creek, between Budd's building and Society Hill. Councils appointed a committee to abate the nuisance. In the following year the committee presented a plan for making the desired improvements, but it was rejected as too costly. In 1744, the Trustees of Province Island were authorized to spend 1,000 pounds sterling in the erection of pest houses on the island for the reception of all visitors to the Province, who might be suffering from pestilential diseases. In the same year, the ships from the Palatinate brought numerous immigrants suffer- ing from eruptive fevers. These were treated on the island under tents and other temporary shelters. In the same year, Dr. Benjamin Push and other prominent men of the city advocated that the marshes along Dock Street, near Spruce Street, be filled in as a precaution against malarial fever. In 1750, the Grand Jury censured the authorities because of "the extreme dirtiness of the streets, not only for want of pave- ment in some places, but through the disorderly practice of throw- ing out all manner of dirt and filth .... whereby the streets that have been regulated at public expense are rendered exceedingly deep and miry in wet weather." The Mayor issued his proclamation against these practices, complaining that water courses were being rilled up with dirt; hatters were casting felts, tails and offal into the kennels, and shoemakers were littering the sidewalks with ends, scraps, etc. The proclamation had no effect, and, in consequence, an appeal was made to the Assembly. In 1754, pestilence again broke out in the town; this time, probably typhus fever. There were, in all, 253 fatalities. The disease was believed to have been introduced by the filthy immi- grant ships. In consequence, a bill was introduced aiming to ameliorate conditions by placing restrictions upon the immigrant trade. It failed to become a law. In 1756, small-pox broke out and affected practically all except the "inoculated." It was especially severe among the Indians. As the condition of Dock Creek had grown from bad to worse, and as it was being used as a depository for all sorts of filth, carrion and refuse, the Assembly, in 1763, recommended that it to be cleaned out, boarded up and secured against con- tinuing a nuisance. Public Health Work in Philadelphia 567 In 1765, owing to the growth of manufactures, a commission was appointed to devise a plan for the regular removal of garbage and refuse. In 1793, there occurred the most devastating outbreak of yellow fever that has ever been seen in a city of the Middle States. Without doubt, that was the most disastrous year in the history of the city, and the tragic experiences of the people stimulated them to take measures to prevent a repetition. In July of this year, there were landed in Philadelphia, 750 refugees from San Domingo. Four weeks later, yellow fever appeared. The inhabi- tants did not, however, connect the two events, but believed the disease to have arisen from putrid refuse that had been lying for a time on the wharves near Mulberry Street. The first cases occurred in the Kensington District, though the epidemic was practically confined to four squares north and south of Pine Street, and between Fourth Street and the Delaware. During the first and second weeks of August, there were respectively nine and seven deaths daily. By the third week, there was scarcely a family that was without a member sick or who had not lost a member by death. Dr. Rush states that at one time there were 6,000 citizens sick of the disease, and only three physicians avail- able. The streets were black with funerals and bells were tolled incessantly. The highways were so filthy that the Mayor ordered them cleaned, and on open lots and by-places, it was a common sight to see the carcasses of dead horses, hogs and cattle, fester- ing in the burning sun. The unexpected advent of the disease; lack of knowledge of its origin; its rapid and insidious spread, threw the inhabitants into a panic. Fear was depicted on every face and hopeless apathy prevailed. All roads leading from the city were crowded with families fleeing with their belongings to the country and the suburban places of safety. The citizens were alarmed to a degree of imbecility. Bells tolled incessantly; fires were kindled everywhere to purify the air; cases of the disease were concealed and all normal pursuits were at a standstill. The College of Physicians undertook to calm matters by publishing advice. It was recommended to discontinue tolling the bells; citizens were advised to keep out of the sun and lead sober lives; all funerals should be held quietly; no cases should be concealed; no bonfires should be started, but instead, gunpowder should be burned. As a result, every one who could secure a gun did so, 568 Institutions Under Municipal Management and the firing was incessant from morning to night. Instead of funerals, the dead were lowered out of windows at night and trundled to the burying ground either on shafts or wheeled chaises, or carried on stretchers. The bedlam caused by the con- tinuous firing of guns was worse for the sick than the tolling of the bells. The doctors ordered it stopped and recommended the burning of nitre. It did no appreciable good. Everything any one might suggest was tried. Tobacco and snufE were burned; garlic was chewed, and worn about the neck, in the shoes or in the pockets; and the same use was made of camphor and other aromatic substances. A story was circulated that during the plague in Marseilles, four thieves were able to pursue their nefarious practices by sprinkling their clothing with a certain preparation of vinegar. Instantly, every druggist in the city started in to prepare "thieves' vinegar," and at once, the demand far exceeded the supply. So general was the belief in the con- tagiousness of the disease, that acquaintances meeting on the street would but nod to each other, or would take opposite sides of the street to avoid coming in close contact. Business was at a standstill and the poor were, therefore, in desperate straits. They endeavored to forget their plight by indulgence in riotous living. They were swept away by scores; often as many as five or six being found dead in a single house, and none dared enter to remove the bodies. The criminal classes plundered with impunity. (In the midst of all this, there was a circus in town!) At the height of this distress, ten citizens volunteered their services as nurses; the bank of North America advanced $1,500 for the relief of suffering; and the Guardians of the Poor seized upon the residence of William Hamilton at Bush Hill 1 and con- verted it into a hospital. At first, it was so badly managed that it became notorious. Our distinguished citizen, Stephen Girard, offered his services and became Superintendent of the Hospital, with Peter Helm (or Hilm) as Assistant. This beneficent scheme went far to bring order out of chaos. The nurses and attendants who had been l Bush Hill Estate extended approximately from Vine Street to Fair- mount Avenue, and from Twelfth to Nineteenth Street; though when the City sold the City Hospital in 1857, the property is described as bounded by Nineteenth and Coats, Wallace and Twentieth Streets. Public Health Work in Philadelphia 569 employed were of the lowest classes. For a time the place was little better than a brothel. So bad had been its reputation that many citizens, terrified at the thought of being taken there, locked themselves in their houses until relieved of their sufferings by death, while others crept away to hide and die unattended in out of the way places. Notions of disinfection were crude. Some citizens burned all their clothes, bedding and furniture; others threw everything into the Delaware ; others smoked them by burning aromatic sub- stances. Dr. Eush used soap and water, and exposed his belong- ings on the ground to the action of the air and sun. Whitewash- ing and painting was done by everyone who could do it. Escape from the city at the height of the epidemic became almost impossible, as all places on the coast and in the interior maintained a rigid quarantine against Philadelphia. Before this, it is estimated that two-thirds of the inhabitants had fled. During the months of September and October the heat was excessive, reaching as high as 119° P. on October 11th. By the end of November the epidemic began to abate, and with the advent of cold weather disappeared. In four months there had been 4,044 deaths, out of a population of about 40,000, and the burying ground is said to have resembled a newly-ploughed field. It is not surprising that vigorous steps were taken to safe- guard the community against a repetition of such an experience. In consequence, at the session of the Assembly in 1794, the bill was passed that is mentioned in the opening paragraph of this sketch. It provided for the appointment of a resident Lazaretto physician; a consulting physician; a health officer, and a Board of Health, the latter to be composed of citizens of Philadelphia and the outlying liberties, and authorized to make rules and reg- ulations for the conduct of the work of quarantine. The framers of the Act assumed that yellow fever, in 1793, had been imported; that it was contagious; and that local condi- tions had little or nothing to do with the epidemic. In conse- quence, the Act relates very largely to maritime quarantine, though in one section it gives to the Mayor, Becorder, ten Alder- men and County Commissioners power to secure a site and erect thereon and equip a public hospital for contagious diseases for the accommodation of the citizens of Philadelphia and the outlying liberties. 572 Institutions Under Municipal Management a physician or surgeon, the written statement was to be made and signed by a member of the family. No sexton or other person having charge of a cemetery or vault was permitted to bury or receive a dead body without its having been accompanied by such a note in writing. On the Saturday of each week the sexton was to deliver to the health officer a list of all interments, together with particulars given in the certificate of death. Failure on the part of a sexton to carry out this law was punishable by a fine of $25. None of the essential features of this Act have been repealed. In many respects it has been strengthened and broadened, either by amendments or by additional Acts, bearing upon special phases of the subject. It stands as the foundation work for the subse- quent development of organized preventive medicine in the city of Philadelphia. In 1820, yellow fever again made its appearance in a partic- ularly malignant form. The first case occurred on Water Street, near Walnut Street, in the month of May. New cases continued to develop until late in September. There were in all 103 cases, with 63 deaths. The malignancy of the disease so alarmed the health authorities that most drastic measures were taken to pre- vent its spread. Water Street was fenced off from Tun Alley to Eose's Wharf, and all shipping was ordered away from that sec- tion. Subsequently, several parallel and cross streets and alleys in the vicinity were similarly isolated by fences. All the inhabi- tants of the fenced off streets were removed from their homes, and were only allowed to return to them by special permission of the board. Notwithstanding the fact that vaccination against small-pox had been introduced into the colonies by Waterhouse, as early as 1801, it had not been generally adopted, and the old practice of inoculation, introduced in 1731, continued up to 1821, when, by Act of Assembly, it was declared a misdemeanor punishable by heavy fine "to convey the infection of small-pox by inoculation," and by the same Act, the Board of Health was invested with authority to make such general rules, orders or regulations for the preservation of the district from the contagion of small-pox, as they already possess in relation to other contagious diseases dangerous to the health of the community. The passage of this bill makes mani- fest two important facts : That small-pox was no longer regarded Public Health Work in Philadelphia 573 by the citizens as a plague against which precautionary measures were useless; and that inoculation, as practiced, was found to be more often instrumental in starting than in checking outbreaks of the disease. Until 1860, public vaccination was but imperfectly done. In that year it was taken up by the Board of Health, and until 1904 was performed by a corps of district vaccine physicians under direction of the Board of Health, who received from the city a fee for each successful operation performed. In 1904, the corps of vaccine physicians was abolished, and their functions assigned to the newly-organized corps of salaried medical inspectors, as a part of their regular day's work, a change that was not only of economic importance to the city, but which enabled the authorities to better systematize the work. People of to-day, enjoying the beneficent results of vaccina- tion against small-pox, cannot realize the almost constant and widespread prevalence of the loathsome malady in olden times. In the early days of the colony, disfigurement from small-pox was one of the commonest sights; high and low, rich and poor were alike affected, or expected sooner or later to be so. According to the records, small-pox was almost constantly present to greater or less extent during the eighteenth century, and between the years 1807 and 1907, there were only nineteen years in which the city was free from it, this too, in spite of the fact that the pro- tective value of vaccination had been known since its introduction in 1801. But the reason is obvious: with the abatement of an epidemic, the terror subsides and carelessness of safeguards takes its place. A generation or two of unvaccinated or imperfectly vaccinated people develop. These are the fuel that awaits the spark. The growing city required public water works. These were begun in 1799 by the building of a power house on the Schuylkill Biver below Market Street, and the erection of a receiving foun- tain in Center Square, the site now occupied by the Public Build- ings. In 1818, the first pumps were installed at Pairmount, and by Act of Assembly of 1828, and of 1832, it was made a mis- demeanor punishable by fine to pollute in any manner whatever the water of either the head race, the river (at specified points), or the water stored in the reservoirs in Pairmount. In 1848, the Committee on Public Hygiene of the American 574 Institutions Under Municipal Management Medical Association reported that in its investigations in Phila- delphia, it was impossible to discover the number of houses con- nected with the city water supply, but that it found about 3,500 families dependent for their water on public hydrants and pumps placed along the principal highways. It found the number of baths in private houses on the Fairmount system to be 3,521, and the number of tenants who paid water rent to be 15,205, so "that the habit of bathing was confined to a comparatively small num- ber." In houses being erected at about the time of the investi- gation (1848) bathing facilities were being installed, and the public were, in general, coming to regard a bathroom as a modern necessity. Until the consolidation, in 1854, the districts of Northern Liberties, Spring Garden and Kensington all owned and operated their own water works. The survey plan of March 15, 1809, reveals the existence of several sewers, notably — those on Pine Street, from Broad to the Schuylkill; on Walnut Street, from Third to Tenth Street; on Twelfth Street, between Spruce and Cedar (South) Streets; on South Street, from Eleventh to Thirteenth Street, and some other short trunks. They had their outlets into the rivers either by way of the creek courses or by culverts following the lines of the same. On July 15, 1809, Councils, by ordinance, directed a sur- vey preparatory to the establishment of a general sewage system. In 1854, when the consolidation of the city and the outlying liberties took place, Philadelphia had already a fair sewage sys- tem in course of development. It was, however, merely designed to carry off surface drainage. In all, there were between "eleven and twelve miles of completed sewers in the city proper, and about fifteen miles in the outlying liberties. Some of the sewers were as much as ten feet in diameter. Coincident with the consolida- tion, there was an extension of the system, but it was not until 1884 that a systematic record of the details was kept. The first intercepting sewer was constructed in 1884. Its object was to prevent the pollution of the Schuylkill Kiver within the city limits, by intercepting sewage that would otherwise drain into it above Fairmount Dam. Since that time, it has been vig- orously extended, so that at the present a vast area of the Schuyl- kill Eiver drainage basin, within the city limits, has been provided with intercepting branch drains or sewers. Public Health Work in Philadelphia 575 At the present time, there are about 1,100 miles of sewers in the city. Between 1855 and 1865, the Board of Health was greatly exercised over certain abuses that had grown out of an ordinance passed by Councils on May 3, 1855, "providing for the granting of permits to make openings into the common sewers." As a result of that ordinance, the board claimed that the public sewers were being converted into elongated cess-pools, which, with their putrid contents and noxious gases, would certainly become a nuisance prejudicial to the public health. The attention of Coun- cils was repeatedly directed to "the filthy condition of the public docks, sewers and inlets" arising from the improper use of the sewers, and they were warned by the board of the evil influences that the condition would have upon the health of the people, and the enormous expense that would ultimately be involved in abat- ing the nuisance if allowed to continue. Councils apparently paid no attention to the reiterations and expostulations of the board. Early in 1864, the Department of Surveys took up the ques- tion of abolishing privy wells altogether, and in lieu thereof, adopting a system of connecting water closets and water privies with the sewers. The Board of Health objected, on the grounds that the supply of water available was not sufficient to insure adequate flushing of the drains and sewers; that there would be an accumulation of putrescible matter in the docks at the outfall of the sewers; and that because of these defects, the sewerage system, if so used, would become a serious menace to the public health and comfort. The reasons for this attitude of the board are somewhat obscure in view of the fact that on April 27, 1853 (minutes of the board), it had resolved: "That it be recommended to City Councils and the municipal authorities of the county to provide by ordinance for a general system of tubular drainage or sewerage, and ventilation in the construction of all new buildings, whereby the fecal and other refuse matters of the population may be dis- posed of, and as far as practicable, that all existing cess-pools or privies may be abandoned or obviated in future." The ultimate outcome of this controversy, however, is the general improvement in the manner of construction, and the capacity of the sewers ; the increase of water supplied to the City ; the more general adoption of water closets of improved type; the 576 Institutions Under Municipal Management prohibition of connecting privy wells directly with sewers; the prohibition of sinking privy wells on any property where a sewer is accessible, and the prohibition of adopting any system of house drainage that has not been submitted to and approved by the health authorities. From the early days, the question of disposing of human excre- ment was constantly before the Board, and the "Poudrette Com- mittee," to which all such questions were referred, is one of the most active in its early deliberations. The final systematization and control of the matter was made possible by an act of Assembly, passed April 4, 1876, requiring all privy cleaners to be licensed, and requiring them to obtain a formal permit from the board before any work could be done. The material removed from the privies by the cleaners was by law to be deposited in "poudrette pits," located in the various districts and controlled by the Board. It is not sur- prising that these pits appear, from the early minutes of the board, to have been a constant source of trouble and annoyance. For years, it was the custom of the board to pay a fee to all persons giving information that would lead to the detection of persons cleaning privies without the board's knowledge. In 1852, the board made a contract with A. Payson for clean- ing all cess-pools within its jurisdiction for $1,000 per annum, payable quarterly. From the minutes of the board it appears that great trouble was experienced in having the contract carried out with satisfaction to both parties. In 1860, one Inspector of Privy Cleaning was appointed to be under the orders of the "Poudrette Committee." In 1889, another was appointed. This corps has never exceeded two. Its present duties are the inspection of the apparatus of privy cleaners, and with the progress that is being made in house construction, it is hoped that, ultimately, this necessity will disappear. In the early records of the colonies, attention to nuisances in general is frequently drawn, and from time to time those in authority attempted, but with indifferent success, to abate them. It was not until 1818 that formal authority was given to an official body to seriously consider this question that is of so much impor- tance to the public health. The law enacted that year, together with supplements in 1830 and in 1866 gave to the Board of Health power to enter upon private property in search for nuisances, and to abate such nuisances at the expense of the owner on whose prop- Public Health Work in Philadelphia 577 erty it was found. In 1849, by Act of Assembly, it was made illegal for anyone to maintain a nuisance by the keeping of hogs or other animals within the jurisdiction of the Board of Health, and authorized the board to destroy the pens, seize the animals, and turn them over to the Guardians of the Poor for the use of the poor. In 1866, the power of the Board of Health in the matter of removing nuisances was made to cover all properties situated in any public highway in the City of Philadelphia, and all Acts inconsistent therewith were repealed. Between 1855 and 1860, current literature gives evidence of a general interest in municipal sanitation. Of special importance is the account of the Quarantine and Sanitary Convention, held in Baltimore, in 1858, at which the Philadelphia Board of Health was ably represented by Dr. John Bell, physician to the Municipal Hospital. The subjects debated indicate an intelligent appreciation of the needs of the times. Dr. Bell reported on the value of systematic registration of births, deaths and marriages; the use of disin- fectants in sanitary work; the importance to the public health of pure water and proper disposal of sewage ; and the economic importance of the sanitary control of cities. In the matter of vital statistics, so essential to the correct operation of a health department, Philadelphia has witnessed an interesting evolution. The earliest accounts of births and deaths are those obtainable from church and cemetery records. These are of necessity incomplete and fragmentary. Death records as far back as 1740 are obtainable. From 1789 to 1807, both birth and death records are filled from the books of the Associated Churches of Christ Church and St. Peter's Church. By order of the Board of Health, all deaths were published annually by the health officers between the years 1806 and 1860, and from 1837 to 1860, there was, in addition, a monthly statement of deaths of adults and of children published. When possible, there was likewise published a weekly statement of deaths and births. This was, however, irregular, because of the difficulty in securing accurate data. There was no uniformity of nomenclature or classification, hence, in the early records many queer things are mentioned. For instance : — The records of 1824 give five deaths from "decay" and one from "drinking cold water." Those for 1837 give five deaths from "starvation"; one from "old age," a woman between 50 and 578 Institutions Under Municipal Management 60; and one death from "teething" in a person over 50 years of ao-e. To-day, equally ludicrous reports are occasionally offered, but are not accepted. With the passage of the Registration Act in 1860, compelling the prompt and accurate reporting of all deaths and births, there began the systematic compilation of vital statistics for Philadel- phia, which has developed to a point of accuracy and value that is not exceeded by the records of any other progressive municipality. Since the passage of that act the system has undergone many modifications to meet the demands of our local and national growth; the most important being the adoption of a system of nomenclature and classification in conformity with that in use by the Federal Government, whereby the figures for Philadelphia may be con- veniently compared with those of the central government, and those of other municipalities employing the same system. Since 1873, the Board of Health has published a weekly bulletin, setting forth not only the morbidity and mortality fignies, but giving such statistical and sanitary data as may be of use to all interested in following the progress of the work. There is no record of a specially constructed and organized hospital for contagious diseases within the city, until 1810, when one was erected for the purpose on Bush Hill, 2 where it remained until 1855. In the early days it was customary to send cases of contagious diseases to farm houses for isolation. The residence and outbuildings on the Bush Hill property had been used for the care of yellow fever cases in 17P.T. In 1704, the board used Fish Tavern, on the west side of Market Street Bridge, as a hospital, and in 1796-97, the Wigwam Tavern, at Eace Street and the Schuylkill, was employed for the same purpose. It was known as the "Wigwam Hospital." In 1805, complaints against the hospital were lodged by the citizens, and it was subsequently removed to a spot on the Wissahickon, near the present intersection of Bidge Avenue and Wallace Streets. From this location, it was in turn removed, because of the protest of the citizens. For a time, the city had no hospital for epidemic diseases, and the citizens insisted that such a hospital should be far removed from the populous center. During an outbreak of small-pox, cases had been isolated in a rented house located at Ninth and South Streets. 2 For location of Bush Hill see footnote to pa<*e 568. Public Health Work in Philadelphia 579 From 1855, when Bush Hill was abandoned, to 1865, the city was again without an isolation hospital, if we except a house, temporarily rented, on Islington Lane for the care of small-pox cases. During most of that interval all patients sick of contagious diseases were transported to the Lazaretto, 12 miles away, the journey causing much suffering. This lapse in the continuity of hospital service was in large part due to the indecision of the Board of Health, which, in 1860, declared that hospital facilities other than those possessed by the Lazaretto were unnecessary. In the year following, however, the appearance of small-pox, together with measles, typhoid, and other febrile conditions among soldiers returning from the war, led City Councils to request the Board of Health to declare a permanent and commodious hospital for the accommodation of persons suffer- ing from contagious diseases to be a necessity for so large a city as Philadelphia. The board, by resolution, made the declaration with the result, that in 1865 the present Municipal Hospital, located at Twenty-second Street and Lehigh Avenue, was formally turned over, furnished and ready for occupancy. Since that time it has been in continuous use for the treatment of epidemic diseases. When constructed, it was well away from populous centers, and of sufficient size for all the demands. With the growth of the city, its location became objectionable, and its size too small for the needs. In consequence, there was purchased in 1902, a lot of 58 acres in extent, the MacAllister Farm, located in the Thirty-third Ward, on which is being erected a group of buildings, which, when finished, will be second to none in existence, for the care and treat- ment of persons suffering from those transmissible diseases requir- ing isolation for the safety of the public. Though the Act of 1818 required the reporting of contagious diseases, it was evidently done in but a perfunctory manner, except possibly in so far as those diseases are concerned that are likely to be epidemic; for the morbidity records, prior to 1895, are but fragmentary. In that year there was passed by the State Legisla- ture an Act for the more effectual protection of the public health in cities of the commonwealth. This, together with other existing general health laws, gave, to the authorities almost complete control of the manifold factors affecting the public health. This act, by all means the most important one passed, up to the date of its passage, was designed specially to control the incidence and spread 580 Institutions Under Municipal Management of contagious and epidemic diseases. It requires the prompt report- ing of such diseases; provides for the isolation of the patients; the placarding or quarantining of the houses in which they are located; regulates the attendance at school of children from such houses ; and of those convalescing from such diseases ; requires the disinfection of infected persons and clothing; forbids public funerals in the case of death from contagion, and directs the manner in which the body shall be prepared for burial; requires that all children in attendance upon the public schools shall be successfully vaccinated against small-pox ; and repeals all acts inconsistent with its provisions ; and provides a heavy penalty for violation of any of its requirements. The act was in successful operation until 1905, when it was superseded in part by another act, having the same object in view, but giving to those in authority somewhat more leeway in the matter of practical regulation. Experience with the Act of 1895 soon demonstrated the error of binding the health authorities to specific regulations that they were powerless to modify or amend without legislative consent, and as occasions had frequently arisen which properly called for action other than that specified in the law, it was decided to secure the passage of a bill authorizing the health department to make its own rules and regulations for the proper control of all contagious and epidemic diseases. This act was passed, and by the authority given, the present regulations of the Board of Health for the conduct of the work were drawn up and put into operation. This plan has the advantage of that pre- ceding in that it is within the power of the department to promptly alter or abandon any of its regulations, as may be demanded by the march of progress, the increase of knowledge or by the peculiarities of special cases. In 188S, a law was passed regulating the matter of house drain- age. It gave to the Board of Health full power to formulate rules and regulations for the sanitary plumbing of houses, and made it illegal to install any plumbing not in conformity with these rules and regulations, and not formally approved by the board. By the authority conferred by the act, the board also required the regis- tration of all master plumbers. Since the first draft of the rules and regulations bearing upon the subject, there have been a number of revisions to meet newer requirements. Those in force to-day may fairly be regarded as a model of careful study of the subject. Public Health Work in Philadelphia 581 The Division of House Drainage, organized under the authority of the act, consists of a chief and 12 inspectors, all of whom are practical plumbers by trade, and all of whom have demonstrated fitness for the work by appropriate examinations. Since the organization of the division, the records of the work have been so carefully kept, that it is now possible to produce in a few minutes full data upon the drainage of every building con- structed since the law went into effect. As early as 1854, the Board of Health was having much trouble with private slaughtering houses located in the built-up portions of the city. To remedy the evil as far as possible, every such establishment was declared a nuisance prejudicial to the public health, unless the proprietors complied with certain sanitary re- quirements. This action brought about some reform, but did not, by any means, correct the defects complained of. During 1865, an application was made to the board on ''behalf of certain parties interested in real estate" in the rural parts of the Twenty-fourth Ward, praying for the establishment of a public abattoir, wherein all slaughtering necessary for the city should be done, in lieu of that practiced in private slaughtering houses located throughout the built-up portions of the city. In answer, the board replied: "that they were not prepared to endorse any particular plan, to recommend any special locality, or to aid and cooperate with any enterprise at that time, which proposes to establish an abattoir in the vicinity of the city for the slaughtering of cattle, they were, however, clearly of the opinion that no slaughter houses should be allowed to exist in a populated neighborhood, but that they should be confined to rural districts and be subject to rigid sanitary supervision." The first step toward the official inspection of meat in Phila- delphia was taken in 1891, when a police officer was detailed for the purpose of causing the arrest of anyone offering for sale meat that was putrid, diseased or otherwise unfit for human consumption. In 1892, by ordinance of Councils, moneys were appropriated as salaries for the employment in the year 1893 of a Meat Detec- tive, a Veterinary Surgeon and a Consulting Veterinary Surgeon, whose duties were to attend to the inspection of cattle slaughtered, and meats exposed for sale. Prom time to time, subsequent to that date, additions were made to the corps, in some cases by the employment of new men conversant with the meat business, in 582 Institutions Under Municipal Management others by the detail or transfer of police officers to assist in the detective features of the work. Until 1904, the corps had been attached to the Bureau of Police, Department of Public Safety. In that year, it was trans- ferred to the Bureau of Health, Department of Public Health and Charities. Until 1905, there was no satisfactory legislative authority for the work of this division, and its results were accom- plished in a roundabout manner, i.e., by bringing offenders under the general nuisance laws, and proceeding against them for main- taining nuisances prejudicial to the public health. The obviously unsatisfactory mode of procedure led to the passage of a bill by the Legislature in 1905, that empowered the Board of Health to enact rules and regulations governing the conditions under which animals or poultry may be slaughtered and dressed, or meat, poultry, fish, game and shell fish may be prepared for use as food, or stored or exposed for sale. It also provides for the issuance of a license to all persons engaged in the aforementioned trades, and empowered the Board of Health to revoke such licenses on failure of the holder to comply with the regulations of the Board. Violation of the act is made a misdemeanor punishable by a fine of not less than five dollars nor more than one hundred dollars. The matter of food supervision had from an early date received attention, though the legislation resulting therefrom has in some particulars become obsolete. The Act of Assembly of 1775, made it illegal to adulterate flour; that of 1855 imposed a penalty for exposing for sale tainted or unwholesome meat or fish or any veal less than three weeks old when killed ; that of 1860 made it a mis- demeanor to expose for sale or to sell the flesh of any diseased animal, or any unwholesome bread, drink or liquor, or any drugs or liquors that have been adulterated; and that of 1873 made it unlawful to bring oysters into this commonwealth for sale during the months of June, July and August. The first steps toward the systematic control of the milk supply were taken in 1888, when City Councils made an appropriation for the employment of a Milk Inspector in 1889. The Pure Food Act, passed later by the Legislature, gave full authority for the develop- ment of this important section of the work. From one Inspector as a beginning, there has developed a Division of Milk Inspection with a Chief Inspector, 12 Assistant Inspectors and one Clerk. From rough tests originally made to detect fraudulent practices, Public Health Work in Philadelphia 583 the work of the Division has grown to include a general inspection of premises, wagons, etc., as to cleanliness; the detection of pre- servatives; the detection of adulterants; and the detection of matters indicative of careless methods of handling the milk and of disease among the cattle producing it. For the proper conduct of this work, there is in constant cooperation with the Milk Division, both the Bacteriological and Chemical Laboratories. The average daily number of bacteriological and microscopic examinations of milk samples submitted by the Inspectors is 50, and the Board of Health authorizes the condemnation of milk that on such examina- tion is found to be dirty; to contain an excess of bacteria; or to contain elements pointing to disease of the cow from which it came. The day's work of the Inspector includes a general survey of premises and output ; inspection of milk in stores ; that in wagons on the street, and that in bulk on the receiving platforms. Several Inspectors, who are specially trained for the purpose, are detailed to supervise the dairy farms located within the county of Phila- delphia. The marvellous advance in the science of medicine noticed during the last quarter of the past century compelled the Board of Health to organize laboratories as important allies in the per- formance of its functions. In 1895, the Division of Bacteriology, Pathology and Disin- fection was added to the equipment of the board. Primarily, it was established for the purpose of manufacturing antitoxin for the treatment of diphtheria, and for the employment of bacteriological methods for the recognition of that dread disease. The scope of the work soon enlarged. All materials and apparatus used by the board for purposes of public disinfection were carefully tested by precise methods before adoption. The board invited all physicians having doubtfully transmissible cases in their care to submit appropriate materials from them for bacteriological study. The diagnosis of typhoid fever by microscopic study of reactions exhibited by the blood from such patients was soon recognized by the board as an important adjunct, and the facilities of the labora- tory for the work were thrown open to physicians of the city. The study of milk and diseases arising from its improper production and handling, brought out the important fact that the application of routine bacteriological and microscopic methods to the study of this important food commodity would be of much assistance in excluding from the city, milk unfit for human consumption. 584 Institutions Under Municipal Management For a number of years the board had had the services of a trained chemist, and he, together with the staff of the Bacterio- logical Laboratory, has rendered splendid services in assisting the board and bureau to the correct interpretation of many complicated questions that came before it. In 1894, the Legislature gave authority to the Board of Health to inspect, supervise, license and revoke licenses of lying-in estab- lishments. An Act of Assembly passed in 1895, placed public lodging houses under the supervision of the Department of Public Safety, of which the Bureau of Health was at that time a part. In 1905, the Tenement House Bill was passed, giving to the Bureau of Health, now in the Department of Public Health and Charities, control over the tenement houses of the city. This bill not only defined what in law is to be regarded as a tenement house, but made it illegal for the proprietor to conduct such an establish- ment without a license, and empowered the authorities to revoke such license if, on inspection, the premises are found not in accord- ance with the legal requirements. Until 1892, all disinfection done by the Board of Health was done by one man. In 1893, five Assistant Disinfectors were tem- porarily appointed. In 1895, Councils appropriated moneys for the regular employment of six Assistant Disinfectors and the Division of Disinfection was organized. Each man in the Division is assigned to a district of the City and held responsible for the correct performance of such work in that district as may be ordered daily by the health authorities. The work of each man is tested twice monthly by bacteriological methods. In this connection, it is of interest to note that when in 1892-1893, the city was threatened with an invasion of cholera, moneys were appropriated for the erection of a commodious public steam disinfecting chamber on the grounds of the Municipal Hospital. This chamber, still in use, is employed for the disinfection of such large objects as bedding, carpets, etc., though in late years, its employment has been less frequent, because of the discovery of other more convenient and equally trustworthy methods. From the organization of the Bacteriological Laboratory until the present time, practically every new device and substance for the disinfection of houses, that has been put before the public, has been carefully tested, with the view of giving to the city the Public Health Work in Philadelphia 585 benefit of all improvements. The methods now used were adopted as a result of such tests as the best from all economic and prac- tical standpoints. A perusal of the available health records reveals many changes for the welfare of the public that have accompanied the steady development of efforts to safeguard its health. In the records of the early days of the Province, mention is often made of illness and death from diseases that are to-day medical rarities. At times such maladies occurred as widespread epidemics. Typhus fever, yellow fever, small-pox, "epidemic pleurisy," "eruptive fevers," Asiatic cholera, cholera morbus, and spotted fever are more or less frequently noted. The records show that in the early days yellow fever was not an infrequent visitor to our city; in some years appearing as but a few sporadic cases, in others as widespread epidemics. Deaths from the disease are recorded in the years 1693/ 1699,^1747, 1762, 1793, 1794, 1795, 1798, 1799, 1802, 1805, 1819, 1820, 1855 and 1870. In 1693, 1762, 1793, 1798, the epidemics were particularly severe, but at no time was there such devastation and demoraliza- tion as that witnessed in the years 1793 and 1798, when, in the former year, about one-tenth the entire population was carried off in a period of four months. As late as 1855, there were 128 deaths recorded from it, and in 1870, the date of its last appear- ance, there was a total of 18 deaths among persons in the city and at the hospitals. Typhus fever, sometimes known as "putrid fever," "camp fever," "ship fever," appears to have been very common in the early days. Between 1808 and 1815, there was not a year with- out some deaths from it, and in 1813, the total reached as high as 102. How many of these deaths were due, however, to true typhus fever and how many to the disease now known as typhoid fever, cannot be said, for it was not until 1836, that Dr. Gerhard, of this city, demonstrated in the Philadelphia Hospital that there is a sharp anatomical distinction between typhus fever and another febrile condition with which it had hitherto been confused. This latter disease is now known as typhoid fever. The first recorded deaths from typhoid fever in Philadelphia are found in the archives for 1837, the year following Gerhard's demonstration. However, later in the century, when the disease could certainly be identified, we find several epidemic outbreaks of typhus fever 586 Institutions Under Municipal Management recorded, notably between the years 1863 and 1870. In 1883, there was a small outbreak of the disease in the Philadelphia Hospital. Since 1887, typhus fever has been a medical curiosity with us. For a number of years after the Civil War, "spotted fever" was prominent among the causes of deaths; especially was this the case during 1863-64. Since 1865, it has been recorded as cerebro- spinal meningitis. In 1870, relapsing fever appeared for the first time in this city as an epidemic. There were 162 deaths from it recorded in that year. There were 300 patients suffering from the disease in the Municipal Hospital at one time. Asiatic cholera was seen in Philadelphia as late as 1875, when eight cases were reported during the three months of June, July and August. In 1866, there was a serious epidemic, in which 910 fatalities were recorded; and in 1832, "thousands of our popula- tion were swept off." It was during the cholera outbreak of 1866, that an interest- ing episode occurred, resulting not only in a mild altercation between the local health authorities and the Federal Government, but also illustrating the temper of the people. It seems that for some years the United States Government had possessed a hospital on Christian Street. As it was not in use at the time of which we write, the Board of Health leased it from the Government, intending to use it for a cholera hospital. On August 1st, it was opened, fully furnished and equipped for the reception of patients. Two days later, the citizens of the neighborhood protested against having a hospital of such character in their midst. On the next day, a mob set fire to it, and it was almost demolished. On the 6th, the Board of Health petitioned the Mayor for sufficient force to protect it in instituting a hospital at the Christian Street site or elsewhere. Two days later, the board having received no reply from the Mayor, a committee was appointed to wait upon and lay the matter before him. On August 9th, the Mayor told this com- mittee that it was out of his power to detail a police force for the special duty of protecting cholera hospitals. On September 5th, the Federal Government desired to know if the Board of Health would pay for the damages done by fire to the Christian Street Hospital. This was referred to the Sanitary Committee with power to act. On September 12th, the Sanitary Committee reports : — Public Health Work in Philadelphia 587 (1) That the question of payment of damages be referred to City Councils. (2) That the board declines to make the necessary repairs to the building. (3) That the board is willing to return the buildings to the United States Government in their present condition. Thus closed the incident of the Christian Street Hospital. Another illustration of the consternation of the period is seen in the radical measures advocated by the Sanitary Committee with reference to certain questions that had been referred to it. In reporting to the board upon the matter of bad odors of which the population of the Navy Yard had complained, it declares: "This was the hog pens at Martinsville, located in the meadows on the Point House Eoad. A desolate, God-forsaken, filthy, ill- drained place, not fit for dogs to live in, ... . where decency is out of the question, and degradation certain." . . . "Your committee believes that there is no other remedy for put- ting a stop to this disease (cholera asiatica) in this ill-fated town, than to remove the hogs and other inhabitants, disinfect the place, and board it up until cold weather, and before they return, have it thoroughly cleansed and disinfected." 3 The practical disappearance of historic pestilences from among civilized peoples is due entirely to the application of mod- ern sanitary and preventive measures. Through the same agen- cies, marked reductions have been effected in the occurrence of the commoner contagious diseases. Thus, for instance, through the introduction of pure water, typhoid fever has been reduced about 80 per cent, in those parts of Philadelphia now getting it. During the decennium 1861-70, there were 36 deaths from small-pox per 100,000 of population, while for the decennium 1898-1909, there were only 6.5 on the same basis. Between 1860-70, scarlet fever carried off 92 per 100,000 of our population, while during the ten years ending with 1907, only 10 per 100,000 died of it, and its occurrence has been cut down by approximately 50 per cent, during the past four years. Diphtheria was fatal to 91 per 100,000 of population between 3 Though I have searched carefully through the minutes of the Board, and though Martinsville is frequently under consideration, I can find no record of favorable action having been taken on this drastic recommenda- tion of the Sanitary Committee. 588 Institutions Under Municipal Management I860 and 1870; while between 1898-1907, only 48 per 100,000 died of it, and this latter figure could be greatly reduced were more use made in the treatment of the disease of the specific agent whose discovery represents an epoch in modern medicine. Not only are diminished fatalities from selected diseases noticeable as a result of the application of modern methods, but the effect is equally obvious in the reduction of the general death rate: thus, for illustration: — If we divide the interval between about 1860 and the present into decenniums, and give the average annual death rates from all causes for each decennium, we see the following almost reg- ular decline : — 1862-1871 there were 22.67 deaths per 1,000 of population. 1872-1881 " " 20.86 1882-1891 " " 21.87 1892-1901 " " 19.83 " '• " 1902-1907 " " 18.18 The highest annual rate for the interval covered was 26.19 in 1872, and the lowest, was 17.25 in 1905. Since mortality among children may be taken as a fair indei of the sanitary condition of a locality and the intelligence of the people, the following figures are of special interest as marking our progress. They give the average annual deaths per 1,000 of population by decenniums. 1871-1880 there died annually 8.29 children per 1,000 of population. 1881-1890 " " " 7.91 " " " " « 1891-1900 " " " 8.97 1901-1906 " " " 5.20 " " " " During the interval covered, the highest annual death rate in this age group was 11.30 in 1872, and the lowest, 4.8 in 1905. As the equilibrium or growth of a population depends in large measure upon the maintenance and increase of the birth rate, the following figures as compared with death rates is reassuring, in so far as this city is concerned: — 1861-1871 average annual birth rate was 26.46 per 1,000 of population. 1872-1881 " " " " « 23.23 " " " " 1882-1891 " " " ■« « 24.27 " " " 1892-1901 " " " " " 25.69 " " " 1902-1906 " " " " " 23.30 " " " " Public Health Work in Philadelphia 589 The highest annual birth rate was 29.24 in 1861, and the lowest, 20.52 in 1879. For the entire period, the average annual birth rate exceeded the average annual death rate by -±.13 per 1,000 of population. It is difficult to realize that the Bureau of Health, in its pres- ent development, with its necessarily large staff, was, fifty years ago, little more than a mere handful of men. The first annual report of the Board of Health after the con- solidation of the city and the outlying liberties, that is on file in the Health Bureau, is that of 1860, the year in which the impor- tant Registration Act was passed. That report gives as the roll of executive officers, appointed by the Governor: A Lazaretto physician, a port physician, a health officer, and a quarantine master; and as officers elected by the board: A chief clerk, a registration clerk and an assistant, a messenger and three assist- ants, a runner, a physician of City Hospital, a matron of City Hospital and a steward of Lazaretto, making sixteen in all. This number did not exceed nineteen at any time during the subse- quent ten years. For that year the total of moneys appropriated by Councils for the expenses of the Board of Health was $29,675, of which only $24,577.70 was expended. Some of the items of expenditure are of interest, notably: For salaries of health officer, port physician, chief clerk, assistant clerk and runner, there was a total of $4,260; for printing, adver- tising, books, publications and newspapers, a total of $188.04 was expended; for coffins and burial expenses, $60 is charged; for carriage hire, steamboat and railroad tickets, tolls, etc., for the Lazaretto Committee, $200 was paid; for salaries of physicians, matron, male nurse, female nurse and watchman at City Hospital, there is an entry of $1,365.63; while for the expenses of the four standing Committees on Districts, Burial Grounds, Poudrette Pits and Bills of Mortality, there was a total expenditure of $1,170.77. The following transcript from the board, meeting, held April 12, 1855, throws an amusing sidelight on some of the customs and opinions of the times: — Mr. Wood offered the following resolution : — • "That from and after the first day of May next ensuing, no spirituous or vinous liquors shall be purchased for or used in the office of the board." 590 Institutions Under Municipal Management Motion was made to amend, by adding the word "segars" after the word liquors. On motion, the amendment and resolu- tion were laid on the table. Twenty years later (1880) a marked growth is seen. There were still four appointees of the Governor on the executive staff, namely: Health officer, Lazaretto physician, port physician and quarantine master, but the elective roll had grown to a total of 49. A number of new positions had been created to meet the demands of the times. There was a chief nuisance inspector, with ten assistants; a medical inspector, two inspectors of privy clean- ing; a vessel inspector; a crew for the Lazaretto boat; male and female nurses and certain non-professional help for the Municipal Hospital. The total appropriations for the year was about ten- fold that for 1860, i.e., $254,871.45. Compare this with the census and the appropriations of, for instance, 1907. In this latter year there were on the pay-roll in the Health Bureau a monthly average of 325 individuals, as fol- lows : A chief of the bureau ; a chief medical inspector ; an assist- ant to the chief medical inspector; two diagnosticians; fifty assistant medical inspectors; a chief clerk; twenty assistant clerks; a health officer; an ophthalmologist; a chief of the Division of Vital Statistics, and eleven assistants; a chief nuisance inspector and twenty-nine assistants; a chief house drainage inspector and thirteen assistants ; a chief milk inspector and sixteen assistants ; a chief meat and cattle inspector and six assistants ; a chief of labora- tory and four assistants; a chemist; two hostlers at Antitoxin Laboratory; two helpers at Antitoxin Laboratory; a chief disin- fector and ten assistants ; a chief tenement house inspector and one assistant ; three stenographers ; one messenger ; a chief resident physician to the Hospital for Contagious Diseases; three assistant resident physicians to same hospital ; four assistant resident physi- cians to same hospital (not on salary) ; a druggist; a superintend- ent to same hospital; two housekeepers; two head nurses; thirty ward maids; eighty-two miscellaneous helpers, including hostlers, gardeners, carpenters, plumbers, engineers, firemen, laundresses, cooks, watchmen, drivers, chambermaids, clerks and telephone operators. The total appropriation in 1907 for salaries and running expenses was $345,460; and for new buildings was $1,127,912.36. On the basis of wages paid and prices of materials in 1907, Public Health Work in Philadelphia 591 the units of work for the several divisions mentioned cost the city on an average : — For a milk inspection 0.21 For a meat inspection 0.22 For a nuisance inspection (several visits) 1.61 For a house drainage inspection (one visit) .... 0.41 For a registration, births, deaths, etc 0.11 For disinfecting 1,000 cubic feet, air space 0.83 For a contagious disease visit (including vacci- nations) 0.27 For a bacteriological analysis 0.19 For a chemical analysis 1.75 For daily maintenance of a patient in the Hos- pital for Contagious Diseases 1. 38*4 The difference is startling, but it must be borne in mind that to-day the population is about threefold that of 1860; that our knowledge of the subject has been enormously enriched by the progress made along the lines of preventive medicine; and more important than either, that in late years there has been ceaseless activity in educating the community in the laws of personal and municipal hygiene, with the result that the people now regard efficient public health service as a necessary function of a pro- gressive municipal administration. Not only has there been a marked increase in the size of the executive staff, but the status and organization of the department has undergone several radical changes. Until the new city charter went into effect in 1887 (approved 1885), the Board of Health had been an autonomous body consist- ing of varying numbers of members, according to the provisions of the several Acts of Assembly relating to it. In 1867, when the new charter became effective, the Board of Health was organized as a body of five, instead of twelve, appointed by the Mayor with the approval of Select Council, instead of by the Courts and Councils as formerly. Its executive officer was to be the Director of the Department of Public Safety, and it was to be "for system's sake attached" to that department. As so composed, it conducted its affairs until 1899, when by Act of the Legislature, "the powers and duties now by law vested in the Board of Health in cities of the first class, shall be exer- 592 Institutions Under Municipal Management cised and performed by a bureau of the Department of Public Safety of said cities, to be known as the Bureau of Health." This abolition of the Board of Health being unconstitutional, and there being no provisions for delegating the powers conferred by all previous legislation to any body other than a Board of Health, the Act was amended in the same year, 1899, at the same session of the Legislature, to read as follows : "In cities of the first class the Board of Health shall continue with the powers and duties now vested in it by law, but the members thereof shall be three (3) in number, to be nominated by the Mayor and confirmed by Select Council for the period of four (4) years, beginning upon the first Monday of May, Anno Domini, one thousand eight hun- dred and ninety-nine." .... "The said board shall be a part of the Department of Public Safety." This Act repeals all Acts inconsistent with its provisions. From 1899 until 1903, the Board of Health, with a partially organized bureau, continued as an appendix to the Department of Public Safety. By Act of Assembly, in 1903, a new department of the city government was created by combining in part the old Board of Charities and Corrections, and the Board and Bureau of Health, into a Department of Public Health and Charities. Though this arrangement transferred public health administration from the Department of Public Safety to that of Public Health and Chari- ties, and placed the Board and Bureau of Health under the direc- tion of the Director of the latter department, it in no way curtailed or altered the powers vested by law in the Board of Health. This arrangement did, however, have the effect of diminishing materially the duties of the board. Many questions formerly referred to committees of the board are now taken up and settled as the daily routine of the bureau, thereby expediting matters. The board became, and has since remained, largely an advisory body, possessed, however, of powers that, as said, were not, and could not legally, be delegated to a bureau. General Hospitals and Dispensaries The Pennsylvania Hospital By FRANCIS R. PACKARD, M.D. AS early as 1709, the Society of Friends in Philadelphia had under consideration the establishment of a hospital. The time was not propitious, however, and the subject fell through. In 1732, the city authorities erected an almshouse' at Third and Spruce Streets. Later it was removed to Spruce Street, between Tenth and Eleventh. This institution, subsequently known as the Poorhouse or Bettering House, was the predecessor of the present city almshouse. As the city grew in population, the num- ber of the inmates of the almshouse increased proportionately, and in time this led to the establishment of a regularly equipped hos- pital in connection with it. The Pennsylvania Hospital was not founded until the year 1751, and for that reason the statement is sometimes made that the present Philadelphia Hospital antedates it. This assertion, however, is not based on a correct understand- ing of the facts of the case. As a city poorhouse or almshouse, the municipal institution is entitled to claim priority of founda- tion, but not as a hospital in the generally accepted sense of the term. This is clearly proved by a number of facts, as follows : — First. Benjamin Franklin, in his "Brief Account of the Pennsylvania Hospital," published in 1754, distinctly states in the following passage that there was no provision made for the sick and injured in Philadelphia prior to the founding of that institution. He says: — "About the end of the year 1750, some Persons, who had frequent Opportunities of observing the distress of such distem- per^ Poor as from Time to Time came to Philadelphia, for the Advice and Assistance of the Physicians and Surgeons of that City; how difficult it was for them to secure suitable Lodgings, and other conveniences proper for their respective cases, and how 38 (593) 594 General Hospitals and Dispensaries expensive the Providing good and careful Nurses, and other Attendants, for want thereof, many must suffer greatly, and some probably perish, that otherwise might have been restored to Health and Comfort, and become useful to themselves, their Families, and the Publick, for many years after; and considering moreover, that even the poor inhabitants of this city, tho' they had homes, yet were therein but badly accommodated in Sickness, and could not be so well and easily taken Care of in their Separate Habita- tions, as they might be in one convenient House, under one Inspection, and in the hands of skillful Practitioners; and sev- eral of the Inhabitants of the Province, who unhappily became disordered in their Senses, wandered about, to the terror of their Neighbours, there being no place (except the House of Correction or Almshouse) in which they might be confined, and subjected to proper treatment for their Eecovery, and that House was by no means fitted for such Purposes; did charitably consult together and confer with their Friends and Acquaintances, on the best means of relieving the Distressed, under those Circumstances Second. The lack of any hospital provision for the sick and insane is advanced in the Petition to the House of Eepresentatives of the Province for a Charter for the Hospital, as the reason for its establishment. The Petition states: — - "Your Petitioners beg Leave farther to represent, that tho' the good Laws of this Province have made many compassionate and charitable Provisions for the Eelief of the Poor, yet some- thing Farther seems wanting in Favor of such, whose Poverty is made more miserable by the additional Weight of a grievous Disease, from which they might easily be relieved, if they were not situated at too great a Distance from regular Advice and Assistance; whereby many languish out their Lives, tortur'd per- haps with the Stone, devour'd by the Cancer, deprived of sight by Cataracts, or gradually decaying by loathsome Distempers; who, if the Expense in the present manner of Nursing and Attending them separately when they come to Town were not so discourag- ing might again, by the judicious Assistance of Physic and Sur- gery, be enabled to taste the Blessings of Health, and be made in a few Weeks, useful Members of the Community, able to provide for themselves and Families." Third. There was for many years no hospital organization •x.^e.A^-14 ttir-?- £>&-?■ 2-^ king allUded with, a-, J tr:i*-- £~ is a proper Patient for the Pcr-m'ylvann IIofpit.il. ^J@&uiA~2-\J^*ii&- '■*■'***. To lA^-tj ■-.- V l/^fteX-fcv c-^, S- Sutmg Man ; Managers, . ~2>cn- >• <^ per Week for Board, during ivvi . Continuance there; to catlfc ti..-^ to be removed when discharged ; and to pay the Expcnfe of Burial, if ( t c. die there. WITNESS in,*- Manel.sthe U . DayofJ c u' M I'rqY ».D ? 1 IT -^Xji_Aj-u v &~i cLtxsi^ iJ <-> ac-t i ^<~% «r<,»,:„t-' //t. ' J','tt fa'c/y 'aJari, *4%(/t ^/,^/tfa^pM^^-t glut Jnj,~,^£ti~i*j $*//sr/<--k*s t ->'9f'* -" 't^'* i''*"* '&** &%?*"■"*** /•*' «3wrf*«*2 ^4i. '$t$HjLt&€ f ft a-'J'Hc.irtj^.wf/V* &*t ffifrHBttim af%&tc/*4;tZ n~i+t*,f*i t»?f% At- • J* <&j£qvh< < jfiZ ft' >^' >'<*'''!'% .-, AUTOGRAPH COMMUNICATION FROM MEDICAL STAFF, 1770. The Pennsylvania Hospital 595 in connection with the almshouse. No provision was made within it for the reception of sick or injured persons, and no staff of physicians was attached to it. These statements are amply sup- ported by contemporary evidence, as follows : — 1. In 1781, the Managers of the Almshouse entered into an agreement with the Managers of the Pennsylvania Hospital by which the latter agreed to admit "sick Paupers" from the alms- house on the payment of one Spanish milled dollar and one-third per week. This rate was subsequently reduced, but the almshouse authorities were remiss in their payments, and in 1789, an attor- ney was employed by the hospital to collect the sum of £945 10s. The suit was brought to trial in February, 1791, when the Alms- house Managers conceded their indebtedness and submitted to a verdict of £1014, due by them in February,£S|^0. "The point at issue was the objection of the Almshouse w*xhe legality of the Hospital's charging for the board of patients who were residents of Pennsylvania, alleging that the Hospital funds were exclusively intended for that description of people, and that the Hospital had no right to take foreigners on charity, or the inhabitants of other States " In 1799, another series of negotiations was entered into by the managers of the respective institutions. There was much bickering over the terms upon which the patients from the alms- house would be received. From the following minute, submitted by the Guardians of the Poor on February 28, 1803, at a confer- ence with the Managers of the Pennsylvania Hospital, it is apparent that their institution did not undertake to cure the sick, the chief function of a hospital, Jut was regarded by its authorities simply as an almshouse. fr WHEKBAS, It has been Customary for the Managers of the Pennsylvania Hospital to admit diseased Paupers into their house for cure, provided the Guardians of the Poor will engage to fur- nish them with Cloathes and pay funeral expenses in ease of their death, and such engagements involve the Guardians in unnecessary, and in case of non-residents perhaps in injustifiable, Expense and at the same time Swell the account of the Guardians while the whole credit results to the Managers of the Hospital. Resolved, i That in Future No Guardian sign Such Engagement to the Hos- pital." This resolution, of the Guardians of the Poor was subse- quently rescinded by them and patients continued to be sent from 596 General Hospitals and Dispensaries the almshouse to the Pennsylvania Hospital, and paid for by the managers of the former institution, until at least the close of the first decade of the eighteenth century. 2. The earliest mention of the appointment of physicians to attend the paupers in the poorhouse is to be found, according to Dr. D. Hayes Agnew in his address on "The Medical History of the Philadelphia Almshouse," in a Minute of the Board of Man- agers, on May 18, 1769, which states that Drs. Cadwalader Evans and Thomas Bond were "reappointed" physicians to the institu- tion. There is one important fact to be borne in mind in relation to their appointment; namely, they were each to receive a salary of fifty pounds per annum, and were required to supply such medicine as was needed for the sick. This savors much more of an appointment to a municipal almshouse than to a hospital. A little later Dr. Agnew, in the following paragraph, adduces facts which go still further in proof of the fact that the Phila- delphia Almshouse in the early years of its existence had no claim to be regarded as a hospital. He writes: "That the medical police of the house was not of the strictest character, may be inferred from the fact that a number of persons were in the habit of visiting the institution, assuming to be doctors, and volunteer- ing their services to the unfortunate sick. This irregularity con- tinued unquestioned for some time, until many of the patients had suffered very great injury, and no small amount of discredit brought upon the management of the house. A resolution was at length introduced and passed by the Board of Managers, per- mitting no one to prescribe except the regular appointees, and requiring them to visit the hospital oftener and with more reg- ularity." 1 3. The attendance upon the sick of the almshouse by the l Dr. Agnew's address is unfortunately inaccurate in several impor- tant particulars. Thus, he states that the Pennsylvania Hospital wa9 founded in 1753, two years subsequent to the actual date. He also states that the appointments of Drs. Kuhn, Duffield, Clarkson and Parke a3 physicians to the almshouse, marks "the origin in this country of gratuitous professional service to public institutions." It is a well-known fact that one of the objections to the establishment of the Pennsylvania Hospital in 1751 was that the cost of medical attendance would be too great for the funds which could be procured, which objection was overcome by Drs. Lloyd Zachary, Phineas Bond and Thomas Bond volunteering their services gratuitously to the hospital. The Pennsylvania Hospital 597 physicians of the Pennsylvania Hospital led, in 1783, to the resig- nation of Dr. John Morgan from the staff of the hospital. This was brought about in the following manner: The Managers of the Almshouse complained to the Managers of the Hospital "against the fee of three pounds ten shillings, charg'd in certain Cases at the Almshouse by two of the Doctors." The Managers of the Hospital took the complaint into consideration, and passed a resolution "that in such instances, the Physicians of this House are not entitled to, and therefore should not demand any fee, or reward for their Services." Dr. Morgan, who was one of the physicians involved in the charge, thereupon resigned. In his letter of resignation he writes as follows : "But I beg leave to remark that in whatever light I view the resolution of your board on the 26th ulto. in respect to certain Almshouse Patients (I speak it with the utmost deference to the Purity of Intentions and Supreme Wis- dom of the Managers) it appears to me to be both impolitic and injurious to the original design of this excellent Charity, as well as incongruous with the Sentiments of the Pounders, and espe- cially the first Physicians of the Hospital, which I always supposed were to perform Acts of Charity to Objects and Cases of Charity. I never imagined they meant to subject themselves or their Col- leagues and Successors in office, to the Extra-Jurisdiction of men, whether in public or private stations, who have no authority over them; nor that they came under any obligation to devote their time and attention to the Cure of Diseases brought on by Con- cupiscence, without fee or reward, which in my humble opinion tends rather to the growth than the diminution of Immorality. If I am not misinformed, that resolution took its rise from per- sons not belonging to your Board, who have no claim to the Services of the Hospital Physicians in behalf of those committed to their charge; and who have and exercise the power of nomi- nating, and paying a Physician for that Duty, whose place thereby becomes a lucrative Sinecure; and whilst one set of Gentlemen perform the Services, without thanks, another reaps the fruit of their labors." 4. It was not until the year 1835, that the hospital depart- ment of the Philadelphia Almshouse was officially styled the Philadelphia Hospital. How this was brought about is told by Dr. Agnew in his address on "The Medical History of the Phila- delphia Almshouse." 598 General Hospitals and Dispensaries "On the 28th of December of this year, 1835, Drs. Gerhard and Pennoek suggested to the guardians the propriety of desig- nating the hospital department by some specific name, as that of almshouse could not technically be regarded in the sense of a hos- pital. When the subject came regularly before the board, it was moved by a member, Mr. Hansel, that it should be styled the Philadelphia Hospital. This received the sanction of the majority vote, and it has been known under that name ever since." The story of the founding of the Pennsylvania Hospital is best told by one, who, although he generously disclaims the credit of originating the idea, nevertheless, was probably the only man in the Province of Pennsylvania who was capable of carrying the scheme to a successful termination. In his autobiography, Benjamin Franklin tells how his friend, Dr. Thomas Bond, conceived the idea of establishing a hospital in the City of Philadelphia and started out to obtain subscriptions for it. The doctor's efforts met with but little success. Finally, he came to Franklin and told him that those whom he had asked for money, often asked him if he had consulted Franklin about the matter, and what the latter thought of it ; and upon his answering that he had not yet spoken to Franklin, as he had thought it was somewhat out of his line, they had put him off with the reply that they would consider it. Franklin, with his usual willingness to aid any enterprise for the public good, engaged heartily in the project, endeavoring first, according to his custom, to prepare the minds of the people by writing on the subject in the newspapers. Subscriptions began to come in more generously, but Franklin soon saw that it would be necessary to secure aid from the Assembly of of the Province. Accordingly, it was petitioned for. The country members opposed the project, as they thought it would only be serviceable to the inhabitants of Philadelphia, and that, therefore, the citizens of the latter city should bear all the expense ; and they also insinuated that there were grave doubts whether the citizens themselves generally approved of it. Franklin's statement that the plan had met with such general approbation that he was able to secure 2,000 pounds by voluntary subscription, they ridiculed as preposterous. Thereupon, Franklin drew up another petition by which it was enacted that whenever the hospital should be organized and its managers have secured 2,000 pounds by voluntary sub- scriptions, the Assembly should grant an equal sum towards the The Pennsylvania Hospital 599 project. This condition carried the day, and the bill was passed. Franklin concludes his account of the affair by the statement : "I do not remember any of my political manoeuvres, the success of which at the time gave me more pleasure ; or wherein, after think- ing of it, I more easily excused myself for having made use of some cunning." No difficulty was encountered in raising even more than the required 2,000 pounds by voluntary subscriptions, but a further objection raised against the petition on its second reading was, that the expense of paying physicians and surgeons would use up the money. In answer to this, Drs. Lloyd Zaehary, Thomas Bond and Phineas Bond offered their services to the hospital without pay. The charter was finally granted the hospital on May 11, 1751. Joshua Crosby was the first president of the Board of Man- agers, and Benjamin Franklin was its first clerk. Many of the early minutes of the hospital are in the latter's beautiful hand- writing, and treasured among its archives are numerous letters and documents written by Franklin on the business of the hospital. „ The managers rented the house of the lately deceased John Kinsey, on the south side of High (now Market) Street, below Seventh. On February 6, 1752, an advertisement was inserted in the Pennsylvania Gazette, stating that the hospital was prepared to receive patients. The managers drew up a set of the most wise rules and reg- ulations for the government of the hospital. Among others, was one providing for a fine to be levied upon any manager who failed to attend a meeting of the board, or was unpunctual in his attend- ance. "The Towne Clock, or when that did not strike, the watch of the oldest person present to be the standard to determine the time." Dr. Zaehary and the two Drs. Bond were appointed phy- sicians and surgeons for the first three years. The board also appointed Drs. Graeme, Cadwalader, Moore and Eedman "to assist in consultations on extraordinary cases." In order to furnish light labor to occupy such patients as might be able to perform it, the board secured several spinning wheels, and two pairs of cards, with wool and flax. Benjamin Franklin and Thomas Bond were appointed a com- mittee to procure a seal for the hospital. The design which the board accepted is in use to the present day, although the original 600 General Hospitals and Dispensaries seal, which was made of silver, became worn out and was destroyed in 1833, being replaced by one made of steel. In 1754, Franklin wrote and published, at the request of the Board of Managers, a pamphlet, entitled "Some Account of the Pennsylvania Hospital from its First Beginning to the Fifth Month, called May, 1754." Fifteen hundred copies were ordered printed. The managers took vigorous measures to secure a permanent site for the hospital. For this purpose they petitioned the Pro- prietaries, Thomas and Richard Penn, for a gift of land. The lot they selected as suitable was on the south side of Mulberry (now Arch) Street, between Ninth and Tenth Streets. The Proprietaries declined their request, but offered to give them instead a grant of land in a part of what is now Franklin Square. The grant was to be accompanied by a Charter from the Proprie- taries. Both the land and the charter were declined by the managers, the former because of its unhealthy character, being marshy and full of ponds, and also because it had already been granted by the Proprietaries to the citizens for other public purposes. The charter was respectfully declined, because the previous charter obtained from the Assembly of the Province was held sufficient, and also because it contained a clause by which the lot granted by the Penns to the hospital was to revert to the Proprietaries upon any failure in succession of the contributors to the hospital. The managers accordingly proceeded to purchase a lot out of the sums which had been accumulated by their efforts. They bought, for 500 pounds, the square between Spruce and Pine and Eighth and Ninth Streets, with the exception of a strip of land on the Spruce Street front. This strip belonged to the Penns, and was subsequently (1767) donated by them to the hospital. By March, 1755, the working plans for the erection of a suit- able building on the lot were submitted to and approved by the Board of Managers. The building was to be erected in three por- tions, a center and two wings. On May 28, 1755, the Board of Managers, accompanied by a number of prominent citizens, marched in a body from the hospital on Market Street to the grounds to be occupied by the new building, where the corner- stone was laid with Masonic rites. The corner-stone has been •vH ._. _. u Sip :||i WmsasaJSSm -.tift ISllff 5= « a §& * j ?> The Pennsylvania Hospital 601 laid bare and can now be clearly seen by all interested. It bears the following inscription, composed by Benjamin Franklin :— IN THE YEAR OF CHRIST MDCCLV GEORGE THE SECOND HAPPILY REIGNING (FOR HE SOUGHT THE HAPPINESS OF HIS PEOPLE) PHILADELPHIA FLOURISHING (FOR ITS INHABITANTS WERE PUBLICK SPIRITED) THIS BUILDING BY THE BOUNTY OF THE GOVERNMENT, AND OF MANY PRIVATE PERSONS, WAS PIOUSLY FOUNDED FOR THE RELIEF OF THE SICK AND MISERABLE; MAY THE GOD OF MERCIES BLESS THE UNDERTAKING. In this year Joshua Crosby died, and Franklin was elected to succeed him as President of the Board of Managers. In this capacity he officiated at the first meeting of the board in the new hospital. In December, 1756, the new building was occupied, the patients being removed to it from the Market Street house on the seventeenth of that month. The west wing and the center of the hospital were completed in 1796. On the top floor of the center building there was a cir- cular "Theatre" for surgical operations, lighted by a skylight. The old room still exists with some of the circularly arranged seats which were placed around it. It was first used as a clinical lecture room in 1804, and continued to be used for that purpose until 1868, when it was replaced by a large amphitheatre, in a specially constructed building, which was in its turn replaced, in 1896, by the splendid Garrett Memorial Building, which also eon- tains the men's and women's receiving wards and a children's ward. It is pleasant to record the kindly feelings which prevailed towards the enterprise from the time of the granting of the char- ter. Subscriptions were readily obtained, tradesmen gave liberal donations, and all the citizens seemed to realize the great benefits which would accrue from the establishment of such an institu- tion. All the religious sects united in raising contributions. The Eeverend George Whitefield, the celebrated evangelist, preached a charity sermon for it in St. Paul's Episcopal Church, in 1764, and 602 General Hospitals and Dispensaries in 1786 a sacred concert for the hospital's benefit was given in the German Eeformed Church. Noah Webster, the grammarian and lexicographer, delivered a lecture in the same year, the pro- ceeds of which were devoted to the hospital. One sum of money which they received was a source of embarrassment to the managers. It was the proceeds from a benefit performance given for the hospital by a theatrical company from London. As many persons considered money derived from such a source as "tainted," the board published an advertisement in the Pennsylvania Gazette, stating they had no authority given them to refuse donations of money from any source, and that accordingly, they were obliged to accept the money. The com- pany gracefully aided the managers out of their difficulty by plac- ing the money realized by the performance in the hands of Gover- nor Denny, by whom it was ordered to be paid to the hospital. Gifts were received, not only from persons living in Philadel- phia or Pennsylvania, but from many who lived in other provinces, in the West Indies and in England. Among the latter should be particularly mentioned Dr. John Fothergill, the friend of Ben- jamin Franklin, who not only gave money and g)t others to do so, but also sent valuable contributions of books, anatomical draw- ings and casts. In 1762, the Assembly of the Province granted the hospital an additional sum of three thousand pounds, and in the same year the directors of the Philadelphia Contributionship for the Insur- ance of Houses from Loss by Fire, notified the managers that they had agreed to sign a policy of insurance for fifteen hundred pounds on the hospital buildings, and that a return of survey had been made. It will be recalled that the Philadelphia Contribu- tionship is the oldest insurance company in what is now the United States, and had been largely founded by the efforts of Benjamin Franklin. It does not require any extraordinary acumen to dis- cern who was at the bottom of the directors' generous action toward his pet charity. The story of Benjamin West's famous picture, "Christ Heal- ing the Sick," is an interesting chapter in the hospital's annals. West was a native of Pennsylvania, but was living in London and was President of the Eoyal Academy when, in September, 1810, the managers wrote, asking him to contribute something to the hospital. He replied that it would give him pleasure to paint OLD CLINICAL AMPHITHEATRE, FIRST IN AMERICA •"VT TT -7358^"^ CL^a* (oi^/X' '/&.*«-, A". IftfiS— <7 ORDER FOR ADMISSION OF PATIENT, SIGNED BY FRANKLIN AND DIRECTED TO THE MATRON. 1 111 l ll'iijj. rpTiOiiTiiiro ■ J^ kM J^ k^ EAST WING OF HOSPITAL WITH "ELABORATORY." THE LATTER BUILT 1768. SOUTH VIEW OF HOSPITAL. SHOWING CHAINS AR OUND PBNN STATUE. Pennsylvania Hospital. The Pennsylvania Hospital 603 them a picture, suggesting as his subject the text, "And the blind and the lame came to Him in the Temple, and He healed them." He accordingly finished, in 1810, a canvas depicting the scene, but when he had finished it, we are told, it was regarded as such a magnificent work that he was compelled by the solicitations of Englishmen of all classes to allow it to remain in England. He immediately, however, set to work to make a duplicate for the Pennsylvania Hospital. In October, 1817, the painting arrived at the hospital. A small building had been erected by the mana- gers on purpose to contain it. Here the picture was exhibited, and for some years the receipts from visitors to the "Picture House" amounted to quite a sum. The total amount collected in this manner, between 1817 and 1832, in which year the managers ceased to exhibit it for money, was a little over $25,000. The picture house was erected largely from private subscriptions, the first name on the list of subscribers being that of Stephen Girard for $1,000. After the house was no longer used for its original purpose, it became for some years the home of the College of Physicians of Philadelphia, and was subsequently converted into a dormitory for the nurses. In 1893, it was torn down to make room for the new surgical wards. The picture was loaned to the Pennsylvania Academy of the Fine Arts for exhibition on several occasions, and was hung for some time in the insane department of the hospital. In 1884, it was cleaned and varnished and hung in the clinical amphitheatre, on the south wall above the operating theatre. It now hangs in the Assembly Hall of the hospital. The leaden statue of William Penn, which has long stood before the Pine Street front of the hospital, was presented to it by John Penn, grandson of the Founder of Pennsylvania, in 1804. The statue originally stood in Wycombe Park, Bucks, England, the estate of Lord le Despenser, 2 where it was seen by Benjamin Franklin, who greatly admired it, and was desirous of having a replica made to be placed in the grounds of the State House in Philadelphia. In some way it got into the hands of a junk dealer in London, from whom it was purchased by John Penn for pre- 2 It may interest some to know that Lord Le Despenser was the notorious peer, who, as Sir Francis Dashwood, was a prominent member of the "Hellfire Club" or "Order of St. Francis," which held its orgies at Medmenham Abbey, and numbered John Wilkes among its members. 604 General Hospitals and Dispensaries sentation to the hospital. In 1850, during a great storm, the statue was blown over. It was found that the metal of one of the feet had become corroded. This was restored and the statue replaced upon its pedestal, where it has remained securely ever since. There are but few institutions in this country concerning whose early history we have such complete and interesting records. The minutes of the Board of Managers and innumerable docu- ments, and letters of Colonial and Eevolutionary times have been preserved, and are accessible to those interested. From them we can glean details concerning the management of the hospital, the patients within it, and the methods employed in their treatment. In Colonial days patients were occasionally admitted to the hospital who had been injured in fights with the Indians. Many of the latter were also patients at various times. On October 13, 1755, "Michael Higgins, a soldier, was admitted having his under jaw shot off in the late engagement under General Braddock." Many other soldiers were admitted who had been wounded while fighting with the provincial forces in the wars between France and England for supremacy in America. When the English deported the French settlers from Acadia, fourteen hundred of the unfortunate victims were landed in Phila- delphia. They were quartered in cabins and huts in the neigh- borhood of what is now Sixth and Pine Streets. Many of these "French Neutrals," as they were called, are registered as patients in the hospital records. The War of the Eevolution marked a great epoch in the hos- pital's history. As was to be expected, the outbreak of the war caused a tremendous falling off in its revenues and also an increase in its expenditures. The British occupied Philadelphia in Sep- tember, 1776, and the military authorities at once took possession of the hospital and filled it with their sick and wounded. In June, 1778, when the British evacuated Philadelphia, they carried off with them the bedding, instruments and medicines belonging to the hospital, without giving it the least compensation. The hos- pital managers, upon getting back control of the institution, found themselves in dire straits for money wherewith to maintain it. An Act of Congress compelled creditors to accept payment of their accounts in Continental money. This had sunk in value to a ridiculously low ebb. Many persons upon whose property the hos- pital had mortgages, or to whom it had lent money, took advantage CELLS AS ORIGINALLY CONSTRUCTED, PINE STREET HOSPITAL. CORNER-STONE, 17 M fit ^.JZtV 'fir- tyfrgtt./af'r/ng.' //?*. f/js, . r«mr #fi/&^ / /!/U//^a?U/l*/(3>.^ LAW REGULATING THE ELECTION OF MANAGERS. DR. RUSH'S " TRANQUILISING " CHAIR. Pennsylvania Hospital. The Pennsylvania Hospital 605 of this situation by offering to pay their debts in Continental money. So low had Continental money fallen that, when in 1780, a grant of ten thousand pounds in Continental money was made by the State Legislature to the hospital, the sum was worth in gold coin only one hundred and sixty-three pounds, eighteen shil- lings and eight pence. The managers, being Friends, had incurred considerable hos- tility by their refusal to take up arms or subscribe money towards the cause of the patriots. In August, 1777, several of them were arrested and exiled to Staunton, Virginia, along with other Friends, by order of the Executive Council of Pennsylvania. In July, 1778, the use of the "Elaboratory," or "North House" of the hospital, was secured by the Continental Army authorities for the purpose of preparing medical supplies for the army hospital serv- ice. The North House had been erected in 1768. It was torn down when the present receiving wards and amphitheatre were opened for service. In the autumn of the year 1778, the managers admitted many sick and wounded Continental soldiers into their wards, enter- ing into agreement with the military authorities concerning their admission, medical attendance and subsistence. All of these privileges were duly paid for by the American authorities, the managers, however, generously leaving it to the officers to fix the amount of compensation due the hospital. In July, 1781, Dr. Thomas Bond, Jr., endeavored to get the managers to accede to a proposition to admit to the wards all the sick British soldiers from the gaol. The board informed him that they would not admit any who suffered from "malignant or infec- tious disorders." Dr. Bond insisted that all must be admitted or none. Finally, Eobert Morris, the financier, took a hand in the negotiations, and it was agreed that the managers would admit the sick British soldiers as patients, under the same rules which had heretofore governed the admission of patients. In the War of 1812, some of the sick and wounded of both the British and American forces were, on several occasions, in- mates of the hospital. On June 3, 1862, at a special meeting of the Board of Mana- gers, the following minute was adopted : — "Resolved, That all the accommodations in the Institution in the Medical and Surgical wards are again offered for the use of 606 General Hospitals and Dispensaries the sick and wounded soldiers of our army who may be brought to the Hospital." When, in 1898, there was again need for the hospital's serv- ices, it responded in the most noble manner, opening its wards for the reception of the sick who were sent back from the large camps and field hospitals. A small but curious source of income for the hospital in its earlier years was derived from a charge of four pence, which was made for the permission to visitors to walk through the hospital and "see the crazy people." From its foundation to the present time, its care of the insane has been one of the most important features of the Pennsylvania Hospital. One of the arguments which was advanced in the petition for the grant of its charter stated that the institution was to be for the "care and treatment of lunatics," in order "that they might be restored to reason and become useful persons to the community." It must be remem- bered that at that time, the idea that insane persons could be cured was quite a new one, the prevailing custom in regard to such persons being to confine them in almshouses to protect the community from their violence, and not with any idea of their restoration to sanity. When the buildings were erected at Eighth and Spruce Streets, special accommodations for the insane were provided on the ground floor. As the number of insane persons increased, the managers were hard put to it to provide them with suitable quar- ters away from the general wards. To provide for the female insane, and to furnish rooms for their recreation and exercise, the managers, in 1825, erected a two-story building at the southeast corner of Ninth and Spruce Streets, which was known as "The Lodge" or "The Ketreat." This was used for the insane until 1841, when the new department for the insane was erected in West Philadelphia. The Retreat was then used, first, as an isola- tion ward, and afterward for the out-patient department until 1893, when it was torn down. The first Superintendent of the Hospital for the Insane in West Philadelphia was Dr. Thomas Story Kirkbride, and he filled the position with untiring fidelity until his death, in 1883. So much did his personality make itself felt, that to the present time probably the majority of the inhabitants of Philadelphia speak of the institution as "Kirkbride's." He was succeeded by Dr. John BENJAMIN RUSH. Pennsylvania Hospital. The Pennsylvania Hospital 607 B. Chapin, who continues to fill the position in a manner worthy of his great predecessor. The most interesting details are extant dealing with the early management of the insane patients of the hospital. Dr. Benjamin Bush was especially active in the study of their eases and in devising methods of treatment for, or measures directed to, the comfort of these patients. The early minutes of the managers contain many letters addressed by him to them on this topic, and furnishing valuable advice for their guidance. For many years there was a perilous disregard of personal rights in the measures employed to secure admittance of alleged insane persons to the hospital. They were frequently committed on the authority of an irresponsible person, who had managed to secure the signature of one of the hospital physicians, to a letter authorizing the patient's admission. A bond was also required of the patient's next friend. As Morton says, no comprehensive lunacy law was enacted in Pennsylvania until 1869. He quotes the minutes engaging a man to take charge of the cells, in 1757, in which it is provided that he shall also assist the matron in the general care of the patients, and in marketing and keeping "ye Garden & Lotts in Order," all for the sum of thirty pounds a year. There are in the minutes many records of payments made for "Madd-shirts," or straight-waistcoats, and for chains and rings wherewith to confine the insane. Dr. Benjamin Bush devised a "tranquiliser," which was a chair with an attachment like a box in which the patient's head was confined. He also constructed a "gyrator," or a revolving machine, which was supposed to accele- rate the flow of blood to the head. Great reliance was placed by Bush, in his treatment of the insane, on cold baths and shower baths, and on regulated rest, recreation and exercise. Although the records show that there were occasional ob- stetric cases admitted to the wards of the hospital, no especial provision was made for this class of patients until the year 1803, when a lying-in department was established in the hospital. Con- tributions were solicited for the purpose of establishing the maternity ward. The list of subscribers is headed by the name of Stephen Girard opposite the sum of $300. Girard's wife was, at this time, an insane patient in the hospital, where she was cared for for twenty-five years prior to her death, in 1815. In 1791, while in the hospital, she had given birth to a child, which died 608 General Hospitals and Dispensaries at the age of five months. When Mrs. Girard died she was buried in the grounds of the hospital. The First City Troop of Cavalry contributed to the maternity department, in 1807, a number of securities which were held by its officers and men as the result of the investment of the sums received by them for their services in the Revolutionary War. The sum thus received from the Troop amounted to between $6,000 and $7,000. It was known as "The Cavalry Fund." When it was first proposed to establish a maternity ward, the objection was advanced that it would encourage immorality. After its establishment, the managers ruled that only respectable married women should be admitted. The ward was first opened on the second floor of the east wing. In 1817, the Contributor's Eoom was altered to serve for the purpose. In 1824, the ward was removed to the second story of the Centre Building, now the Library. Here it remained until 1835, when it was again removed to the Picture House. In 1851, the physicians, because of the fre- quent prevalence of puerperal fever in the patients of the hospital, decided that the ward should be closed. In 1854, the maternity department of the hospital was entirely abolished. For many years the Pennsylvania Hospital has held a promi- nent position in the teaching of clinical medicine and surgery in this country. Upon its staff it has numbered many of the greatest teachers of their day, and thousands of students have availed themselves of the opportunities afforded by it to study the clinical aspects of disease. The managers and the staff have always appreciated this aspect of their trust, and have spared no effort to make the clinical material within its wards of service in the cause of medical education. As early as 1757, the hospital received from Deborah Morris the gift of a skeleton, to be used for teaching purposes, and in 1772, the managers purchased a skeleton and some anatomical preparations from the estate of Dr. William Logan. In 1762, Dr. John Fothergill, of London, presented the hos- pital with a splendid collection of anatomical casts and drawings for use in the instruction of students. 3 3 The Fothergill pictures are still in the hospital, in a good state of preservation. They have been well described by Dr. J. Allison Scott in an article entitled "Concerning the Fothergill Pictures at the Pennsylvania Hospital," which was published in the University of Pennsylvania Medical Bulletin, January, 1904. The Pennsylvania Hospital 609 In 1763, the managers inserted the following advertisement in the Pennsylvania Gazette : — "The Generous Donation of Doctor Fothergill of London to the Pennsylvania Hospital of a Set of Anatomical Paintings & Castings in plaister of Paris representing different views of the Several Parts of the Human body being now deposited in a Con- venient Chamber of the Hospital, As there may be many Persons besides Students in Physic desirous to gain some general knowl- edge of the Structures of the Human body; "Dr. William Shippen jun'r, proposes to attend there on the seventh day of the Week at 5 o'clock p.m. and once a fortnight on the same day of the Week at the same house during the summer season to explain and demonstrate to such persons who are willing to give a Dollar Each for the benefit of the Hospital." At that time, most prospective doctors received their medical education by serving a regular apprenticeship to some physician. The physicians to the Pennsylvania Hospital brought their appren- tices to make rounds with them, and also many other neophytes anxious to avail themselves of the great opportunities for clinical observation afforded by the hospital. The managers thereupon passed a resolution that such students as were not regularly apprenticed to physicians on the hospital staff should be compelled to pay a fee for the privilege. The amount of the charge was referred by them to the physicians. The latter met and resolved that each student who was not an apprentice should pay a fee of six pistoles, the money collected from this source to be applied to the purchase of books for the library of the hospital. To this the managers agreed. At the end of his term of instruction, each student was to receive a certificate signed by the physicians and managers of the hospital. In 1775, the hospital began to take young men as apprentices to the hospital itself. They were indentured to the hospital for a term of five years. These appren- tices were the predecessors of the "resident physicians." It was not until 1824 that the hospital required its "residents" to be regularly graduated from a medical college previous to their appointment. Clinical lectures were begun at the hospital in 1766, the first being given by Dr. Thomas Bond. They have been continued down to the present time, with the exception of an interruption caused by the occupation of the hospital by the military authori- ties during the Eevolutionary War. Previous to the establishment 39 610 General Hospitals and Dispensaries of the clinical lectures, the members of the hospital staff had been in the habit of providing instruction to students in the wards of the hospital. When clinics were first started, a small fee was charged the students who attended them. In 1774, the fee was five pounds to the students who were not apprenticed to the physicians. In 1869, the managers granted permission to the students of the Woman's Medical College of Pennsylvania to attend the clinics. At first there was considerable opposition to their attend- ance, not only by the male students, but by the hospital staff. This, however, soon subsided. At the present time, the clinic is open to all students of medicine and physicians, and no fee has been collected for many years for attendance at them. When Dr. Lloyd Zachary died in 1767, his executors presented his medical library to the hospital, and in the same year the estate of Dr. Benjamin Morris also made them a gift of medical books. The following letter from the Library Committee of the Hospital to Mr. William Strahan, the London bookseller, who figures so frequently in Boswell's "Life of Johnson," constitutes an inter- esting link between medical Philadelphia and Samuel Johnson's London : — Phila., 4th Mo., 1774. Respected Friend :— The Managers of the Pennsylvania Hospital having deputed us to procure books for the Medical Library, as we appre- hend thou canst supply us on the most advantageous Terms we herewith send thee a List of them desiring thee to prepare and ship them by the first Vessel coming to this Port that they may be here before the winter. This we are very desirous of as the young Students who from the neighboring Provinces attend the Lectures of the several professors in our Medical School may then have the benefit of reading them a year sooner than they can if they should not arrive before next Spring; for the Cost of them we will send thee a timely Remittance. When any new Books or Essays on any branch of Medicine appear we shall be glad to have Copies of such of them as are of small Cost and an acc't of such as are more costly that if we judge them necessary we may send for them. The publisher generously responded by sending to the library a gift of books to the value of one hundred pounds. In 1790, the managers of the hospital requested Dr. John Coakley Lettsom to choose and purchase for them such medical books as he might deem of value for their library. Dr. Lettsom not only served them as their purchasing agent, but he also sent them many donations of books. The Pennsylvania Hospital 611 In 1787, the managers, with $2,770 of the library funds, pur- chased the library of Dr. Benjamin Barton. Most of the books in his library were on natural history, and very few on medical sub- jects. When the library was small, the books were placed in the Board Boom, in which the managers held their meetings. Book shelves were also placed about the wall of the general office on the ground floor of the Centre Building. In 1807, the long room occupying the length of the Pine Street front of the Centre Build- ing was dedicated to the use of the library, and continued to be used for that purpose until 1824, when it was converted into a lying-in ward. In 1835, the long room was again restored to its original purpose, and is still used as the library of the hospital, and also as the place of meeting of the Board of Managers. A training school for nurses, in connection with the hospital, was established in 1875, when Miss Francis Irwin was appointed Chief Nurse. In 1879, the title of the head of the Training School was changed to Superintendent of Nurses, and Miss Bachael A. Bunting was chosen to fill the position. In 1893, the building known as the Nurses' Home was first occupied for that purpose, and the nurses are still quartered in it, although owing to the increase in the number of nurses, it has been found necessary to place some of them in a building belonging to the hospital on the southeast corner of Eighth and Spruce Streets. Various publications have appeared from time to time under the auspices of the Pennsylvania Hospital. We have already alluded to Benjamin Franklin's "Some Account of the Pennsyl- vania Hospital from its First Beginning to the Fifth Month, called May, 1754," which was written by him at the request of the mana- gers. This was supplemented by subsequent editions continuing the history of the hospital down to later years. In 1868, a volume entitled "The Pennsylvania Hospital Beports, Vol. I," was pub- lished. The first contribution was a most interesting paper, entitled "The Pennsylvania Hospital, and Reminiscences of the Physicians and Surgeons who Have Served It," by Dr. Charles D. Meigs. The rest of the volume consisted of a remarkably good series of clinical reports and laboratory studies. In 1869, a second volume of Pennsylvania Hospital Beports was issued, but it was not feasible to continue them after that date. In 1880, the man- agers authorized the publication of a volume entitled "Surgery in the Pennsylvania Hospital : Being an Epitome of the Practice of 612 General Hospitals and Dispensaries the Hospital since 1756; Including Collations from the Surgical Notes, and an Account of the More Interesting Cases from 1873 to 1878 ; with Some Statistical Tables." The book was edited by Dr. William Hunt and Dr. Thomas G. Morton. In 1869 a "Catalogue of the Pathological Museum of the Pennsylvania Hospital/' com- piled by Dr. William Pepper, was printed. In 1873, the systematic method of reporting the histories of cases in the hospital was begun, and the last-named volume was intended to make use of some of the material which had already been accumulated in this manner. These case records, which have been carefully continued to the present time, constitute a large bulk of most interesting data, and are invaluable as a source of reference as to the past history of individuals who may at any time have been inmates of the hospital, and for the compilation of statistics. In 1857 a "Catalogue Baisonne of the Medical Library of the Pennsylvania Hospital" was prepared by Dr. Emil Fischer and printed by the Board of Managers. It constituted a volume of over eight hundred pages. Although the publication of detailed medical and surgical reports has been discontinued, the hospital publishes each year a statistical report of the work done in all its various departments. There is also issued from time to time the Bulletin of the Ayer Laboratory. The latter contains papers of much scientific value, and is published in the most creditable style. In 1895, the managers authorized the publication of "The History of the Pennsylvania Hospital," by Drs. Thomas G. Morton and Frank Woodbury. In this splendid volume are contained, not only the narrative of the hospital's wonderful work, but many interesting illustrations, and reproductions of manuscripts relative to its history. To it, all those who write of its history are indebted for their authority, and it has covered the ground so completely, that subsequent histories can merely repeat the story told in its pages. The St. Joseph's Hospital 613 The St. Joseph's Hospital By JOSEPH M. SPELLISSY, M.D. THE FOUNDING THE third General Hospital in Philadelphia — but the first suc- cessfully founded by a religious organization — was "The St. Joseph's Hospital." The underlying reasons for the establishment of a third general hospital existed from the beginning of the colonization of the Province, and were dependent upon conditions abroad as well as at home. They are stated by a reviewer, speaking of the north of Scotland, who said that, "the chief social feature" — "was famine, and the other was emigration." Irish immigration, which in 1684, established a settlement in New Jersey, extended in 1690 to Pennsylvania. 1 In the year 1729, 2 the Province of Pennsylvania received 43 Scotch, 243 Palatine, 267 English and Welsh and 5,655 Irish. The disease and mortality incident to emigration were doubtless most prevalent among the Irish famine refugee emigrants overcrowded in unven- tilated ships for weeks at a time. Deaths at sea, the landing of orphans and of ship-fever patients were constant attendants upon emigration. In the early days the emigrants were mostly landed and housed near the water front in the neighborhood of Walnut Street. The city made provision for sick strangers by placing them in unoccupied houses and employing physicians to attend them. This district was in the parish of St. Joseph's Church, which was built shortly after the purchase of the ground in Willing's Alley near Fourth and Walnut Streets, in 1731, by Father Joseph Greaton, a Jesuit from Devonshire, but more recently from Maryland. "The Friendly Sons of St. Patrick," a dining-club organized in 1771, having the names of Washington and Franklin among its members, the former being "adopted," became on its reorganization after the Eevolution, in 1790, also "The Hibernian Society for the Eelief of Emigrants from Ireland." It was resolved at a meeting i Genealogy of the MeKinstry Family, William Willis, Boston, 1858. Also History of Friendly Sons of St. Patrick and Hibernian Society, John H. Campbell, Philadelphia, 1692. 2 Gordon's History of Pennsylvania. 614 General Hospitals and Dipsensaries on March 10, 1847, "that instead of the expense usually incurred by a dinner on that occasion" (the seventeenth of March), "each mem- ber be requested to pay into the Charity Fund such sum as he may think proper." The money derived from this unprecedented act of self-denial by the society, was intended for the relief of the numer- ous emigrants driven from Ireland by the famine then prevailing in that country. On February 2, 1847, a month prior to the action of the Hiber- nian Emigrant Society, the Pastor of St. Joseph's Church, the Eev. Joseph Felix Barbelin, S.J., a native of Lorraine, called a parish meeting for the relief of immigrants from Ireland and collected $850, in those days a large sum. 3 On January 30, 1848, 4 Father Barbelin presided at a meeting for the organization of relief, held in the basement of the church. He was elected president and the Rev. A. L. McMullin, S.J., treas- urer of the society then formed. On February 10, 1848, at an adjourned meeting, the constitu- tion of the society was reported from committee. A copy of it printed in 1848, bears the title "The St. Joseph's Society for the Belief of Distressed Immigrants from Ireland, and for the Estab- lishment of an Hospital." It provides for twelve managers, four officers, two solicitors and six physicians. Francis Tiernan, a mem- ber of the Friendly Sons and Hibernian Belief Society, was elected vice-president and John C. Kirkpatrick, secretary. Capt. Joseph Dimond and Mark Devine, who were members of the "Emigrant" were also charter members of the "Immigrant Society." The pastors of St. Joseph's Church urged by the sickness and destitution among the immigrants concentrated in their parish, organized the society, but only accepted office in it because no other churchmen had consented to do so, and they published 6 their desire to transfer the trust to any other clergymen willing to accept it. The funds were divided into "Permanent," "Contingent" and "Charity" for Hospital Foundation, Society Expenses, and Belief. 3 Historical Narrative of St. Joseph's Church, Rev. P. Aloysius Jordan, S.J., Philadelphia, page 32-33. * Sharf and Westcott's History of Philadelphia, page 1670. 5 Consulted by courtesy of the Rev. Samuel Cahill, S.J., Pastor of St. Josephs Church. 6 Constitution of the St. Joseph's Society for the Relief of Distressed Immigrants from Ireland and for the Establishment of an Hospital. P. 13, Wm, J. Cunningham, Philadelphia, 1848. ST. JOSEPH'S CHURCH. /Mr*,., h'fy 1776 jwarm 'TT i i i i 11 [n lfij|| i | £ I jtt ill i ihlniltijl ! ! I i ilf it a « MT~mm'w ViL'*""Wk if"i £ fc" 'a*~ 1359 1876 1 l*« •" I ill | |~i I *;?! f fll "ripif i *~l i.Hl i< *Bl ITU I I I li! -* 6.B {J ^^*U. JjM 1909 ST. JOSEPH'S HOSPITAL ST. EDMONO'S ANNEX. The St. Joseph's Hospital 615 The managers, in committees of three, rendered relief to deserving immigrants within one year after landing. The dues were $3.00 per year. Ten dollars constituted life membership. The nineteenth of March, the Feast of St. Joseph was celebrated as the Anniversary of the society. It is evident that while the society owes its organization to Father Barbelin, it is indebted for its form to the Hibernian Society, which derived its nucleus from the dining-club of "The Friendly Sons of St. Patrick." The physicians of the society were: Dr. William E. Horner, Dr. William V. Keating, Dr. John Gegan, Dr. J. G. Nancrede, Dr. Bernard McNeil and Dr. J. McAvoy. The physicians and two solicitors were ex-officio members of the Board of Managers. On November 12th, Dr. Keating reported to the managers that the Franklin Medical College, on Locust Street near Eleventh, was purchasable for $3,000 coin and $3,000 on mortgage. Mr. George W. Edwards offering the use of $2,000 to the society and the latter having $1,000, Dr. Keating was authorized to complete the purchase. This building, erected in 1829, for Nathaniel Chapman's Medical Institute, became the Franklin Medical College, which was chartered in 1846. On November 13, 1848, at a quarterly meeting held in the base- ment of St. Joseph's Church, "The St. Joseph's Society for the Belief of Immigrants from Ireland," 7 established The St. Joseph's Hospital and "with the object of concentrating the influence of the whole Catholic community upon the project in view," it authorized its own Board of Managers "to appoint" another distinct Board of Managers for the Hospital, subject to the approbation of the Bight Bev. Bishop. On the same date Dr. Keating was requested to procure the services of the ladies of some religious order for the hospital, and it was "Resolved, That in testimony of the high appreciation of Doctors McNeil, Gegan and Keating for their unwearied efforts to establish a hospital, be ex-officio members of the board and physicians to the hospital." On November 22, 1848, the first meeting of the Board of Managers of the St. Joseph's Hospital took place in the Franklin Medical College. The object of the hospital being Catholic it was desired "that the several congregations of the city and county should ' 7 The Immigrant Society having founded the hospital, did not disor- ganize, but continued its own good work. 616 General Hospitals and Dispensaries participate in the honour and labour of its establishment and subse- quent maintenance." With this in view, the individual managers of the hospital were appointed by the Board of the Immigrant Society. There were present: "The Eight Eev. Bishop Kenrick, George W. Edwards, John Savage, B. Durand, Eobert Ewing, E. P. Walsh, James McCann, A. J. Brazier, James M. Smith, E. F. Darragh, Joseph Dimond, Walter Patterson, Bernard McNeil, M.D., John Gegan, M.D., William V. Keating, M.D., J. C. Kirkpatriek, Mark Devine, William A. Steel, J. J. Meany, J. Murray, J. P. Coombs, P. Quigg, Michael McGill, Patrick Sharp, Joseph Gisse, P. Pitzpatrick, Cornelius Myers." The Eight Eev. Prancis Patrick Kenrick, Archbishop of Phila- delphia, and Mr. J. C. Kirkpatriek, 8 were elected president and secretary of the board. Mr. James M. Smith, Chairman of the Board of the Immigrant Society, addressed the board of the hos- pital, of which he was also a member, and presented to the hospital management the building, in which the meeting was held, as that of St. Joseph's Hospital. At the second meeting of the board, held at the office of Dr. Keating, on South Fourth Street, the latter reported a flaw in the title of the Franklin Medical College. Its papers were returned, Dr. Keating resigned the chairmanship of the Committee on Property, and was succeeded by Mr. James M. Smith. "The Ladies' Auxiliary Hospital Society," which had organized on the same date at St. Joseph's Church, elected, on January 15, 1849, the following officers: President, Mrs. Pleasanton; Vice-President, Mrs. Dulany; Treasurer, Mrs. Boudny; Secretary, Mrs. Christie and ten managers. In the school room of St. Mary's Church the fourth meeting of the board authorized the purchase of one of the lots and buildings on Green Hill. A letter bearing many signatures, stating that a legacy of $6,000 was applicable to St. Joseph's Hos- pital, if a section of it could be reserved for homoeopathic physicians "was filed." The Act incorporating the hospital, signed March 12th, was read to the Board of Managers on March 26th at their first meeting at the pastoral residence of St. Joseph's Church, where meetings were held until the occupancy of the hospital. The Act specified "the purpose of establishing an hospital, to be placed under the immediate supervision of ladies of a religious order of the Eoman 8 Secretary of the Immigrant Society. The St. Joseph's Hospital 617 Catholic Church, the benefits and advantages of which institution shall be extended to the sick, without reference to creed, country or color." This instrument in defining the number of officers, specifies that the President is, ex-officio, the Bishop of Philadelphia; that the twenty-five managers are to be annually elected on March 19th by the "Corporators" from among the "Life Contributors," twenty-five dollars constituting the specified subscription. One hundred dollars collected by any individual for the hospital also conferred the title of life contributor. The officers, five in number, president, two vice-presidents, treasurer and secretary, were exempt from the quali- fication of life contributorship as a requisite to election by the corporators. Managers qualified by being life contributors, became corporators by virtue of election and contribution. Any life con- tributor might become a corporator when elected as such by unani- mous action of the Board of Managers. Of the two vice-presidents it was specified that one should be a Eoman Catholic clergyman, exercising clerical function in the Diocese of Philadelphia. With the Medical Board, life contributorship was required. Government of all hospital affairs was vested in the managers. The meetings of the board were assigned to the second Monday of each month. The hospital committee of three members was required to meet at the hospital on Wednesday and Saturday of each week, at 4 p.m. The direct administration of the hospital's affairs was entrusted to a Finance Committee, a Hospital Committee and a Committee of Supplies. The method of electing the staff will be stated later on. The donation of $500 endowed a bed for one patient, the bed to retain in perpetuity the name of the donor, with whom rested nomination of the bed's occupant. A gift of $5,000 endowed a ward of ten beds with similar faculties to the donor. Provision was made that the names of beneficiaries be preserved in the hospital's archives, and June 18th, was later selected as a day of commemoration of deceased benefactors. .The hospital seal was authorized on April 9th. Its device represented St. Joseph with the Infant in his arms, with the words "The St. Joseph's Hospital, Incorporated, A.D. 1849." The deeds of purchase from Mr. Charles Macalester of the Green Hill property, consisting of a substantial three story house situated near the western boundary of terraced grounds extending westward on Girard Avenue from Schuykill Seventh, now Sixteenth 618 General Hospitals and Dispensaries Street, southward on the west side of Schuylkill Seventh to a street called Cambridge, occupying one-half of the city block now occupied by the hospital, were executed on April 17th. The Rev. George Emlen Hare, D.D., who tenanted the house, gave immediate posses- sion, receiving a vote of thanks from the board. The terms of purchase were t$15,000, including an annual ground-rent, the prin- cipal of which being irredeemable, the rent is still paid. This house was first occupied as a hospital on June 18th, by the following Sisters of St. Joseph's 9 who accepted its care on March 29th: Mother St. John (Julia Alexia) Fournier, of St. John's Orphan Asylum; Sister M. Jane Frances Carroll, Assistant and four other Sisters. As physicians to the hospital, pending further action of the board, "Doctors McNeil, Gegan and Keating" and Dr. William Edmonds Horner were appointed on May 25th. Article XIII of the By-Laws provided that the managers, within ten days of their election by the corporators, shall elect by ballot, a medical staff con- sisting of three surgeons, three physicians and three obstetricians, who shall be life contributors to the institution. On June 11th, the board elected as surgeon, Dr. William Edmonds Horner; as physicians, Dr. Samuel Jackson, Dr. William V. Keating and Dr. Alfred Stille; as obstetricians, Dr. Bernard McNeil and Dr. John Gegan. The Surgical Department was temporarily unfilled. Pro- vision was made for the annual election, by ballot, of two resident physicians, an apothecary and gatekeeper, and it was specified that "No person shall be eligible as resident physician, without having given to the Medical Board satisfactory evidence by interrogatory or otherwise" "of his competency to the duties of the station." Dr. McNeil did not, for some time, accept his election, and Dr. Gegan resigned upon notification. EIGHTEEN HUNDRED AND FORTY-NINE TO NINETEEN HUNDRED AND EIGHT-IN SIX DECADES First Decade (184-9-1859). — St. Joseph's Hospital, on Green Hill, opened with a capacity of twenty beds, and received its first patients on June 25, 1849. On that day, the first resident, Dr. 9 This congregation, founded in 1650, was organized, after the disor- ders of the French Revolution, by Mother St. John Fontbonne, at St. Etienne, on July 14, 1807. Established in St. Louis in 1847, this order, in the person of Mother St. John Fournier, took charge of St. John's Orphan Asylum, then on Chestnut near Thirteenth Street. The St. Joseph's Hospital 619 Eomaine Schlater, was elected. On the day following, the managers attended Mass at the hospital, and on July 9th, Dr. Horner presid- ing, held their first meeting in the institution. The opening of the dispensary was entrusted on August 6th, to Dr. Keating, Dr. Stille and Mr. Walter Patterson. Drs. Henry H. Smith and J. H. B. MeClellan, were elected attending surgeons by the managers, respectively, in October and November. In Septem- ber a sign surmounted the hospital gate, and the meetings of the managers reverted to the pastoral residence of St. Joseph's Church. Extension of the hospital was soon rendered necessary by pestilence and resultant illness among the nursing Sisterhood. On November 1st, the adjoining house and grounds were purchased from the heirs of Blihu Chauncey, for $15,000. The possession of the two properties gave the hospital its present frontage on G-irard Avenue, some 395 feet from Sixteenth to Seventeenth Streets, and a depth in the center of the lot of some 188 feet to Cambridge Street. The cost of the two lots, bounded by the four streets named, was $30,000. Exclusive of street areas, they occupy about one-sixteenth of the Green Hill estate. The estate contained 100 acres. It was deeded by William Penn 10 in 1692 to Thomas Lloyd, physician and deputy governor, from whom this "Plantation" was inherited by his grandson, Lloyd Zachar}', born in Philadelphia, and one of the first students of medicine in the province. (What could be more fitting than the establishment by a Society for the Eelief of Distressed Immigrants, of Philadelphia's third hospital in the inheritance of Lloyd Zachary, who in 1728, was commissioned Philadelphia's port physician?) The Medical Board was organized on February 11, 1850. Dr. Horner was elected President, Dr. Smith, Secretary and a Com- mittee on Organization appointed. The St. Joseph's Hospital Beneficial Society, organized by a committee of the managers, held its first meeting on February 24th. Its constitution 11 printed in 1850, states the requisites of member- ship : signature of by-laws, payment of $1.00 initiation, monthly payment of 25 cents or $3.00 per year; $25.00 constituting life 10 This record is indebted to the Solicitor of the Hospital, Mr. Joseph G. Magee, for tracing the property through sixteen owners to its original proprietor. 11 Consulted by courtesy of Rev. Samuel Cahill, S. J., Pastor of St. Joseph's Church. 620 General Hospitals and Dispensaries membership. Members were attended, and in case of death buried without charge; admission being contingent upon twelve months' membership and the endorsement of the attending physician to the hospital. The officers of the society were annually elected by the managers of the hospital. The treasurer of the society deposited its funds with the treasurer of the hospital, receiving certificates of deposit bearing six per cent, interest. The records of the eight months of the first year, like those of the ten succeeding hospital years, were closed on March 1st to permit the completion of reports and accounts for the corporators' meeting which was and has since been held on March 19th, except when it occurred on Sunday, the meeting in that event, being held on the following day. At the first meeting of the managers after that of the corporators, the announcement is annually received of the election of the board and of its officers for the ensuing year. The managers then elect the attending and resident staff. Dr. J. McCourt was elected to the obstetrical vacancy on the first Medical Board. The first resident physician was accorded a vote of thanks, and his successor elected. The first printed report gratefully acknowledges the assistance of the Eev. E. J. Sourin and the fur- nishing of the hospital to the extent of $1,700 by the Ladies' Auxiliary Society. Possession of the west house was obtained on June 1, 1850, and wards and beds were redistributed in both buildings. The west 12 house was devoted to women, the Sisters, the chapel, parlor and library ; the east, to men, the pharmacy, dispensary and the resi- dents. The first hospital chaplain appears to have been the Eev. Mr. Shields. The first legacy, $150, bequeathed by John Lawrence, was trans- mitted by Dr. Keating on June 24th. The service of two residents began on September 9th. Mother St. John Pournier was succeeded by Mother M. Jane Frances Carroll. Plans for the hospital's extension, present and future, were rejected for lack of funds. The Building Committee was obliged to be content with reporting the completion of a one story frame structure, containing a kitchen and a passageway 44 feet long, connecting the two houses. Schuylkill water was introduced, but Green Hill being higher than the Spring Garden Water Works, tanks 12 The volume is indebted for these notes to Sister Assisium, of the Sisters of St. Joseph, and to Dr. George C. Harlan, a resident in 1858-59. J. Henry Smaltz (2) (O. 1851-53) Alfred Stille (1) (P. 1849-56) F. Gurney Smith (P. 1851-58) Rene de la Roche (P. 1856-57) William Keller (P. 1858-62) Samuel Jackson (4) (P. lc49-50) William V. Keating (P. 1848-94) W. Edmonds Horner (2) (S. 1849-53) Henry H. Smith (S. 1849-50) G. H. B. McClellan (S. 1849-63) t W. Byrd Pase (S. 1853-61) Joseph Leidy (3) (Pa. 1852-91) A. H. Bournonville (O. 1853-1906) Portraits of Samuel Jackson of Northumberland (P. 1850-51). Bernard McNeil ( P. and 0. 1848-58), T. A. Reilly (0. 1850-52), ohn McCourt (O. 1850-51), C. G. Schwartz (O. 1852-53), J. D. Bryant (O. 1853-75) and John Flynn (O. 1859) unobtained. P. -Physician, Pa. -Pathologist, O. -Obstetrician, S. -Surgeon. PLATE IV.— THIRTEEN* OF TWENTY MEMBERS OF THE MEDICAL BOARD. l.S-IS-1839. Deceased, f Approximate date. Photographs: (1) Lent by - Ifltltl. ■d. t Photographs donated hv .Mr. P Gutckunst. Rt .Tnspnh's Hospital. The St. Joseph's Hospital 627 study of bacteriology, blood secretions and specimens. An X-ray apparatus, the gift of Mr. Gustavus A. Miiller, was installed in 1898. During the Spanish-American War, 224 soldiers were treated throughout the 5,015 hospital days, with but six deaths, and a hos- pital train was sent at the institution's expense, in relief of sick soldiers at Camp Meade, Pennsylvania. The Training School for Nurses opened in 1894, was in its first two years instructed in succession by three secular nurses, who bore the title of supervising nurse. The first of these was a graduate of the Pennsylvania Hospital. The first class was graduated in 1896, a Sister, a graduate of the Massachusetts General Hospital, having become supervising nurse. Since that time, four Sisters have succeeded to the office, and the course was then lengthened to three years. The administrative head of the hospital is the superin- tendent of the training school. Instruction is received from the supervising nurse and from lectures by the staff. Obstetrical training is provided in special hospitals. The receiving ward grew coincidently with the placing of a sign at the eastern end of the hospital. The patrol service of 1896, contrasted 410 patients with 250 of the preceding year. The opening of the dispensary pharmacy brought an increased out- patient attendance. Within the hospital, the register of 1898 showed an increase of nearly 1,000 patients compared with five years before. The Women's Board of St. Joseph's Hospital, organized by Mrs. Eobert B. Cruice at the semi-centennial of the hospital's life, calls to mind the Ladies' Auxiliary Hospital Society at its founding. By the efforts of the board some $800 were contributed. Its officers were: President, Mrs. Eobert B. Cruice; Vice-Presidents, Mrs. John M. Keating and Mrs. John H. Brinton; Treasurer, Mrs. B. Mason Lisle; Secretary, Miss Sophie B. Keating; Chairman of Committees, Mrs. John H. Brinton, Mrs. Alfred C. Gibson and Mrs. Eussell Thayer. Sixth Decade (1899-1908).- At the beginning of this decade, the Board of Managers for the first time became non-denommafaonal, inaugurating a precedent. Sister Angeline Davis, a most pro- gressive executive in constructive and administrative extension, died on April 30 1903, and was succeeded by Sister Eaphael Jones, who in 1906, was succeeded by Sister Elizabeth Sheehan, late of the Providence Hospital, now serving. 628 General Hospitals and Dispensaries Metal wainscoting and ceiling, enameled painting and hardwood floors completely renovated the interior of the hospital, as the painting of outside wood and metal work, and the paving in cement of driveways and of the surrounding sidewalk, made the institution bright and modern in every detail. A new kitchen with improved ventilation has a service capacity of 350 warm meals. A new X-ray and dark room were placed available to all departments, and in 1902 were organized for service in radiotherapy as well as radiog- raphy. To the right of the main entrance is a modern business office of immediate accessibility. Alterations enlarged the receiving ward, and added additional baths to the east wing. The erection of fire towers and installment of pipes and hose, safeguard from fire. A new laundry, heat and light plant, dormitories for male and female help, and an ambulance stable were completed in this decade. The erection of St. Edmond's Annex, a detention and isolation ward, consisting of two stories and a basement with a ground plan of 21 x 108 feet, at Sixteenth and Cambridge Streets, fills a much felt need. It also contains a newly equipped pathological laboratory, dark and post-mortem rooms, cold storage, a mortuary and driveway, direct to Cambridge Street. In compliment, this building bears the name of the patron of the present Vice-President of the Board, the Et. Eev. Edmond P. Prendergast, D.D., V.G. The Ex-resident Association formed provisionally on May 6, 1907, was permanently organized on May 19, 1908, with an active membership of 91 and an honorary membership of the past and present staff, of 49. The Dean of the active members by seniority, is Dr. George C. Harlan of 1858-1859. The training school has graduated 144 nurses in the past 9 years, the last class numbered 24. There are 61 pupils at present in the school. The Alumnas Association was organized in 1904, and maintains a fund for sick nurses. The Out-patient Department in the past nine years increased in all its services; in the laryngological from 264 to 866; the emergency from 2,000 to 4,455; the gynecological from 208 to 550; the medical from 695 to 1,038; the surgical from 1,164 to 2,071; the eye from 6G7 to 823 and the pediatric from 504 to 611. From 1849 to 1890, 44,150 free meals were served to the needy and 52,040 dispensary patients were treated ; from 1890 to 1899, 25,352 cases; in the past nine years, 72,420 cases; a total of 149,812 out- patient cases. The St. Joseph's Hospital 629 SUMMARY In the sixty years of the hospital's life, there have been thirty- four printed reports. A statistical table (p. 630), has been prepared by reference to the hospital registers, as well as to the reports. It presents financial columns kindly supplied by the treasurer, Mr. William J. Power. A glance contrasts 3,736 patients treated in the first ten years with 22,915 in the last nine, an increase of over six times. The number of patients in the first full hospital year ending in 1851, was 373. In 1908, there were 2,599, an increase of nearly seven-fold. The gain has been progressive, the apparent falling off in 1869-79 is explained by emergency Civil War service which abnormally increased the total of the previous decade, and the con- struction of the central and east wings in the third decade, which diminished both accommodations and money for maintenance. The statistics of operation illustrate the effect of Listerism. The death rate in the second, third and fourth decades is between 8 and 9 per cent. In the fifth decade the total number of operations more than doubles that of any of its predecessors, and yet the mortality is but little over 5 per cent. In the past nine years 10,891 operations, over three times the number of the previous decade, has a death rate of 320, a little over 2 per cent. The cost per patient, $24.81, in the first decade obtained by dividing total expenditure by total patients, is of interest when com- pared with $42.92, the maximum of expense in 1879-89, and the rate of the past nine years $39.97. A study of receipts and ex- penditures discovers those of the second decade to be double those of the first, and those of the past nine years likwise almost double its predecessor, the relation being that of $490,864 to $915,661. The present normal capacity of the hospital is 170 beds, the maximum census of patients, 175, in Spanish-American war time. There is emergency capacity for 200 cases. The beds are distributed in eight general and three private wards, and fifty-four private rooms. In support of the hospital, especially in the first decade, there have been various entertainments, each contributing from $200 to $1,000. Among these sums are $248 from Mrs. Frances Ann Kemble, and $500 from Miss Jenny Lind. Prior to 1865, sums as large as $4,000 to $5,000 were obtained from fairs. In the first decade, each subscription of $100 from a congregation entitled its pastor to name patients in succession to one bed for one year. In 630 General Hospitals and Dispensaries M a H © i-l ca ■U eq P-, a <) ew O) H cp Q M ^ o .3 a o H izi CO ai H << -a H C3 *j 02 l> o CN CO °i H -ipnadxa CN as r i CO c-i - Ol Ol IO CO O 09- CN la < g 6© lO 01 CN CO Ol in CO oo -T- io Tf -- IO CO £ s co" co' o "* r-i Ol" c-: i- - CO CO S^dT808H o >-( •<# o X CO CO r^" ci o" iO co" Ol :i Ol CO O) ©& CN 74 CO ^r Ol CO CN 99- 01 O t- J> IO CN r— ■O l> c-. CO IB»Oi cn 3. CO x_ 1> o" CO iO "^ CM CO Ol a (N co iO o 71 7-1 o (N &H <] ■y ?, 7 1 Ol 1-7 CN »n0 cn >— ! CO CO "* °P- « 1-1 CO X — "■ CM a" E- co iO r- iO 71 UO O CO CO i- - X iO ai t-^ c~^ OT " 7f -. r: Ol CO_ CO IO IO* X ltT CN CN CO w (M t- CO ~~ x~ iT;. iC n — •^M IO Ol Ol aeo I> IO lO IO ^1 TOO! 00 CO ITS Ol I> T3 1 °i Ol CO io" UTj* x" htJ CN CN CO SainiBui CN l> CN CN iO CN o Q -sk 2 3 • ■: CO S8 X X X iO CN IO r- ■* o rH o P3M T* to CO o X CN CO r~ M rH ■w CO o X r> w pQAOinay CO CO oi CM ■rf I- Ol o CD -4 paAOjd Ol CO CN W CO p -ihiuq CN Tj" CD paAOja CI O IO O - CN X CO O -rai ^ or CO •<* "di CN CN ■TJH rH co - ~eo~ 00 CN — — l paano 3 Ol CN co Ol CO CN r}-" ■^1* CO m x" t-^ Ol Ol Ol Ol Ol X o Ol s Ol 00 rH X o sad voaa S 3 3 Ol c CO I X s X s 1 -4 Has nan co -a CN T3 CO •a S CD 03 o EH The St. Joseph's Hospital 631 the first decade five free beds were endowed at the rate of $500, the first in 1852 in the name of Mrs. Eilzabeth Welsh Homer. The endowment was increased to $5,000, and since then fifteen beds have been founded, the first in 18G2 in the name of Mr. Bernard McKane. The greatest bequest in any decade was $106,161, between 1879- 89. Of this, $72,000, the largest single endowment of the hospital, came from the estate of Mr. Francis A. Drexel. If it is added to the $61,000 received from Mr. Hutchins and the $35,000 from Mr. George S. Pepper, the aggregate, $168,000, is nearly two-thirds of the total sum bequeathed, $361,143, in the sixty" years of the hospital. The State first appropriated $5,000 in 1863, and repeated that amount in 1864 and 1865. In the nine years of the present decade, four appropriations amounting in all to $60,000 for maintenance and $17,000 for improvements, make the total State aid $92,000. The total of private bequests and of State appropriations amounts to $453,143. Subtracted from the total receipts, which are $2,316,619, there is a balance of $1,862,306. It is plain, therefore, that less than one-fourth of the hospital's support has been derived from bequests and appropriations, and that more than three-fourths come from the receipts from pay-patients and from the smaller donations of numbers of people of very moderate means, by whom the hospital has been supported. The subscription lists show gen- erous contributions from all denominations in the community. The care by St. Joseph's Hospital of 61,650 patients within its walls and of 149,812 in its Out-patient Department, making in all, 211,462 cases treated in the past sixty years — resulted from that parish, meeting called by Joseph Felix Barbelin, S.J., at "Old St. Joseph's Church"; from the organization of "The St. Joseph's Society for the Eelief of Distressed Immigrants from Ireland and the Establishment of an Hospital"; from the assistance of George W. Edwards that made possible the purchase of part of the "Planta- tion" of the colonial port physician; and from the commission of the care of the sick to the Sisters of St. Joseph under the adminis- tration of the Board of Managers. Conspicuous in the latter and in the Medical Board for philanthropy and professional attainments, were William Edmonds Horner and William V. Keating. Such were the foundation and the founders of the third gen- eral hospital in Philadelphia, but the first a religious organization opened "to the sick" and "without distinction of creed, country or colour." 632 General Hospitals and Dispensaries The Hospital of The Protestant Episcopal Church in Philadelphia By ISRAEL W. MORRIS THE Hospital of the Protestant Episcopal Church in Philadel- phia was chartered on July 18, 1851, and was the outgrowth of a movement inaugurated by Et. Eev. Alonzo Potter, Bishop of Pennsylvania. Immediately after assuming his official position, on September 23, 1845, he called together a number of prominent lay- men in order to ascertain what urgent matters were calling for attention and assistance in the diocese which he had come as a stranger to manage. These laymen directed his attention to the necessities as they individually saw them, leaving to his judgment the decision as to which were the most imperative. Among them was one, a leading physician in the city, whose experience in the care of the sick had made him thoroughly aware of the lack of hospital accommodation in the then rapidly growing city, and who pleaded very earnestly for an increase in such accommodation. At that time the Pennsylvania Hospital, located at Eighth and Pine Streets, was the only general institution of the kind in the city, and, while it was doing everything in its power to meet the growing demands upon it, the growth of the population of the city had outstripped the accommodations which it could offer, and many sufferers were prevented from securing relief because of its distance from the scene of accidents and the overcrowding of its wards. It is true that at that time the city maintained by taxation the Philadelphia Hospital (commonly known as the Almshouse) but admirable as that institution was and is, it failed to meet the crying calls for assistance constantly made by self-respecting mechanics, and steady laborers who had a mortal horror of being consigned in their hour of need and misfortune to what they considered a city charity relief institution. This physician, Dr. Caspar Morris, pre- sented the subject with such earnestness that the meeting adopted his views and requested him to prepare an appeal to the public upon the subject. This was done and in 1851 an "Appeal on Behalf of the Sick" was issued by him and largely circulated. Thus was the plan started, which resulted in the organization of the "Hospital of the Protestant Episcopal Church in Philadelphia." K c- J H Q < £ P-J 0, H w H E-i O rt c- H M H O J < O The Episcopal Hospital 633 At a subsequent meeting of this committee of laymen, which was held at the house of John Welsh (afterwards Minister from the United States to Great Britain) it was decided to start a hospital upon the plan suggested, and committees were appointed to obtain a charter, and to raise funds for the accomplishment of the object in view. The Bishop also requested the clergy of the several churches in Philadelphia to bring the matter before their respective congregations by means of sermons. Among other clergymen who responded to this call was the Beverend William Bacon Stevens, M.D., D.D., rector of St. Andrew's Church, afterwards successor of Bishop Potter in the office of Bishop of the Diocese of Pennsylvania. Dr. Stevens was not only a powerful speaker, but had practiced medicine for a number of years before he entered the ministry. Taking his text from the Gospel of St. Matthew, fourth chapter, twenty-fourth verse: — "And his fame went throughout all Syria, and they brought unto him all sick people that were taken with divers diseases and torments, and those which were possessed with devils, and those which were lunatic, and those that had palsy ;' and he healed them," he presented the cause to his congregation so earnestly and impres- sively that two ladies (sisters) Miss Ann Leamy and Mrs. Eliza H. L. Stout, were led to offer for the use of the embryo institution their ancestral homestead, where their childhood had been spent. This property was situated at Front Street and Lehigh Avenue, and embraced, not only the mansion house, but a square of ground sur- rounding it. The location of this lot was by many considered inaccessible, there being no car system at that time, and too far removed from the central part of the city, but, careful consideration by the com- mittee, whose members were aware that the city was rapidly growing in that direction, with factories springing up, railroads located and others projected, it was decided that the location was a good one and well adapted to meet the object for which the proposed institution was designed. They therefore accepted this generous gift, which assured the location of the Episcopal Hospital at Eront Street and Lehigh Avenue upon a tract of land which with adjoining land since purchased, embraces more than ten acres. It appears to be proper at this point to mention the names of some of the citizens, who took a lively interest in thus starting an institution which has grown to its present large proportions. There 634 General Hospitals and Dispensaries is very little documentary evidence available as to who these parties were, but some of those most prominent in the movement were the Et. Eev. Alonzo Potter, the Eev. W. H. Odenheimer, Hon. Joseph E. Ingersoll, Hon. Peter McCall, George M. Wharton, Esq., and Francis Wharton, Esq. ; these, too, appear in the charter. The following were among the liberal contributors at an early date: — Estate of Josiah Dawson, Benjamin W. Prazier, Joseph E. Ingersoll, Mrs. Maria Blight, Mrs. E. A. Burd, Mrs. Mary M. Eicketts, A. Whitney and Sons, Miss Emily Hollingsworth, John C. Cresson, Harry Ingersoll, Marshall Hill, Tobias Wagner, John William Wallace, Caspar Morris, M.D., Edward Lowber, Joseph Harrison, Jr., Samuel Welsh, John Welsh, Mrs. Dr. Mutter, Wm. H. New- bold, son and Aertsen, Thomas Eobins, H. Pratt McKean, William Welsh, Mrs. Elizabeth W. Horner, Mrs. E. W. Ebbs, Samuel V. Merrick, Merrick and Sons, John Bohlen, Miss Catharine M. Bohlen, Adolph E. Borie, George L. Harrison, Thomas A. Kewhall, Wm. H. Stewart, Thomas Sparks, Anthony J. Drexel, Jay Cooke and Isaac Boyd. There were many others who assisted largely either with advice, direct contributions or collections of money, and these ardent workers aided in no small degree in the accomplishment of the work. An interesting feature in the starting of the institution is the action of the ladies who were the first contributors : Miss Leamy and Mrs. Stout contributed the house and land where a beginning was made; Jenny Lind, (the "Swedish Nightingale") and Mrs. Latimer, made the first cash contributions of $500 and $100, as appears by the treasurer's accounts in 1851 ; and from that day to the present a large percentage of the funds necessary to keep the hospital going has been received from its female friends. The hospital was opened in the Leamy mansion on December 11, 1852, and on Christmas Day, 1852 the first patients were admitted and the building was soon filled to its capacity of twenty- three beds. At the annual meeting of the contributors, held on January 4, 1853, the Bishop reported that $54,000 had been subscribed toward the erection of proper buildings for the hospital, and at that meeting a regular Board of Managers was elected, as provided in the charter, as follows : — Managers for term expiring January, 1854. — Eev. M. A. De- The Episcopal Hospital 635 Wolfe Howe, D.D., Eev. Eichard Fewton, D.D., Eev. Wm. Bacon Stevens, D.D., John Bohlen, Joseph E. Ingersoll, W. H. Klapp, M.D., Wilson C. Swann, M.D. Managers for term expiring January, 1855. — Eev. Benj. Dorr, D.D., Eev. James Fowles, Eev. W. H. Odenheimer, Thomas Alli- bone, John C. Cresson, Benj. W. Frazier, Marshall Hills, B. S. Janney, M.D. Managers for term expiring January, 1856. — Eev. H. W. Ducachet, D.D., Eev. Henry J. Morton, D.D., John K. Kester, Peter McCall, Caspar Morris, M.D., George M. Stroud, Francis Wharton, George M. Wharton, Samuel Welsh, Treasurer; Prancis Wharton, Secretary. It may be well to look into the nature of the connection of these gentlemen with the hospital. Many of them had been promi- nent in the various conferences held with Bishop Potter prior to obtaining the charter, in which they were named as managers ; but the first regular meeting of the contributors was in January, 1853, at which time they were duly elected and divided into three terms of service. Many of them continued their services to the institution up to the time of their death, some for a period of thirty-five years. The Eev. William Bacon Stevens served as manager until the year 1865, at which time he was elected Bishop of the Diocese of Pennsyl- vania, and became thereby ex-officio President of the Board of Managers. He held this position until his decease in 1886, never failing during this time to give the closest possible attention to the needs of the hospital, both physical and religious. Many of the contributions now appearing in the endowment or other funds, were given largely in consideration of the influence which he exerted with the donors. The same may be said in regard to the laymen whose names appear upon the Board of Managers. They never omitted an opportunity to lay before their friends the needs of the hospital, and the result was a continuous flow of pecuniary assistance, which enabled the managers to construct and support the large institution which has grown out of the small beginning at Christmas, 1852. These gentlemen threw themselves into the work with great energy, being determined that the institution, thus modestly started, should exhibit a yearly growth. The annual reports show that their confidence was well founded, for, while in the year 1852, but six patients were admitted into the hospital, we find that, in the year 1907, the admissions to the house were 3,483, and that assistance 636 General Hospitals and Dispensaries through the dispensaries was tendered to 24,862 individual cases. During the fifty-six years ending December 31, 1907, 83,218 patients had been received into the wards of the hospital, and, in addition, seven hundred and five soldiers were cared for during the" Civil War; 835,328 cases have also been treated in the out-patient or dispensary department. From 1852 until 1859, the hospital continued to do all the work possible in the old Leamy Mansion, but it was soon found that it did not permit of proper arrangements for the care of patients. The ventilation was inadequate and the sanitary con- ditions defective. The building accommodated about twenty-five patients — sometimes as many as thirty-five — and, while undoubt- edly much good was accomplished, the hands of the physicians, surgeons and executive officers were tied by unfavorable condi- tions, and they could not perform the service which was expected of them. While the collections in churches and individual contributions during this period were ample to support the few patients received, the board were well aware that they could not meet the wants of the district, and made constant efforts to collect, either by gift or subscription, sufficient money to enable them to erect buildings with modern arrangements particularly applicable to the object for which the hospital was established. In 1859, it was found that $100,000 had been pledged for the erection of a proper building, and arrangements were made with architects to submit plans for the work. A number of plans were submitted, and Mr. Sloan, an architect of that period, was authorized to complete his plan and to prepare for the erection of the new building as early in 1860 as possible. A copy of the original plan and elevation will be found in the report of January, 1860. Preparation for the work was made as rapidly as possible, and, on May 24, 1860, the corner-stone was laid at the northeast corner of the main or administration building. Upon this occasion, which coincided with the Annual Convention of the Diocese, a large number of the clergy and laity was present, and, after the corner-stone was properly laid by the Eight Eev. Alonzo Potter, D.D., assisted by the Eight Eev. Samuel Bowman, Assist- ant Bishop, addresses were made by the Bishop, by Dr. Caspar Morris and by the Eev. Dr. Muhlenberg, of New York. After these addresses the services were adjourned to be continued at St. The Episcopal Hospital 637 Andrew's Church, Eighth Street above Spruce, in the evening, when further addresses were made by the Rev. William Bacon Stevens, M.D., D.D., and the Hon. Joseph It. Ingersoll. A full account of these addresses will be found in a pamphlet which is tied into the Minute Book of 1860. Work was continued upon the new buildings as rapidly as possible, but, owing to the commencement of the Civil War, dis- turbance in labor conditions and the difficulty in obtaining sup- plies, some time was consumed in completing the work, which embraced the chapel, the main or administration building, and the west wing, the latter now occupied by the men's surgical and medical wards. This work was nearly completed in the early part of 18G2, when, on account of the great demand for hospital accom- modation occasioned by the many wounded and sick in the army, the Government requested the use of the building as a military hospital, and were given temporary possession of it. They took possession at the close of July, at which time forty-six sick and wounded soldiers were received by Dr. Bichard A. Cleemann, United States Contract Surgeon in charge. The entire number of soldiers received was seven hundred and five, of which thirty- three died, the remainder being either returned to service or dis- charged as being no longer able to perform military duty. In March, 1863, the soldiers were removed to the Government hos- pital, and the buildings of the Episcopal Hospital were prepared for the reception of such patients as they were originally intended to accommodate. In accordance with the report of the Building Committee the cost of constructing the foregoing buildings was $165,244.03, which amount was contributed by about one hundred and twenty-five- individuals in varying amounts. The foregoing is but a sample of the experience of the board; the demand for accommodation has continually increased, and our charitably disposed citizens have generously supplied the funds necessary for new buildings, which have been added, until the present capacity is four hundred beds, occupied by an average of about three hundred patients. The present buildings are com- posed of a group of so-called pavilions : — The receiving ward, known as the Ingersoll Building; the men's surgical ward, and the men's medical ward; the women's surgical and medical wards ; the Harrison Memorial House, which is an independent building, though connected by corridors with 638 General Hospitals and Dispensaries the main building. It was erected and endowed by the children of the late George L. Harrison, who for many years was the faith- ful Treasurer of the Hospital, and is occupied by those unfortu- nates who are hopelessly diseased, or injured in such manner as to permanently prevent them from making their own living. There are also the Aspinwall Building, designed for the care and relief of convalescent girls; the Nurses' Home; the Deten- tion Building, erected in 1907 by Mr. James Logan Fisher, as a memorial, which is designed and equipped in the most scientific manner for the care of such sporadic cases of infectious or con- tagious diseases as are liable to make their unwelcome appearance in every hospital; the Chapel, erected in 1861, in connection with the main building, in accordance with the gift of Miss Emily Hollingsworth, as a memorial to her uncle, the Eev. Bird Wilson. It is under the charge of a resident Chaplain, whose salary is pro- vided for by an endowment fund for that purpose. Erected upon the grounds are other buildings necessary to the proper administration of the affairs of the hospital, such as the following: — • A well-equipped steam plant; a residence which is occupied by the superintendent and his family; an Out- Patient or Dispen- sary Building, which is situated upon the Huntingdon Street front of the grounds, and was formerly occupied by the Hospital Mission. Three hundred patients are here treated daily by the dispensary staff, the cases being those needing relief from temporary ills which are not sufficiently serious to make them inmates of the hospital proper. It will be seen from the foregoing that a great mass of build- ings has gradually accumulated, as, owing to the growth of the population and manufacturing industries in that section of the city, the pressing demands upon the service of the hospital have increased. This growth has not been accomplished without the expenditure of a large sum of money, and the managers have often been sorely pressed to know where it was coming from, and how the increased cost of maintenance was to be met. Provi- dentially, up to this time, our liberal fellow-citizens have nobly stood by the managers, and the means have been provided, either by gifts or legacies, so that it is the privilege of the board to be able to say that all this has been accomplished without there being The Episcopal Hospital 639 at this time any debt upon the property, and without any State or city aid, except one small contribution from the State in 1864 and 1865 of $10,000. This is a proud record of the past, and it is the confident belief of the managers that the citizens will not in the future allow the work of charity to be curtailed for the want of a few paltry dollars necessary to maintain and perfect the work so ably founded in their midst. The hospital, while under the charge of Episcopalians, can in no sense be called a sectarian institution, for the charter expressly provides that it shall be open for "all persons, without regard to creed, color or nationality." That this principle is fully carried out by the institution is evidenced by the statement that since the opening of the institution in 1852 down to December 31, 1907, the nationalities of the occupants of beds were as follows : — Nationality. — United States, 40,732; Ireland, 15,954; Eng- land, 7,619; Germany, 8,213; Scotland, 1,943; Sweden and Norway, 3,023 ; other countries, 5,734. Total, 83,218, and for the seven years, from 1900 to 1907, inclusive, the religious denomina- tions are shown as below : — Religious Denominations. — Episcopalians, 4,830 ; Roman Cath- olic, 9,201; Lutheran, 2,744; Methodist, 2,589; Presbyterian, 1,997; Baptist, 1,173; Hebrew, 286; Congregational, 67; Ger- man Eeformed, 222; Friends, 28; Evangelists, 65; unrecorded, 1,913. During the fifty-six years that the hospital has been in opera- tion 83,218 patients have occupied beds in the wards, and 835,328 out-patients have been attended to by the out-patient or dispen- sary department. How can any calculation be made from these figures which will indicate the vast amount of suffering that has been alleviated, or the number of lives that has been saved by the prompt and conscientious ministrations of the physicians, surgeons and nurses who have aided in furthering the work ? The management of affairs has been under the charge of a board composed of the Bishop of the Diocese and eight clerical members, while the laity is represented by sixteen members. This board is divided into committees, whose duty it is to visit the hospital weekly. There are also committees having charge of finance, property, administration and supplies. These committees have always been faithful in the discharge of their respective duties. 640 General Hospitals and Dispensaries The present Board of Managers is composed of the following members : — BOARD OF MANAGERS President Ex-officio.— Right Eev. 0. W. Whitaker, D.D., L.L.D. Vice-President. — Eight Eev. Alexander Mackay-Smith, D.D. Treasurer. — George Harrison Frazier, member ex-officio. Term of Service Expiring January, 1909. — Eev. J. Blake Falkner, D.D., Eev. J. Andrews Harris, S.T.D., Eev. Floyd W. Tomkins, S.T.D., John C. Browne, Israel W. Morris, Ewing L. Miller, W. W. Frazier, Charles Edward Ingersoll. Term of Service Expiring January, 1910.— Eight Eev. Alex- ander Mackay-Smith, D.D., Eev. Nathaniel S. Thomas, Charles Biddle, Francis A. Lewis, Caspar Morris, M.D., Lincoln Godfrey, G. Clymer Brooke, Eobert C. Drayton. Term of Service Expiring January, 1911. — Eev. Joseph D. Newlin, D.D., Eev. J. B. Harding, Eev. Louis C. Washburn, D.D., Thomas H. Powers, James Logan Fisher, Wharton Sinkler, M.D., Henry B. Coxe, C. S. W. Packard. Secretary. — Ewing L. Miller. The hospital has always been served without fee or reward by a staff of professional men, who have been, and are, an honor to their calling, and by their skill have kept it in the forefront of such institutions. The following are at present on the staff, and are ably assisted by the resident physicians: — MEDICAL BOARD President. — Dr. Thomas E. Neilson. Secretary. — Dr. Elliston J. Morris. Physicians. — Dr. Francis W. Sinkler, Dr. Elliston J. Morris, Dr. A. A. Stevens, Dr. Wm. Egbert Eobertson, Dr. David L. Edsall, Dr. Charles H. Weber. Surgeons. — Dr. Thomas E. Neilson, Dr. Charles H. Frazier, Dr. H. C. Deaver, Dr. G. G. Davis. Ophthalmic Surgeons. — Dr. G. Oram Eing, Dr. William T. Van Pelt. Aural and Laryngeal Surgeons. — Dr. Joseph S. Gibb, Dr. Charles C. Biedert. Pathological Department. — Dr. Courtland Y. White. Resident Physicians. — Dr. Eric von Buddenbrock, Dr. John The Episcopal Hospital 641 W. Price, Jr., Dr. Edward F. Corson, Dr. James A. Livingston, Dr. Eobert H. Ivy, Dr. W. Wellington Woodward, Dr. Charles H. Auf- hammer, Dr. William E. Brown, Jr., Dr. William A. Newell, Dr. William H. Gorton MacKay. Superintendent. — E. F. Leiper. Chief Nurse. — Mrs. 1ST. P. W. Crossland. Chaplain. — Eev. William F. Ayer. The Out-Patient, or Dispensary, has a staff as follows, and they are called upon to look after over 300 patients per day : — DISPENSARY STAFF Physicians. — Dr. Wm. W. Fox, Dr. H. G. Godfrey, Dr. Howard Gurney Fretz, Dr. Cyrus C. Moore, Dr. George Mason Astley, Dr. Eichard S. Hooker, Dr. Charles M. Montgomery. Surgeons. — Dr. Emory G. Alexander, Dr. A. P. C. Ashhurst, Dr. John A. Boger, Dr. Harry S. Carmany, Dr. Warren Walker, Dr. E. E. W. Given, Dr. Z. M. K. Fulton, Dr. L. H. Mutsehler. Assistant Ophthalmic Surgeons. — Dr. John L. Bromley, Dr. H. W. Weyant. Radiographer. — Dr. Henry C. Welker. Registrar. — Dr. G. Mason Astley. The work heretofore described has called for the expenditure of a vast sum of money which has been furnished by the liberal citizens of Philadelphia, the City of Brotherly Love, and they have our heartfelt thanks for their past generosity. It is true that the hospital has some endowment funds, but the income from them falls far short of meeting the current expenses, and, were it not for the daily gifts of friends and sympathizers, the work of the hospital would have to be curtailed at the very time that the demands upon it for assistance are most urgent, and rapidly growing. 41 642 General Hospitals and Dispensaries The Howard Hospital By ALBERT E. ROUSSEL, M.D. IN the year 1853, a number of enterprising physicians and sur- geons of Philadelphia, felt the necessity of organizing in the pro- fession a new mode of classifying and treating diseases, with facility and greater succcess by means of specialties, after the plan of the Vienna Hospital, each physician selecting the department for which he, either from study, inclination or experience was best fitted. All were highly educated physicians, some having had unusual opportunities both at home and abroad. This was the case with Dr. 0. H. Partridge, who had acquired a reputation in the treatment of diseases of the skin, having spent several years abroad in its study. Another was Dr. Joseph Klapp, who had been very successful in diseases of the digestive organs. The institution was called the "Western Infirmary," and it was proposed that each man should take a special branch of practice under his charge, and prescribe, at the infirmary, for diseases per- taining to it. The first President, William M. Swain, Esq., elected May, 1854, was a zealous and able presiding officer, and showed a warm interest in the welfare of the institution. Mr. Swain was one of the original founders and proprietors of the Public Ledger. The second President, was Jasper Harding, Esq., elected April 1, 1856, well known as the proprietor of the Philadelphia In- quirer. He devoted both time and money and the valuable aid of his popular paper to the interests of pure charity in the dispensation of the "healing art" to the worthy poor. Thomas H. Powers, Esq., was the third President. Elected 1859, he served until 1878. In his continual good gifts the "Howard" was frequently his debtor, and in his death it lost a most devoted friend. He died November 20, 1878, and left the hospital three thousand dollars a year, for ten years. William P. Cresson, Esq., was the fourth President, from 1878 to 1892 (the date of his death). Descended from good old Quaker stock, he was born in Philadelphia and was one of the most active managers in locating the institution in its new home. He saw the main building completed and occupied, and secured a large portion of the endowment fund by his own personal efforts. The Howard Hospital 643 LOCATION The first location of this institution was in two rooms at the northwest corner of Seventeenth and Pine Streets, over the store of John Goodyear, druggist. After a while these rooms were found to be too small to accommodate the large number of patients attracted by the success of the work. The hospital was therefore moved into the large, old-fashioned house of the Lukens family, situated on Christian Street, between Fifteenth and Sixteenth Streets. This included a large piece of ground with a truck farm, a hospital with Superintendent, Matron, etc., and was amply sufficient for a time. For fear of incurring too much debt, this fine old place was abandoned, much to the regret of the managers and physicians, and another removal was affected to Lombard Street above Eighteenth, the work being confined to the dispensary department. Later, by a great effort, they were able to purchase the Welsh Church, Nos. 1518- 1520 Lombard Street. The hospital continued in this locality for many years until Dr. Laurence Turnbull was elected a manager, after having been physician and surgeon to the eye and ear depart- ment for over thirty years. He felt with Mr. Cresson, that the term "hospital" was a misnomer, and that if he were to continue a member of the Board, he should make an effort to have a hospital in reality, and not simply in name. It was determined to appoint a committee, and accordingly a resolution was adopted, May 10, 1886: "That a committee be appointed to take into consideration the obtaining of a more suitable and commodious building for hospital as well as dispensary purposes, and that the said committee shall prepare an appeal to the public for that purpose." Dr. Turnbull was appointed Chairman, with Messrs. Azariah W. Hoopes, Gustavus S. Benson, Jr., William M. Bunk and G. Coles- berry Purves. They immediately entered upon the work and assiduously con- tinued it during the summer. When the fall sessions of the managers commenced they had a list of properties to present; but all were rejected for one cause or another. After several meetings of the managers in the fall of 1886, and after much discussion, a lot was purchased at the southeast corner of Broad and Catharine Streets, extending to Kater Street, 97% feet on Broad Street, and 100 feet on Catharine and Kater Streets, 644 General Hospitals and Dispensaries for the price of $24,000, where it was determined, with the consent of the contributors, to erect a hospital and dispensary. The plan proposed and carried out was, to erect a presentable building, with- out any extravagant expression of architecture, three or four stories high. By the most strenuous efforts the requisite amount was raised to buy the lot and erect this fine building (at the corner of Broad and Catharine Streets) in 1889. Its annex, "Anna H. Wilstach Memorial," was completed in 1894, from a portion of a fund con- tributed by Mrs. Anna H. Wilstach, who became much interested in the hospital through the efforts of Mr. William P. Cresson. THE ORIGIN OF THE HOWARD HOSPITAL Its success was assured from the beginning, and it is gratifying to realize that the honor of originating the Howard Hospital is due to a few well known and philanthropic physicians and their generous friends, who gave their valuable time and means to the worthy cause, with no other emoluments or reward than the comfort of a satisfied conscience in the performance of Christian work. By their efforts, in conjunction with those of other liberal donors, after forty years of persistent labor, the undertaking has been carried to its present completion. A third story was added to the annex in 1897, affording space for some twelve additional beds and three additional private rooms. A sick diet kitchen, and a new steam laundry costing $5,000, fully utilize all the ground space and complete the "plant." In 1905, the properties, 1350 Catharine Street and 1351 Web- ster Street, were purchased and demolished. On the southern end of the lot and extending from the existing laundry building there was erected the nurses' home. In 1909, a new addition to the hospital was erected on the northern end of the same lot. To the house committee, Messrs. Caleb Cresson, E. Smith Kelly, Strickland Kneass, Edward Hopkinson, G-. S. Benson, Jr., B. H. Lowry, Alexander P. Purves, George E. Bower, the Board of Managers of the hospital are very much indebted for the efficient aid and valuable services rendered, in beautifying and improving every department and administering to the comfort of the patients. HOWARD HOSPITAL. The Howard Hospital 645 REPORT OF CASES TREATED SINCE THE FOUNDATION OF THE INSTITUTION May 1, 1853, Specialties to (Old System). Mar. 1, 1889. Diseases of the Digestive Organs 43,498 Chest and Throat 51,487 Nervous System 10,941 Eye and Ear 15,802 Women and Children 15,990 Visco-Renal Affections 1,700 Eevers 23,484 Surgery 24,643 Teeth Extracted 12,405 Vaccinations 2,395 Total 202,345 Mar. 1, 1892, Mar. 1, 1906, Mar. 1, 1907, Specialties to to to (New System). Mar. 1, 1906. Mar. 1, 1907. Mar. 1, 1908. General Surgery and Ortho- paedics 27,710 2,831 2,440 General Medicine 33,885 1,861 1,686 Women 8,385 749 767 Children 11,397 939 918 Mind and Nervous Diseases.. 4,306 273 284 Eye 10,078 689 679 Throat, Ear and Nose 7,824 697 656 Skin 7,547 631 543 111,132 8,670 7,973 Total May 1, 1853, to Mar. 1, 1907 322,147 Grand total 330,120 The Board of Managers, Staff and Officers of the hospital as constituted to-day are as follows : BOARD OF MANAGERS 1908-1909. President. — Charles S. Whelen. Secretary. — C. Cresson Wistar. Treasurer. — Samuel Woodward. Managers for one year. — Strickland L. Kneass, Wm. A. M. Puller, Earl B. Putnam, J. Percy Eemington, Jr., Walter E. Eex, E. Smith Kelly, Chas. P. Sinnickson, Bernard Gilpin, Frank D. LaLanne, Herman L. Duhring, Jr. Managers for two years. — Charles S. Whelen, Caleb Cresson, Joseph Wright, W. P. H. Heed, Craig Heberton, Chauncey H. 646 General Hospitals and Dispensaries Brush, Henry S. Drinker, Jr., W. Atlee Burpee, W. G. Hopper, Samuel Woodward. Managers for three years. — Caleb Cresson, Jr., Edward P. Bor- den, Caleb J. Milne, Edward L. Perkins, Howard W. Lewis, Henry C. Fox, Edward Hopkinson, Gustavus S. Benson, Jr., C. Cresson Wistar, J. Hunter Ewing. Solicitor. — Henry Budd. MEDICAL STAFF Elected April 13, 1908. Consulting Surgeon, George McClellan, M.D. General Sur- gery and Orthopaedics, Edward Martin, M.D., Alfred C. Wood, M.D. General Medicine, Albert E. Eoussel, M.D. ; John E. Hume, M.D. Diseases of Women, Barton C. Hirst, M.D.; John B. Shober, M.D. Diseases of Children, Francis B. Jacobs, M.D. ; Arthur Newlin, M.D. Diseases of the Mind and Nervous System, John H. W. Ehein, M.D. Diseases of the Eye, Wm. Campbell Posey, M.D. Diseases of the Throat, Ear and Nose, George B. Wood, M.D. Diseases of the Skin, Henry W. Stelwagon, M.D. Assistants to the Medical Staff. General Surgery and Orthopedics, Service of Dr. Edward Martin: Dr. Macey Brooks, Dr. E. Y. Eich, Dr. Wm. Morrison, Dr. E. L. Eliason, Dr. A. M. Moore. Service of Dr. Alfred C. Wood : Dr. E. L. Eliason, Dr. S. W. Moorhead, Dr. H. J. Bartle. General Medicine, Service of Dr. A. E. Eoussel: Dr. Arthur Wrigley, Dr. Joseph P. Craney, Dr. David O'Donnell. Service of Dr. John E. Hume: Dr. Lynn Deichler, Dr. Geo. P. Deschweintz, Dr. Samuel Ellis. Diseases of Women, Service of Dr. B. C. Hirst: Dr. Mahlon E. Eaby, Chief of Clinic ; Dr. Henry J. Bartle, Assistant ; Dr. John C. Hirst, Dr. L. F. Luburg, Dr. Wm. Whetstone, Dr. Edward W. Beach (Anesthetizer). Service of Dr. John B. Shober: Dr. Charles C. Norris, Chief of Clinic; Dr. C. A. Blaney, Assistant. Diseases of Children, Service of Dr. F. B. Jacobs : Dr. Horace H. Jenks. Service of Dr. Arthur Newlin : Dr. Horace H. Jenks. Diseases of the Mind and Nervous System, Service of Dr. John H. W. Ehein : Dr. John P. Mulrenan, Dr. Cyrus W. Fridy. Diseases of the Eye, Service of Dr. Wm. Campbell Posey : Dr. Frederick Krauss, Dr. Albert Pilkinton, Dr. C. C. Eves. The Howard Hospital 647 Diseases of the Throat, Ear and Nose, Service of Dr. Geo. B. Wood: Dr. Paul B. Cassidy, Dr. Joseph Smith, Chiefs of Clinic; Dr. Elmer, Dr. E. 0. Drumheller, Dr. Hawman, Dr. C. Cavanaugh. Diseases of the Skin, Service of Dr. Henry W. Stelwagon : Dr. Charles N. Davis, Dr. Frank Crozer Knowles. Officers of the Hospital. Besident Physicians, A. Nowell Credick, M.D. ; James P. Donnelly, M.D. ; Charles M. Buckner, M.D. Pathologist, John C. Hirst, M.D. {pro tern.) ; Director X-ray Department, Samuel McClary, 3d, M.D. ; Superintendent and Head Nurse, Miss Anna E. Barrett; Head Operating Boom Nurse, Miss Florence Biddle; Assistant Head Nurse, Miss Sara Strang; Massage, Miss C. T. Milligan; Dietetics, Miss Katherine McCollin; Day Clerk, Miss E. K. Sheaf; Apothecary, Miss Jamella Pox. Women's Visiting Committee. Mrs. Charles Piatt, Jr., Chairman; Mrs. Charles S. Whelen, Mrs. Edward H. Johnson, Mrs. Howard W. Lewis, Mrs. Sydney E. Hutchinson, Mrs. John L. Wentz. The Training School which started in 1893 has been one of the most successful in Philadelphia and its graduates have been noted as especially proficient in the exercise of their profession. In an address to the Section of Laryngology, Bhinology and Otology of the American Medical Association on June 8, 1897, Dr. Thomas Harper, one of the founders of the hospital, presented data which proved that the Howard Hospital had been a source of sup- ply to the faculties of nearly all of the medical colleges in this vicinity. 648 General Hospitals and Dispensaries St. Mary's Hospital By JAMES A. KELLY, M.D. EARLY HISTORY ON April 9, 1855, The Institute of the Third Order of St. Fran- cis was founded by the Eight Rev. John Nepomucene New- mann, C.SS.R., the first members consisting of Mother M. Francis, Sister M. Margaret and Sister M. Bernardine. The first convent was established in a small house on Lawrence Street above Girard Avenue. In 1858, the Mother House was transferred to 505 Eeed Street. In 1871, the Mother House and Novitiate were transferred to the Convent of Our Lady of Angels, Glen Riddle, Pa., which was founded September 7, 1871. After the lapse of several years from the time of founding of the Order, the question of establishing a hospital for the worthy poor was at various times considered. This project, however, did not take definite shape until December 10, 1860, when a small house was secured at the northeast corner of Girard Avenue and Fourth Street, and Mother M. Francis founded St. Mary's Hos- pital, and was its first Superior. She, however, was shortly suc- ceeded by Mother M. Agnes at the end of the year of 1860, and the latter remained in charge until 1869. The hospital was estab- lished with the help of seven sisters, and there were accommoda- tions for five patients. In addition to attending the patients in the hospital, the sisters were sent from time to time to nurse patients in the immediate neighborhood on a plan similar to the methods in use to-day by graduate nurses. PRESENT SITE In August, 1866, the original site was abandoned, and the hospital was transferred to Frankford Avenue and Palmer Street. The site selected had previously been used as a drug store and the adjoining property as a grocery store. These two buildings were combined and converted into a hospital after considerable altera- tions had been made. The hospital was then a brick building, 40 feet by 80 feet, and four stories in height. Its capacity at this time consisted of forty-two beds for patients. The operating facili- ties for the first twenty years were, if judged by the present-day o X s. St. Mary's Hospital 649 standards, very inadequate. The majority of the operating was done in a small room at the end of one of the male wards on the second floor, and, indeed, many were performed in the wards. In 1882, an addition was made along the Palmer Street end of the hospital. It consisted of a four-story brick structure with a 22-foot frontage on Palmer Street, and it extended to the north for a distance of 60 feet. The building was erected to give more room to an already overcrowded institution, and it increased the capacity of the hospital to sixty-three beds for patients. In 1891, a two-story building, consisting of an operating room and laboratory, was erected. This was situated at the northern aspect of the hospital and faced on Prankford Avenue, although some distance from the house line. There were no further changes in the hospital until 1900, when the operating pavilion was razed to make room for the new building. Por several years previous to 1900, the limitations of the hos- pital were well realized by those in charge, and the inadequate facilities offered to an ever-increasing number of patients — pri- vate, ward and dispensary — it was decided to enlarge the hospital. With the aid of an appropriation from the State Legislature this plan was found to be feasible. In 1900, ground was broken and the building was ready for occupancy July 1, 1901. The new building is a four-story and basement vitrified brick structure, with sandstone trimmings. It is fireproof throughout. The base- ment is used for boiler, engine and dynamo rooms, and laun- dry. The first floor is devoted to executive offices, residents' din- ing-room, sisters' dining-room, kitchen and pharmacy. On the second floor there are accommodations for the five resident phy- sicians, three surgical wards, one ophthalmic ward and seven pri- vate rooms. On the third floor there are two surgical, one gyne- cological, and one aural ward and eleven private rooms. The fourth floor is devoted to two private wards, two operating rooms and a chapel. The two operating rooms are entirely separate from each other. Bach operating room has individual anaesthet- izing, sterilizing and dressing rooms. One room is used for surgical and the other for gynecological operations. The chapel, also situated on the fourth floor, is very commodious, and is used by the sisters and convalescing patients. All of the floors of the new building have been made to communicate with similar floors of the old building. An elevator capable of accommodating eight 650 General Hospitals and Dispensaries persons was installed. The pathologic laboratory was removed to take the place vacated by the pharmacy. The hospital is now capable of accommodating 145 patients, and when the nursing staff move to their new building within a few months, this will be increased by twenty-five more. All of the medical wards since 1901 have been in the old building, the new building being devoted entirely to surgical, aural, ophthalmic and private patients. NURSES' HOME Previous to the remodeling of the old hospital in 1882, the nursing was performed entirely by the sisters, who at irregular intervals, received courses of lectures from the visiting chiefs. After 1882, and until 1901, the sisters still performed all the duties connected with nursing, and they received regular lectures upon the various branches of nursing from the chiefs. In 1901, however, after considerable agitation and coincident with the reconstruction of the hospital in this period, it was decided that a regular training school should be established, not only for the sis- ters, but also for lay members. These latter are taken irrespec- tive of denomination. This school was organized December, 1901, and consisted of five sisters and six lay nurses. These comprised the first class. The course consists of three years instruction. The number of lay nurses has steadily increased, so that at present there are seven sisters and twenty-two lay nurses in the Training School. The accommodations for the nurses until the present year have been in the hospital proper. After considerable effort and with the aid of the State Legislature a separate building is now being erected, at a cost of $22,000. This building will be ready for occupancy February, 1909, and will fill a long-felt need. It is a three-story structure, built of white brick with sand-stone trimmings. The hospital will be very fortunate in having so good a house to which the nurses may be transferred from the very unsuitable quarters in the hospital to their home. It will increase the bed capacity of the hospital, and will relieve the administration force of the unpleasant duty of rejecting suitable applicants for want of room. AMBULANCE STATION Until the year 1901, the ambulance service was not as efficient as it should be. This was due to the fact that the ambulance station was situated one square away and with very inadequate arrange- St. Mary's Hospital 651 ments. In 1901, a stable was secured next to the hospital, and while not primarily arranged for the purpose, had given very good service. In the building of the Nurses' Home the ambulance stable had to be removed to make sufficient room. A property was bought several doors above the hospital on Frankford Avenue, and on the ground there has been erected an entirely new build- ing. It is modeled in a manner similar to those in use by the fire department, so that the horses can step quickly to their places in the ambulance. The following sisters have been in charge of the hospital since its founding: — Mother M. Francis, 1860; Mother M. Agnes, 1860 to 1869; Sister M. Hieronyma, 1869 to 1872; Sister M. Ausalia, 1872 to 1875; Sister M. Lucy, 1875 to 1877; Sister M. Borromeo, 1877 to 1892; Sister M. Pauline, 1892 to 1894; Sister M. Xavier, 1894 to the present time. Following is a list of the medical directors who have been connected with the hospital: — Dr. Comisky, Dr. Nebinger, Dr. Keating, Dr. Donnellon, Dr. J. V. Kelly. At St. Mary's Hospital many of the men celebrated in the advancement of medical and surgical knowledge in this city began their early career. Of the most notable there may be mentioned such familiar names as Keen, Grove, Mears, Kooper, Eoberts, Harte, Coplin, Strittmatter, the two Deavers, O'Hara, Stewart, etc. A short review of the following statistics will give an idea of the growth of the hospital since its beginning: — 1860. Capacity, 5 beds. 1903. Capacity, 145 beds; total number of patients admitted, 1,613; of these 1,271 (78.8 per cent.) were charity patients, while the remaining 342 (21.2 per cent.) were pay or partially-pay patients, the greater number of which contributed but very little to their support; ambulance calls, 433; police patrol calls, 865. Out-patient department, new patients, 7,209; total number of visits made, 31,018. 1905/ Total number of patients admitted, 1,854; charity patients, 1,503; pay-patients, 351; number of ambulance calls, 512; number of patrol calls, 405. Out-patient department, new patients, 7,702; total number of visits made, 26,504. 1906 and 1907. Total number of patients admitted, 4,180; 652 General Hospitals and Dispensaries charity patients, 3,472; pay-patients, 708; number of ambulance calls, 1,191; number of patrol calls, 936; plus 1,175 to 0. P. D. Out-patient department, new patients, 14,802; total number of visits made, 47,644. The German Hospital of the City of Philadelphia By HENRY F. PAGE, M.D. ABOUT sixty years ago, many of the German inhabitants of Philadelphia discussed for the first time the advisability of establishing a hospital in which German people could be treated by physicians and nurses who could speak their native tongue. An attempt to form a permanent organization on this basis was made in 1850 by Dr. H. Tiedemann, Dr. Wilhelm Keller, Dr. G. Seidensticker, and Messrs. L. Herbert, J. Logo, H. Wesendonck and J. M. Eeichard. While their efforts at the time were unavail- ing, the idea was not allowed to die and for several years the work proceeded quietly until 1860, when the Legislature of the State of Pennsylvania passed an Act incorporating the German Hospital of the City of Philadelphia, the object of the hospital being to receive and care for the sick and wounded, without distinction as to nationality or color. The incorporators of the hospital were Jacob Muller, Jacob Kemper, Charles Wilhelm, William Grossholz, George Vogt, Charles Lorenz, Joseph M. Eeichard, Frederick Heyer, M. Eich- ards Muckle, Francis M. Drexel, Francis F. Wolgamuth, J. Theophilus Plate, Mayer Arnold, Frederick Staake, Martin Lan- derberger, Chas. Psotta, Frederick L. John, John P. Persch, Leonard Benkert, J. Ibelshauser, Mayer Gans, S. T. Freeman, J. H. Schomacker and Philip Becker. On the twelfth day of May, 1860, the contributing members of the Hospital Society met and elected as the first officers of the new institution the following gentlemen: — President, Joseph M. Eeichard ; Vice-President, Jacob Muller ; Treasurer, Francis M. Drexel; Secretary, M. Eichards Muckle, and Solicitor, Frederick Heyer. The German Hospital 653 The organization of the society having been established, the next step was the purchase of a suitable building for the hospital itself. For this purpose a committee consisting of M. Eichards Muckle, Frederick Heyer and John P. Persch was appointed. This committee, on the twentieth day of May, 1861, purchased the old homestead of William Norris, known as Penn Brook, situated at the corner of Twentieth and Norris Streets. The property was three acres in extent, and was purchased for the sum of $20,000. It is a fact worthy of note that the first money paid in the transaction came not only from the hospital society, but also from the Ladies' Aid Society. This latter organization, composed of friends of the institu- tion, was formed during the year following the granting of the charter, and was of great assistance to the hospital society, both personally and financially. From its incipiency to the present time the Ladies' Aid Society has been a dominant factor in the history of the institution. Arrangements for the occupancy of the building were about completed when the United States Government, at that time in great need of hospital facilities, took possession of it on June 20, 1862. As the capacity of the building was somewhat limited, the Government built an addition in the rear for the use of con- valescents, and the institution was known as the Turner's Lane Hospital. In 1864, the hospital authorities purchased an additional strip of land, extending from Norris to Diamond Street, thereby securing an unbroken frontage on Twentieth Street. In July, 1866, the Government turned over the building to the hospital authorities, and on Thanksgiving Day, November 29, 1866, the hospital was formally opened for the reception of patients, with a capacity of fifty beds. The treatment of patients was entrusted to the Medical Board, consisting of Drs. A. H. Fricke, J. Schrotz, E. Fisher, Th. Demme, J. Keorper, Julius Kamerer, C. Beeken and Julius Patzki. One resident physician was appointed. On January 27, 1869, a change occurred in the official head of the hospital which was destined to have a far-reaching effect upon the future life and growth of the institution. Joseph M. 654 General Hospitals and Dispensaries Eeichard resigned his position as President, and John D. Lan- kenau, who had been a Trustee since 1866, was elected his successor; and it is mainly through the personal oversight, the self-sacrificing spirit and the generosity of this man, that the German Hospital has taken rank among the hospitals of the city. In 1871, Mr. Joseph G. Eosengarten was elected Solicitor, and has faithfully served the institution up to the present day. In 1872, it was seen that more commodious quarters were necessary to accommodate the increasing number of patients, and the Board of Trustees considered the advisability of removing the hospital to a location which would be more central and at the same time afford greater opportunities for increasing the scope of the hospital as circumstances demanded. With this object in view, the present property, at the corner of Girard and Corinthian Avenues, was purchased for $35,000. Formal control of the property was taken on October 1, 1872, and the removal from the old to the new hospital took place on Octo- ber 23d of the same year. Adjacent properties were gradually added to the original purchase, until the hospital controlled the block between Girard Avenue and Poplar Street, and Corinthian Avenue and Twenty-second Street. On May 8, 1874, the Board of Managers approved a contract for the rebuilding of the hospital, and on June 3d, the corner- stone of the new addition was laid with suitable ceremonies. On October 26, 1875, the formal opening took place. In 1873, a movement was started to organize a free dispen- sary, and in April of the following year it was opened to the public. During 1878, several improvements were made in the hospital. On May 20, 1879, several German societies held a Maifest, which was attended by nearly the entire German population of the city. At this festival $6,000 was raised and given to the hospital. The medical library of the hospital was started in 1881, and the most noteworthy addition was made in 1884, when Consul Charles H. Meyer obtained through the publishing house of P. A. Brockhaus, of Leipsic, three hundred and twenty-two volumes of the current medical publications. Additions are being constantly made, and as a reference library it is now unusually complete. The Pathological Museum, with its material arranged and The German Hospital 655 catalogued, was established in 1881, and maintains a permanent loan collection in the Mutter Museum of the College of Phy- sicians. It was in 1884 that the greater number of the new buildings on the hospital property were completed. Mr. Lankenau had purchased the adjoining strip of ground which had been used by the Bureau of "Water for storage purposes, thus giving the hospital a frontage on Corinthian Avenue from Girard Avenue to Poplar Street. He then erected a four-story and basement wing, "In memory of a wife, son and daughter." A fourth story was added to the hospital proper, and a modern operating room with amphitheatre was completed. During this year he erected a boiler house and dynamo room, laundry, stable and mortuary. These buildings were dedicated on November 18, 1884, and at that time were presented by President Lankenau to the Board of Trustees. It was in this same year (1884) that one of the most radical changes in the history of the hospital occurred. Prior to this time the patients were nursed by paid help, an arrangement not eminently satisfactory. For several years the management of the hospital had been considering the introduction of a number of Lutheran deaconesses from Germany to take the place of the paid helpers, and, finally, on June 19, 1884, there arrived from Iserlohn, seven deaconesses to take up their work at the hospital. From that time, until the growth of the hospital necessitated the establishment of a train- ing school, in 1900, the nursing was done entirely by the Sisters. It is impossible for one not intimately associated with the work of the institution to realize what a great part the skill and untiring devotion of the Sisters has played in the development of the German Hospital. At the present time the nursing staff of the hospital is about equally divided between the Sisters and pupil nurses. In 1885, the resident staff was increased to three, and in the following year the office of Chief Besident was created, Dr. George A. Bodamer being elected to fill the position. One of the greatest improvements on the grounds of the hos- pital was the erection, by Mr. Lankenau, of the Mary J. Drexel Home, which was dedicated on December 6, 1888. This building contains the Deaconess' Home, a Children's Hospital, Old Folks' 656 General Hospitals and Dispensaries Home and a School for Girls. On its completion, all children under thirteen years of age, who had formerly been treated in the German Hospital, were transferred to the new Children's Hospital. In 1889, Dr. George A. Bodamer, who had served for three years as Chief Eesident Physician, resigned, and Dr. Carl Frese was elected his successor. The following year, when Professor Koch published the results of the use of his lymph in the treatment of tuberculosis, the Board of Trustees sent Dr. Frese as a representative of the German Hospital to Berlin to investigate his methods. Through his former acquaintance and through letters furnished by Consul Charles H. Meyer, Dr. Frese was enabled to study the action of the lymph under Professor Koch and others in Berlin; he also secured from Professor Koch several vials of the lymph with which treatment was instituted at the hospital. In 1891, the isolating house was built. In this same year the Board of Trustees secured the services of Mr. Martin I. Wilbert as apothecary, and through his efforts this department has become a model hospital pharmacy. Mr. Wilbert was also in charge of the Radiographic and Photographic Laboratory up to October, 1908, when he resigned to accept a position under the Government in the Bureau of Health at Washington. In 1892, the position of Pathologist was created, and Dr. Alfred Stengel was elected to fill that position. In 1894, work was begun upon the Corinthian Avenue exten- sion, and this magnificent building was presented to the Board of Trustees by Mr. Lankenau on Xovember 14, 1895. In 1897, there was inaugurated one of the greatest changes in the medical service of the hospital. Instead of the old system of rotation in the services of the various chiefs a continuous service with one chief and assistants was established. The following chiefs were elected: Medical, Dr. James C. Wilson; Surgical, Dr. John B. Deaver; Ophthalmological, Dr. Charles S. Turnbull; Ear, Xose and Throat, Dr. Arthur A. Bliss. This continuous service is still in vogue. In 1898, during the war with Spain, the German Hospital was one of the first to offer its services and accommodations to the Government for the care of sick and disabled soldiers. Sev- The German Hospital 657 eral hospital trains were equipped at the expense of the hospital authorities and sent to various military camps, and in this man- ner over 275 eases of typhoid fever were brought to the hospital for treatment. In 1899, Dr. A. D. Whiting was appointed Eegistrar, and he at once inaugurated, and has since maintained, a most com- plete system of filing and preserving the medical records of the institution. In 1900, the resident staff was increased to nine, and the term of service lengthened to twenty-seven months. In this year, a Training School for Nurses was established, which has grown until there are now thirty-six nurses under training. On August 30, 1901, Mr. John D. Lankenau, who had been President of the Hospital since 1869, died after a protracted illness. Associated with the hospital since its infancy, he had watched and nurtured its growth with the zeal and devotion of a parent. Mr. Hermann Hessenbruch, in this year, succeeded him as President. During the past eight years the work of the hospital has con- stantly increased necessitating larger and improved facilities, and in this time there have been added to the plant of the institution a Home for Nurses, diet kitchen, sterilizing and etherizing rooms, additions to the laundry and men's quarters and out-door patients' waiting-room. At the present time, there is under construction a six-story addition, 85 x 56 feet, with a frontage on Corinthian Avenue; the basement of this building is to be used for dispensary purposes. The hospital plant consists of the hospital building proper, with accommodation for 220 patients ; forty-five private beds, two private wards of five beds each ; Nurses' Home, Pathological Lab- oratory, mortuary, isolating house and lodge; laundry, kitchen, stable, boiler and engine house. OFFICERS FOR THE YEAR 1909 President. — Hermann Hessenbruch. Vice-President. — M. Eichards Muckle. Secretary. — Eev. Adolf Hellwege. Treasurer. — Edmund E. Teubner. Solicitor. — Joseph G. Eosengarten. 42 658 General Hospitals and Dispensaries BOARD OF TRUSTEES M. Eichards Muckle, G. A. Schwarz, Henry D. Justi, Geo. W. Bremer, Dr. Samuel Laird, Theodore Bremer, Eev. A. Hellwege, Horace E. Smith, Wm. P. Dreer, Herman Dercum, Hermann Hessenbruch, Herman C. Eumpp, Walter Horstmann, Albert Schonhut, Otto C. Wolf, Eev. George W. Sandt. HOSPITAL STAFF Chief of Medical Department, James C. Wilson, M.D. Assist- ant Physicians, Harvey Shoemaker, M.D.; Henry P. Page, M.D. Chief of Surgical Department, John B. Deaver, M.D. Assistant Surgeons, George G. Eoss, M.D.; A. D. Whiting, M.D. Chief of Ophthalmological Department, Charles S. Turnbull, M.D. Assist- ant Ophthalmologists, William T. Shoemaker, M.D.; Edward A. Shumway, M.D. Consulting Laryngologist and Aurist, Arthur A. Bliss, M.D. Chief of Laryngological and Aural Departments, Barton H. Potts, M.D. Assistant Laryngologists and Aurists, Ellwood Matlack, M.D.; Ealph Butler, M.D. Chief of Patholog- ical and Bacteriological Department, Aloysius 0. J. Kelly, M.D. X-ray Laboratory, Assistant Director, Albert G. Miller, M.D. Medical Superintendent, Henry P. Page, M.D. Eesident Phy- sicians, John M. Bernie, M.D. ; B. B. Vincent Lyon, M.D. ; B. Alexander Eandall, M.D.; Alan L. Diefenderfer, M.D.; Lyell C. Kinney, M.D.; Henry G. Turner, M.D.; Victor D. Holloway, M.D.; James W. Eobinson, M.D.; Earl E. Whipple, M.D.; Ker- win W. Kinard, M.D. Eegistrar, A. D. Whiting, M.D. Apothe- cary, John K. Thum, Ph.G. MEDICAL BOARD Charles S. Turnbull, M.D.; James C. Wilson, M.D.; A. 0. J. Kelly, M.D.; John B. Deaver, M.D.; Henry F. Page, M.D.; Bar- ton H. Potts, M.D. OFFICERS OF THE BOARD OF TRUSTEES-1860-1905 Presidents. — Joseph M. Eeichard, 1860-1869 ; J. D. Lankenau, 1869-1901; Hermann Hessenbruch, 1901. Vice-Presidents.— Jacob Miiller, 1860-1866; M. E. Muckle, 1867. Secretaries.— M. E. Muckle, 1860-1863; B. Sprungk, 1863- 1866; F. Steeb, 1866-1867; L. T. Ladner, 1867-1872; W. E. Ackermann, 1872-1873; Joseph Kienike, 1873-1875; C. F. The Charity Hospital 659 Moelling, 1875-1882; Wm. N. Meneke, 1882-1893; Rev. F. Wischan, 1893-1905; Rev. A. Hellwege, 1905. Treasurers. — Francis M. Drexel, 1860-1863; Hermann T. Plate, 1863-1866; Joseph Kienike, 1866-1867; W. Grossholz, 1867-1871; Godfried Keebler, 1872-1876; Charles A. Woerwag, 1876-1902; Edmund R. Teubner, 1902. Solicitors. — F. Heyer, 1860-1872; Joseph G. Rosengarten, 1872. Chiefs of the Hospital Staff, 1866-1909.— A. Fricke, J. Schrontz, E. Fischer, Th. Demme, 1866-74; J. Koerper, Jul. Kamerer, 1866-72; E. Beeken, 1866-71; Jul. Patzki, 1866-70; A. F. Miiller, J. Boisnot, 1871-74; R. H. Weber, 1872-74; Wm. Turner, 1873-74; F. H. Gross, 1874-91; M. Franklin, 1874-86; A. Trautmann, 1874-76; Adam Trau, 1874-97; Jas. Collins, 1874-87; R. M. Bertolet, 1875-78; J. Solis-Cohen, 1875-87; Wm. Ashbridge, 1875-80; Chas. S. Turnbull, 1878; Frank Woodbury, 1878-86; J. M. Barton, 1880-86; G. W. Volger, 1882-88; John B. Deaver, 1886; W. H. Baker, 1888-89; E. T. Bruen, 1888-90; Lawrence Wolff, 1888-97; J. W. White, 1888-95; J. C. Wilson, 1890; C. Penrose, 1891-92; G. G. Davis, 1893-95; Arthur A. Bliss, 1897-1903; Barton H. Potts, A. O. J. Kelly, 1903. Assistants to the Hospital Staff. — Harvey Shoemaker, Henry F. Page, George G. Ross, A. D. Whiting, 1897; Edmund K. Perrine, 1897-1901; Wm. T. Shoemaker, 1897; Barton H. Potts, 1899- 1903; Ellwood Marlack, 1899; Wendell Reber, 1902-1906; Ralph Butler, 1904; Edward Shumway, 1906. The Charity Hospital of the City of Philadelphia By JOSEPH H. LOPEZ, M.D. ABOUT the year 1858, a number of prominent citizens of this city met for the purpose of instituting a dispensary and hospital, in which free clinic service would be extended daily, and from which medicines might be supplied gratuitously to the worthy sick poor, the design being also to include the provision of beds for patients during definite or temporary ailment. In the minds of these gentlemen, there appeared to be, at that time, an obvious and somewhat urgent need for such an institution in the 660 General Hospitals and Dispensaries north central part of the city, east or west, in close proximity to the large and numerous industrial and manufacturing works. The families of these workers, men, women and children, with but meager earnings to adequately meet proper need, indifferently and unhealthily housed, subject to accident and disposed to disease through neglect, inattention and ignorance of simple sanitary pre- caution, presented an element of the population needing help. The purpose took definite shape when a meeting was called to inaugurate the preliminary steps and to present the subject to the public and especially to the local interests which would be benefited. In 1861, a corporate charter was procured under the title of The Charity Hospital of the City of Philadelphia and a permanent organization of trustees and medical officers was effected. Subsequently, and soon thereafter, a location was secured on Buttonwood Street, east of Broad Street with limited space and appliances. From this beginning the purpose was joined with an earnest intention to make its dispensations as far-reaching as possible among the worthy poor, using discrimination against impostors and avoiding encouragement of those whose abuse of charity would curtail the extent of relief offered to the deserving, and thus avoid the result most to be deplored, chronic pauperism. After several years of successful and encouraging work, it was deemed expedient to remove several blocks to the westward, and a temporary location was secured on Hamilton Street above Eight- eenth. Subsequently the property at No. 1832 Hamilton Street was purchased and the hospital located here for more than twenty years. These were years of increasing usefulness, limited unfortunately by the want of means. By careful expenditure and judicio\is invest- ment a certain amount of capital was accumulated, and the trustees, finding the facilities for the enlarged work of the hospital too limited, decided to purchase the present location, jSTo. 1731 Vine Street. This is a large and commodious building, well adapted to the uses and requirements of a hospital, with ample dispensary facilities and large audience room. There are well-arranged clinical departments for all the various branches of medical practice with adaptations to limited and minor operations in surgery, presenting to the interested visitor a complete and attractive medical house. This is claimed to be "the cleanest charity in the City of Brotherly Love." It makes absolutely no charge for its services or medicines, thus reaching a class of worthy patients including those Reception Room. Gyneco- logical Room. Throat ami Nose Depart- ment. Hospital Building. CHARITY HOSPITAL. The Charity Hospital 661 from the city's outskirts, many of whom have been known to walk miles to its clinics, perhaps carrying a sick child, lacking the necessary carfare to reach the hospital, or the means to pay even the trifling charge made for medicaments in other hospitals. Such is the brief history of the origin, growth and progress, the work, the resources and the locality of the Charity Hospital of Phila- delphia. But the inner history of this hospital has never been written. Its work of quiet, unostentatious, far-reaching benevolence is not of public record. Its doors have never been closed upon a worthy applicant, nor its ministrations withheld from a deserving sufferer. The stranger, sojourner and resident are admitted with- out discrimination as to creed, color or religious faith. The con- sciousness of well doing abided in those who have administered it, and has been the chief stimulus to its support, strengthening the hope that its work and mission in the broad field of benevolence would ultimately meet recognition at the hands of those whose abundance enables them to bestow liberally. The government of the institution is vested in a Board of Trustees consisting at present of the following: — • President, Clarence L. Harper; Vice-President, Newton F. Cressman ; Secretary and Treasurer, William E. McCall, Jr. ; Dr. H. St. Clair Ash, Dr. Joseph H. Lopez, Alexander H. Morgan, Francis F. Milne, Elihu C. Irvin, Charles Mortimoore, Coleman Sellers, Jr., Charles A. Green, John P. Balderston, Samuel B. Wills, George W. Spiese, John E. Hathaway, W. I. Shore, Walter S. Mclnnes, William Kirkbride. MEDICAL BOARD This board meets monthly at the hospital. The medical administrations is in charge of a staff and board, consisting of an ample number of medical men among whom to apportion the daily clinic service, and by whom all the departments are skilfully served. These are: President, Dr. H. St. Clair Ash; Vice-President and Medical Director, Dr. Joseph H. Lopez; Secretary, Dr. Swithen Chandler; Dr. C. P. Franklin, Dr. Wilmer Krusen, Dr. Justus Sinexon, Dr. Lewis Adler, Dr. Thomas Tait, Dr. Henry B. Ingle, Dr. William Nichols, Dr. H. B. Nightingale, Dr. Wm. Wilson Crowe, ' Dr. Howard C. Millick, Dr. S. Hamill Home, and Dr. Fred'k Eft, resident physician. The number of patients treated at these clinics varies from 662 General Hospitals and Dispensaries 9,000 to 12,000 annually. A computation upon this basis will give evidence of the large number of beneficiaries who have received gratuitous aid from the Charity Hospital during its many years of existence. The following gentlemen, all eminent in public life, have been associated with the administration of the Charity Hospital : — George Nugent, J. P. Bruner, Eobert Boiling, M.D., Edward N. Benson, John Sharp, John O. James, Hon. Oswald Thompson, William H. Kern, Hon. J. B. Ludlow, William H. Kemble, Hon. William D. Kelley, Levi Knowles, Hon. Alexander Henry, Thomas K. Gill, Bev. Benjamin Watson, Geo. H. Colket, Bev. Charles D. Cooper, Thomas H. Fenton, M.D., Bev. J. Hyatt Smith, William H. Pancoast, M.D., Bev. John Chambers, E. Evans Peterson, Samuel Chapman, Thomas Allman, Albert C. Boberts, William S. Stewart, M.D., Francis Fearon, Samuel Simes, Nicholas Wallace, Bichard H. Townsand, M.D., Samuel A. Bispham, William S. Bey- burn, Albert P. Linderman, James H. Harper, Joseph Germon, Nathan Hatfield, M.D., Charles H. Boker, M.D., George Lee, Thomas P. Stotesbury, Isaac S. Sharp, Amos B. Little, Henry B. Tener, Britton Corlies, Uselma C. Smith, Bichard Peterson, John D. Moore, Christian J. Hoffman, Henry J. Verner, Seth I. Comly, Antoine Bournonville, William B. Thompson, Frank Pearson, Theodore Earp, Horace Y. Evans, M.D., Victor Guillou, Gen. George W. Mindil, J. Henry Williams. The rooms for clinic administration at the Charity Hospital are distinctly separate, and the patients are seen each alone, or accompanied by friends or relatives, and prepared by the nurse for examination. This affords a grateful privacy to patients, many of whom experience shows, would prefer to suffer from ail- ments and disabilities rather than be the objects of observation by large classes of medical students in the arena or by classes of special students and novices at the bedside. The larger institu- tions of medical service and of instruction, such as the various college hospitals, extend this privilege as part of the curriculum, but the administration of the Charity Hospital studiously avoids this as being in every aspect objectionable. Especially in the department given up exclusively to the treatment of diseases of women and children, the appointed medical adviser onty, sees the patient; thus absolute privacy is assured. Two female professional nurses are in constant attendance at The Jewish Hospital 663 the call of the physicians and surgeons. The need and usefulness of this service will he apparent in preparing the patient for examination and after the termination of operations or physical examinations of patients, particularly of women and children. These facts are presented to show that the Trustees and Med- ical Staff are solicitous to obviate the objectionable features of hospitals and dispensaries where often only curt and perfunctory attention is the experience of the sick and unfortunate class of invalids. The present management of the Charity Hospital aspires to the accumulation of sufficient means by bequests from the benev- olent and wealthy to enable a provision of sufficient beds and other accessories for its prospective needs. The hospital has been wholly self-supporting, to use the term in an exact sense; it has never accumulated the debt which seems inevitably connected with the conduct and management of most institutions of the kind. The Charity Hospital has derived support from occasional bequests of small sums and donations, and a careful and conserva- tive use of its means has carried it forward to this time with an encouraging, though not wholly, satisfactory progress. It has never received State or municipal aid, except the remission by the city of the annual tax on the real estate. The Jewish Hospital Association of Philadelphia By HENRY N. WESSEL TO properly compile the history of the Jewish Hospital, giving due credit to those who have so conscientiously labored in behalf of humanity, would be a restatement of volumes containing prolific records of unselfish charity, discriminatingly but widely distributed. Prom a small dwelling in West Philadelphia, which had been altered into a hospital for the sick and a home for the aged and infirm, it has grown to include twenty-two acres of ground, upon which are located twenty beautiful buildings, con- structed, equipped and maintained with all that modern ingenuity and science have produced for the treatment of the sick and the physical, moral and religious care of the aged arid destitute. 664 General Hospitals and Dispensaries During the first year of its existence (1866) there were treated in the hospital about fifty patients and in the home there were four inmates. For the fiscal year ending April 30, 1908;, there were treated 1,503 patients in the General Hospital, 75 patients in the Lucien Moss Home for Incurables, 103 patients in the children's ward, 4,581 patients in the Mathilde Adler Loeb Dispensary, 11 inmates in the Infirmary for the Aged, 211 patients in the Guggenheim Building for Private Patients, and 44 inmates in the Home for the Aged, furnishing 115,864 days' support; 20,299 patients have been treated in the General Hospital since its opening in 1865; 562 patients in the Lucien Moss Home since its opening in 1900; 709 in the Guggenheim Building for Private Patients; 568 in the Henry M. Phillips and Simon Muhr Chil- dren's Wards; 40 in the Isolation Building; 277 inmates in the Home for Aged and Infirm, and 130,174 patients have received treatment in the Mathilde Adler Loeb Dispensary since its founda- tion in 1878. The cost of supporting the various institutions in 1865 was less than $5,000 ; during the last year it was $151,887.31 ; and with this large increase in expenditure, the average annual expense of supporting one inmate has fallen from $895 in 1872 to $650 in 1908. The Legacy and Endowment Fund, on May 1, 1908, amounted to $444,897.25, much of which has been consumed in the construction of buildings, laying out roads, etc. There was but one medical assistant in 1865. At present there is a Chief Resident Physician, with six assistants and sixty-seven consulting surgeons and physicians. The Jewish Hospital Association of Philadelphia owes its initial existence to the philanthropy of Mr. Abraham Sulzberger, who, on the fourteenth day of August, 1864, initiated a movement in the District Grand Lodge, Fo. 3, of the Independent Order of B'nai B'rith, which resulted in the appointment of a provisional committee, consisting of Max Thalheimer, Chairman; Rev. Isaac Leeser, Vice-Chairman; Abraham Sulzberger, Secretary, and Solomon Hofheimer, Raphael Teller, Lewis Ellinger and Samuel Weil, with directions to "take immediate steps to secure the co- operation of all Jewish societies and individuals for the purpose of founding a Jewish Hospital" within the limits or the immediate vicinity of Philadelphia. This committee, on the eighteenth day of August, 1864, issued circulars to the various persons who were deemed to be interested; they visited the various lodges of the The Jewish Hospital 665 order, to ascertain how many subscribers could be obtained, at a sum not exceeding $5 per annum, towards the support of a Jewish Hospital. After having secured some three hundred sub- scribers, it was decided to popularize the movement by inviting the co-operation of the entire Jewish community. A meeting was therefore held in the Hall of the Independent Order of B'nai B'rith, on December 4, 1864, at which every congregation in the city of Philadelphia (with but one exception) was represented, and many societies sent delegates, representing every shade of opinion and nationality among the Israelites of this city. It was decided at that meeting that a hospital, conducted according to Jewish custom, was necessary, and that a society for the conduct of such a hospital should be organized. This convention, after very care- ful and patient consideration of the subject, adopted a Constitu- tion and By-Laws, and thereupon called a public meeting of the Israelites of the City of Philadelphia, which was held at National Guards' Hall, Pace Street below Sixth, on Sunday, February 19, 1865, at which the Jewish Hospital Association was duly organized and Alfred T. Jones elected President; Isadore Binswanger, Vice- President; Samuel Weil, Treasurer ; Mayer Sulzberger, Secretary; Henry J. Hunt, Corresponding Secretary; and Messrs. Abraham S. Wolf, Isaac Leeser, Joseph Einstein, Samuel Hecht, Simon Ezekiel, M. Thalheimer, William B. Hackenburg, Simon Alex- ander, Dr. Judah Isaacs, M. M. Bayersdorfer and Hezekiah W. Arnold, managers ; and Alexander Goodman, messenger. A mem- bership committee was appointed and 650 members secured. On September 23, 1865, the Jewish Hospital Association of Philadel- phia was incorporated by the decree of the Court of Common Pleas for the County of Philadelphia. Immediately after its organization, subscriptions were opened for the purchase of a suitable property, and a piece of ground of about one and one-fourth acres, located at the junction of West- minster Avenue, Haverford Eoad and Fisher's Avenue (Fifty- sixth Street), West Philadelphia, was bought for the sum of eight thousand dollars ($8,000). At the first annual meeting, held January 7, 1866, the atten- tion of the members of the association was directed to the advisa- bility of extending the usefulness of the society by adding to the hospital an Asylum for the Destitute, Aged and Infirm; and in consequence of this, an amendment to the Constitution was 666 General Hospitals and Dispensaries approved by the Court of Common Pleas of Philadelphia County, on July 7, 1866, and the association was given the power to estab- lish an asylum for the support and employment of the aged, infirm and destitute, under such rules and regulations as might there- after be prescribed in the By-Laws. On April 10, 1866, the association took possession of the property, and it was altered to make it suitable for hospital pur- poses. Wells were dug, the cellar was remodeled, both interior and exterior improvements were made, involving an expenditure of $5,200. This work was done under the supervision of the first Building Committee, which consisted of Messrs. A. S. "Wolf, Chairman, William B. Hackenburg, Judah Isaacs, Henry Mayer and S. Hecht; $2,350 was expended under the directions of the committee in the furnishing of the hospital. Mrs. Mary D. Brown, of the Society of Friends, was the first "stranger to our faith" who, by her liberal gift of five hundred dollars ($500), assisted in the work of the association. On June 28, 1866, two lots of ground adjoining the property on either side were purchased at an expense of $3,750, of which $750 was paid at the time of the purchase, and the balance liquidated in four yearly instalments of $750 each. By this pur- chase the association became the owner of three and one-fifth acres of ground. On August 6, 1866, the hospital was opened for the reception of patients, and on September 17, 1866, the first applicant was admitted as an inmate of the "Asylum for the Aged, Infirm and Destitute." The dedication services were not held until May 28, 1867. In the first five months there were treated 28 patients, of which three were non-Israelites, and all patients, with two excep- tions, were treated gratuitously. There had been four admissions to the Asylum for the Aged. The first death which occurred in the hospital was that of Isaac Hirsch, of Ichenhausen, Bavaria, on October 6, 1866, the result of the unskilful act of a dentist in extracting a tooth. The mortgage upon the property was satis- fied in October, 1869, through the efforts of the Widows' Belief Association of the B'nai B'rith. During the fiscal year which ended January 9, 1870, it was found that the wards of the hospital were too small to accom- modate all applicants, and that it had become necessary to limit The Jewish Hospital 667 the number of admissions to the Home for the Aged and Infirm. On November 4, 1869, a committee of the Board of Officers, con- sisting of Messrs. Lueien Moss, Mayer Sulzberger and William B. Hackenburg, having investigated, reported that they found the accommodations inadequate, the location unadapted, and recom- mended a sale of the property and the appointment of a com- mittee on new buildings, with instructions to ascertain a suitable place for the erection of a building for the purposes of the association. The labors of this committee were hastened by notices received on July 8, 1871, that it was the intention of the municipal authorities to open Haverford Boad through the hos- pital property, from Somerset Street to Sixty-eighth Street, which would necessitate the removal of the western wing, at that time occupied by the steward's family and the physician. At the meeting on January 8, 1871, the association approved the resolution offered by the Building Committee authorizing the purchase of a suitable site, the erection of all buildings necessary for a hospital and asylum, and the board was empowered to devise ways and means to procure the necessary funds. On February 2, 1871, the Board of Officers created a build- ing fund; in March, 1871, the Committee on Site was increased to five; at the May meeting a plan was adopted, and on July 6, 1871, the present hospital site was agreed upon as the most suita- ble, and the following August it was purchased. On May 1, 1871, the President, Mr. Abraham S. Wolf, issued a circular requesting contributions toward a fund of $50,000, and a Committee on Subscriptions to the Building Fund, consisting of seventy members, was appointed. That this committee performed its work diligently is shown by its report, made at the annual meeting held January 14, 1872, which shows that it had agreed upon purchasing the site on Olney Boad near Old York Koad, Twenty-second Ward, consisting of fourteen and one-half acres, of which about ten acres were on the south side of Olney Boad and the remainder on the north side. The buildings consisted of a spring-house, barn, farmer's house and mansion. The price of the property was $18,500, of which $9,500 was paid on account. The corner-stone of the new Jewish Hospital was laid Wednesday, October 9, 1872, at 3 o'clock p.m., by the officers of the Bight Wor- shipful Grand Lodge of Masons of Pennsylvania, in the presence of the members and contributors to the hospital, lodges of the 668 General Hospitals and Dispensaries various Jewish orders, Mayor, Presidents of Select and Common Councils of the city, Judges of the different courts, and many prominent citizens. In 1872 a special Act of the Legislature was passed exempt- ing the hospital property from taxation, and in that year the hospital was awarded $1,300 for damages resulting from the widening of Haverford Road through the hospital's property in West Philadelphia. It required energy and perseverance to secure the money necessary to pay for the completion of the new buildings. On January 14, 1872, the subscriptions to the Building Fund were less than $30,000. On November 19, of that year, they had only increased to the sum of $36,600, and it then became a matter of very serious consideration as to whether sufficient funds could be secured to construct the building without soliciting aid from Israelites in other cities. On the evening of that date, however, a meeting was held, and it was concluded to place the matter of subscriptions in the hands of a committee of six, who labored diligently in this behalf, and on the twelfth day of January, 1873, had increased the subscriptions to $48,322. The entire cost of the new building, including the farmer's house, deadhouse and summer shed, was $88,379.88, all of which was raised by the subscriptions of the Israelites of Philadelphia, except the sum of $10,000, which was raised upon mortgage on the West Philadelphia property. Part of the funds — to wit, about $11,000 — necessary for the erection of the building was secured through the efforts of Lazarus Morgenthau, Esq., of New York, who presented to the association an elegantly bound "Golden Book of Life," and gen- erously volunteered his services in taking charge of it on the day of dedication. On September 14, 1873, the new Hospital and Home for the Aged and Infirm was dedicated and the Synagogue consecrated, and on the eighteenth of the same month the patients and inmates of the Home were removed to the Hospital and Home, amid con- gratulations and much happiness. Until the annual meeting of January 11, 1874, the contrib- utors assisting in the support of the hospital were all known as "Members." The removal to the new location, the increased labors and the widened field of effort, naturally resulted in The Jewish Hospital 669 increased expenses, and for the purpose of providing for the pay- ment of these outlays, at that meeting members who were willing to contribute $25 were formed into a class and designated as "Patrons." The Constitution was also amended by the addition of a section providing for the election of an Executive Committee, which should be composed of the President, Treasurer and five members of the Board, and likewise for a committee of ladies, a medical staff and standing committees, known as the Committee on Home and the Committee on Admissions. The necessity for providing for a dispensary service soon became evident, and in the President's report to the annual meet- ing, held January 11, 1875, an amendment to the Constitution was suggested (and subsequently adopted) by which the associa- tion would have the power to establish and maintain a dispensary. The Legislature of the State of Pennsylvania was applied to for aid in the erection of a dispensary building, and an appropria- tion of $25,000 passed the House of Eepresentatives, but failed in the Senate, notwithstanding that in the same year the agent of the State Board of Public Charities had reported that "a better arranged hospital, a more comfortable asylum, I have not yet seen. It compares favorably with the best in the land. I recommend it as a model for institutions of similar magnitude and for similar purposes for adoption in cities and in the country." In 1876, an appropriation of $25,000 for a similar purpose passed the House of Eepresentatives and the Senate, but was vetoed by the Governor. However, helping hands were extended. Mr. and Mrs. Abraham Adler and Mr. August B. Loeb, public-spirited and philanthropic citizens, knowing the distress then prevalent and the utter lack of proper medical treatment for poor out-patients, and desiring to perpetuate the memory of Mr. and Mrs. Adler's daughter and Mr. Loeb's wife, the late Mrs. Mathilde Adler Loeb, proposed at the thirteenth annual meeting of the association to erect on the hospital grounds, northeast of the main building, an edifice suitable for a dispensary, it being stipulated that the bene- fits of the charity were to be without distinction of creed, color, sex or nationality. The offer, together with the proposed plans and specifications, were submitted to the Board of Officers, which approved and accepted them. The corner-stone of the Mathilde Adler Loeb Dispensary was 670 General Hospitals and Dispensaries laid in April, and the building was completed and dedicated August 26, 1878. The expense of maintenance was, for several years, provided for by Mr. August B. Loeb personally. He like- wise, in 1883, endowed it in the sum of $2,500, and this he subsequently increased to $10,000. Mrs. Hannah Adler also be- queathed to the association $2,000, the interest to be used for its support. It has been continuously open to the poor. Since May 27, 1900, a small charge is made in discretionary cases. In 1907, a clinic for tuberculosis patients was established in the dispen- sary, and has proved of great usefulness. Abraham S. Wolf, the second President of the association, died in August, 1880. By his will he provided, on the termina- tion of certain life estates and sundry contingent remainders, for the establishment of a home, to be incorporated, named and styled "The Abraham S. Wolf Home for Aged and Infirm Poor Israel- ites." A special meeting of the association was held for the pur- pose of considering this bequest; but on account of the peculiar wording of the will, it was found that a corporation was to be erected to take charge of the home, and that the trustees were to be created out of the members of three Jewish congregations. This corporation was to build a home on the grounds of the Jew- ish Hospital Association, and might control the home without consultation with the association. It was felt that the moneys already donated to the association, which, with the property owned, was worth upwards of $100,000, were given to and held by the association in trust, for the aged and the sick, and that to abandon this trust would be attended with the gravest legal and moral difficulties. After negotiations, it was found impossible to complete satisfactory arrangements with the executors and trus- tees, and at a special meeting of the association, held May 29, 1881, a resolution was adopted reciting the impracticability of accepting the bequest, so far as it related to the erection of the home upon the hospital property. In 1883, Mrs. Gabriel S. Mayer endowed the first bed in perpetuity. It is known as the "Carl Theodore Mayer Bed." Miss Julia B. Eckstein paid $1,000 for the life privilege of a bed, and during this year the Board of Officers first designated Decora- tion Day, May 30, as "Donation Day." By reason of certain investigations made by a special com- mittee, the Board of Officers recommended to the association the £3i22s?ff£jgsS 111 r -®mr&**&& HIM Wm^x Mdtei^^fr tf '• hR The Jewish Hospital 671 erection of certain additions and alterations to the building, for the purpose of providing bathrooms, laundry, kitchen, engine rooms, coal vault and stable, the expense of which was estimated to be about $15,000, and at the nineteenth annual meeting, held January 13, 1884, the matter of raising the funds necessary to defray the expenses of these improvements was referred to the Board of Officers with full power. It was found, upon further investigation, that the cost of making these improvements would require an outlay of $32,000, and it was therefore decided to make temporary repairs, which necessitated the expenditure of about $3,000. In the following year the stable, carriage sheds and other outbuildings were finished at an expense of $6,474.08. During the fiscal year ending January 1, 188G, the encum- brances upon the West Philadelphia property were paid off and the association thus held this property clear of encumbrance. In the President's report for the fiscal year ending December 31, 1885, the attention of the association was called to the neces- sity for the erection of a suitable building for the proper care of the inmates of the home, and suggesting that the wing then used for the aged might be occupied as a ward for incurables. At the twenty-second annual meeting, held January 9, 1887, resolutions were adopted, referring to the Board of Officers the matter of providing proper accommodations for the aged and infirm and the care of incurables, with instructions to prepare a plan for that purpose, and with that end in view, to confer with the various Jewish orders that might desire to assist in accomplishing this object. A committee of seven, on December 2, 1887, reported to the Board of Officers that the incurable and contagious diseases should be treated outside of the regular wards, that a suitable home for the aged as well as kitchens, boiler house and laundry, should be erected separate and apart from the hospital; that the whole system of buildings should have a frontage on Thirteenth Street as then laid out, and that the home building should be first erected. This was approved at a meeting of the Board of Officers, held December 4, 1887, and at the twenty-third annual meeting of the association, held January 8, 1888, the Board of Officers was directed to open subscriptions payable in four equal instalments, and was authorized to make necessary arrangements for carrying out these plans. In order to provide funds, the right was also 672 General Hospitals and Dispensaries given to any person, upon payment of $5,000, to name a room in either the hospital or Home for the Aged, and amendments were adopted extending to the Home for the Aged the same privileges as were then in existence relative to the hospital for the endow- ment of perpetual and life privilege beds. In January, 1888, the Board of Officers made its appeal for subscriptions, having first appointed a Committee on Building Fund, composed of one hundred members. Within six months the subscriptions amounted to $85,613.75, which was then supposed to be sufficient to pay for the new home building, laundry, kitchen, boiler houses and alterations to the roads and grounds. The corner-stone was laid October 9, 1888, this being the sixteenth anniversary of the laying of the corner- stone of the hospital building, and the home was dedicated Thurs- day (Thanksgiving Day), November 28, 1889. The total receipts for the Building Fund to January 1, 1890, were $90,462.70. The total cost of the new building, including the roads, furniture, insurance, portraits, advertising and sundry expenses connected with laying the corner-stone and dedication was $105,610.58. The part of the hospital building which had been used as a Home for the Aged was, about the first of September, 1890, occupied as a ward for incurables. It was opened with the use of three beds in the male and three beds in the female department. In March, 1892, the property adjoining the hospital to the west and extending to York Boad, containing about four acres, was purchased for the sum of $20,000, of which $5,000 remained on mortgage and $15,000 was raised by loan from the Chestnut Street National Bank. This was repaid out of a mortgage of $25,000, which was subsequently created. On January 1, 1892, the Nurses' Training School was estab- lished, and on November 30, 1901, the Nurses' Training School Committee was created, and requisite rules for its government and the government of the nurses were adopted. The term of instruction, which originally was two years, was changed to three. Nurses were classified as Seniors, Juniors and Probationers, Pro- bationers being the term applied to students for the first two months; the Junior period covers the balance of the year, and the last two years constitute the Senior period. Lectures are delivered by the staff of physicians and others not directlv con- The Jewish Hospital 673 nected with the hospital. Examinations are held and diplomas awarded. On May 30, 1908, the Training School consisted of one chief nurse, four head nurses and forty-nine pupil nurses, and since its formation, beginning with the Class of 1894, there have been graduated 102 nurses. A Nurses' Alumni Association was organ- ized in 1903, its present membership being fifty-two. The advance in sanitation of buildings and the adoption of preventive measures to combat disease resulted in the construc- tion, in 1897, of a building known as the "Sanitary Tower." It is connected with the central portion of the main building on the south side, and contains all the known modern improvements in sanitary and scientific plumbing, drainage and ventilation. There are plunge, steam, vapor, needle, hot and cold shower-baths, the necessary toilet-rooms, nurses' laundry ; the ground floor was used for servants' quarters. The expense of this was $13,886.03. The West Philadelphia property had not been a source of much income; it had for some time been rented for school pur- poses at $750 per annum; but at several meetings of the associa- tion resolutions had been adopted looking to its sale either as an entirety or in lots. It was finally sold on April 25, 1898, for $30,000, the receipt of which enabled the association to satisfy the mortgages upon its new property. The incurable ward was always a source of much grave con- sideration. Located in the old part of the hospital, in close connection with the convalescing, among conditions which did not tend to best results, it stood as a mute appeal for further bene- factions. Mr. Lucien Moss, a director until his death, April 19, 1895, saw the necessity of providing in a separate building for the chronic invalids, where the care, attention and treatment would be better adapted to their ailments. He, therefore, by his last will, directed that upon the death of his widow (which occurred November 25, 1907), his entire residuary estate should pass to the association for the erection of a new Home for Incurables, and for the support and maintenance of its inmates. The net prin- cipal received by the association from this source was $184,069.27, and ten shares of the stock of the Mount Sinai Cemetery Associa- tion. Its erection was commenced in the middle of June, 1899, the corner-stone laid September 21, 1899, with Masonic cere- monies, and the building dedicated June 10, 1900. 43 674 General Hospitals and Dispensaries The erection of the Lucien Moss Home and other buildings necessitated the enlargement, in 1899, of the coal vaults, the building of additional greenhouses (one of which was erected by Mr. Henry Fernberger) and the construction of a new laundry building, at an expense to the Improvement Account of $5,252.07. Mrs. Eose Frank has for eighteen years been one of the most active workers in the upbuilding of the institutions under the association's control, and since her removal a few years ago to New York City, her interest in the institution has not abated, though she is necessarily unable to give the kind of service she rendered while living here. Not only has she given unsparingly of her time and energy, but she has assisted in many other ways. On June 4, 1900, Mrs. Frank, then Chairman of the Ladies' Visiting Committee, expressed to the Board of Officers her desire to erect a synagogue on the grounds of the association, in memory of her deceased husband, Henry S. Frank, and to be used by the inmates of the home and the patients in the hospital. She provided that it should be dedicated to the worship of God in the manner of the Jewish faith, but might be used for such meetings of the associa- tion as the Board of Officers deemed proper. The corner-stone was laid January 27, 1901, the building was completed and dedicated with appropriate ceremonies, Thursday, September 12, 1901, and opened for divine services on the Satur- day following, being the first day of Eosh Hashonah. It is located on the site of the old house, directly in front of the hospital and home buildings, and facing York Eoad. It is one of the most beautiful and completely furnished houses of Jewish worship in this country, designed after the architecture employed in the Synagogues of Palestine in the first and second centuries, and the inscription over the outer entrance is literally copied from one of these. It is built of Indiana limestone, the woodwork being of oak. In December, 1900, a small lot of ground lying between Tenth and Twelfth Streets (about three acres), bounded on the south by Clarkson Avenue, comprising about twenty lots, was purchased to square the lines of the property, at an expense to the association of $2,857.40. It is but natural to suppose that, with the advance in surgery, new fields of usefulness were opened to the association. The operations at this time were performed in a comparatively small The Jewish Hospital 675 room, with artificial light and inadequate appliances. Mr. Marx B. Loeb (who had been Treasurer and a Director of the Associa- tion, and who was always deeply interested in its work) and his wife offered, on May 26, 1901, to erect and equip a building for use as an operating room, in memory of Mrs. Loeb's parents, Mr. and Mrs. Samuel Frank, and her brother, Henry S. Frank. This offer was accepted by the association at its twenty-sixth annual meeting, the corner-stone was laid Sunday, June 1, 1902, and the building dedicated October 4, 1903. The Jewish Hospital Association was enabled, from its income, to pay for all expenditures until the fiscal year ending December 31, 1876. From that time it has been taxed, by its beneficiaries, far beyond its receipts. To such an extent had this grown, that the management was yearly obliged to encroach upon its invested funds. Many of the other Jewish charitable organi- zations of this city felt the same needs, and to meet these condi- tions and permit the management of the constituent associations to apply their time and attention to the needs of their several institutions, the Federation of Jewish Charities was organized in 1900. It is founded upon what is known as the Liverpool system, the purpose of which is the collection of regular yearly contribu- tions and devoting its income to the support and assistance of local charitable institutions. It alone collects subscriptions as well as dues for the beneficiary societies, so that there is one cen- tral organization providing funds for the carrying on of the work. By the laws of the Federation it was provided that none of the beneficiary associations should be permitted to collect any membership dues, give any balls, bazaars, fairs, excursions, picnics or theatrical benefits, or solicit money or contributions, other than permanent endowments or legacies, from members of the Federa- tion. The organization of this society was commenced by Messrs. Max Herzberg and Louis Wolf. During this year the Hebrew Charity Ball, which for forty-five years was an important factor in contributing support to the Jewish charities, was abandoned insofar as it had theretofore been conducted for their benefit. It was found, however, that, with all the efforts of the Fed- eration, enough could not be secured to meet the expenditures. In 1901, therefore, the Legislative and Executive Departments of this State appropriated $10,000 for maintenance for two years, and since then regular appropriations have been made, by reason 676 General Hospitals and Dispensaries of which much aid has been given which otherwise would have been denied. On November 18, 1901, the late Meyer Guggenheim addressed a communication to the Hon. Mayer Sulzberger, informing him that his attention had been called to the annual deficit in the finances of the Jewish Hospital, and stating his belief that if a private hospital was built, a sufficient income might be secured to largely overcome this deficit. He, therefore, signified his willingness to donate a sum not exceeding $60,000 (subsequently increased to $80,000) for the erection of a private hospital, to be known as the Meyer Guggenheim Private Hospital. This munifi- cent offer was gratefully accepted and a building committee at once appointed. The corner-stone was laid Sunday, June 1, 1902, and the building was dedicated October 4, 1903. It is operated as a pay hospital and is planned without wards, the bedrooms being connected with bathrooms en suite. It is red terra-cotta and brick, with stone basement. The construction of the Henry S. Frank Memorial Synagogue, the Loeb Operating Building and the Guggenheim whig for pay patients brought in its wake many needed improvements. The old frame building, which had first been used for an old folks' home, was demolished; the old Synagogue was converted into two surgical wards of three beds each, divided by a wide corridor connecting with the operating room; the Isaac Leeser Memorial Window was placed in the meeting room of the Board of Officers; two children's wards were fitted up between the hospital building and the Meyer Guggenheim Private Hospital. They both have a southern exposure, are capable of receiving sixteen beds for chil- dren. One has been designated as the "Henry M. Phillips Ward" and was endowed by the bequest of Emily Phillips; the other is the "Simon Muhr Ward," endowed by the liberal gifts from the estate of that eminent citizen. New roads were constructed, and the entrance to the grounds removed from Clarkson Avenue to a point about 150 feet north, at which were erected six white granite columns, previously used as part of the United States Mint on Chestnut below Broad Street. The entrance to the hospital was also changed to the southwest side of the hospital building, almost directly north of the entrance to the home building, and east of the line of Thirteenth Street. A serious drawback in connection with the training of the The Jewish Hospital 677 nurses was the lack of proper accommodations for their comfort. Their quarters were small and ill-arranged, and it was felt that when women perform the severe work necessary to the proper dis- charge of their duties, they should, when off duty, have reasonable comfort and conveniences and be removed from the atmosphere of the hospital. It was also deemed advisable to arrange for the proper care of persons who might, while inmates of the hospital, develop contagious diseases, and that they might be properly pro- vided for at some place without peril of infection to the other inmates. By reason of the hospital being a part of the Federa- tion, it was not deemed wise to urge appropriation for these highly necessary purposes, and the President, in his report at the thirty- seventh annual meeting, held May 29, 1902, called the attention of the members to these urgent requirements, stating that it was necessary to either "rely on the generosity of philanthropic friends or alternatively await the development and further extension of the Federation system." It was not long before both these appeals were answered. The attention of Mrs. Sarah Eisner was called to the condition of the nurses by her daughter, Mrs. Julius Sondheim, of the Ladies' Visiting Committee. On May 31, 1902, Mrs. Eisner advised the Board of Officers that she was prepared to donate a sum not exceeding $20,000 for the erection of a suitable building to be known as the "Eisner Home for Nurses." It was gratefully accepted by the board, the corner-stone was laid Sunday, October 26, 1902, and the building was completed March 6, 1903, and dedicated October 4, 1903. The site selected was east of the dis- pensary and northeast of the Lucien Moss Home, at the junction of Twelfth Street and Tabor Boad. The building for the care of persons who might become afflicted with contagious or infectious diseases while patients in the hospital was erected through the beneficence of the Legisla- ture of the State of Pennsylvania in appropriating, in 1903, the sum of $10,000. It is situate on Clarkson Avenue, about 200 feet southeast of the Lucien Moss Home, and about 150 feet east of the stable, and is built of stone similar to the hospital and home buildings. The association was likewise aided in its labors by the appro- priation, in 1907, of $5,000 by the State of Pennsylvania for the erection of a morgue and laboratory. It is one story in height, 678 General Hospitals and Dispensaries is constructed of stone, on the line of Clarkson Avenue, west of the Isolation Building, and was completed at a cost of $6,687.55. On February 6, 1907, Mrs. Louis Fleisher signified to the Board of Officers her desire to perpetuate the memory of her sister, Dr. Kebecca Fleisher, by erecting solariums for the use of patients. They were built at the eastern end of the hospital building and connected therewith. By this addition, the con- valescent ward patients are furnished suitable sitting-rooms and sun parlors, in which they spend much of their time. The sola- rium was opened to patients October 13, 1907. Conflagrations are, ordinarily, the means of much loss and distress. In a hospital they may be attended with dire conse- quences. The records of the association show only two fires, one on November 12, 1875, about 8 p.m., in the northwestern portion of the building, then used as the female department of the home. Furniture was damaged in the sum of $100, and the building $322.92. The money realized from insurance was spent in instal- lation of steam heating. The other occurred on September 29, 1890, in the dispensary, and was caused by spontaneous combus- tion. The damage was trifling. Notwithstanding this record, however, in view of the many additions to the buildings and the erection of so many new buildings, the Board of Officers deemed it imperative to provide some adequate system of fire protection. Therefore, an independent 12-inch main was put in, extending from York Boad to the pump house, connected with a fire-pump having a capacity of 750 gallons per minute; 12 outside fire-plugs, fire stations on each floor of the main buildings, sufficient hose to reach every point, axes, chemical extinguishers and other neces- sary appliances were installed in 1907. A large fire-pump house is centrally located in the group of buildings. It is built of stone, and was constructed so as to provide against the danger of being crushed by falling walls. Besides the fire-pump, it contains a 40- gallon chemical engine, hose-cart, 600 feet of hose, extension ladders and other fire-extinguishing appliances. The entire cost was $12,287.29. The liberal donation, in 1907, by Mr. Felix Isman of a tri- angular tract, containing about one-half an acre of ground, at the northwest corner of Clarkson Avenue and Tenth Street, enabled the association to square its property at that point. The latest addition to the beautiful group of buildings belong- The Jewish Hospital 679 ing to the Jewish Hospital Association is the structure known as "The Pennsylvania Building." It is used as a surgical ward and nurses' home. It was erected through an appropriation of $30,000, made by the State of Pennsylvania. The building was started on the sixth day of March, 1908, the corner-stone was laid with Masonic ceremonies on the second day of June, 1908, and was opened, completely furnished, on Thanksgiving Day, Novem- ber 26, 1908. The expense of the purchase of the furniture was borne by the Board of Officers and the Women's Auxiliary Com- mittee. The building is directly north of the Lueien Moss Home, to the east of the dispensary, and is close upon Tabor Eoad. No history of the association would be complete without at least the mention of the names of those who, by their untiring efforts, have brought it to its present high position. A list of officers, etc., is hereto attached. How nobly they have labored is attested by those well-equipped buildings that have been reared, and by a continuous record of forty-three years' service in the cause of humanity. Many of them have joined the "great majority," but they have left for the present and future genera- tions an institution firmly established in the hearts of an appre- ciative community, fully equipped to help the distressed and afflicted. "A wise God shrouds the future in obscure darkness;" but the citizens of this State may confidently gauge their antici- pations by past records. The Jewish Hospital Association will, by the continued application of the broad principles which have in the past guided its management, not only continue to alleviate suffering and care for the poor and afflicted in their declining days, but will also be one of the most important causes which will eventually unite mankind into one brotherhood. "For He who gave this vast machine to roll, Breathed life in them, in us a reasoning soul, That kindred feelings might our state' improve, And mutual wants conduct to mutual love." SURGEONS AND PHYSICIANS TO THE JEWISH HOSPITAL Consulting Surgeons. — Drs. William W. Keen, J. William White, John B. Eoberts, Edward E. Montgomery, Orville Horwitz, J. M. Baldy, Charles P. Noble, Benjamin B. Wilson. Surgeons. — Drs. Lewis W. Steinbach, William H. Teller, Will- iam L. Eodman, Max J. Stern, Melvin M. Franklin. 680 General Hospitals and Dispensaries Consulting Orthopcedic Surgeon. — Dr. DeForest Willard. Orthopedic Surgeon. — Dr. Walter G-. Elmer. Ophthalmologists. — Drs. Isaac Leopold, Jay C. Knipe. Otologists. — Drs. S. MacCuen Smith, Eli L. Klopp. Laryngologist. — Dr. Arthur W. Watson. Dermatologist. — Dr. Jay P. Schamberg. Obstetrician. — Dr. William H. Randle. Pathologist. — Dr. Mortimer Herzberg. Examining Physicians. — -Drs. Philip A. Trau, Edwin A. Heller, Louis H. Jacob, Abr. J. Cohen. Consulting Physicians.— Drs. John H. Musser, James Tyson, James C. Wilson, Poland G. Curtin, Alfred Stengel, James M. Anders, Lawrence P. Flick, Solomon Solis-Cohen, Thomas Betts. Physicians. — Drs. Adolph Peldstein, David Riesman, Moses Behrend, Bernard Kohn. Neurologists. — Drs. Francis X. Dercum, Max H. Bochroch. Consulting Pediatrist. — Dr. J. P. Crozer Griffith. Pediatrists. — Drs. Thompson S. Westcott, Ludwig Loeb, Joseph B. Potsdamer. Physicians to the Tuberculosis Department of the Lucien Moss Home. — Drs. W. B. Fetterman, Jr., Abr. J. Cohen, Edwin A. Heller. Assistant Physicians Lucien Moss Home. — Drs. Victor A. Loeb, Samuel Leopold, Maurice J. Karpeles. Radiologist. — Dr. Sidney L. Feldstein. The Mathilde Adler Loeb Dispensary Staff is as follows : Dis- eases of the Ear, Drs. Eli L. Klopp, Leo Strousse (assistant) ; Diseases of the Eye, Dr. Jay C. Knipe; Diseases of the Nose and Throat, Drs. R. F. Ridpath, H. M. Goddard; Diseases of the Skin, Drs. William G. Shields, George P. Katzenstein; Diseases of Chil- dren, Drs. M. Solis-Cohen, H. L. Bates; Diseases of the Nervous System, Dr. Milton K. Meyers; Diseases of the Lungs, Drs. William B. Fetterman, Jr., John A. Murphy, Albert Strickler; Medical Clinic, Drs. M. J. Karpeles, E. I. Becker, H. F. Weber, A. Reiss; Surgical Clinic, Drs. Nate Ginsburg, Victor A. Loeb; Diseases of Women, Dr. Louis H. Jacob. Presidents.— Alfred T. Jones, 1865-1871; Abraham S. Wolf, 1871-1878; William B. Hackenburg, 1878. Vice-Presidents. — Isadore Binswanger, 1865-1869; Abraham The Jewish Hospital 681 S. Wolf, 1869-1871; Abraham Goldsmith, 1871-1891; Simon Muhr, 1891-1895; Hon. Mayer Sulzberger, 1895. Second Vice-President. — Isidore Langsdorf, 1904. Third Y ice-President. — Benjamin Wolf, 1904. Treasurers.— S. Weil, 1865-1869; William B. Hackenburg, 1869-1878; Marx B. Loeb, 1878-1880; August B. Loeb, 1880. Secretaries. — Mayer Sulzberger, 1865-1869; Henry J. Hunt, 1869-1875; Joseph L. Berg, 1875-1880; Simon A. Stern, 1880- 1894; Bphraim Lederer, 1894-1902; Henry N. Wessel, 1902. Corresponding Secretaries. — Henry J. Hunt, 1865-1869; S. Hecht, 1869-1875; Simon Pfaelzer, 1875-1890; Jacob Wiener, 1890-1891; Herman Jonas, 1891-1902; Arthur A. Fleisher, 1902. Medical and Surgical Staff of the Jewish Hospital since open- ing its hospital, 1866: Drs. W. H. Wallace, B. B. Wilson, W. Sergeant, 1868; Drs. J. E. Wells, Bichard J. Lewis (President of the Staff until his death, in 1890), 1869; Dr. S. S. Stryker, 1871; Drs. D. Davidson, P. D. Keyser, 1872; Drs. J. C. Hall, Wilson B. Smith, Thomas G. Morton (President of Staff from 1890 until his death, 1903), 1873; Dr. Joshua R. Evans, 1874; Drs. A. Felds.tein (still on staff), Owen J. Wister, 1875; Dr. Thomas Betts (still on staff), 1879; Dr. Daniel Bray, 1881; Drs. L. W. Steinbaeh (still on staff), Joseph Darrach, 1885; Drs. John B. Roberts, Chas. S. Turnbull, 1886; Dr. S. Solis-Cohen (still on staff), 1887; Dr. Wm. H. Teller (still on staff), 1892; Dr. Isaac Leopold (still on staff), 1893; Dr. W. A. Gross, 1895; Dr. F. X. Dercum (still on staff), 1896; Drs. David Riesman (still on staff), J. C. Knipe (still on staff), 1898; Dr. Courtland Y. White, 1902. Messenger. — Alexander Goodman, 1865-1875. Resident Physicians. — Dr. A. Feldstein, 1865-1876 ; Dr. Geo. S. Kemble, 1876-1878; Dr. Aloys Sehappringer, 1878-1883; Dr. Jos. B. Potsdamer, 1883-1884; Dr. Morris S. Cohen, 1884-1888; Dr. Bernard R. Lee, 1888-1889; Dr. Jacob S. Pragheimer, 1889- 1890; Dr. William H. Teller, 1890-1893; Dr. Jay C. Knipe, 1893- 1897; Dr. Edwin A. Jarecki, 1897. Stewards.— S. W. Kronheimer, 1866-1875; Moses E. Cohen, 1875-1876; Moses Klein, 1890-1891. Superintendent and Resident Physician. — Dr. A. Feldstein, 1873-1876. Superintendents.— Moses E. Cohen, 1876-1877; Max Thal- heimer, 1877-1890; Esther A. Davidson, 1890-1892; Edward 682 General Hospitals and Dispensaries Gruner, 1892-1896; Selig Rosenbluth, 1896-1904; Berthold Hevessy, 1904. Matrons.— Mrs. S. W. Kronheimer, 1866-1875 ; Mrs. Moses E. Cohen, 1875-1877; Mrs. Max Thalheimer, 1877-1890; Mrs. Edward Gruner, 1893-1895; Dr. Anna S. Kosenbluth, 1896-1904; Mrs. Otillie Hevessy, 1904. Chief Nurses. — Miss Douglass Benson, 1894-1897 ; Miss Eliza- beth Hanson, 1897-1901; Miss Anna Maybee, until August 1, 1901; Miss Fannie Ochser, August 1, 1901, to July 1, 1902; Miss Carrie S. Louer, September 1, 1902-1905; Miss Margaret P. Pridham, 1905. The Germantown Dispensary and Hospital By FRANK J. FIRTH THE Germantown Dispensary and Hospital of to-day occupies, with its various departments, between nine and ten acres of ground located on both sides of Penn Street (formerly Shoemaker's Lane), and extending from the southeast side of Penn Street, through to Wister Street, or Stenton Avenue, Germantown. It comprises a group of fourteen buildings, large and small, among them a free hospital and dispensary building where the sick and injured poor are cared for without charge. This building has men's, women's and children's surgical and medical wards, operating rooms, and a capacity for one hundred and twenty-five beds. The free service includes a tent dispensary, apart from all the other buildings, for the treatment of tubercular cases with a special nurse who attends the dispensary and visits the patients at their homes, aiding them in maintaining the best modern sanitary con- ditions. There is also a cottage building endowed by Mrs. Pauline E. Henry, the founder of the institution and devoted to the free care of convalescent women and children. A pay-patient building, furnished, endowed and presented to the institution, represents the best type of accommodation for this class of hospital work. It is a detached fireproof building with twenty-five private rooms, baths, kitchen, parlors and operating rooms. Germantown Dispensary and Hospital 683 The Nurses' House, formerly Pauline Home, now in use, does not accommodate all of the training school nurses, and it is hoped that it will soon be replaced by a fireproof house of sufficient capacity. A central plant supplies the steam and the electric current needed for heat, light and all other requirements ; a power laundry does all the laundry work of the institution. A small isolated memorial building furnishes temporary accom- modation for contagious or suspected cases developed in the wards, while waiting permanent disposition ; and a well appointed labora- tory in a separate memorial building provides for the necessary pathological work of a modern hospital. A mortuary, stables, storerooms and an incinerator to care for the waste, complete the building plant. Portions of the ground not yet built upon are utilized for flowers and vegetable gardens and for chicken yards, so that the patients are supplied with flowers, garden produce and fresh eggs from the place. Such was the Germantown Dispensary and Hospital when on December 31, 1908, it closed the forty-fifth year of its dispensary service and the thirty-ninth of that of its hospital. The history of the origin and growth of the Germantown Dis- pensary and Hospital is a simple but interesting one. It is a story of quiet persistence in good work by good people. Dr. James E. Ehoads, a well-known and respected practicing physician of Germantown, in January, 1864, called together some of his friends and neighbors : James M. Aertsen, Blliston P. Morris, J. Livingstone Erringer, Norton Johnson, John S. Haines, Charles J. Wister, Jr., Owen J. Wister, M.D., William M. Ellicott, Jr., Anthony Miskey, P. Mortimer Lewis and Redwood E. Warner, all well-known public spirited citizens, men to be relied upon to aid in every good work. Two of them were, in after years, Presidents of the Germantown Dispensary and Hospital, namely, P. Mortimer Lewis (1885-1886) and Elliston P. Morris (1896-1907). Dr. Ehoads told them why he thought there should be a dis- pensary established in Germantown to aid the worthy sick and injured poor with gratuitous advice and medicines. It was decided to establish such a dispensary. The City of Philadelphia contributed the use of a room on the first floor of the Town Hall and Dr. T. J. Leavitt was the first physician in charge. 684 General Hospitals and Dispensaries The whole annual outlay amounted, at first, to only about two hundred dollars. Dr. Owen J. Wister, one of the founders of the dispensary, was (in 1870) the physician of Mrs. Pauline B. Henry, who being her- self an invalid, was greatly interested in having a cottage hospital established in Germantown. Her attention having been directed to the work of the dispensary she offered to purchase a lot and build and furnish a cottage hospital. The Board of Managers of the dispensary accepted the trust contemplated by this gift and proceeded to provide for the proper care, maintenance and operation of the new hospital. On March 21, 1870, the Germantown Dispensary and Hospital was incorporated under the laws of the State of Pennsylvania. Dr. James E. Ehoads became its first president. (1870-1885.) The objects of the corporation were stated in its charter to be the main- tenance of a dispensary and hospital in Germantown for the purpose of offering gratuitous medical advice and medicines ; and to provide medical and surgical aid for the sick and disabled, either in the wards of the hospital or at their homes and such other means as may tend to the prevention of disease and restoration of health to the poor of Germantown and its vicinity. On April 11, 1870, Mrs. Pauline E. Henry transmitted to the Board of Managers of the new corporation a "Deed of Gift," for a lot on Shoemaker's Lane, now Penn Street, 140 feet front by 225 feet deep. On this lot, Mrs. Henry erected at her own expense, a cottage hospital of brick, one story high, arranged to permit the subsequent erection of one or more stories and having twelve beds all of which she provided should be free forever for the sick poor, or for those who have met with accidents or casualties. Two out of the twelve beds were set apart for the use of "incurable patients." It was in this way that the Germantown Dispensary and Hospital originated and became an institution for the free care of the sick and injured poor of Germantown and vicinity. The amendments since made to its charter increased the limit of income of real estate and moneys at interest which the corporation was authorized by law to possess, first from $5,000 to $20,000 per annum and subsequently from $20,000 to $50,000 per annum ; pro- vision was also made for the election of one-third of the managers each year to serve for three years. PAY PATIENT BUILDING. &£ LABORATORY AND ISOLATION BUILDINGS. Germantown Dispensary and Hospital. Germantown Dispensary and Hospital 685 The story of the hospital's growth may best be told chronologic- ally, as follows: — 1870. — The new institution was formally opened on Saturday, October 5, 1870, but the old dispensary office was still kept open for the convenience of patients, in the rooms of the centrally located Town Hall, on the Main Street. At this early date the useful serv- ices of the Board of Lady Visitors, appointed by the Board of Managers, was recognized and acknowledged in the annual report. (The Lady Visitors still continue a valued aid to the Management.) 1871. — The end of the first working year found a constantly increasing list of dispensary and of hospital cases and of expenses. 1872. — An adjoining lot was purchased, graded and fenced at a cost of about $3,275, which was contributed by friends of the hospital. 1873. — The work continued to grow and the English Hospital Saturday plan was considered as a method of increasing current revenues. 1874. — The first house physician was appointed, but as there was no accommodation for him in the hospital, he gave it only a part of his time and went to and from his residence as required. The increasing demands on the ward room caused the board to con- sider the advisability of an addition with beds to accommodate 20 male patients. Mrs. Henry, the founder of the hospital, called attention to the need for a school for training nurses, there being then several such schools in Great Britain, one in New York and one in Boston. The President stated that he would consider such a school desirable when the hospital had 50 beds. 1875. — The board appealed for an operating room, a consulting room, a mortuary, a room for male nurses and a business office. Attention was called to the fact that lack of proper room obliged physicians, at times, to perform important and critical operations in the ward, in the presence of other patients; and that it was impossible to separate the dying, or even the dead, from the living, except by an ordinary movable screen. A building fund was started and at this time about $6,000 in subscriptions was secured towards the $10,000 needed to make the fund effective. 1876. — The new ward for men was approaching completion. The Lady Visitors had their first donation day ($646.31) a custom still in annual use ; churches of all denominations commenced taking up collections at some convenient time in the year, in aid of the hospital. 686 General Hospitals and Dispensaries 1877. — At this time the annual reports began to detail the causes of medical and surgical cases. The dispensary was removed from the Town Hall and the entire work of the institution con- centrated at the Penn Street property. The new men's ward with twenty beds was completed and furnished at a cost of about $18,000. A mortuary was added at a cost of nearly $700. The first resident physician, quartered in the house, was elected for the dispensary and hospital. The board called attention to the absence of a culvert on Shoemakers Lane to receive the hospital drainage. 1878. — Overseers of the poor appointed an outdoor physician and undertook to give relief to the poor at their homes, so that the hospital dispensary became confined to office practice. A sewer was finished on Shoemaker's Lane. Increasing detail as to medical and surgical statistics appear in the annual report. 1879. — Scarcity of funds made it necessary to limit admissions during two months of this year. 1880. — To avoid abuse each new applicant to the dispensary was required on the second visit to bring a certificate of worthiness from the Gemiantown Eelief Society which agreed to investigate all cases. Plans were prepared and work begun on a second story addition to the women's ward to contain 14 beds, an operating- room, diet kitchen, elevator, etc., increasing the capacity of the hospital to 36 beds, or, in case of emergency, to 45. The estimated cost of this addition was $10,750. 1881. — The new women's ward was opened February 1, 1SS1. A nearby dentist arranged to give free advice and attention when needed. 1882. — An eye and ear service was added to the dispensary. A balcony was attached to the new women's ward and an ambulance built and donated. 1883. — The patients and expenses continued to increase. 1884. — Donations were received to start a fund, the income of which was to be used to raise the standards in nursing. 1885. — An additional resident physician was appointed, mak- ing two in residence. With the appointment of this second resident the payment heretofore made to the physician holding this position ceased, the two residents receiving board and lodging only. 1886. — Medical and surgical annual statistics here commence to show results of treatment, i.e., whether the patients were cured, Germantown Dispensary and Hospital 687 improved, unimproved, etc. A prize was offered from the income of the fund for faithful nursing. The first experiment with a col- lector to increase the subscription list was made and was not satis- factory. The board appealed for better dispensary accommodations and for a new laundry building. The Pauline Home property on Penn Street was purchased and used for a nurses' house — cost about $7,000. 1887. — The requirement of Belief Society certificates of worthiness had fallen into disuse with the increased number of cases needing care. Throat and nose service was added to the ear service in special dispensary. A dark room was constructed; also additions made to sleeping accommodations for employees, and to the steam heaters. A second ambulance was appealed for; also a new laundry to replace the old tubs and hand service in the base- ment of the main building. 1888. — An honorary membership was created, based on $1,000- contributions. A new power laundry was donated and put in operation, costing about $7,000. The employment of women nurses in the male ward with a male orderly was satisfactorily established and a second ambulance secured. 1889. — The staff was represented this year by its Chief on the Medical Committee of the Board of Managers. An appeal for two special rooms for delirious patients was made. 1890. — It was found that a central heating plant was needed ; also that it was advisable to remove all fires from the hospital building. 1891. — Additional porches were erected for patients' use and plans made for new heat and light plant to cost about $7,500. The police patrol commenced bringing cases to hospital. 1892. — A service for nervous diseases was added to the dis- pensary and a nurse's training school and nurse's directory estab- lished. 1893. — Shoemaker's Lane or Penn Street was paved, making access to the hospital more convenient, and more comfortable for patients. 1894. — Facilities for reception of accident cases, and also a more commodious operating room were found to be necessary. A permanent fund committee was created and given custody of securities. 1895. — The new heating plant was practically finished and in 688 General Hospitals and Dispensaries working order and the electric light equipment progressing toward completion. A fund was started to provide a children's ward. New and better dispensary accommodations were needed. Dr. James E. Khoads, the first president of the dispensary, and also the first president of the Germantown Dispensary and Hospital, died suddenly at Bryn Mawr, Pa., on January 2, 1895, aged 67 years. 1896. — This was a year of quiet and successful work. 1897. — A new wing was commenced at the west end of the male ward with dispensary accommodations on the ground floor, an X-ray apparatus was donated and work pushed on the con- struction of a children's ward. Sunday schools were asked to endow beds and to appoint representatives on a young ladies auxiliary to the Board of Lady Visitors. 1898. — The new men's ward and dispensary, and children's memorial ward were opened. An isolated memorial building was presented. The Weiner lot of about 6% acres, adjoining the hospital, with residence and stable thereon, were purchased at a cost of $30,000. 1899. — The new surgical ward for women was completed and donated. Copies of memorial tablets were first printed in annual reports. 1900. — A children's ward porch, glass enclosed and steam- heated, was donated. 1901. — The children's ward porch was finished and put in use. 1902. — New surgical operating rooms were in use this year. 1903. — Work was pushed on the new pay-patient building. The staff urged the establishment of an up-to-date laboratory build- ing and equipment. 1904. — The fireproof pay building was opened October 13, 1904. $100,000 was contributed in $5,000 shares; $50,000 to be used for building purposes and a like amount for endowment; $7,000 additional was contributed for furnishing and $2,500 for an increase in boiler plant to heat the building, making the total donation $109,500. A memorial laboratory building was erected, donated and equipped. 1905. — An Honorary Advisory Committee was appointed as an adjunct to the Board of Managers, available for counsel when needed. Outside shutters for entire pay building were donated. Mrs. Pauline E. Henry, the founder of the hospital, died May 19, 1905, aged 78 years, and left the hospital special legacies and WEINER ANNEX (IH)RMTTOKY A CORNER OF THE FREE HOSPITAL TUTILIMNn Germantown Dispensary and Hospital. Germantown Dispensary and Hospital 689 her residuary estate. Her will made provision for the care of convalescent -women and children. A cottage adjoining the hos- pital was purchased for this purpose. 1906. — The Pauline B. Henry Convalescent Cottage was opened. 1907. — An adjoining vacant lot was purchased and donated. Cost, $10,000. A modern fireproof nurses' house was found to be needed, and an appeal was made for a building fund. 1908. — Amended By-Laws, Organization and Eules, recording valuable results of accumulated experience were adopted. A free tuberculosis dispensary tent and visiting nurse service were estab- lished and a fund for new X-ray apparatus raised. In 1908, the hospital cared for 1,640 patients in its wards and 19,375 visits were paid to its dispensaries. Its surgical and medical staff comprised 57 surgeons, physicians and specialists, which included 5 resident physicians. It had 35 nurses in its training school. Its net current expenses for maintenance and operation, and for betterment for the year were over $50,000. In addition to the real estate and buildings before described and costing about $225,000, the institution had about $525,000 in its permanent fund invested in interest-bearing securities. It has paid out for current expenses of maintenance and operation, during its existence, about $775,000 and has received innumerable valuable donations of service and of provisions and supplies of every kind. If one should ask where the institution obtained all of this property, (which is free from debt) ; all the money invested in the securities of its permanent fund, together with the professional and other gratuitous service, and the money and supplies that have met its current needs, the reply would be — it came freely and gen- erously; it came as current contributions small and large of serv- ice and of money ; it came as thank offerings and as memorials ; it came in bequests by will ; it came in every way in which those who remember Christ's commands to love our neighbors as ourselves and to heal the sick, could give expression to their willing obedience. Many of them have gone to their reward. Many are still with us. Not one dollar of State aid has ever been received and not one dollar has ever been charged for any service rendered to any poor sick or injured neighbor coming to the dispensary or to the hospital for free care. Can anyone who reads this record wonder that the people of Germantown, Chestnut Hill and vicinity look backward 44 690 General Hospitals and Dispensaries filled with pride and thankfulness, and forward with hope and confidence ? OFFICERS December 31, 1908. President, Frank J. Firth; Treasurer, William H. Haines; Secretary, James G. Leiper. Managers, William H. Haines, Frank J. Firth, Francis Stokes, Alex. W. Wister, William H. Scott, Norton Downs, M.D., Thomas H. Shoemaker, Henry L. Davis, Edward H. Hance, Geo. Woodward, M.D., Edgar H. Butler, Francis E. Cope, Jr., Wm. J. Montgomery, James G. Leiper, T. Harvey Dougherty. The Presbyterian Hospital in Philadelphia By JAMES E. TALLEY, M.D. DTJEING the early sixties, a vague idea of a Presbyterian Hospital was already in the Presbyterian mind, but neither branch of the disrupted church, was able to support it alone. The first printed article on the subject to which I have been able to find any reference, was one entitled, "Shall Presbyterians have a Hospital in the City of Philadelphia," by Dr. John Neill, who was afterward one of the consulting surgeons of the hospital. I have not seen this article, but the Eev. Dr. Grier of "The Presbyterian" refers to it as having been offered to him and printed "in war times." In November, 1869, at Pittsburg, Pa., was consummated the reunion of the two branches of the Presbyterian Church. The Philadelphia Presbyterian Alliance was formed September 19, 1870 as a result of this reunion. The object of this association was to combine the interests and energies of Presbyterians, and among the specific things sought was the founding of hospitals and homes for the care of the sick and needy. Various committees were appointed, and among them was one on hospitals, consisting of the following named gentlemen: — Eev. William T. Eva, Eev. William 0. Johnstone, Eev. Alfred Nevin, D.D., Eev. Matthew New- kirk and William J. McElroy, Esq. The Eev. Dr. Musgrave and Fulton W. Hastings, Esq., were subsequently added. Soon after this, one evening in the session of Dr. Mc Cook's The Presbyterian Hospital 691 church in Penn Square, the pastor suggested the practicability of agitating anew the subject of a hospital in the community, and a physician who was interested in the Charity Hospital said that the managers would be willing, under certain conditions, to place their institution under some denominational influence. A few days later Dr. McCook advocated in the Presbyterian Ministerial Association an investigation of the Charity Hospital with the idea of making it the starting point of Presbyterian hospital work. The committee, probably the one referred to above visited the institution late in 1870, but after consideration declined the tender, possibly because of the more desirable offer made by the Eev. Dr. B. D. Saunders at the suggestion of Dr. Robert H. Girvin. The gist of the report of the committee on hospital of the Presbyterian Alliance, held in the Seventh Presbyterian Church, February 8, 1871, is here given, because it is a complete presentation of the whole matter. "To the Executive Committee of the Philadelphia Presbyterian Alliance: The Committee on Hospitals respectfully report that, with the aid of the Eev. Dr. Musgrave and Professor P. W. Hastings, who were added to the Committee with reference to this special matter, they have considered the subject referred to them, viz. : the proposition then introduced in regard to the establishment of a Presbyterian Hospital. "The Rev. Dr. Musgrave, the Rev. Mr. Eva, Professor Hastings and Mr. McElroy, as a sub-committee, visited the premises proposed to be conveyed for the purpose of a hospital and had an interview with the owner, the Rev. E. D. Saunders, D.D. They reported to a meeting of the Committee on Hospitals, held last Monday, at which all the members were present, and which Professor Saunders attended, and explained his views and intentions with respect to the matter. The Committee now report the facts ascertained by them for the information and consideration of the Executive Committee. "The proposition made by Professor Saunders is as follows : He will convey his property in West Philadelphia, bounded by Filbert Street, Powelton Avenue, Thirty-ninth Street and Boudi- not 1 Street, to such Trustees as may be named, for the use of a l Boudinot, formerly also called William Street, is the present Thirty- ninth Street; the Thirty-ninth Street referred to above, is the present Saunders Avenue, in early' days called Saunders Lane, or Thirty-ninth Street. 692 General Hospitals and Dispensaries hospital, to be established and maintained by the Presbyterian Church. The property to be conveyed clear of all incumbrances, except the sum of $40,000 for the following considerations: An annuity of $4,000 to be secured to him during the joint lives of himself and wife; in the event of her surviving him this annuity to be reduced to $3,000; in the event of his surviving her, the annuity to be reduced to $2,000. They and the survivor of them to have also the free use and occupation during life of the dwelling- house fronting on Filbert Street, and the lot of ground originally attached thereto, embracing about three-quarters of an acre, and the grantees to keep the same in good repair so long as it is thus occupied. "Professor Saunders also engages, if the property shall be accepted on these terms, to use all due diligence to raise the sum of $75,000, without any salary or any deductions from the sums collected, except simply traveling expenses, and other necessary outlays in prosecuting the work. This sum he names as a sum covering the $40,000 incumbrance, and the annuity for at least eight years at the rate stipulated in the event of his wife and him- self both living during that period. He also engages to use his best efforts to secure, in addition to this sum, the means necessary to sustain the institution during the same period. His purpose, as he expresses it, is to secure this property to the Presbyterian Church, through the aid of his subscribing friends, without any expense of paying an agent. "The property thus proposed to be conveyed, extends northward from Filbert Street to Powelton Avenue, and east and west from Thirty-ninth Street to Boudinot Street, embracing this entire square of ground, with the exception of a lot 150 feet square at the southeast corner of Boudinot Street and Powelton Avenue. The fronts on the street are, according to Mr. Smedley's map, as follows : On Filbert Street, 112 feet 3% inches; on Powelton Avenue, 130 feet 8 inches; on Boudinot Street, 573 feet and on Thirty-ninth Street, 616 feet 5*4 inches. The whole square contains very nearly three acres, and the lot above mentioned is about half an acre, leaving two acres and a half, nearly, belonging to Professor Saunders. "He states that the half acre lot, with the house upon it, can now be purchased for $20,000. There is erected on Professor Saunders' ground, a dwelling-house on the Filbert Street front, now ;v f. ADMINISTRATION BUILDING. Presbyterian Hospital. The Presbyterian Hospital 693 occupied by himself and his family; north of this is a large and substantial stone structure, used for the purposes of the Saunders College ; and near this is a new cottage building, nearly completed, and which Professor Saunders is to complete at his own expense. "It was stated to us that experienced and reliable physicians had pronounced the location and condition of this property to be such as to render it available for the purpose designated, and that the college building, can, at a moderate expense and with slight delay, be adapted for this purpose. There are now thirteen furnished rooms in this building, and the large rooms can be so partitioned as to make twenty-four additional rooms, if desired. The cottage building also contains several rooms, say thirteen, and a good kitchen. "By the certificate of J. A. Gendell, hereto attached, it appears that, on an examination of the buildings, he has estimated their value at from $40,000 to $45,000, more probably the latter sum. The certificates of Messrs. Sedgwick and Son, and other competent judges of real estate, also attached, make the estimated value of ground and buildings at least $100,000. "The incumbrances consist of five ground-rents, amounting to $5,800, and three mortgages, amounting to $25,000. The balance of the $40,000 consists of obligations of Professor Saunders, which are not now, but are to be made liens on the premises. Professor Saunders states that the mortgages are so held that payment will not be immediately demanded, and that he has no fear of not being able to raise the amount of them before the money will be required. "There are the facts in relation to this matter, which were brought to the attention of the Committee, and, after a full con- sideration of them the Committee unanimously resolved that the whole matter be recommended to the favorable consideration of the Executive Committee. "William J. McElhoy, Secretary." The committee had given the subject a most careful and thorough examination, having consulted physicians, real estate agents and property owners, and the results of their examinations were set forth in the documents accompanying the report. By a resolution of the Executive Committee of the Alliance, the Com- mittee on Hospitals was instructed to accept Dr. Saunders' pro- 694 General Hospitals and Dispensaries posal and take all necessary steps towards the establishment of a hospital. The Eev. Dr. Saunders and Dr. Eobert M. Girvin were requested to co-operate with the committee in drafting a charter, and in accordance with the agreement, the former, April 1, 1871, became the official agent of the hospital. The Committee on Hos- pitals prepared the charter and secured from the Supreme Court of Pennsylvania, March 22, A. D. 1871, the necessary Act of Incorporation. The original Board of Trustees consisted of the following gen- tlemen: Eev. George W. Musgrave, Eev. Ephraim D. Saunders, D.D., Eev. William 0. Johnstone, Eev. Alfred Nevin, D.D., Eev. Z. M. Humphrey, D.D., Eev. Alexander Eeed, Eichard H. Allen, William T. Eva, Eev. J. Addison Henry, Eev. Matthew Eewkirk, Hon. William Strong, Hon. William A. Porter, Charles Macalester, Alexander Whilldin, Samuel Field, Jacob A. Gardner, William Montelius, Pulton W. Hastings, John D. McCord, John B. Gest, William J. McElroy, John Wanamaker, James Hogg, Henry Diss- ton, Henry E. Eaiguel. They met in the mansion on the hospital grounds on the third of April, 1871, and organized the election of officers, the Eev. Dr. Musgrave being president of the board, ex- officio, William J. McElroy, Esq., was elected secretary and John D. McCord, Esq., treasurer. The Hospital Committee of the Alliance was requested to procure the device for a seal of the corporation and to prepare by-laws for the institution. The device presented by a sub-com- mittee after some alterations was adopted and is now in use by the corporation. They also presented a draft of the by-laws which after some modification was adopted. In the preparation of the latter the committee was aided by the suggestions of Dr. D. Hayes Agnew and Dr. Eobert M. Girvin, who had been asked to assist them. This same committee was also subsequently asked to prepare and publish a historical sketch of the movement, which they did and from it I have derived much of the information concerning the hospital's early history. Here justice leads me to turn aside to say a few words con- cerning the Eev. E. D. Saunders and his gift, for, at least outside of Presbyterian circles, I get the impression that the encumbrance against the property has seemed to dwarf, in the minds of many, his really great services to this noble cause. The grounds and buildings The Presbyterian Hospital 695 were at a very conservative estimate worth $100,000, which minus the $40,000 encumbrance, left $60,000, practically his whole fortune. This he was determined to give the project finally, and was willing to give at once, so that the hospital could be opened at the earliest possible date, provided he received an annuity to live upon. In view of this, the $4,000 annuity guaranteed him, which was reduced the second year to $3,000, was but a fair interest on the property, considering the rate of interest at that time. In the first annual report (January 16, 1872), it is stated that to acquire ownership of the square it was necessary to purchase the half-acre lot mentioned in the hospital committee's report. This was accomplished by Dr. Saunders at a cost of $17,000. In the same report we find that the total amount of subscriptions, "exclusive of the fund contributed by Mr. Brown, is $52,800, secured by the untiring efforts of Dr. Saunders." The trustees' second report, issued about four months after Dr. Saunders' death, showed that there had been received from subscriptions during the year, in cash $22,800, and in securities, $29,000, a large part of which it seems fair to infer was due to the work of Dr. Saunders. On September 13, 1872, Dr. Saunders died, having thus lived to see well established this project for a Presbyterian hospital where the sick were to be cared for, according to his oft expressed wish "irrespective of creed, country or color." He was an enthusiast by nature, as is shown by the ardor with which he plunged into this undertaking, and even more so by his attitude on the subject of the rebellion. He felt that it would be a disgrace to Philadelphia to have men drafted, and during the war he used to ride back and forth in the horse cars on Market Street, haranguing the men going to and from their work, urging them to enlist. His house and school became a regular rendezvous for those wishing to enlist and for the new recruits. A member of his family at that time relates that on coming down stairs in the morning, many a time the family found neither room nor breakfast, the whole house being filled with newly enlisted soldiers, ever wel- come to whatever the house afforded. East of the site of the Presbyterian Hospital in those days were open fields to Thirty- eighth Street, where the West Philadelphia Eiflemen and other newly enlisted men camped and drilled, and the school kitchen was brought into requisition to furnish them food and coffee. So keen was Dr. Saunders on this subject that later, when the time of some 696 General Hospitals and Dispensaries of the companies was about to expire, he journeyed, at his own expense it is said, as far west as Ohio to persuade them to re-enlist. Thus was his time, influence and energy given, and perhaps he wrought more than had he taken the field himself, where his patriotism would have been officially recognized. His son, Courtland Saunders, fell a martyr to the Union cause, and no doubt the fact that this left him childless, influenced him in providing for the institution which is really a monument to his name. Mrs. Saunders, who died July 24, 1884, gave $5,000 out of the money which came to her from the institution, to found a bed in memory of her son. At her death her household furniture went to the institution and her house was soon afterward used for the reception of private patients. To return to the development of the hospital. July 1, 1871, the board met to receive officially from Dr. Saunders the papers of conveyance of the property. This was made a general meeting of the friends of the hospital in the "beautiful grove on the grounds." The regular meeting of the Board of Trustees on August 21, 1871, was made memorable by the reception of the following letter from John A. Brown, Esq. through his son, Mr. Alexander Brown. "To the Trustees of the Presbyterian Hospital in Philadelphia: "Gentlemen : — • My father requested me to transmit you a copy of a deed of trust made to the Philadelphia Trust, Safe Deposit and Insurance Company, for the benefit of the hospital. "By reference to this deed you will more fully comprehend the nature of this endowment ($300,000). I may add here that the income of these securities, held in trust, will give an annual revenue to the hospital, exclusive of taxes and commissions, of about eighteen thousand dollars. ,„ , . ,, .Respectfully yours, I(T n,., j i i • A i. -m -miv-i » "Alexander Brown. Philadelphia, August 10, 1871." This munificent gift eased the responsibilities of the trustees for maintenance, when once the hospital was opened. Still they were confronted by the necessity of raising between $50,000 and $60,000 to pay off the encumbrances and then alter the school build- ing and the new dwelling-house for hospital purposes. Though they felt it expedient that the institution should be opened free of The Presbyterian Hospital 697 debt, the trustees, trusting to the future, went forward with the alterations and the physicians and surgeons and executive officers having been chosen meanwhile, the hospital was opened July 1, 1872, with room for 45 patients. Thus this institution began its work one year from the time the property came into the hands of the trustees. The first Medical Board consisted of the following physicians and surgeons: D. Hayes Agnew, John Neill, Jacob M. Da Costa, John L. Ludlow, S. Weir Mitchell, Edward Wallace, D. Flavel Woods, James Markoe, Oscar H. Allis, Thomas B. Eeed, H. Lenox Hodge, William G. Porter, Bobert M. Girvin, John S. Parry, W. Wallace McClure, George Strawbridge, DeForest Willard, George S. Gerhard and Charles H. Burnett. Of these, five are still connected with the institution, viz. : S. Weir Mitchell, DeForest Willard, Oscar H. Allis, D. Flavel Woods and George Strawbridge. The next step was the establishment of an out-patient department and the north building was altered for use of apothecary, dispen- sary and a few pay patients. Though the panic of 1873, decreased the collection of the sub- scriptions, the first pavilion ward was erected in 1874, and was the first ward of the army or pavilion type built by a civil hospital in this country. The trustees finding already that the sums available were inadequate for maintenance alone, the next building was made possible by the Ladies Aid Society, which raised the sum of $20,000 to build the second pavilion ward in 1878. Dr. Musgrave, the first president, died August 8, 1882, aged 77. He had lived to see two modern wards added to the plant, twenty-one free beds endowed, and the hospital caring for 666 pa- tients in the wards and 1,150 in the out-patient department during 1882. Dr. Charles A. Dickey, D.D., a trustee since 1875, was elected president to succeed Dr. Musgrave and has filled the position ever since. The tremendous growth of the institution under his admis- istration must be a source of great personal satisfaction to Dr. Dickey. The appreciation of his services by the Board of Trustees is set forth in a minute adopted November 19, 1907, and printed in the thirty-seventh annual report on the completion of his quarter of a century as president. The annual reports of this period had been setting forth the need of more room, more modern buildings and more endowments ; but that the next few years were to see such 698 General Hospitals and Dispensaries a generous response to the renewed pleadings of the new president and trustees was hardly to be imagined. The results of the policy of making known repeatedly the wants of the hospital, are shown in the chronological list of new buildings and their donors taken from a handbook of the hospital prepared by Dr. Dickey. November 22, 1883, Eobert Lenox Kennedy, Esq., of New York, presented to the hospital, a medical ward for women. In 1887, the boiler house and laundry were completed, many generous friends having contributed. January 28, 1888, Mrs. John Wanamaker presented the children's ward. January 15, 1891, The Administration Building was presented by John H. Converse, Esq. January 15, 1891, the new surgical ward for women was pre- sented by Lady Kortright. January 15, 1891, the new surgical ward for men was pre- sented by the Ladies' Aid. In 1892, The Eichardson Home for Convalescents, at Devon, was presented by Lady Kortright. In 1893, The Eliza Cathcart Home was presented to the hos- pital by the will of William C. Stroud, Esq. In 1895, The Hutchinson Ward, bestowed with partial endow- ment, by the will of Miss Mary M. Hutchinson, was erected at Devon, together with a chapel for the use of patients at Devon. In 1895, the new dispensary was presented by John D. McCord, Esq. In 1898, the Eev. Thomas Hoge Ward for Nervous Diseases, was erected under the will of Mrs. Elizabeth Pleasanton. In 1899, The Margaret Welsh Dulles Ward for Gynecological cases was presented by Miss Mary C. Dulles. In 1899, the Nurses Home was presented by J. Eenwick Hogg, Esq. In 1905, The Maternity House was presented by an unknown friend. The Ladies' Aid Society, in existence practically since the foundation of the hospital, whose first annual report was issued November 6, 1873, has been an important factor in the develop- ment of the hospital. Organized originally for the purpose of visiting systematically and ministering to the welfare of the patients, both spiritually and physically, it has been able to do far The Presbyterian Hospital 699 more than was anticipated. It has supplied almost all the bed- ding, bed linen and clothing used in the hospital since its founda- tion. The magnitude of this undertaking is grasped when one realizes that in one year, 1905, it placed 10,580 pieces in the various departments, the new Maternity House requiring about 3,600 at the outset. The Aid has been the active agent in secur- ing the annual contributions from the churches. In the first twenty-five years of its existence it had endowed fifteen beds. Six were given by individual members, and the other nine were secured by the Aid, the money being collected in smaller amounts. The Aid has also built and completely equipped two wards. An editorial in the Outlook for November 21, 1908, dates the beginning of social service for hospital patients back to Johns Hopkins in 1901, and the Massachusetts General Hospital on a wider scale in 1905. As a matter of fact, the Ladies' Aid Society of the Presbyterian Hospital has been doing social service work among the patients for years under the name of "Benevolent Work." In 1888, they systematized the work and divided it into a house and out-patient department, putting a trained nurse in charge. There was a "Comfort of Patients' Fund" for the needs the nurse found among the hospital patients, and the object of the out-patient work they outlined from their experience in their report of 1892, as follows : — 1. To follow hospital patients to their homes, aid with neces- sities during convalescence and assist in a readjustment of occupa- tion made necessary by loss of limb or continued illness. 2. To visit the families of hospital patients which on account of the illness of the bread-winner or care-takers of the family, are in need or perplexity. 3. To attend dispensary patients, especially children, in their own homes, providing necessary diet, loaning various articles nec- essary in sickness, as bed rests, ice-bags, hot water-bags, extra linen, etc. 4. To send out a trained nurse to such families to help for a short period daily. The fruition of this benevolent work, or social service, if you will, has been the building and endowment of the Richardson and Cathcart Homes. That the Ladies' Aid is still alive to its opportunities is shown by the raising of the funds necessary for the establishment of the tuberculosis class in November, 1907. 700 General Hospitals and Dispensaries They pay the visiting nurse and provide for needs found among the patients, to the best of their ability. The work was suggested to the Aid by Dr. John H. Musser, was organized under his direc- tion, and is in charge of Dr. C. J. Hatfield, President of the Pennsylvania State Society of Tuberculosis. The object is to take care of the consumptives who apply to the hospital or dispensary for treatment. They are given a thorough examination and care- ful records are kept. Some are sent to sanatoria, the advanced cases to appropriate hospitals, and those who cannot get away and are well enough to attend the classes, are instructed how to care for themselves and how to avoid being a menace to those with whom they come in contact. The nurse visits them at their homes, reports on the hygienic surroundings, determines their ability to secure proper food for themselves, and, if necessary, provides it. The importance of the work is shown by the fact that in the first year they have had 125 patients. The Eichardson Home for Convalescents, the gift of Lady M. E. Kortright as a memorial to her father, Mr. John Eichardson, was dedicated May 15, 1893. It occupies a beautiful tract of fifty-two acres at Devon, sixteen miles from the city. For a long time the Trustees and the Ladies' Aid had been confronted by the fact that a patient, when ready for discharge from the hos- pital, is usually not able to return to work at once. As their funds allowed, patients were assisted by the Ladies' Aid who paid their board in the country or at the seashore ; but the need of a place of their own where they could send patients more freely, was par- ticularly felt. This gift of Lady Kortright has been a blessing to many. Here good air, good water, good plain food, comfortable rooms and the supervision of a resident physician and trained nurse are to be had at from three and a half to six dollars a week for those who can afford to pay, and the same free for those who cannot. The certificate of any reputable physician, stating that a patient is convalescent, is in genuine need of rest, and is not suffering from tuberculosis, mental derangement, or contagious or infectious disease, will, on presentation at the hospital in person or by agent, be sufficient to gain admission to the home, if there be a vacancy. William C. Stroud provided in his will that $200,000 be set aside for the construction and maintenance of a home for incur- ables, to be known as the Eliza Cathcart Home, a memorial to the The Presbyterian Hospital 701 donor's mother. This home was built at Devon, a short distance from the Eichardson Home, and was dedicated November 25, 1893. The number of applicants yearly far exceeds its capacity, pointing strongly to the need of such institutions. The ambulance service was established in 1883, and plans made for connecting the hospital by telephone with the central police station, the Pennsylvania Eailroad Station and the surgeons' offices. The success of this project was due to the energy of Dr. DeForest Willard. Dr. John L. Ludlow, a physician to the hospital since its opening, died in 1888, and in his will left his valuable medical library to the hospital. Mrs. Ludlow afterward made additions thereto. Miss Caroline L. Farnum assumed charge of the organization of the Training School for Nurses September 17, 1889. In November of the same year, the first training school nurses were put in charge of the women's medical ward; two months later, in charge of the women's surgical ward, and at the end of the year there were ten pupils and two probationers in the school. There were already ninety-two applicants for the school, so that there was no lack of material from which to select. Gradually the nursing in the whole hospital was given over to their charge. There have been but four directresses in the Training School since its foundation — Miss Farnum, Miss Brownlee, Miss Walker, and Miss Milne, the last of whom has been in charge since 1896. Lectures and demonstrations in the wards, and at the bedside were begun from the first by Miss Farnum, and this has been supple- mented by a course of lectures by members of the staff. The first class of eight nurses graduated in 1891. In 1894, the course was increased from two to three years. Before the establishment of the maternity department, the training in obstetrics was supple- mented by courses elsewhere. The Nurses' Home, given by Mr. J. Eenwick Hogg, with room for seventy nurses, dedicated in 1899, was one of the most important steps in the development of the Training School. The last report showed that the school consists of a directress, assistant directress, seven graduate head nurses, dietitian, thirty-three pupils and twenty-two probationers. This corps is increased according to the varying needs of patients by graduate nurses from the outside. A useful feature of the Train- ing School is the directory for graduates kept at the hospital, 702 General Hospitals and Dispensaries where at any hour of the day or" night a physician or family may secure a nurse. The efficiency of the graduates is shown by the number who have been called to important places in other hospitals. In 1897, the late Dr. J. Dutton Steele was appointed bac- teriologist, and reorganized the Clinical Laboratory, in which he did much of his well-recognized work in gastroenterology. The X-ray Laboratory was founded in 1898. The hospital has been built, endowed and supported entirely by private contributions, largely Presbyterian, although other gen- erous friends have helped. It has never received any aid from State or city, except the contribution made annually by the city toward ambulance service which is given to all hospitals. The greatest need of the hospital to-day is endowment with unrestricted use of the income, for since its founding the rate of interest on investments has decreased about one-third and the average daily cost of maintaining a patient, owing to the increase in wages and the necessities of living, has almost doubled, being $1.10 in 1874 and $1.96 in 1907. That the original intention of Dr. Saunders to found a hos- pital where patients were to be cared for irrespective of "creed, country or color" has been realized, is shown in every annual report. The census has shown, as a rule, 25 to 30 per cent, of Presbyterians, the same proportions of Eoman Catholics and the remainder is distributed among the other denominations. Like- wise, neither has color nor nationality been a ban to admission. The Annual Report for 1908, shows that 2,572 patients were treated in the hospital during the year. Of these 1,111 were entirely free patients, and 331 were partial-pay patients. The remainder were either pay patients or occupied endowed beds. In the out-patient department 5,677 patients made 21,380 visits. In the accident ward 3,397 persons applied for treatment, of whom 269 were admitted to the house and the remainder were referred to their physicians or the out-patient department, according to their choice. The total registration for the year shows that 11,320 applicants have found the necessary care in time of injury or sickness. The entire medical staff consists of sixty-four phy- sicians, surgeons and specialists. It is regretted that the space allotted forbids a more detailed account of the benevolence that has made this good work possible. The Presbyterian Hospital 703 A list of the trustees and members of the Medical Board since the hospital's foundation, taken from the Thirty-seventh Annual Eeport, is appended: — BOARD OF TRUSTEES Organized April 3, 1871. Presidents. — Eev. Geo. W. Musgrave, D.D., 1871; died August 8, 1882. Rev. Charles A. Dickey, D.D., 1882. Vice-President. — Charles H. Mathews, 1900. Secretaries. — William J. McElroy, 1871; resigned 1873. William L. Mactier, 1873; resigned 1879. William B. Tenbrook, 1879; died 1881. William L. Mactier, re-elected 1881; died 1888. John H. Converse, 1888. Treasurers. — John D. McCord, 1871; resigned February 19, 1891 ; elected Treasurer Emeritus February 19, 1891 ; died July 1, 1900. Frank K. Hippie, 1891; died August 24, 1906. The Fidelity Trust Trust Co. of Philadelphia, 1906. Trustees. — Eev. Geo. W. Musgrave (ex-officio) , 1871; died 1882. Justice William Strong, 1871; resigned 1871. Eev. E. D. Saunders, D.D., 1871; died 1872. Eev. William O. Johnstone, D.D., 1871; died 1883. Eev. Alfred ISTevin, D.D., 1871; died 1880. Eev. Z. M. Humphrey, D.D., 1871; resigned 1875. Eev. Alex. Eeed, D.D., 1871; resigned 1873. Eev. Eichard H. Allen, D.D., 1871; resigned 1880. Eev. William T. Eva, D.D., 1871; resigned 1889. Eev. J. Addison Henry, D.D., 1871; resigned 1880. Eev. Matthew Newkirk, 1871; resigned 1876. Benedict Stewart, 1871; died 1885. John D. McCord, 1871; died 1900. Henry Disston, 1871; resigned 1878. Charles MacAlester, 1871; died 1873. Alexander Whilldin, 1871; resigned 1891. Samuel Field, 1871; died 1891. William G. Moorhead, 1871; died 1879. Jacob A. Gardner, 1871; resigned 1873. William Montelius, 1871; died 1884. Fulton W. Hastings, 1871; died 1885. John B. Gest, 1871; resigned 1884. William J. McElroy, 1871; died 1877. John Wanamaker, 1871; resigned 1873. James Hogg, 1871; died 1887. Henry E. Eaiguel, 1871; resigned 1880. Will- iam L. Mactier, 1872; died 1888. Eev. John L. Withrow, D.D., 1872; resigned 1873. Eev. Thomas J. Shepherd, D.D., 1873; resigned 1883. Eev. David A. Cunningham, D.D., 1873; resigned 1876. David Thain, 1873; died 1880. Theodore W. Baker, 1873; 704 General Hospitals and Dispensaries died 1886. Kev. Charles A. Dickey, D.D., 1875. Rev. John DeWitt, D.D., 1876; resigned 1880. Eev. Prank L. Bobbins, D.D., 1876; resigned 1883. William E. Tenbrook, 1877; died 1881. Christian J. Hoffman, 1878; died 1886. George Steven- son, 1880. Eev. Henry C. McCook, D.D., 1881; resigned 1890. Eev. John H! Munro, D.D., 1881; resigned 1887. Eev. William Greenough, D.D., 1881. Eev. David Winter, 1881; resigned 1882. Eev. Hughes 0. Gibbons, 1881 ; resigned 1884. Henry B. M. Birk- inbine, 1881; died 1886. Charles N. Thorpe, 1881; died 1891. J. Eodman Paul, 1881; resigned 1893. Eev. John S. Sands, D.D., 1883; resigned 1889. Eev. John S. Macintosh, D.D., 1883; re- signed 1892. Eev. Loyal Y. Graham, D.D., 1883. Eev. J. Hervey Beale, 1883. Eev. J. P. Dripps, D.D., 1883; resigned 1884. John H. Converse, 1884. B. K. Jamison, 1884; resigned 1898. Eev. Stephen W. Dana, D.D., 1884; resigned 1892. George S. Graham, 1886; resigned 1898. John Shedwick, 1886; died 1896. Andrew Blair, 1886; died 1898. James F. Magee, 1886; died 1903. John B. Gest, re-elected 1887; resigned 1893. John Wana- maker, re-elected 1888; resigned 1893. Eev. Geo. D. Baker, 1888; resigned 1893. Charles P. Haseltine, 1888. Charles H. Mathews, 1889. Eev. John Hemphill, D.D., 1889 ; resigned 1893. Eobert C. Ogden, 1890; resigned 1898. Eev. William H. Miller, D.D., 1890; died 1907. Edward H. Williams, M.D., 1891; died 1899. John H. Watt, 1891. Eev. James D. Paxton, D.D., 1891; re- signed 1897. Samuel B. Huey, 1891; died 1901. Eev. Louis F. Benson, D.D., 1891. William A. Patton, 1891. Frank K. Hippie, 1891; died 1906. Eev. Eobert H. Fulton, D.D., 1893; resigned 1896. Eev. Louis E. Fox, D.D., 1893; died 1894. Rev. Henry C. McCook, D.D., re-elected 1893. Henry 1ST. Paul, 1893; died 1899. Thomas B. Wanamaker, 1893. Eev. J. E. Miller, D.D., 1893; resigned 1895. George M. Troutman, 1893; died 1901. Eev. William A. Patton, D.D., 1895. Eev. Charles Wadsworth, Jr., D.D., 1895. John Marshall Gest, 1896. Clarkson Clothier, 1897. William W. Allen, 1897. J. Eenwick Hogg, 1898. Eev. William Hutton, D.D., 1898. Rev. Marcus A. Brownson, D.D., 1898. Joseph M. Collingwood, 1898; died 1899. Henry N. Paul, Jr., 1899. John F. Craig, 1899. George W. Bailey, M.D., 1900. Judge John B. McPherson, 1900. D. H. Lovell, 1901; resigned 1903. John B. Gest, re-lected 1901; died 1907. H. S. Prentiss Nichols, 1903. William H. Castle, 1903. William P. Gest, 1906. The Presbyterian Hospital 705 MEDICAL BOARD D. Hayes Agnew, M.D., 1872; resigned, 1875. John Neill, M.D., 1872; resigned 1875. Jacob M. Da Costa, M.D., 1872; resigned 1875. John L. Ludlow, M.D., 1872; died 1888. Oscar H. Allis, M.D., 1872. Thomas B. Eeed, M.D., 1872; died 1891. H. Lenox Hodge, M.D., 1872; died 1881. William G. Porter, M.D., 1872; died 1906. S. Weir Mitchell, M.D., 1872; resigned 1875. Edward Wallace, M.D., 1872; died 1875. D. Flavel Woods, M.D., 1872. James Markoe, M.D., 1872; died 1884. Robert M. Girvin, M.D., 1872; died 1900. John S. Parry, M.D., 1872; died 1876. W. Wallace McClure, M.D., 1872; resigned 1886. George Strawbridge, M.D., 1872. Charles H. Burnett, M.D., 1872; died 1902. DeForrest Willard, M.D., 1872 (elected Consulting Surgeon 1907) ; resigned 1907. George S. Gerhard, M.D., 1872; resigned 1878. James V. Patterson, M.D., 1875; resigned 1887. Joseph G. Eichardson, M.D., 1875; resigned 1886. Grayson M. Prevost, M.D., 1877; resigned 1881. Edward L. Duer, M.D., 1877. Carl Seiler, M.D., 1878; resigned 1884. H. Augustus Wilson, M.D., 1881; resigned 1884. William D. Blackwood, M.D., 1883; resigned 1888. John H. Musser, M.D., 1884. Edward Shippen Mcllvaine, M.D., 1884; resigned 1885. M. B. Hartzell, M.D., 1885; resigned 1890. Oliver P. Eex, M.D., 1886; resigned 1893. Roland G. Curtin, M.D., 1888 (elected Con- sulting Physician 1907); resigned 1907. J. P. Crozer Griffith, M.D., 1888; resigned 1894. Allen J. Smith, M.D., 1890; resigned 1891. D. Hayes Agnew, M.D., 1891; died 1892. Henry W. Cat- tell, M.D., 1891; resigned 1899. Henry R. Wharton, M.D., 1891. Samuel S. Stryker, M.D., 1894. William E. Hughes, M.D., 1894. S. Weir Mitchell, M.D., 1897. Charles A. Oliver, M.D., 1898. J. D. Steele, M.D., 1898. Joseph Sailer, M.D., 1899. John H. Gir- vin, M.D., 1900. George Erety Shoemaker, M.D., 1900. Arthur H. Cleveland, M.D., 1901. George C. Stout, M.D., 1902. John H. Jopson, M.D., 1905. John K. Mitchell, M.D., 1905; resigned 1907. James E. Talley, M.D., 1907. Samuel McClintock Hamill, M.D., 1907. Charles A. Fife, M.D., 1907. William L. Eodman, M.D., 1907. Charles W. Burr, M.D., 1907. John M. Swan, M.D., 1907. Clifford W. Farr, M.D., 1907. Eobert 1ST. Willson, M.D., 1907. 45 706 General Hospitals and Dispensaries St. Agnes' Hospital By B. FRANKLIN STAHL, M.D. THE Sisters of the Order of St. Francis had conducted St. Mary's Hospital in Kensington, Philadelphia, for many years. The desire to enlarge their sphere of -usefulness led them to seek a locality suitable for the establishment of a similar institution in another part of the city, to be known as St. Agnes' Hospital. After an extended search and painstaking investigation they selected a site in a part of the city that marked the southern extremity of sparsely inhabited Broad Street, commonly designated as "The Keck." This section was largely used as a dumping ground, the horse car line had its barn just below the location chosen, the ground was low and marshy and the mosquitoes made the section almost uninhabitable. Truly a most unpromising location upon which to project a hospital to minister to a population not yet attracted to the region. It required judgment of a very high order to foresee the changes that have come, and discern a sphere of activity in an unsettled section which has since grown to a fine residence and manufacturing district. The land on Broad Street extending from Mifflin to McKean Streets was purchased, June 21, 1876, for $40,000, from Stephen Flanagan. Later a generous donation of $30,000 from Miss Elizabeth Drexel (the late Mrs. Walter George Smith), Miss Katharine Drexel (now Mother Katharine, Superior and Founder of the Order of the Sisters of Blessed Sacrament), and Miss Louisa Drexel (now Mrs. E. deV. Morrell), enabled the Sisters to pur- chase the land required to make the boundaries of their property, Broad to Fifteenth Streets and Mifflin to McKean Streets. The principal benefactors of this early period were Drs. Andrew and Bobert Nebinger whose bequest and donations amounted to $176,000. Mr. Francis A. Drexel bequeathed $150- 000. Mr. Adam Glasz $4,000. At a later period Dr. J. H. Grove bequeathed $5,000. In recent years the hospital has been under many obligations to the Vare Brothers for generous contributions and assistance. On account of the scarcity of funds the commencement of the building operation was delayed until 1879. After the foundation is a St. Agnes' Hospital 707 had been built work was discontinued until September, 1881. The corner-stone was laid October 8, 1882. The ceremonies were con- ducted by the Very Eeverend Maurice Walsh, V.G. ; Archbishop Wood was present. The sermon was delivered by the Very Reverend D. I. McDermott. The drawing of plans and specifications as well as the early building operations on St. Agnes' Hospital were under the care of Edwin T. Durang. Dr. Andrew Nebinger died April 12, 1886, and Dr. John H. Grove became Medical Director of both institutions and continued in office during the building and for three years after the formal open- ing of St. Agnes' Hospital. Ill health compelled him to relinquish this office and he became consulting surgeon to the hospital. The staff of the hospital was : Medical Director. — Dr. J. H. Grove. Surgeons. — Dr. W. W. Keen, Dr. J. Bwing Mears, Dr. J. B. Roberts, Dr. J. M. Fox. Physicians. — Dr. James Tyson, Dr. M. O'Hara, Dr. J. C. Wilson, Dr. J. M. Keating. Gynecologist. — Dr. D. W. Cadwallader. Ophthalmologists. — Dr. C. A. Oliver, Dr. F. M. Perkins. Dispensary Department. — Dr. H. A. Hare, Dr. George Dock, Medical Clinic; Dr. C. B. Penrose, Dr. J. P. Walsh, Surgical Clinic; Dr. E. G. Rehfuss, Eye Clinic; Dr. L. P. Smock, Throat, Nose and Ear Clinic; Dr. R, Kilduffe, Children's Clinic. Resident Physicians. — Dr. T. Sprissler, Dr. G. L. Cassel, Dr. J. P. H. Stedem, Dr. C. Feel. The first Sister in charge of the hospital was Sister M. Eulalia, she was succeeded in July, 1892, by Sister M. Borromeo, who is still in charge. During 1887 there was but one patient in the hospital. In 1888, a small number of patients were treated before it was formally opened. There is no discrimination regarding creed or race in the admission of patients. Ministers of all denominations are freely admitted when their attendance is desired by patients. The hos- pital is provided with a chaplain, and religious services are held regularly in the hospital chapel. The sources of revenue are bequests, donations, pay-patients and from patients paying part of cost of maintenance, entertain- ments and lectures. 708 General Hospitals and Dispensaries In 1901, the first appropriation of $2,500, was received from the State. To date the State has contributed $80,256.97. When the hospital opened there was an indebtedness of $100- 000 upon which no payment was made until 1892 when $15,000 was paid on account of mortgage. In 1903 the entire indebtedness has been liquidated, notwithstanding the expenditure of $30,000 for the building of a heat, light and laundry plant in 1898, and inclosing the grounds with a stone fence in 1900. The newer portion of the hospital extends from the main building to McKean Street and is 168 by 56 feet on Broad Street and 150 feet on McKean Street. Ground for this building was broken on June 21, 1905. The completed structure was consecrated May 29, 1906. The Et. Eev. Bishop Prendergast officiated. The sermon upon this occasion was preached by Bev. Benedict A. Neithart, C.SS.B. The capacity of the hospital is 196 ward beds and 108 private beds, total 304. The Training School for Xurses was instituted in 1894, under the direction of Miss Maud Banfield. She was succeeded by Sister M. Maura as head nurse. In 1897, the first class was graduated and comprised ten Sisters and one lay nurse. In 1907, the enlarge- ment of the hospital necessitated an increase in the number of pupils in the training school and Miss Katharine V. Kane became associated with Sister M. Maura as head nurse in charge of the lay nurses. There are now 36 Sisters engaged in the work of the hos- pital. Four more are in the training school for nurses, and 25 lay nurses are undergoing training. The hospital has no endowment fund and it was not until 1895 that the first free beds were founded, one in memory of John Carew and "the Dwyer bed." In 1896, a bed in memory of Mrs. Mary A. Filon and one in memory of Mrs. Catherine Horstman were endowed, in 1901 Michael Corr, 1904 Hiram Brooke, 1908 Samuel Blkin, in memory of Eva Elkin. During the war with Spain in 1898, the hospital bore the expense of a train and sent sisters and doctors to bring 74 soldiers from Camp Meade, Pa. When the city of Philadelphia sent its train to Fernandina, Florida, to bring home sick soldiers, Sister M. Didaca and Sister M. Marianna, and Dr. B. Franklin Stahl, of the staff, represented the hospital. During this year the hospital treated 493 soldiers, a larger number than was treated by any other St. Agnes' Hospital 709 hospital in the State. Of this number 144 had typhoid fever, five of whom died, giving the unusually low mortality of 2 per cent. Although the hospital undertook the care of these patients without thought of remuneration the government later made an allowance of $1.00 a day for their treatment. The staff and former resident physicians furnished a number of members to the Medical Corps of the Army and Navy. St. Agnes' Hospital has had at different times a ward set apart for British sailors, the Navigation Company, the Marine Hospital service, and the consumptives under the care of the League of the Sacred Heart. The Eeverend J. Scully, S. J. was prime mover in this work which was afterwards merged with the Free Hospital for Poor Consumptives at White Haven, Pa. The total number of patients treated in the wards of the hos- pital is 34,282. In the out-patient department 509,028 visits have been made. The Medical Directors of the hospital have been Dr. Eobert Nebinger from its inception until 1886; Dr. J. H. Grove, 1886 until 1891; Dr. Wm. V. Keating, 1881 to 1894; Dr. Michael O'Hara, 1894 to 1898 ; Dr. Wm. H. Parrish, 1898 to 1903 ; Dr. B. Franklin Stahl, 1903 to 1906 and again in 1908. The staff of the hospital to-day is : Medical Staff. — Physicians, Dr. B. Franklin Stahl, Dr. Arthur A. Stevens, Dr. A. O. J. Kelly, Dr. Joseph M. O'Malley; Surgeons, Dr. Wm. J. Taylor, Dr. Orville Horwitz, Dr. Leon Brinkmann, Dr. George M. Dorrance; Consulting Surgeon, Dr. John B. Deaver; Gynecologists, Dr. John M. Fisher, Dr. Wilmer Krusen, Dr. John A. McGlinn; Consulting Gynecologist, Dr. John C. Da Costa; Assistant Gynecologists, Dr. Alfred Heineberg, Dr. John A. O'Con- nell; Ophthalmologists, Dr. Austin O'Malley, Dr. James A. Kearney; Consulting Ophthalmologists, Dr. Charles A. Oliver, Dr. Emil G. Eehfuss ; Aurists and Laryngologists, Dr. Nathan G. Ward, Dr. Benjamin D. Parish; Consulting Aurist and Laryngologist, Dr. D. Braden Kyle; Dermatologist, Dr. L. W. Atlee; Consulting Dermatologist, Dr. Charles N. Davis; Neurologist, Dr. D. J. McCarthy; Orthopedic Surgeon, Dr. H. Augustus Wilson; Assist- ant Orthopedic Surgeon, Dr. Chas. H. Muschlitz; Pathologists and Bacteriologists, Dr. Austin O'Malley, Dr. Edward M. L'Engle; Anesthetizer, Dr. Paul B. Cassidy; Skiagrapher, Dr. Thomas S. Stewart; Besident Physicians, 1906, Dr. B. J. Lachner, Dr. J. Boy McKnight, Dr. Martin C. Gaughan, Dr. Wm. C. Eyan, Dr. Joseph 710 General Hospitals and Dispensaries P. Bums, Dr. M. C. Stayer; 1907, Dr. John D. Wilson (Resident Pathologist), Dr. Michael A. Burns, Dr. Oscar W. LaMotte, Dr. H. N. Scholl, Dr. E. J. Sweeney, Dr. G. T. Fox, Dr. Leonard Laufen- sweiler. Out-Patient Department. — Medical, Dr. Francis J. Kelly, Dr. Wm. T. Dempsey, Dr. Joseph P. Burns; Surgical, Dr. George M. Dorrance, Dr. Thomas W. Bailey, Dr. Walter A. Wood; Gynecol- ogical, Dr. Alfred Heineberg, Dr. George E. Johnson, Dr. John A. O'Connell, Dr. Wm. C. Eyan; Children's, Dr. Paul B. Cassidy; Eye, Dr. Austin O'Malley, Dr. James A. Kearney; Assistant to Eye Clinic, Dr. T. Grace Andrews; Throat, Nose and Ear, Dr. Nathan G. Ward, Dr. Benjamin D. Parish; Assistant Chiefs of Throat, Nose and Ear Clinics, Dr. H. D. Fraser, Dr. Charles I. Stiteley; Skin, Dr. L. W. Atlee; Nervous, Dr. D. J. McCarthy; Assistant Chiefs of Clinic for Nervous Diseases, Dr. Eugene Lin- dauer, Dr. Milton Meyer; Orthopedic, Dr. H. Augustus Wilson; Assistant Chief of Orthopedic Clinic, Dr. Chas. H. Muschlitz; X-ray Clinic, Dr. Thomas S. Stewart; Dental, Dr. Chas. F. Bailey. Staff Officers. — President, Dr. William J. Taylor; Vice-Presi- dent, Dr. A. 0. J. Kelly; Secretary, Dr. A. A. Stevens; Executive Committee, Dr. William J. Taylor, Dr. B. Franklin Stahl, Dr. A. A. Stevens, Dr. A. 0. J. Kelly, Dr. Joseph O'Malley, Dr. Orville Horwitz, Dr. Austin O'Malley; Training School Committee, Dr. A. 0. J. Kelly, Chairman; Dr. Leon Brinkmann, Dr. B. Franklin Stahl, Dr. John M. Fisher ; Sister Superior, Sister Mary Borromeo, 0. S. F.; Head Nurses, Sister Mary Maura, 0. S. F., Katharine V. Kane; Apothecary, Sister Mary Avellina, 0. S. F. Women's Homoeopathic Association of Pennsylvania By FANNY L. SKINNER SEVENTEEN women anxious to aid the sick and suffering in some effectual way, met in October, 1882, to devise some means to that end. Most of them had been members of the Auxiliary Board of the Cuthbert Street or Philadelphia Homoeopathic Hos- pital, and they were soon joined by seven others. They decided to start a hospital on purely humanitarian lines, Women's Homoeopathic Association 711 and to carry out homoeopathic principles in their strict integrity. At the outset they had at their disposal not quite $150. On December 13, 1882, a charter was granted which states that the object of the Women's Homoeopathic Association of Pennsjdvania "shall be to establish and maintain homoeopathic medical, surgical and maternity hospitals with school for nurses connected therewith, and that the existence of the association shall be perpetual." Also "that applicants of all classes shall be admitted to the institutions upon the most liberal terms consistent with their proper management, and the laws of the State of Pennsyl- vania." As soon as the association was fairly launched the charter members endeavored to interest their friends in the project, enlist- ing members, and trying to raise money in order to begin their practical work. That they succeeded in making friends will be shown by the fact that in July, 1888, two brothers, Mr. Chas. D. Eeed, of Philadelphia, and Mr. Gideon F. T. Eeed, of Boston, gave the association $30,000 for the purpose of buying sufficient ground for their buildings. This generous gift enabled the managers to pur- chase a lot of two acres in the then sparsely settled northwestern section of the city, at Twentieth Street and Susquehanna Avenue, and a long distance from any other hospital. The women were most anxious to start their hospital work. Another friend then came to their aid, Miss Mary Jeanes bought two small houses within half a square of where the permanent hospital was to be erected, and rented them to the association for a merely nominal sum. March 12, 1884, the hospital containing twelve beds was formally opened in these small houses. As soon as possible, July 17, 1884, a building was started on the lot, but the work upon it was necessarily slow, as the managers were not willing to incur debt. By degrees, however, the needed money came. Fairs and entertainments were held, subscriptions and donations solicited, and members added to the association, giving an initiation fee of five dollars, and annual dues of one dollar. In October, 1887, the new building was ready for occupancy. The managers had given a great deal of time to studying hospital architecture not only in this city but in many others, and the result was a building, up-to-date hygienically in every respect. The maternity work was carried on in the two small houses 712 General Hospitals and Dispensaries until May 15, 1890, when the new Maternity Building was opened in the hospital grounds. Meanwhile Miss Jeanes had died, and her executors in accordance with her wishes, had presented the two houses to the association ; these were renovated and advantageously rented. In November, 1890, a building was begun for special cases, or an Isolation Ward, and was first occupied in May, 1891. This was furnished by the patients of Dr. Adolph Lippe as a memorial to him. During the Spanish War this building was given up to the soldiers who were brought to the hospital in such numbers that there was not room for them in the few rooms which were appro- priated for men in the main building. As the northern part of the city increased in population the emergency cases which were brought to the hospital increased accordingly, and the number of accident cases of men taxed the existing accommodations to such an extent that additional room became an absolute necessity. Plans were made for a men's wing, and as the space allotted to children was also insufficient, and, was so located that the children disturbed the adult patients, it was decided to erect a three-story building, and to use the upper story exclusively for children. Ground was broken for this building in March, 1906, and it was formally opened May 20, 1908. The hospital now in all departments has accommodations for 125 patients, and is fully equipped with the most approved appliances including all necessary recent inventions for surgical work. The visiting staff of physicians and surgeons is composed of well-known doctors, and the resident staff consists of both men and women. The Training School provides for twenty-five pupil nurses, to whom a thorough three years' course of training is given. A legacy enabled the association to purchase a small house directly back of the hospital grounds which is used for a Nurses' Home. Though not what is really needed it gives the nurses a place of their own, until such time as a home more adequate can be built on the grounds where there is still room for more buildings. In 1885, the State granted the association $5,000 towards the building fund, and, since then the Legislature, recognizing the large amount of charitable work done by the hospital, an average of nearly eighty-five per cent, of all patients being non-paying, at nearly every session has appropriated some money for the work. The Methodist Episcopal Hospital 713 The Methodist Episcopal Hospital in the City of Philadelphia By JAMES HENDRIE LLOYD, A.M., M.D. THE Methodist Episcopal Hospital of Philadelphia was founded by Dr. Scott Stewart, an old practitioner of medicine, who for many years practised his profession in the southeastern section of the city. Dr. Scott Stewart deserves to be commemorated as one of the public benefactors of Philadelphia, but details of his life are unfortunately rather meager. He was born in Ireland and educated in Dublin, but the date of his coming to America is uncertain. He lived a quiet, unostentatious life, taking but little part, so far as it appears, in the usual medical activities of the city, but pursuing his profession, in which he acquired a handsome fortune, until an advanced age. He resided for many years at the southeast corner of Eighth and Pine Streets, and we are told that he was a member of St. Paul's M. E. Church on Catharine Street near Sixth. All his social and church connections, and nearly his entire practice, were below South Street, a fact which doubtless accounts for one of the provisions in his will. Dr. Stewart, who had a long, prosperous life, and was nearly eighty years old when he died, on June 27, 1881, had accumulated by his industry and saving a large fortune. Having no one depend- ent upon him, being a widower without children or the issue of any child, he determined to found a charity, in the line of his life work, and to place it under the protection and supervision of the church of his affiliation. This thought found expression in his will and was afterward elaborated in a codicil. 1 The motives which inspired Dr. Stewart are easily understood. An earlier scheme to found a Methodist Hospital had been started in Philadelphia, but had come to naught, although a charter had been taken out. The founder of the present institution doubtless had in mind the already flourishing hospitals which had been estab- lished by other religious denominations, notably the Presbyterian, the Episcopalian, the Jewish, and the Eoman Catholic, and he must l History of the case by the Appellees, in the Appeal of Mary N. Sea- grave to the Supreme Court of Pennsylvania. 714 General Hospitals and Dispensaries have felt a strong impulse and desire to lay the foundation of a similar hospital which should be under the care, and bear the name, of his own church. Being a physician it was but natural that his thought should turn to the endowment of a hospital rather than of some other charity. By will dated November 1, 1877, Dr. Stewart, after remember- ing a few near relatives, provided for the foundation of a hospital which should be under the control of the Methodist Church. His scheme was further elaborated in a codicil of June 21, 1879, as follows : — "The remaining principal of my residuary estate .... I wish to be used as a nucleus for the erection of a hospital to be founded and established within five years after the decease of my last surviving sister, in that part of the city south of South Street, to be under the auspices of the Methodist Episcopal Church; said hospital must be under the charge or care only of regularly educated physicians of the old school who shall have received the degree of A.B. from some university or college, and no homoeopathic or eclectic physicians shall have anything to do with the management or charge of said hospital or with the treatment of any patient or patients therein. I authorize the Conference of the Methodist Church for the district in which the City of Philadelphia is situated, .... to organize in such way as to it shall seem best, a scheme for this charity. I desire them to appoint a Board of Trustees, which may become incorporated or not " Further details are given at length, but they need not be repeated here. The testator knew and wrote that his estate would be but the nucleus of what would be requisite, and he did not wish it wasted in an abortive scheme, nor buildings commenced unless the funds at command were sufficient to erect, equip and endow them. Hence he expressed his reliance upon the Conference and Bishop to refrain from calling for the payment of the money unless they had devised a scheme for the hospital, of a practical nature and seemingly certain of success. It is necessary to bear in mind that at the time of this bequest the whole plan was still a sort of "castle in the air," and that there were not a few persons who doubted of its realization. The amount of the bequest was something over $250,000, which, although a most liberal gift and practically all that Dr. Stewart had to give, was nevertheless not great enough to build and support a large general SCOTT STEWART. Methodist Hospital. The Methodist Episcopal Hospital 715 hospital. Everything therefore remained to be done, and litigation had to be met. The authorities of the Methodist Church promptly availed themselves of the opportunity thus offered. Action was taken by the Annual Conference in 1882. A statement was made by Bishop Simpson, and a committee was appointed by him to make a report, which was adopted, accepting the trust with its conditions and limitations. A Board of Trustees, composed of ten clergymen and eleven laymen, was elected, and these trustees subsequently organ- ized, and held meetings with a view to the establishment of a hos- pital under the will. By decree of the Court of Common Pleas of Philadelphia the "Methodist Episcopal Hospital in the City of Philadelphia" was incorporated, and a charter granted, bearing date February 14, 1885. Plans were also adopted to raise additional funds from private persons and from the churches. Dr. Stewart's last surviving sister, who had a claim as an annuitant under the will, died February 18, 1883. Thus there remained, under the terms of the bequest, five years from that date in which to found and establish the hospital. As was to be expected there was opposition on the part of Dr. Stewart's next-of-kin. These heirs were represented by a large array of legal counsel at the second adjudication by Judge Penrose in the Orphan's Court, near the end of the term of five years. Much testimony was taken, and an attempt was made to show that the conditions of the will had not been complied with, and that the trustees of the prospective hospital were not in a financial position to build and endow such an institution, and hence to receive the bequest. On the other hand it was shown that the Trustees had already raised a considerable fund by subscription, that they had purchased ground on South Broad Street, and that their plans were practicable and promising of success. The Court decided in favor of the hospital, and on January 31, 1888, awarded the estate to the trustees designated by the Bishop in Conference to receive it. This award was subsequently confirmed by the Orphans' Court in banc. An appeal to the Supreme Court of Pennsylvania on the part of the heirs failed to secure a reversal of this award. The history of these court proceedings takes many pages, and need not be given here. It is likewise not practicable to review here in full detail the successful attempts of the Board of Trustees to raise additional funds. Great credit is due to the Bev. James Neill, and to the 716 General Hospitals and Dispensaries late James Gillinder, at one time President of the Board. Sub- scriptions amounting to more than $70,000, of which over $36,000 had been paid in, were reported to the Court in 1888 ; and besides these subscriptions a number of men, prominent in Methodist councils, had given a written agreement making up the amount raised by subscription, to $100,000. During the recent years of the hospital's existence these subscriptions, of course, have been largely increased by wise and systematic efforts to raise funds through the allied churches and from friends. There has thus accrued an endowment fund, including the original bequest of Dr. Scott Stewart, which amounts at the present time (1909) to almost $400,000. The Methodist Hospital can claim to its credit that it has never received state aid. On June 6, 1887, the trustees purchased the ground on which the hospital stands. The plot comprises a full city square, and is bounded by Broad, Wolf, Bitner and Thirteenth Streets. The price paid was $40,000, which, considering the increased valuation of real estate on South Broad Street, was a good investment. The plans and specifications for the buildings were prepared by Thomas P. Lonsdale, architect, with advice and suggestions from Dr. John S. Billings, of Washington, D. C, a recognized expert in hospital construction. The plan adopted is what is known as the pavilion plan, which is held by common consent to be the best for hospitals. This plan called for the ultimate erection of six separate ward buildings, octagonal in shape, each of which should consist of a basement and two stories, each story constituting a separate ward, thus securing ample light and ventilation. These six buildings were to be built in two rows of three each, along Wolf and Bitner Streets respectively, connected by covered passage ways with each other and with a central building for boiler house and other pur- poses. As the hospital now stands this original plan has had to be somewhat changed because of the need arising for other buildings for special purposes, such as an operating room, dispensary building, nurses' home, and laundry. Only one of the pavilions has thus far been erected, and this, with the handsome Administration Building, facing on Broad Street, constitutes at the present time the main hospital. There is still ground available, however, for the erection of some of the other pavilions, as originally planned, and these buildings will doubtless arise in time. The present pavilion has accommodations in each ward for The Methodist Episcopal Hospital 717 twenty-four patients; the upper story is for women, the lower for men; and the basement, which was recently fitted up as a very attractive ward for children, also holds twenty-four beds. So these three wards can hold seventy-two patients. There are also a few large rooms in this building which are used as small wards. In the organization and construction of the hospital the trustees had had the advice of an advisory board of physicians, appointed in 1885, and composed of H. C. Wood, D. M. Barr, J. S. Pearson, C. K. Mills, S. D. Risley, S. Harlow and A. C. Deakyne. Mention should also be made here of the Women's Association of the Hos- pital, which has done an important work in raising funds and otherwise promoting the welfare of the institution. The corner-stone of the hospital was laid on Thursday, June 31, 1888, with appropriate ceremonies. The Administration Building, which occupies the center of the front on Broad Street, was erected as a memorial of the efforts of the Sunday schools, which contributed largely for the purpose. It is a handsome brown stone building, containing necessary offices, reception rooms, dining-room, and chapel. The second and third stories are fitted up as private rooms, which it is within the bounds of moderation to say are probably unsurpassed in attractiveness by any similar rooms in any hospital in Philadelphia. The fourth, or attic, story is also used for private patients at a reduced rate. The corner-stone of this building was laid with ceremonies in May, 1890. The hospital was opened to receive patients on April 21, 1892, and the first patient was admitted on the following day. The exercises at the opening were attended by a large concourse of people, showing the interest which had been aroused by this com- paratively new project, and promising well for its future. The address of presentation was made by Stephen Greene, on behalf of the Building Committee; the address of acceptance by James Gillinder, the President of the Board of Trustees; and the dedicatory address by Bishop Poss. Since its opening day the hospital has pursued a course of uninterrupted usefulness as one of the large general hospitals of Philadelphia. Its advantageous location on South Broad Street, overlooking the Delaware Eiver in the distance, its handsome equipment, its generous support by a large and enthusiastic religious community, have all contributed to its success, and promise well for its future. 718 General Hospitals and Dispensaries The growth of the hospital has rendered necessary several new buildings which were not included in the original plans. The Coulston Building was erected by Amanda L. Coulston as a memorial of her husband, Charles E. Coulston. It contains sur- gical and gynecological operating rooms, sterilizing room, etherizing room, instrument room, and all the accessories required by modem science in a first class hospital. The surgical instruments were presented as a memorial of Jesse Harding by his widow. The Power House, including a laundry, with a very complete equipment, was built with money given by several of the trustees. It stands at the corner of Thirteenth and Eitner Streets. A Dispensary Building was erected recently with money par- tially obtained by loan on the annuity plan from a friend of the hospital. It fronts on Wolf Street, and contains, besides the various dispensary rooms and drug store, a mortuary and an autopsy room. One of the handsomest additions to the hospital is the Nurses' Home, on the corner of Thirteenth and Wolf Streets. This build- ing, of brick and ornamental terra cotta, was erected and furnished, in memory of his mother, by T. Comly Hunter, at a cost of $40,000. It is a complete home for the nurses and students of the training school, and has accommodations for thirty-four people. The Isolation Building, situated near the center of the yard, is intended, as its name implies, for the isolation of patients with contagious diseases. It is a one story structure, divided into a central hall, and several rooms for patients and nurses. It is entirely separated from all the wards. The hospital owes this much needed building to Stephen Greene, a most generous benefactor, who gave in all nearly $100,000 for various purposes. It is impossible in the space at command to give credit to all those persons who have given generously to the hospital. One of the largest gifts was by William Clare Allison, who left a residuary bequest of about $100,000, to be added to the endowment fund. The Methodist Hospital, although so recently founded, has already outgrown its present capacity, but fortunately there is room for it to expand on its own ample grounds. The most pressing need is for another pavilion, or ward building, to match the one now in use, and to be^ erected according to the original plan on the Eitner Street front. It is probable that this building will be erected before long. WOMEN'S WARD. OPERATING ROOM. The Methodist Episcopal Hospital 719 The provision in Dr. Scott Stewart's will, which has met with the most criticism, is the one which makes it obligatory upon all medical attendants on the hospital to have the A.B. degree. Dr. Stewart doubtless took this mode of showing his belief in the higher education of physicians. The condition, however, has sometimes proved a source of embarrassment in filling vacancies on the medical staff. As is well known, many of the most eminent men in the medical profession have not taken this degree, while on the other hand some men who have taken it are not eminent or specially fitted for hospital positions. In other words, the mere possession of the academic degree (while a good thing in itself) is not necessarily a criterion of a man's capacity as a physician or surgeon. Some of the advisors of the hospital have hoped that a ruling may yet be obtained from the courts recognizing the degrees of B.S. and Ph.D. as equivalent to that of A.B. This would greatly enlarge the field of choice, and would not only be fair to many capable men, but would also be advantageous to the hospital. Perhaps it may yet be done. The Presidents of the Board of Trustees since the foundation of the hospital have been James Gillinder, 1885, Stephen Greene, 1903, and Thomas Bradley, 1907. Special mention should be made of the services of Bev. A. Bittenhouse, first superintendent, who was active and efficient in organizing and starting the hospital, and of Bev. J. A. Lippincott, for a long time corresponding secretary. THE BOARD OF TRUSTEES President, Thomas Bradley; Vice-Presidents, Frank A. Free- man, Bev. S. M. Vernon, D.D. ; Recording Secretary, Bev. J. B. T. Gray, D.D. ; Treasurer, Charles E. Kreamer ; Corresponding Secre- tary, Bev. J. D. Martin, D.D. ; Solicitor, Samuel H. Kirkpatrick, Esq. Trustees. — Term Expires 1909: Bev. Samuel W. Gehrett, D.D., Rev. Edwin C. Griffiths, D.D., Bev. Samuel M. Vernon, D.D., Bev. G. Bickley Burns, Ph.D., Bev. J. D. Martin, D.D., Bev. T. S. Wilcox, D.D., John J. Ziegler, Samuel H. Kirkpatrick, Esq., Charles E. Kreamer, T. Comly Hunter, Bobert Carson, Hon. John A. Wallace, George I. Bodine, Baymond W. Tunnell, William H. Rometsch. Term Expires 1910 : Bev. Bishop Cyrus D. Poss, D.D., LL.D., Bev. Samuel W. Thomas, D.D., Bev. Jacob S. Hughes, D.D., Bev. 720 General Hospitals and Dispensaries George Gaul, D.D., Key. T. W. McKinney, Eev. C. Wesley Burns, S.T.D., Francis Magee, Samuel K. Felton, Thomas Bradley, E. E. Hansconi, Stephen W. White, W. L. Megary, Seward L. Bowser, Charles Scott, Jr., Frank A. Freeman, William L. Simmons. Term Expires 1911 : Eev. Frank B. Lynch, S. T. D., Eev. J. E. Taylor Gray, D.D., Eev. W. L. McDowell, D.D., Eev. A. S. Mowbray, D.D., Eev. E. E. Burriss, Ph.D., Eev. Alpha G. Kynett, D.D., Eev. Holmes F. Gravatt, Eev. Edmund Hewitt, D.D., Stephen Greene, J. G. Yeager, Mahlon Bryan, Edward Perry, Joseph H. Chubb, J. McGregor Gibb, Esq., Clement W. Shoemaker, John Walton, Joseph H. Kenworthy, J. E. Brenneman. The medical staff is as follows : — Physicians. — James Hendrie Lloyd, Thompson S. Westcott, Thomas L. Coley and Alfred Hand, Jr. Surgeons. — John B. Eoberts, J. M. Spellissy, James P. Hutch- inson and L. J. Hammond. Gynecologists. — Eichard C. Norris and Louis A. Salade. Ophthalmologist. — Philip H. Moore. Aurist and Laryngologist. — Walter Eoberts. Pathologist. — Harlan Shoemaker. Orthopcedist. — J. Torrence Eugh. Superintendent. — Eebecca S. Young. Directress of Nurses. — Alice M. Garrett. St. Timothy's Memorial Hospital By J. VAUGHAN MERRICK ST. TIMOTHY'S Memorial Hospital and House of Mercy, Eox- borough, Philadelphia, was founded by the late John Yaughan Merrick, Sc.D., and Mary Sophia, his wife, in memory of their parents, Samuel Vaughan Merrick and Sarah, Ms wife, Samuel Wagner and Emilie Obrie, his wife. It was dedicated June 11, 1890. The original house, now the administration building, was the homestead of the James family, situate at the corner of Eidge and Jamestown Avenues, Eoxboroueh. The hospital is strictly non-sectarian, and no distinction is made on account of creed, race or color. The population of the Twenty-first Ward is about 38,000, and St. Timothy's Memorial Hospital 721 as many eases are brought in from the Falls of Schuylkill and from Montgomery County on the west side of the Schuylkill River, it is probable that the hospital serves a community of 60,000 people. The endowment fund is at present $4-9,277.75, the income from which, together with the appropriation from the common- wealth, provides about one-half the amount needed to carry on the work. The remainder is made up by the generous gifts of a hard- working and by no means wealthy district. The hospital plant consists of the following : An Administra- tion Building, the hospital and Percival Eoberts Ward, the Nugent Operating Ward, Nurses' Home, Laundry, Pathological Laboratory, Isolation Ward and Stable. The hospital contains sixty-three free beds, eight private rooms, four private wards. Since its doors opened over 30,000 patients have been treated. A Training School for Nurses has been in operation for 10 years and the graduates of St. Timothy's Hospital stand high in the estimation of the medical profession; a number of them are filling the position of superintendent in various places. From the first, the "Ladies' Aid," composed of about 75 efficient and energetic women of the neighborhood, has been a tower of strength to the management. Monthly meetings are held when sewing, bandage-rolling, etc., is done, and annually they conduct 3. successful "Lawn Fete," and from time to time, other activities for the raising of money. The medical staff consists of four physicians and five surgeons with five consultants. This institution is primarily an emergency hospital, and as it serves a large manufacturing district, many severe accident cases are brought in daily. Plans have been made for a new administration building to replace the present inadequate house, and the Board of Managers intend to proceed with the erection of this building as soon as sufficient funds are in hand. BOARD OF MANAGERS Chairman Ex-officio, Bev. James B. Halsey; Members Ex- officio, J. Vaughan Merrick, Wm. Penn Stroud, J. Hartley Merrick, Peter Liebert, John Flanagan, Frank S. Whiteman, J. J. Foulkrod, Jr., James Christie, Edward H. Preston, John J. Foran, Robert 46 722 General Hospitals and Dispensaries Hey, John H. Dearnley, William H. Lush, George C. Bowker; Treasurer, Charles W. Gifford; Secretary, J. Vaughan Merrick; Superintendent, Annie C. Nedwill; Head Nurse, Etta M. Staub; Night Head Nurse, Bertha M. Kelly; Resident Physicians, George F. Boss, M.D., Blase Cole, M.D., Hubert J. Goodrich, M.D.; Besident Physicians for 1908 and 1909, P. E. Hudson, M.D., Earl C. Sherrick, M.D., Henry T. Harvey, M.D., Charles E. Hayes, M.D. MEDICAL BOARD Medical Staff.— M. Howard Fussell, M.D., Alfred H. Mellersh, M.D., Wm. C. Cahall, M.D., Joseph V. Kelly, M.D. Surgical Staff.— Otto A. Bath, M.D., Addinell Hewson, M.D., Alfred C. Wood, M.D., Harry S. Carmany, M.D., James B. Hutchinson, M.D. ; Out-Patient Staff.— -Otto A. Bath, M.D., Harry S. Carmany, M.D. ; Ophthalmologist, E. S. Saylor, M.D.; Pathologist, M. Howard Pussell, M.D. ; Medical Begistrar, Orlando H. Petty, M.D. ; Eadio- grapher, Edward A. Eichman, M.D. ; Consulting Surgeon, Bichard H. Harte, M.D.; Consulting Physician, Boland G. Curtin, M.D.; Consulting Ophthalmologist, Geo. E. de Schweinitz, M.D. ; Con- sulting Neurologist, Charles K. Mills, M.D. ; Consulting Aurist, B. Alexander Bandall, M.D. ; Masseuse, Mrs. Ada P. T. Dean. The West Philadelphia General Homoeopathic Hospital and Dispensary By H. M. GAY, M.D. WHEN the call for a public meeting, to consider the necessity for a hospital in the western section of West Philadelphia and to devise ways and means for attaining that object, was- issued early in the fall of 1904, it met with an enthusiastic response, and resulted in a representative meeting in Fletcher M. E. Church, which the officers of the church body had very courteously granted for the purpose. At this meeting the present corporate body was formed, and a Board of Trustees elected and empowered to pur- chase and equip a building for hospital purposes, and to obtain a charter under the corporate laws of the State of Penns3'lvania. The property on Pifty-fourth Street, north of Girard Avenue was selected as being the most suitably located for the purpose, being situated in the midst of a rapidly growing section of the city, sur- West Philadelphia Homoeopathic Hospital 723 rounded by numerous manufactories and readily accessible from all parts of the city. It comprises a plot of ground of 220 feet front- ing on Fifty-fourth Street and extending 224 feet to Conestoga Street, together with a substantial three-story brick building, con- taining eighteen rooms, wide halls and spacious porches; after the necessary alterations were completed, the building was opened for the reception of patients January 12, 1905. The indebtedness incurred for improvements and equipment was a very great handi- cap at the beginning of our existence. This debt, however, we are very glad to report, is being gradually reduced, with the aid of the noble band of women who have associated themselves with the Board of Trustees in conducting the financial and domestic affairs of the hospital. In October, 1905, it was found to be absolutely necessary to enlarge the facilities of the hospital. This was accomplished by renting a house opposite the building and converting it into a nurses' home, giving us, for hospital purposes, the beds occupied by the nurses. The building was also fitted up for treating the out- patients, or dispensary patients. This change made possible the addition of seven beds to the equipment, making fifteen public ward beds and seven in private rooms. Even with these increased facilities the needs soon outgrew the capacity, but the management was compelled to struggle along as best it could until the spring of 1907, when, through the efforts of the Board of Trustees and friends of the institution, it was placed upon the list of institutions receiving State aid. At the last session of the Legislature there was donated $5,000 for building purposes and $10,000 for maintenance for two years, beginning June 1, 1907. With this appropriation for building and equipment, a building has been erected in the rear of the old hospital which has increased the capacity of the institu- tion from twenty-two beds to forty. The indications are that the plant will be taxed now to its utmost capacity. The work of the hospital has more than tripled in the last two years. Instead of fifty accident cases a month, there are now received in the neighborhood of three hundred and fifty; in fact, the accident and emergency ward threatens to crowd out all other charity work. The Nurses' Committee has found it necessary to increase the force of nurses to twelve notwithstanding the fact that the accommodations for the present force are inadequate; more commodious quarters will soon be an imperative necessity. 724 General Hospitals and Dispensaries During less than four years of active life, compared with the early growth of other hospitals, immense strides have been made, and now there is a very fair equipment. An elevator has just been installed, largely the work of the Ladies' Auxiliary which has under- taken to finance the project. As soon as this is completed it will be necessary to build two more bathrooms, the present facilities in this respect being decidedly inadequate. And beyond these things there is a long list of necessities of a like practical nature which will come into immediate and constant use as soon as obtained. Those who have worked faithfully for the institution feel more than satisfied with its progress and deeply appreciate the commen- dation which has been so freely given by those who have had either as patients or visitors an opportunity of viewing its methods of administration, management, etc. They are also grateful for the very general and loyal support of the members of the community which the hospital benefits, and with the continuance of this spirit and with hope of substantial future recognition by the State they are looking forward to a steady and continuous enlargement and improvement. OFFICERS Board of Trustees. — W. E. Marbaker, President; T. L. Palmer, Vice-President; H M. Gay, Secretary; Marshall A. Brooks, Treas- urer. Trustees.— John F. Culin, T. L. Palmer, H. M. Gay, M.D., William H. Kreider, Wm. D. Culin, M.D., Thos. W. MacFarland, Richard B. Morrell, Herbert F. Williams, M.D., W. E. Marbaker, Chas. H. Harvey, M.D., Chas. K. Hibbs, Evan J. Hackney, M.D., M. W. Sloan, M.D., Marshall A. Brooks, L. T. Ashcraft, M.D., H. C. Evans, G. P. Stubbs, M.D., W. M. Hilleg'as, M.D. Board of Lady Managers. — Mrs. M. W. Sloan, President; Mr?. Geo. P. White, First Vice-President; Mrs. E. S. Gay, Second Vice- President; Mrs. J. P. Culin, Treasurer; Mrs. J. S. Wilson, Record- ing Secretary; Mrs. Geo. Newton, Corresponding Secretary; Mrs. J. D. Carlile, Mrs. W. D. Culin, Mrs. E. S. Gay, Miss Bella Gray, Mrs. C. H. Harvey, Mrs. W. E. Marbaker, Mrs. Malachi Sloan, Mrs. John P. Culin, Mrs. Curry, Mrs. Wm. Allen, Mrs. P. H. Pierce, Miss E. M. King, Mrs. H. Johnson, Mrs. Van Eoden, Mrs. David P. Leas, Mrs. Wetherell, Mrs. Geo. P. White, Mrs. John S. Wilson, Mrs. T. L. Palmer, Mrs. P. Wanderer, Miss A. J. Williamson, Mrs. Harry C. Evans, Mrs. Geo. Newton, Mrs. Busch. Frederick Douglass Memorial Hospital 725 Frederick Douglass Memorial Hospital and Training School 1 THIS institution situated at Lombard and Sixteenth Streets, was founded in the year 1895, and incorporated the following year under a charter granted by the Legislature of Pennsylvania. Since its foundation it has done and is still doing much needed work in the care and treatment of the humble and indigent sick. The Nurses' School has afforded unequalled facilities for the train- ing and equipment of young colored women and the hospital gives a large field of practical service and usefulness to the thirty-five colored physicians of Philadelphia. A post-graduate course for Doctors of Medicine is planned. The hospital is largely under colored control; the staff, how- ever, is made up of both white and colored physicians and surgeons of prominence, and in the admittance of patients for treatment, there is no racial or religious discrimination. The young women in the training school for nurses have been drawn from northern and southern states, and are proving themselves ministers of mercy and helpfulness in various parts of the country. Since its foundation the hospital has treated nearly 3,400 in-patients and upwards of 40,000 out-patients. Such work as this should command the confidence and deserve the support of any community. The establishment and later development of the hospital are due, in great part, to the intelligent and persistent labors of Dr. Nathan P. Mossell, the president medical director. The Officers and Board of Directors are as follows : — OFFICERS President, Andrew F. Stevens; Treasurer, Lewis M. Mintess; Secretary, James H. Williams ; Financial Secretary, Dr. W. A. Sin- clair; Medical Director, Dr. N. F. Mossell. Board of Directors. — Robert W. Savage, Eichard A. Cooper, James H. Williams, 1ST. F. Mossell, M.D., Bishop J. S. Caldwell, Lewis M. Mintess, Eev. W. G. Parks, Andrew I. Woodlyn, Hon. i This sketch was prepared by the editor from data furnished by the hospital. 726 General Hospitals and Dispensaries George H. White, Mrs. J. B. Taylor, Andrew F. Stevens, Mrs. Mary A. Campbell, Eev. C. A. Tindley, John H. Clower, Bishop L. J. Coppin, Mrs. Henrietta Capps, S. C. Moseley, Jerome J. Baptiste, William A. Sinclair, M.D., Prof. H. T. Kealing. St. Luke's Homoeopathic Hospital of Philadelphia By WILLIAM H. KEIM, M.D. IN the early fall of 1895 a number of physicians held a few meetings to consider the practicability of opening a dispensary in close proximity to numerous large industrial works and railroad centers in the north central section of the City of Philadelphia. As a result of these meetings, it was resolved : To enlarge the scope of the project and create a hospital, there being but one gen- eral Homoeopathic Hospital in Philadelphia, and that located in the central portion of the city. The originators of the plan invited the co-operation of other physicians, who became greatly interested in the proposed insti- tution. A Board of Trustees consisting of fifteen laymen and ten physicians was organized, with Mr. William D. Kelly as President. A name for the hospital was the subject of an interesting dis- cussion; the suggestion of William H. Keim, M.D., that it be named "St. Luke's Homoeopathic Hospital of Philadelphia" at once met with general favor and was accepted as the name for the institution under consideration. A house was rented at 3318 North Broad Street and first opened for the reception of patients on January 9, 1896. In this house there were accommodations for twelve beds, also three beds in private rooms, two beds in the accident ward and sufficient room for the chief nurse, and resident housekeeper, as well as rooms for dispensary departments. On March 21, 1896, a charter was granted under the laws of the Commonwealth of Pennsylvania, by the Court of Common Pleas No. 4. A hospital association of ladies was created and an auxiliary association, known as the Germantown Auxiliary was organized at St. Luke's Homoeopathic Hospital 727 this time ; the latter has uninterruptedly rendered valuable services to the cause of humanity. During the first thirteen months, there were 303 patients admitted. Of these 234 were operative surgical cases and 69 were medical. During the same period, there were 14,000 visits of patients to the dispensary. The second year's report shows an increase in the figures under all these several headings, proving satisfactorily the necessity of a hospital in this location. The rapid development and broadening usefulness of the institution soon overtaxed its income. Notwithstanding the gen- erous appropriation by the Legislature of Pennsylvania in 1897, the hospital, owing to the importunities of creditors and the failure to obtain an appropriation from the State in 1899, was compelled to close its doors in July of the same year. Among those interested in the hospital there were a number who felt that the abandonment of the project which gave such a great promise of success would be almost criminal; this feeling crystallized in the formation of the Hospital Association. Mrs. M. E. Stewart, President, and Miss Mary B. Lewars, Secretary of the Association, after a conference with Carl V. Vischer, M.D., decided to purchase the hospital fittings. In the summer of 1899, the legal transfer was consummated whereby the management of the institution was vested solely in the women interested heretofore in the association known as the Germantown Auxiliary; at this time they purchased the adjoining house thus doubling the capacity of the hospital, so that there were 22 beds in the general and private wards, and 6 private rooms ; also accommodations for the nurses and house staff. The increasing demand each year for larger accommodations and more sanitary surroundings and the erection of a large stable on the adjoining lot, made it imperative to seek a new location for the hospital. In July of 1904, a property was purchased, located between Broad and Fifteenth, Wingohocking and Blavis Streets, with a total area of two and three-quarters acres. The large mansion on this ground was altered and equipped for hospital purposes and a second building on the same lot was equipped for the dispensary and nurses' house. Two other smaller buildings, one a stable and carriage house and the other a servant's dormitory, were fitted up 728 General Hospitals and Dispensaries for the purposes required and on December 27, 1904, the patients were moved to the new building and the routine of general hospital work resumed. In April, 1906, ground was broken to the south and west of the • main building for the erection of two one-story pavilions, the State of Pennsylvania having granted an appropriation sufficient for that purpose. These pavilions, connected with the main building and with each other by corridors, contain, first, the Surgical Pavilion with fifteen beds and the second known as the Women's Ward, with accommodation for fifteen beds, eight of which are in a general ward and five in private rooms, with two in a solarium. The surgical pavilion was named the Vischer Pavilion in com- memoration of the valuable services of the late Carl V. Vischer, M.D., first surgeon to the hospital. A generous appropriation by the Legislature of 1907 enabled the management to meet the demand for the accommodation of free patients by increasing the number of beds, and equipping the institution in accordance with sanitary precautions to add to the comfort of the sick. Within two years, the capacity of the institution was more than doubled from a total of 34 beds in 1906 to 60 in 1908. An excellent ambulance service assists the institution in the care of a large number of emergencies it is called upon to respond to by reason of its location in the heart of a manufacturing section and near to the main railroad avenues of the city. A well regulated training school of nurses is conducted in the institution to meet efficiently the activities of the work and graduates from four to six pupils annually after a required three years' course of training. The dispensary meets a great need as shown by the large fig- ures in our annual report of cases treated in the out-patient depart- ment of the hospital. In the thirteen years' existence of the hospital, we have record of 140,000 patients treated in the dispensary departments. Woman's Southern Homoeopathic Hospital 729 The Woman's Southern Homoeopathic Hospital of Philadelphia By LYDIA WEBSTER STOKES, M.D. IN September, 1893, a young doctor and her friend opened a small dispensary in the slums of Philadelphia, where they did medical and missionary work among their poor neighbors. In three months the growth of the work made a move to larger quar- ters necessary, and in five months more they were obliged to rent a whole house. Patients flocked to the dispensary, another doctor came to help, and there were almost more out calls than they could attend. In less than two years 6,357 prescriptions had been made, and the need for more doctors, more room and more money was urgent. The popularity of the homoeopathic method of treatment spread rapidly, and results were so good that in the next year the amount of work done by this little group of women almost doubled that done in the first two years. Feeling the necessity of having some of their patients under close supervision, they rented an adjoining house, where they treated and nursed as many patients as they possibly could. It had become evident that there was a real need for a homoeopathic hospital in this section of the city; in September, 1896, the Woman's Homoeo- pathic Medical Club and some friends decided to take up the work, and on September 30th the institution was incorporated under the name "The Woman's Southern Homoeopathic Hospital of Philadel- phia." It was then located at 321 and 323 South Seventh Street, but these two houses soon proved inadequate to the needs, and in 1898 the present property — 724 Spruce Street — was purchased and heavily mortgaged. For part of one year, early in its history, it became necessary to practically close the doors of the institution from lack of neces- sary funds; the dispensary was kept open, however, and had an occasional patient. In April, 1900, the work was again resumed. One of the greatest needs was supplied, in 1901, by a generous friend — a small brick building being erected in the rear of the yard for dispensary and laundry purposes. Another friend of the hospital erected, furnished and pre- sented to the hospital, in 1903 and 1904, a Convalescent Home at 730 General Hospitals and Dispensaries Spring Lake, New Jersey, in memory of her daughter. After a year it became apparent that the coast towns needed a general hos- pital, and this institution was therefore transferred to a local Board of Managers. In 1905, the second floor of the back part of the house was rebuilt, making six small private rooms; these are in constant use, being popular with both doctors and patients. The special aim of the management has always been to supply the needs of self-sup- porting women when ill; they cannot afford private rooms at the usual prices, and yet should not go into a large public ward. For these the twelve cozy rooms, at a low rate, are a God-send, and indeed, the small wards are almost as desirable. The home- like atmosphere of the hospital is one of its strong features. Another improvement was made in 1906, when the fourth floor was rebuilt, making comfortable quarters for the nurses. In this year, also, a small fire occurred on the first floor, truly a catastrophe, but through the prompt and concerted action of the nurses, the twenty-five patients were moved to the dispensary without injury. The Nurses' Training School has been increased in size and efficiency with the growth of the hospital. The course is two years, and in 1907 and 1908 eight well-equipped young women were gradu- ated. The usual number of nurses in training is ten, and we feel that it is reasonably certain that these receive especially good individual instruction and experience. The hospital's latest acquisition is an ambulance, which was built in 1907. The need for this had long been felt, but the neces- sary money was lacking, until one of the founders of the hospital undertook the task of collecting the money required. The first two bequests were made in 1907, both being from women doctors; though small, they were gratefully received, and » were made the basis of an endowment fund. Since 1903 there has been received small appropriations from the State of Pennsylvania; without the contributions of friends, however, it would be impossible to continue this great charity. As a rule about one-third of the patients are treated without charge, one-third pay from one to five dollars per week, and the other third pay a sufficient amount to nearly or quite cover their cost. Starting with but 1 bed and treating 40 patients the first year, the hospital has grown and the work increased each year, both inside and at the dispensary and on the out-practice. With but The Mount Sinai Hospital 731 36 beds altogether, we treated 430 patients in our last year (October 29, 1907, to October 27, 1908). Ninety-four of these were births, 96 medical and 128 surgical cases. In the dispensary 2,352 prescriptions were given, and in the out-practice 1,145 visits were made. The following are the officers of the hospital : — President. — Mary Branson, M.D. Vice-Presidents. — Amelia L. Hess, M.D., Miss Anna Morris, Mrs. M. B. Young. Recording Secretary. — Miss Annie M. Miller. Corresponding Secretary. — Mrs. Sarah Dunn Wood. Treasurer. — Mrs. Emma Speakman Webster. Assistant Treasurer. — Lydia Webster Stokes, M.D. The Mount Sinai Hospital By HENRY B. SHMOOKLER, M.D. THE crowded southeastern section of the city, mostly inhabited by the poor and foreign elements of the population, had long felt the necessity of a hospital, and attempts to establish one had been made at various times, but without success. In August, 1899, a meeting was called at which plans were discussed for the estab- lishment of a hospital for destitute sick and ailing, to be supported mostly by voluntary contributions. It was named the Beth Israel Hospital Association, and had for its main purpose the maintenance of a hospital and dispensary, to afford medical and surgical relief to the sick poor of the Jewish faith residing in the City of Phila- delphia, but not excluding other sects from its benefits. Later, the Board of Directors of the Franklin Free Dispensary was invited to unite with it, and the name of the latter was adopted. As a char- ter of the last-named association antedated the legal restrictions, it was thought that a hospital could now be legally opened ; accord- ingly the premises of 236 Pine Street were leased, and an adequate dispensary for the free treatment of diseases and dispensing of drugs to the poor was established. In April, 1900, the Franklin Free Dispensary joined with a second independent organization of charitable citizens of the south- 732 General Hospitals and Dispensaries eastern section of the city, under the title of the Mount Sinai Hos- pital Association, which had been incorporated in March, 1900. It was clearly demonstrated that the agitation for the establishment of two new hospitals would jeopardize the successful issue of either one. After a good many conferences the older association decided to take the name of the younger one, the Mount Sinai Hospital, and both agreed to work earnestly with the one purpose in mind, namely, the establishment of a hospital in the southeastern section of the city, where the foreign as well as the native-born would be treated. Jacob D. Lit, a well-known merchant of Philadelphia, was elected President of the Mount Sinai Hospital Association, and, so far, has been the only president it has had. It was at first thought that, while removal was not permissible, a hospital on the premises of 236 Pine Street might be opened, but the best legal opinion obtainable at that time was that nothing in that direction could be done until the existing law was modified. It is true that a hospital might have been built outside of the city proper, but to serve the purpose intended, i.e., to treat the foreign element which is not familiar with the English language, it must of necessity be located within convenient reach of those for whose benefit the institution was established. The law, however, effect- ually debarred the erection of any hospital in the built-up portion of the city, and no portion of the city could be found that was not legally built up, as there were everywhere a few houses, a church or a school. There was at that time very little hope that the Mount Sinai Hospital would ever develop into a well-organized modern hospital, but, when least expected, relief came. To permit of the location of a hospital for consumptives in Philadelphia the law had to be modified, as otherwise the hospital for which Mr. Phipps had donated a million dollars would have been established in the city of New York. The hospital law was accordingly amended by the Legislature of 1903, the only condition imposed being that such an institution must be modern and sanitary, and approved by the health authorities of the city. A plot of ground containing a four-story building and situated on Fifth Street between Eeed and Dickinson, was bought for the sum of $25,000, and after having been remodeled into a hospital and dispensary, it was opened to the public in March, 1905. The Mount Sinai Hospital 733 The institution proved itself popular, as well as necessary to the welfare of the neighborhood. It is the only hospital south of Pine Street and east of Broad Street, and ministers to a popula- tion in excess of 100,000. The river front, dotted with manufact- uring plants of various kinds, avails itself in cases of accident and emergency of its beneficent work, and the accident and emergency services of the hospital have ever been a very prominent feature of its general work, about 500 cases being treated monthly in the emergency ward. The out-patient department in a short time became one of the best attended in Philadelphia, as many as 50,000 patients receiv- ing treatment during the year. Every bit of available space is made use of to accommodate its enormous out-patient service, several different services having to occupy the same rooms through the day. The wards have always been crowded and often overcrowded. While there are thirty-three beds for patients in the wards, as many as forty have occasionally been accommodated. The following constitute the staff of the hospital : — • Visiting Surgeons. — Max J. Stern, M.D. ; Max Staller, M.D. ; Louis W. Steinbach, M.D. Visiting Physicians. — Henry B. Shmookler, M.D. ; Alexander Klein, M.D. Ophthalmologists. — Samuel J. Gittelson, M.D.; Walter L. Pyle, M.D. Pediatrists. — Edwin Eosenthal, M.D. ; Sol. Seilikovitch, M.D. Dermatologist. — E. S. Gans, M.D. Neurologist. — Alfred Gordon, M.D. Rhinologist, Otologist and Laryngologist. — Arthur W. Wat- son, M.D. Gynecologist. — Leon Brinkmann, M.D. Pathologist {Acting).— Simon Wendkos, M.D. The hospital maintains a Training School for Nurses, and at present has about fifteen pupil nurses under the able management of Miss May Cook, who has been associated with the school for the last three years. It has a three-year graded course, which includes instruction in dietetics, practical nursing, massage and electricity, and other more distinctly medical subjects. It has graduated one class of three nurses, and is about to graduate another class of the same number. 734 General Hospitals and Dispensaries The institution proved itself popular, as well as necessary to by contributions from annual members varying from $1.20 to $100, and voluntary donations from the community at large. The income from pay patients plays a very small part in the mainte- nance, as this institution ministers mostly to the very poor, to whom $7.00 a week for board is a very great outlay, and brings in altogether less than a thousand dollars a year. To meet the always existing deficiency, the Board of Directors are compelled to solicit donations, and this burden mainly falls on the President, Mr. Jacob D. Lit, who, almost single-handed, raises the necessary funds. The State has appropriated $10,000 yearly for the last two years for maintenance, and also some money for a new building. The latter, however, could not be utilized, as the Governor reduced it to $5,000. This prevented the directors from undertaking the building of a new hospital during the general financial depression of the years 1907-1908. The demand, however, for increased accommodation for the out-patient department, and for more ward space, has been so insistent and so based on absolute necessity, that the Board of Directors were finally compelled to undertake in earnest the build- ing of a new hospital, and Mr. Louis Magaziner, architect, has been commissioned to draw up a set of plans for which estimates are now being asked. The addition probably will cost from $75,000 to $85,000. The hospital, as planned, will accommodate about a hun- dred ward and twenty private patients. The institution has been maintaining an ambulance service since 1906. It has general medical and surgical services, also gynecological and pediatric services, and admits patients suffering from any affection, excepting contagious diseases and tuberculosis. While it has no regular maternity service, a good many emergency maternity cases are treated in the wards, and all labor cases requir- ing surgical interference, are promptly admitted. The hospital maintains its own pharmacy. The majority of the patients treated in the various dispensaries, too poor to buy their own medicines, are supplied with them free of cost. The following are the officers : Mr. Jacob D. Lit, President; Mr. Max J. Stern, Vice-President; Mr. Jacob Cartun, Treasurer; Dr. Henry B. Shmookler, Secretary; Dr. Simon Wendkos, Super- intendent. The Frankford Hospital 735 The Frankford Hospital By B. FRANK WALTERS, M.D., and CHARLES M. STILES, M.D. THE Frankford Hospital had its nucleus in the concerted efforts of two physicians — Jos. P. Ball, of Frankford, and Chas. P. Brady, of Fox Chase. These men, in August, 1902, opened a free dispensary in the first floor rooms of a little house at 2360 Orthodox Street, which they rented at their own expense. They constituted a philanthropic organization of two, with the object of giving aid and comfort to the sick and suffering poor of the locality, many of whom were in no condition to make the long trip to the city, or even to the nearest hospital, the Episcopal. In the six months that the dispensary was held at this address a total of 304 people were treated gratuitously. The two doctors soon found that they had more than they could attend to. They then invited three more physicians — per- sonal friends — to combine with them. These men were working in special lines of medicine and surgery in connection with down- town hospitals. Thus the actual working force of the organization was increased to five members, with separate departments of medi- cine, viz. : general surgery, diseases of women, diseases of the eye and ear and diseases of the nose and throat. Larger quarters were now needed, and were occupied at 4429 Frankford Avenue, where the philanthropic service was carried on for several months under the name of the Frankford Dispensary. It had long been a cherished idea of Dr. Ball that there should some day be a Frankford hospital, legally chartered, completely organized, with buildings properly adapted and of adequate size to carry on the badly needed work of hospital service in a territory comprising over one hundred thousand people, and including Frankford, Bridesburg, Wissinoming, Holmesburg, Torresdale, Tacony, Byberry, Somerton, Bustleton, Fox Chase, Lawndale, Wyoming and Olney. The nearest hospital to Frankford was three miles away. Frankford itself was a manufacturing district; accidents were of daily occurrence, and yet every emergency case, of whatever gravity, had to be taken that long trip before the patient could receive proper attention. Frankford evidently needed a hospital, so the five doctors, Jos. P. Ball, Chas. P. Brady, Chas. M. Stiles, B. Frank Walters and John W. Wilkins, made 736 General Hospitals and Dispensaries application for a Prankford hospital charter, which was approved and granted on March 27, 1903. The time had now arrived to obtain real hospital quarters, the building in which the dispensary was conducted at 4429 Prankford Avenue being altogether too small. In a few weeks' time the double house at the corner of Penn and Sellers Streets was pur- chased for $7,500, $1,000 in cash being raised, $150 apiece subscribed by six physicians (the five originators were joined by Dr. E. Bruce Burns, the six doctors named constituting the first Board of Trustees), and the remaining $100 being donated by a friend of the newly-born hospital, the balance of the purchase price being carried on a mortgage. Further funds were secured by contributions from firms and individuals, entertainments, fairs, porch parties, benefits, etc., sufficient to suitably alter the property, and install the necessary furniture, apparatus and instruments. A resident physician was now appointed, nurses were installed, and on July 4, 1903, the Frankford Hospital, at the corner of Penn and Sellers Streets, was formally thrown open to the public. During the succeeding months the work of the hospital grew mightily, and the institution obtained the confidence of the com- munity. Five more local doctors — Samuel Bolton, Geo. C. Hanna, M. K. Henry, S. Eaughley and E. E. Keiser — obtained positions on the staff, which was further strengthened by the appointment of two consulting surgeons, Chas. P. Nassau and Wm. H. Morrison. In the spring of 1904, the physicians resigned from the Board of Trustees, and the following lay members were elected: John M. Mack, President; Eobt. Lewis, John Eapp, Wm. H. Burns, Eobt. Pilling, Jr., and Chas. J. Eussell. The present efficient Superin- tendent and Directress of Nurses, Miss Anna C. Garrett, formerly of the Pennsylvania Hospital, was also appointed this year. In 1906, owing to the smallness of the quarters at Penn and Sellers Streets, the Board of Trustees purchased for the hospital the Wilbraham mansion and grounds, situated at Frankford Ave- nue, Wakeling and Franklin Streets, and early in 1907 the new buildings were commenced. The corner-stone was laid by Mr. Isaac Schlichter, of the Board of Trustees, on April 6th, and the buildings were completed before December of the same year, the funds coming from State appropriations and generous public sub- scriptions, the latter being augmented by a very successful four-day The Chestnut Hill Hospital 737 bazaar — the Fete of Nations — held in the new buildings in Novem- ber, which netted the hospital the sum of $8,133.75. In January, 1908, the hospital sustained an irreparable loss in the death of Wm. H. Burns, Treasurer from May, 1904, to the day of his death, during which time he gave unstintingly of his time, thought and money to advance the interests of the institution, finally bequeathing to the hospital the generous sum of $25,000, its first legacy. The patients were moved from the old hospital building at Penn and Sellers Streets to the new hospital early in 1908, and on Tuesday, February 25th, the latter was formally dedicated. Mr. James S. McMaster, of the Board of Trustees, presiding, the principal addresses being made by Drs. B. Frank Walters, Samuel Bolton and the Bev. John B. Laird. During 1908, 14,735 patients, including re-visits, were treated. The hospital property, buildings and appointments are valued at $143,409.86. It is safe to say that seldom in the history of hospitals has there been such a speedy establishment and phenomenal growth ; and Frankford owes a debt of gratitude to its founders, trustees and staff for their indefatigable and self-sacrificing labors in the furtherance of its hospital interests. The Chestnut Hill Hospital By HENRY H. KINGSTON THE Chestnut Hill Hospital, located in the beautiful grounds of Norrington, formerly the residence of the Norris family, is centrally located to care for the work for which it was established. Previous to 1904, Chestnut Hill was without any hospital facilities, and accident or emergency cases arising in its vicinity were dependent on facilities far remote, the nearest being four miles away. In 1903, the question of establishing a hospital was suggested, resulting in the obtaining of a charter on November 21, 1903, fol- lowed by the opening of the Chestnut Hill Hospital on October 4, 1904, in two small dwelling houses on West Gravers Lane. The first Board of Trustees were: — Badcliffe Cheston, M.D., 47 738 General Hospitals and Dispensaries J. Andrews Harris, S.T.D., Henry H. Kingston, Robert Glendin- ning, J. Murray Ellzey, M.D., William Findlay Brown, J. Andrews Harris, Jr. The trustees soon found that the accommodations at the Gravers Lane location were entirely inadequate to the rapidly growing demands, and being generously assisted by residents of Chestnut Hill, purchased "JSTorrington," and after necessary changes in the old homestead, the hospital was duly installed there in the summer of 1907. For the furnishing of the private rooms, wards, public rooms and operating rooms at both the original and present locations, the hospital is indebted to the generosity of the ladies of Chestnut Hill. The private rooms have been most tastefully and comfortably furnished with a view to creating as pleasing an effect as possible, and a home feeling in those occupying them. The institution is fully equipped as a small hospital of the first class, and provides a men's ward with eight beds, a women's ward with eight beds and fourteen rooms for private patients, as well as ample and comfortable accommodations for nurses and household help. The trustees, officers and staff at present are : — Trustees. — Eadcliffe Cheston, M.D., J. Andrews Harris, S.T.D., Henry H. Kingston, Robert Glendinning, William Find- lay Brown, Arthur E. Newbold, J. Andrews Harris, Jr., T. Henry Dixon, B. Franklin Pepper, Russell H. Johnson, M.D., J. F. McCloskey, M.D., Very Rev. Dr. Martin J. Geraghty, O.S.A., Edward D. Toland, Alexander Van Rensselaer. Finance Committee. — Robert Glendinning, J. Andrews Harris, S.T.D., Arthur E. Newbold. House Committee. — B. Franklin Pepper, Edward D. Toland, Robert Glendinning. Executive Committee. — Arthur E. Xewbold, Henry H. Kings- ton, Very Eev. Dr. Geraghty, O.S.A. Officers and Staff.— President, Radcliffe Cheston, M.D. ; Vice- President, J. Andrews Harris, S.T.D.; Secretary, J. A. Harris, Jr.; Treasurer, Arthur E. Newbold; Medical Staff, Radcliffe Cheston, M.D., Russell H. Johnson, M.D.; Pathologist, J. F. McCloskey, M.D. ; Surgical Staff, J. Murray Ellzey, M.D. ; J. F. McCloskey, M.D.; X-Ray-Ologist, Robert Perry Cummins, M.D. ; Consulting Physician, J. H. Musser, M.D.; Consulting Surgeon, Henry E. /' ■■■■ ■- r £ ' : ^^ E E £ 1 £ 3 ^ I J Hi L-o/ ^ rt --_&- ----- CHESTNUT HILL HOSPITAL. The Stetson Hospital 739 Wharton, M.D.; Consulting Gynaecologist, John 6. Clark, M.D. ; Consulting Laryngologist, Arthur Ames Bliss, M.D. ; Consulting Ophthalmologist, William Campbell Posey, M.D. Household Staff. — Superintendent, Miss Mary L. Jacobs, Miss Bertha S. Kauffman, Assistant; Operating Boom Nurse, Miss Bertha A. Biddle; Night Supervisor, Miss Anna L. Phillips; Pupil Nurses, Miss Alice M. Dawe, Miss Ella S. Mulhern, Miss Margaret M. Irwin, Miss Ida M. Jones, Miss Minnie E. Newell, Miss Lila B. Shepard, Miss Olivia B. Coale. The Stetson Hospital of Philadelphia By CHARLES B. WARDER, M.D. ON the fifteenth of February, 1887, a dispensary was opened in a small room adjoining the Library of the North Fourth Street Union Mission, and furnished with a few necessary instru- ments and appliances. This was done by Mr. John B. Stetson for the benefit of various employees in the hat factory of the John B. Stetson Com- pany, who needed medical or surgical treatment. Before this time Mr. Stetson had sent a number of his employees to a specialist for treatment, at his own expense. This specialist, realizing the loss of time incurred by these patients in going to and from his office, volunteered to go to the factory twice a week and treat all cases there. Thus it was that the dispensary was started. At this time it was suggested that this dispensary be made the Medical Department of the Union Mission, which was done. In the beginning only the employees of the factory were treated, but from time to time other departments were added, and later on the families of the employees were allowed the privilege of treatment in the dispensary. During the first year 3,745 visits were made; and by the end of the fourth year the number of annual visits to the dispensary had increased to 8,460. The work by this time had grown to such an extent that it was necessary to enlarge the accommodations. In 1891, through the liberality of Mr. Stetson, the dispensary 740 General Hospitals and Dispensaries was transferred to more commodious quarters in the apex of the factory building, where the offices are now situated. From this time it was known as the Union Mission Hospital, and it opened its doors to all sufferers entitled to free advice and treatment. In 1893, it was visited by 1,271 new cases, who made 11,278 visits. At this time it had five departments, Eye, Medical, Surgical, Gynecological and the Ear, Nose and Throat Departments. In 1895, two new departments were added (the Skin and Nervous). The work in the Out-Patient Department steadily increased until, in 1897, 4,125 new cases applied for treatment, making 27,337 visits. In 1893, in connection with the Out-Patient work, it became necessary to establish a small ward containing three beds, where patients who had been operated upon might remain for a short time thereafter. This soon proved insufficient and another small ward with four beds was added. The record for the year 1898 was : Number of cases treated in the wards : Male, 38 ; Female, 27. Total 65. In the fall of 1898, however, the John B. Stetson Company found it necessary to use, in the operation of the factory, the rooms which the hospital had occupied. So it was accordingly moved into two small houses directly opposite the factory, at 1745 and 1747 North Fourth Street, where only an Out-Patient Department was conducted. During the next five years while plans were maturing for the development of our present plant, the Out-Patient Depart- ment was continued. In the fall of 1903, ground was broken and work commenced on the present hospital. This will accommodate from sixty to seventy patients. The property adjoining the hospital on the South has erected thereon the Nurses' Home. This building is of the same construction as the hospital, is four stories high and contains twelve rooms. Up to this time the hospital had been conducted under the name of Union Mission Hospital. In 1905, the Court was petitioned and the charter of the hospital was amended and the name changed to the Stetson Hospital of Philadelphia. On February 22, 1905, the hospital was opened for inspection and the reception of patients. To October 31, 1905, the end of the hospital year, 196 patients were admitted to the house, and 218 operations performed on 159 patients. Hospital days for these 1 — iMi ; The Philadelphia Home for Incurables 865 year a fine playhouse and gymnasium was built for the children, this latter being the generous gift of an individual donor. In 1904, the demand for room for cancer patients became so urgent that a new- Cancer Annex, exclusively for men, was built at a cost of some- thing over $50,000. The little rented cottage of 1877 has now become the great group of specially adapted buildings, and instead of the sixteen patients which the first year recorded, there are now in the home an average of about one hundred and fifty-seven; and a great number have passed through these quiet rooms to the eternal life. It is beyond the power of statistics to sum up the good that has been done and the suffering relieved by this great charity. The death rate is very large; the patients die; but the numbers in the home are ever increasing. The following serves to show this increase, taking the month of May in the respective years : In May, 1877, there were 16 inmates; 1880, 28 inmates; 1882, 32 inmates; 1883, 33 inmates; 1884, 50 inmates; 1885, 51 inmates; 1886, 52 inmates; 1887, 53 inmates; 1888, 63 inmates; 1889, 73 inmates; 1890, 71 inmates; 1891, 68 inmates; 1892, 71 inmates; 1893, 72 inmates; 1894, 74 inmates; 1895, 77 inmates; 1896, 85 inmates; 1897, 98 inmates; 1898, 108 inmates; 1899, 118 inmates; 1900, 126 inmates; 1901, 130 inmates; 1902, 138 inmates; 1903, 148 inmates; 1904, 146 inmates; 1905, 151 inmates; 1906, 143 inmates; 1907, 155 inmates; 1908, 157 inmates; 1909, 157 inmates. The cost of maintenance the first year was $7,911.03, sixteen patients; the tenth year, $22,527.33, fifty-three patients; the twentieth year, $38,158.98, ninety-eight patients; the thirtieth year, $61,805.02, one hundred and fifty-four patients. The cost has increased with the larger accommodations of the home, and almost in exact ratio, notwithstanding the greatly increased cost of living. The home is managed carefully and prudently, and is almost entirely dependent on voluntary contributions. Its endowment fund is very small, and wholly inadequate to the maintenance of this great institution. In this City of beautiful charities none is wider in its scope or more beneficent in its accomplishment. It has no limitations of age, race, sex or creed, and it takes into its care and keeping the incurably sick, and gives them both a hospital and a home. 55 866 Asylums, Homes and Training Schools Home of the Merciful Saviour for Crippled Children By HELEN L. INNES THIS institution, situated at 4400 Baltimore Avenue, Philadel- phia, was incorporated in 1882, and is the first of its kind in this country. Its mission is to the crippled, helpless and homeless child. Many such a one, on being discharged from a hospital where it can no longer be retained, finds its way to the home, and is often greatly improved, both physically and mentally, by the treatment therein received. No entrance fee is demanded nor is there any charge for board, and the best medical and surgical skill are likewise freely bestowed. The treatment is not limited to the body, but the condition and trend of the child's mental faculties are also carefully studied and a training for its future life work is instituted as soon as its physical condition permits. The home has cared for hundreds of children, and continues to receive them as vacancies occur. Many self-supporting men and women have received their early training here, where a pro- tracted residence generally made necessary by the nature of their affliction, insures favorable development, and often permanent cure. Among the occupations pursued successfully by former inmates, are those of organist, librarian, typewriter, stenographer, machinist, clockmaker, telegrapher, clerk, seamstress and bookkeeper. There is a daily school within the home, a kindergarten and a sewing room, where the older girls make the uniforms. Three months in summer are spent at Avon-by-the-Sea, New Jersey. The buildings and grounds, which occupy an entire square, are large and commodious, and filled with all necessary appliances. The following buildings should receive special mention : — The Chapel — Memorial to Frederick Klett Gibson. The Boys' House — Built by the contributions of many. The Hutchinson House — Memorial to Mr. and Mrs. Benjamin Hutchinson, by their daughter, Miss Mary M. Hutchinson. The Operating Room — By money collected by Mrs. John Gibson McCall and Miss Mary Beed. The William Riddle Surgical House — Memorial to Col. William Riddle, by Mrs. Thomas A. Scott. This house contains eight beds, a solarium, a room for trained nurses, kitchen, bathroom and all The Pennsylvania Home Teaching Society 867 modern conveniences. In it a child, after an operation, has the care of a trained nurse and skilled physician. The School House — Memorial to Mrs. Virginia Harrison, built, furnished and kept in order by Mr. Mitchell Harrison. The Girls' House — Memorial to Mrs. Anna P. Wilstach, Miss Elizabeth Schaeffer and Mrs. Lucy Gascoigne. In this house are the large dining-room, kitchen, pantries, steam heater, infirmary, rooms for girls, etc. The entire property in the city and at Avon-by-the-Sea is free from debt. The following are, the officers and medical staff: — President. — Francis" I. Gowen. Finance Committee. — Francis I. Gowen, W. W. Frazier and Parker S. Williams. Managers. — Francis I. Gowen, W. W. Frazier, Kev. Robert F. Innes, Parker S. Williams, George E. Packard. Rev. Robert F. Innes, Chaplain; Rev. C. C. Parker, Assistant Chaplain; Dr. James Hendrie Lloyd, Physician; Dr. Charles H. Frazier, Surgeon; Dr. De Forest Willard, Consulting Surgeon; Dr. George P. Miiller, Dr. William J. Merrill, Assistant Surgeons ; Dr. John F. Sinclair, Assistant Physician; Dr. W. C. Posey, Opthal- mologist; Dr. Ralph Butler, Aurist; Dr. William G. Spiller, Pathologist; Dr. Eliza Yerkes, Dentist; Mrs. Robert Francis Innes, Treasurer; Messrs. Gowen, Ingersol and Williams, Solici- tors; Parker S. Williams, Secretary. T The Pennsylvania Home Teaching Society and Free Circulating Library for the Blind By ROBERT C. MOON, M.D. HIS Home Teaching Society for the Blind, which has been in operation for twenty-seven years, was founded through the efforts of the late Dr. William Moon, of England, who, with his daughter, Miss Moon, visited this country in 1882. The home teaching and library work for the blind, which was then commenced, was successfully earried on in the Bible House, Philadelphia, by the late Mr. John P. Rhoads, the treasurer of the Philadelphia Bible Society. The Home Teaching Society was reorganized in 1898, and incorporated in 1901, under the title of the "Pennsylvania. 868 Asylums, Homes and Training Schools Home Teaching Society and Free Circulating Library for the Blind." Being himself blind, Dr. Moon, the inventor of the Moon type for the blind, well knew the requirements of his fellow sufferers, and his embossed books are especially adapted to the needs of those who have become blind since youth, or whose sense of touch has become blunted by laboring with the fingers. The objects of the Home Teaching Society are to provide a library of embossed books, and to send teachers to the homes of the blind for the purpose of teaching them to read, and to exchange their books periodically. By a special arrangement the society's library of embossed books is operated by the Free Library of Phila- delphia, but the cost of the books, and the expenses connected with the home teaching part of the work, and the circulation of books outside of Philadelphia, are met by the funds of the Home Teaching Society. Those blind persons who live in Philadelphia, or its vicinity, are taught in their homes without charge by the visitors engaged by the Home Teaching Society. The purposes of the Society, as stated in the articles of incor- poration, are, "the instruction of the blind in the art of reading by means of books printed in embossed or raised Moon type, or other characters, at their homes and elsewhere, and to establish and operate by itself or through the medium of others, a free circulating library, or libraries, of books printed in said type, or other characters, for the use of the blind." The report for 1908 states that four teachers are employed by the society to give instruction in reading to blind persons in private houses and public institutions, and to furnish them with an exchange of books. One of these teachers, who is totally blind, is located in Pittsburg. The society has 1,876 readers upon its roll, and 16,297 volumes, printed in all the embossed types, were distributed through the Free Library of Philadelphia during 1908. Of these 11,856 volumes were in the Moon type. The circulation of the books has been greatly facilitated and increased since the enactment of a law by Congress, in 1904, which granted free postage of all embossed books for the blind when loaned by institutions or public libraries, as a large number of the books is sent to the blind outside of Phila- delphia, to different parts of Pennsylvania, and other States of the Union. The schools for the blind of the State provide efficiently for READING FOR THE BLIND, BY W. MOON, LL.D. A b C A L 1 O Q- -fl O » DE f G H I J K L m N -j r v 'i » j j t l -i »j R^T UVWXY Z & \ / - J V n > J "i r CL ASSIFI ED ALPHABET. b \ Ef I ) N ,J a- — jj m rj T - z ~> - 1 -• r I' l L 4 / s r : j -•• a A c £ v v d ;> K< U'J Xv w /■ i g/*J yJ r.o'jh^ THE LORD'S PRAYER. EVEN NUMERALS. . • u. ODD NUMERALS. W H J C H A It T l y H -X A V B ■ S i-ialS'J a .- I.J yTAinJ. 'j V v n\— '-aTA /ii»lCj a\- I, J arA'JJVM GSIK Y H T , E M A N I. H T EB DEWOLLAU J /'JjJli ji.-VTTAJ J'st-'-rL 3frV»»LL'As» y Idom come. thy will be done in i/\j rj\-\>>kJru\r^ j\ /i -i /a *->\*\r' •-Ji/ >aJ 'jv\ ;>ajlj LxTaj. r ro ^ \ /\*>r r/i >A /r//A-/r\- wo >^# rviv \'|Jv/J- -jTI ->'JA i ,r/— >\// A J |Al»J/-\ /.J-A-— ~jr- "o— *-Ji -o.j /i* jatl jy>i>' H&- jrLivr\ *->• Ksn rviL. i*6\ \ i r - j r ') to \ J . i'o \ r vr . r r vr ... A~ir*»J.. PubUibal by MWi 3o<-i«ty for Eratwnlni; and Cimibling Book*. Ac, im tiw Blind, 101, Qomh 1 . B^d, Bright™. Sawcs, a^land. Alto to be b»d M Ih? BitlaSoaetj Uopie, Seventh 4 Wslmil, PblUJelpbia, 0.3 imd Uio Fr» Libnuj 1 31 J, Cub.bul SukI. Phila-I^b* H.B MOON TYPE FOR THE BLIND. A BLIND READER. Pennsylvania Home Teach. ISor. Home for Consumptives 869 those under 21 years of age, but hardly 500 are at the present time receiving instruction in schools for the blind in Pennsylvania, whereas the total population of blind in the State is more than 5,000. Of these 82 per cent, are over 21 years of age, so that the adults, who are so greatly in the majority, could not enter the schools if they would; and it may well be supposed that few would become inmates of them if they could. The plan of home teaching is, therefore, a necessity for the adults, and employment could easily be found for a dozen more teachers to search out and teach the blind of Pennsylvania alone. This society devotes its efforts, free of charge, to the blind of all classes, without distinction of sex, age, color, nationality or religion. It is supported by annual subscriptions, direct contributions, legacies and appropriations from the State of Pennsylvania, but it is greatly in need of more funds to carry out its operations on a more extended scale. The officers are : Hon. William N. Ashman, President; John E. Baird, John Thomson, L. Webster Fox, M.D., LL.D., Vice- Presidents; Frank Bead, Treasurer; Eobert C. Moon, M.D., Secretary. Board of Managers. — Edward Ellis Allen, Hon. William N. Ashman, John E. Baird, O. H. Burritt, A.M., Eev. Edgar Cope, D.D., Rev. Leighton W. Eckard, D.D., Eev. Alfred L. Elwyn, L. Webster Fox, M.D., LL.D., Thos. S. MeAloney, Eobert C. Moon, M.D., J. Rodman Paul, Frank Eead, Wm. H. Eichardson, Eichard H. Thomas, Jr., John Thomson, John J. Wilkinson, Mrs. Edward Ellis Allen, Mrs. Charles E. Colwell, Mrs. Samuel Dickson, Mrs. Louis Estel Fagan, Mrs. Margaret Morris Moon, Mrs. Thomas B. Morris, Miss Emma E. ISTeisser, Miss Sarah Nicholson, Mrs. Beulah M. Ehoads. Home for Consumptives By Rev. HERMAN L. DUHRING. D.D. THE Home for Consumptives, Chestnut Hill, Philadelphia, is in charge of the Philadelphia Protestant Episcopal City Mis- sion, office, Old St. Paul's Church, 225 S. Third Street, Philadel- phia, of which Eev. Herman L. Duhring, D.D., is Superintendent; 870 Asylums, Homes and Training Schools Eev. H. Cresscm McHenry, Assistant Superintendent and Mr. Effingham Perot, Treasurer. Logically the House of Mercy at 411 Spruce Street should head the list of city mission institutions for tuberculosis, for it is in reality the mother of the Home for Consumptives, Chestnut Hill. This House of Mercy was the first attempt in the whole State of Pennsylvania, and incidentally the second in the country, to stop the ravages of this white plague. The home was founded by the Et. Eev. Wm. Bacon Stevens, D.D., LL.D., Bishop of Pennsylvania, in 1876. Its location has always been until this year at 411 Spruce Street, Philadelphia. The house has a capacity for twelve patients. Prom the date its doors opened until the present time, it has con- stantly received consumptive patients for treatment. In 1887, the Home for Consumptives at Chestnut Hill was erected. These buildings are located upon one of the finest pieces of ground, covering thirteen acres, some five hundred feet above tide water. This institution was exclusively for women from 1887 until 1907. At the present writing both men and women are received at Chestnut Hill. In all probability 411 Spruce Street will be used as a settlement house with a dispensary attached. Both the House of Mercy and the Home for Consumptives possess the peculiar honor of being pioneers in establishing the cold fresh air treatment. To this end, particularly at Chestnut Hill, the cottages are equipped with large porches, of sufficient size to per- mit all the patients to be in the open air day and night, in winter as well as in summer. The diet consists of an abundance of milk, eggs, meat, butter, game, fish, oysters, vegetables and fruit, all of which are of the very best quality. For this reason the expenses are somewhat higher than most institutions of like nature; but to those who examine the accounts and compare them with the percentage of cures reported for the year, it will clearly appear that the cost of main- tenance of the home is as nothing compared with the blessed results that are accomplished annually. In justice to the home, it must also be borne in mind that unlike any other sanatorium, even including those who make extravagant charge for treatment, con- sumptives are received in all stages of the disease. Of course this policy is most damaging to percentages ; but these are not sought. All that is desired is beneficial results for those afflicted sons and daughters of humanity. For the past year there have been an ADMINISTRATION BUILDING. POWERS COTTAGE ROOF GARDEN— HOUSE OF MERCY. Home for Consumptives. Home for Consumptives 871 average of seventy patients, men and women, at Chestnut Hill, and this past year has yielded brighter and more beneficial results than any other year in the history of the institution. The medical management of the home, both male and female departments, is now under Dr. Charles M. Montgomery, assisted by a matron and chief nurse. And it is gratifying to note that one of the significant and pleasing features of the home is the affectionate and loyal attitude of its inmates towards the management, and the letters of gratitude so often received from those who return to their friends. The consulting physicians at Chestnut Hill are as follows : Drs. Eadcliffe Cheston, Myer Solis-Cohen, Norris W. Vaux, Samuel Ehoads; Dr. Francis Olcott Allen, Jr., Surgeon; Dr. Eufus B. Scarlett, Laryngologist; Dr. Eobert L. Pitfield, Bacteriologist and Dr. Wm. H. L. Hale, Ophthalmologist. The State makes no appropriation in favor of the home and no charges for treatment are made, but those who are able, always con- tribute cheerfully something towards the expenses of the institution. The diet plan is of interest and the daily fare which is gen- erally followed in the Home for Consumptives is given below. 8 a.m. Breakfast — Cereal, twenty-four ounces milk, two eggs, bread, butter and coffee. Lunch — Twenty-four ounces of milk, one egg. Dinner — Soup, relish, roast meats, three vege- tables, bread and butter, dessert. Lunch — Twenty-four ounces milk, one egg. Supper — Twenty-four ounces milk, two eggs, salads, stewed fruit, bread and butter. 8 p.m. Lunch — Sixteen ounces milk. Upon analysis you will note that according to the above each patient takes daily three and a half quarts of milk and six eggs, which are so distributed through the day that it makes it possible for the patient to take the diet without any physical inconvenience. This plan is always followed except, of course, where complications are present, which may demand a change. However, Dr. Mont- gomery has his patients under constant observation, and regulates all special diet. In the last report for 1908, in the consumptive department, is the following : Patients admitted to the House of Mercy and Home for Consumptives, Chestnut Hill, during the past year (including 10 A.M. 1 P.M. 3 P.M. 6 P.M. 872 Asylums, Homes and Training Schools all patients under our care, April 15, 1907), 168; consumptives and others receiving weekly aid in their homes, 381. Since the organ- ization of the department in 1876, thirty-two years ago, up to April 1, 1908, 4,711 consumptives have been cared for in our two institu- tions and in their own homes throughout the city. Summarizing briefly the story of this work for consumptives, it might be said that it was on February 21, 1876, that the Board of Council for City Missions took the first step toward establishing under the direction of the City Mission, a home for consumptives. From that date to this the work has grown until now the situation is thus: There is the small building in the city called the House of Mercy, and at Chestnut Hill to-day four large buildings that house some seventy-five patients when all the beds are filled. While each patient has his or her own room, with every home surrounding and comfort, at the same time they can live night and day in the open air, by having the beds pushed out upon the large porches. These porches are sheltered by awnings and glass partitions, when it is stormy or foggy. The administration building provides home comforts for the officers and nurses, and the annex to the adminis- tration building is used by the help. There is a large dining-room for the patients, and separate dining-rooms are provided for the nurses and the help. About a thousand feet away is the steam plant, run throughout the year and never shut down, so that whether winter or summer, if steam heat is needed suddenly on account of great dampness, it is always on hand for service. The buildings are so placed that all rooms look due south, and thus sunlight, the great enemy of tuberculosis, is ever ready to co- operate with the work for the care and cure of these afflicted people. There is a chaplain for the institution, whose faithfulness is charac- teristic of the man. After the inmates are sufficiently helped and the disease arrested, visits are made to them in their own homes, so as to show them how to live and prevent a return of the malady. Not only when in the home, but when in their own families, the watchword of the medical staff is to help them to help themselves. Towards this end all who are able are given light duties which they cheerfully take upon themselves. A most remarkable fact regarding the institution is that Christian women are in the majority in providing the buildings for the institution, and in the endowment of free beds. For example, I 1 p \ Pi O Home for Consumptives 873 Mr. Isaac A. Sheppard erected the Sheppard Memorial Building, but the Shields Building, the Administration Building, the Powers Building and the Wilstach Building, were all erected by faithful women. So with the free beds; there are eight of these endowed by Christian women, and one only by a man. The greatest need at this moment is just this endowment of free beds, for thus the management is able to plan the way for the erection of more cottages, and finally the erection of a chapel in which the patients can worship. At present the dining-room is used for this purpose. But the work the City Mission does for consumptives is not confined to these institutions, but through the sick diet work, out- side relief is constantly and daily given to those consumptives who may be too sick for removal to the Chestnut Hill home. This out- side relief work really antedates both the House of Mercy and the Home for Consumptives, and has been a work until recently peculiar to the City Mission. There will necessarily always be many men and women in the City of Philadelphia, victims of tuberculosis, who, for various reasons are not eligible for admission to either of these homes. Chief among these are those who are so far advanced and so weak that they would die on their way to the home. For this class of patients, the City Mission is employing the department of outside or home relief. This relief consists in supplying the patients with eggs and milk as prescribed by the doctor, and in granting a small pension with which to purchase the necessary medicines and diet. Able assistance in this outside work is being given by the Visiting Nurse Society ; mention is made of this matter for these visiting nurses are constantly co-operating with us in helping to fix and clean up and produce better surroundings for those who have this fearful sickness in their homes. Not only providing work for patients when they leave an institution with the disease arrested, but preventive work in the way of banishing unhealthy surroundings in the homes to which they return, are two lines in which both the staff of physicians and visiting workers are constantly laboring. As everyone knows, this work amongst poor consumptives is of the highest importance, and ought to receive the undivided attention and practical sympathy of the public. Consumption is a disease that works more havoc amongst those who live in narrow alleys and side streets, which are always filthy, than any other disease known to man. It is for this reason that both the home at Chestnut Hill, as well as all kindred 874 Asylums, Homes and Training Schools institutions and sanatoria in Philadelphia, should be, not only liberally, but handsomely, supported. And such large benefactions would be forthcoming if the community would think for a moment how terrible are the ravages of this great white plague. For example, the death rate from consumption daily in Pennsylvania is forty, in the United States the daily death rate is four hundred, and for the whole year the death rate is one hundred and fifty thousand, or ten per cent, of the number of deaths in the United States are due to consumption. Throughout the whole world, one death in every seven is due to this disease. One writer declares that prob- ably five millions die annually throughout the world from tuber- culosis. The Widener Memorial Industrial Training School for Crippled Children By DE FOREST WILLARD. M.D., and A. BRUCE GILL. M.D. THE Widener Memorial Industrial Training School for Crippled Children was founded by Mr. P. A. B. Widener as a memorial to his wife, Josephine, and their son, Harry K. Mr. Widener's attention had been directed some years pre- vious to the condition of crippled children, to their need of assistance in their efforts to become useful and self-supporting members of society, and to their great susceptibility to improve- ment under proper surgical, mechanical and educational treatment. In consequence he felt a strong desire to do something to aid these children in America, and especially those in the City of Philadelphia. In this desire and intention he was strongly supported by Mrs. Widener, a woman of superior culture, goodness and benevo- lence. After her death, the desire to put into operation their mutual plans for these helpless little ones, was only increased by the fact that the institution that he should found would now be a lasting memorial to a good and noble woman. In company with his physician, Dr. T. J. Yarrow, he con- sulted with Dr. De Forest Willard, Professor of Orthopsedic Surgery in the University of Pennsylvania, concerning the form Widener Memorial Industrial Training School 875 his benefaction should take in order best to accomplish his pur- poses. Dr. Willard heard Mr. Widener's propositions with the liveliest pleasure and interest, because for many years he had cherished a hope that he might see erected and maintained an institution for crippled children, where they should receive the best surgical and medical attention, to cure or correct, as far as possible, their weakness and deformity, and where they should be educated and taught a trade whereby they might become self- maintaining and self-respecting citizens of the State. The old Rogers' property, situated within the corporate limits of Philadelphia, at the intersection of North Broad Street, Old York Eoad and Olney Avenue, was purchased in 1899. On this plot of ground, consisting of thirty acres, was begun, in April, 1902, the erection of the buildings that were completed and dedi- cated on March 3, 1906. The grounds and buildings cost $1,000,- 000, and the school has been endowed with $3,000,000 in order that its perpetuity may be insured. Mr. George D. Widener, a son of the founder, has given to the School from its very beginning his close personal supervision. The buildings, designed by Mr. Horace Trumbauer, with sug- gestions as to detail made by Dr. Willard, are a beautiful example of the Colonial style of architecture. The large central hospital building is for the care and treat- ment of the children until they have attained such improvement and reached such an age that they may be transferred to the cot- tages. It contains wards with contiguous solaria, operating suite, surgical dressing rooms, photographic and X-ray departments, gymnasium, dentist's room, general offices, dining-rooms and kitchens. Two smaller buildings, cottages for the older children, are situated at the north corners of the main building, and are con-, nected with it and with each other by glass enclosed passageways. Two similar ones, the Home for Nurses and the Industrial Building, are situated to the south. The Isolation Ward and the houses for the chief engineer and the head gardener are on different parts of the grounds, but are in uniform style of architecture with the buildings already described. The grounds comprise woodland, vegetable gardens, play- grounds, terraces, and lawns adorned with flowers and shrubs. 876 Asylums, Homes and Training Schools Children are admitted to the Widener School free of any charge and without distinction as to creed, nationality, or sex, but subject to the following requirements: — 1. First choice is given to children residing in Philadelphia, second choice to children residing in Pennsylvania outside of Philadelphia, and third choice to those from other States. 2. On admission they must be between the ages of four and ten years. 3. Parents or guardian must sign an indenture binding the child over to the Trustees of the institution until it shall reach its majority. 4. It must be of good mental condition; feeble-minded or backward children are not eligible. 5. It must be a permanent cripple as a result of disease and not of accident, yet giving promise of improvement under treat- ment. A child that does not present evidence that it could become at least partially self-supporting, is ineligible. On admission, children are detained from two to three weeks in the Isolation Ward, in order to prevent their carrying infection into the school. Thence they are transferred to the hospital department, where they are given surgical, mechanical and hygienic treatment until every possible improvement in their condition has been rendered, regardless of the time required. Many of the apparently helpless and hopeless victims of the deformities following infantile spinal paralysis and tuberculous joint diseases are partially or wholly restored to good or fair walk- ing condition. This is accomplished through one or more of the following measures of treatment. Surgical operations are per- formed, calculated to correct deformities, and to give the child the best possible use of the member. Apparatus and braces, all manu- factured in the industrial department of the school, are designed to suit each individual case, giving support to weakened limbs and permitting locomotion. Massage and electricity have their place ; and active and passive exercises in the well-equipped gymnasium, under a competent instructor, and according to the definite pre- scriptions of the medical officers, give increased muscular power and movement. The best hygienic conditions prevail in a full supply of nutri- tious food ; definite and regular hours for work, recreation, sleep- ing, and eating; habits of personal cleanliness; and in an abun- Widener Memorial Industrial Training School 877 dance of sunlight and fresh air. Much time is spent in the open air where an out-door gymnasium and broad playgrounds tempt in summer to exercise and amusement, and where a large asphalted plateau, with adjoining glass-covered pavilions furnishes a winter playground always dry and free from snow. Abundant and com- plete ventilation of school and recreation rooms, of workshop and sleeping apartments, is maintained, while many children sleep on open porches. Children incapable of locomotion are transported on wheel chairs and go-carts; none are confined to the house except in case of acute illness. At all times they are under the care and supervision of a resident physician and trained nurses. As soon as conditions permit, the children are advanced to cottages separate for boys and girls. They are thenceforward under the direct care of a house-mother, who is expected to main- tain as far as possible, the conditions of normal home life, to inculcate habits of industry, order, cleanliness, economy, and self- reliance. An evening recreation room and a well-equipped library develop in the children the manners, tastes and customs that prevail in a well-conducted home, and they enjoy the privacy of well-furnished individual sleeping rooms. When a child is of the proper age and its physical condition permits, it is sent to the school room. The grades correspond to those in the Philadelphia public schools, and every pupil will secure a good common school education, advancing as far as to the high school grade. Possibly a few who show unusual aptitude for learning will be given a higher education. All children receive instruction and practice in the elements of music, sight-reading, singing of songs and chorals. The better voices have been organized into a choir for the Sunday services, while some of the girls who have shown special taste and aptitude are being taught to play the piano and the organ. A brass band of fifteen instruments has been under instruc- tion for a year, and has made exceptional progress. Children showing unusual ability on any instrument or in voice receive such training as may enable them to earn a livelihood thereby. Manual training is begun when the pupil has reached a cer- tain advancement in the school grades, and the time allotted to it is increased each year, until finally an occupation or a trade will he selected and mastered by each student. The choice of a trade 878 Asylums, Homes and Training Schools will be determined in part by the desire and inclination of the pupil himself, in part by the mental and physical abilities he has manifested during the preceding years of development, and in part by the financial remuneration to be secured. It is the object to select for each pupil that trade that will develop and employ his greatest earning capacity, provided it be not contrary to his tastes. Classes have been already organized in sloyd, reed and raphia and bead work, caning and chair repair — the elementary manual department; but the advanced departments have yet to be estab- lished, since the school has been in operation less than three years, and the oldest pupils are but fourteen years of age. Trades may be selected from the following: Farming, gar- dening, floriculture, care of poultry and stock, dairying, carpentry and woodwork, use and care of machines and engines, operation of elevators, leather work and making of shoes, tailoring, dress- making, millinery, printing, telegraphy, stenography, library work, and the domestic arts of cooking, housekeeping and laundering. Wages will be paid to advanced students, who will then be charged for board. A savings fund has been established to cultivate habits of thrift and economy. Students will be graduated at about the age of twenty-one years, when it is believed they shall have become wholly or par- tially capable of self-maintenance. A boarding house may, in the future, be erected and main- tained to assist those graduates who are only partially self-sup- porting, and to continue the refining and elevating influence of the School and prevent return to undesirable surroundings. Discipline is maintained by the methods commonly employed in well-governed homes, and there is found to be no more occasion for punishment than occurs in the ordinary family under wise parental care. The children are taught the use of good language and polite manners, respect for elders and obedience to those in authority, orderliness of conduct and care of property, and a spirit of unselfishness and of helpfulness toward each other. The principles of the Christian religion are taught, apart from any sectarianism. A form of grace is repeated in concert at the table, and the Lord's prayer on retiring at night. On Sun- day afternoon a clergyman conducts a short undenominational serv- ice, which all attend. The larger boys and girls are taken on Sun- Widener Memorial Industrial Training School 879 day mornings, when the weather is suitable, to attend church services nearby. Eoman Catholic children are privileged to attend their own church under the same conditions. Every measure is employed to make the children happy and to afford them pleasure and recreation, as far as is consistent with their work and discipline. They are not permitted to go home at any time ; but relatives and friends may visit them on every Sunday and the first Saturday of each month from 2.00 p.m. to 4.00 p.m. The first patients were admitted to the school in March of 1906, and at the time of this Writing (January 1, 1909) there are eighty-four children, ranging from four to fourteen years of age, and comprising fifty-six boys and twenty-eight girls. There are present accommodations for not more than one hundred and twenty. The Widener School is as yet in its infancy. It is a venture along a new line of work in many particulars, and is modeled after no institution, either in this country or in Europe. While much has been accomplished, much remains to be done, many problems to be solved, many difficulties to be overcome. It is no easy task nor light responsibility to take a hundred and more children from their homes in early childhood, to rear and guide and train them with an affection and individual care such as exists in the well-ordered family, to maintain and educate them through many years, to bring them to noble manhood and beautiful womanhood, and at length to send them forth inclined and equipped to be self-supporting and useful members of society, and good citizens of the State. But these are the children, in large part, who, if left unassisted, would always be dependent upon charity, whether of their family, of society, or of the State. Therefore, the purposes of both economist and humanitarian are to be accomplished in this work. Already such progress is to be observed in the physical, mental and moral development of the children of the school, that the founder and those in charge are encouraged to continue and advance the work, believing that the ultimate results will fully justify the great labor and the great cost. [Editob'b Note —It was intended to include in this section of the volume, the history of The Pennsylvania Institution for the Instruction of the Blind, but the manuscript was not received in time for publication.— F. P. H.] Medical Societies and Medical Journals of Philadelphia History of the Medical Societies of Philadelphia 1 By J. MADISON TAYLOR, M.D.. and RUFUS B. SCARLETT, M.D THE year 1765 saw the birth of the first medical society in the City of Philadelphia. It was at this time that a number of medical men gathered together and formed themselves into an organization which they called the Philadelphia Medical Society. While the membership list contained the names of such men as Drs. Graeme, Cadwalader, Eedman, Morgan, Kearsley, Clarkson, Bayard, Harris, Kush, Sowman, Glentworth and Potts, its life was not long. Within three years it merged with the American Society for Pro- moting Useful Knowledge, which later became the American Philosophical Society, an organization existing at the present time and enjoying an enviable reputation in scientific circles. In 1789, another society bearing the same name was formed. It received articles of incorporation in 1792, was re-chartered in 1827, and after a useful existence of half a century, amalgamated with the College of Physicians of Philadelphia. The Academy of Medicine of Philadelphia was another society formed during the closing years of the eighteenth century, 1797, but it is now extinct. On May 29, 1905, an organization of the same name was formed in the city, the membership of which is very largely composed of the physicians of the Douglass Memorial Hos- pital staff. Many medical societies were formed during the past century i The data concerning the earlier societies were obtained from Dr. F. P. Henry's "Standard History of Medicine in Philadelphia,'' and from Dr. F. R. Packard's "History of Medicine in the United States." The lack of space forbids the publication of the names of all those who kindly responded to the request for data concerning the respective societies. Much of the material received has been copied verbatim, while considerable has had to be omitted. Slight changes of form have also been necessary in some places in order to fit the various accounts together. The writers wish to hereby express their grateful appreciation to one and all for the courtesies extended and the assistance given. (880) The Medical Societies of Philadelphia 881 with lofty motives in view, but the majority of the active ones to-day had their origin within the present generation. The distinction of being the oldest existing medical society in Philadelphia, with the exception of the College of Physicians, falls to the Northern Medical Association. It was at a meeting of physicians on December 5, 184G, that, after making a few pre- liminary remarks on the advantages and mutual benefits to be derived from the meeting together at stated periods for the reading of medical papers and discussions on medical subjects, Dr. Wilson Jewell offered the following preamble and resolutions, which were adopted : — "Whekeas, Concerted action is at all times necessary for the successful prosecution of any object, and "Wheeeas, The improvement in the science of medicine, the promotion of our usefulness as medical practitioners, the preserva- tion and advancement of our interests and honor as members of the same fraternity, are objects deserving our highest regard, and can- not be better secured than by cultivating opportunities for social, scientific and literary intercourse, therefore be it "Resolved, That we proceed to organize a Xorthern District Medical Association for the improvement of our profession." At the next meeting, held January 7, 1847, the constitution, by-laws and rules of order of the Northern Medical Association were adopted, while the election of officers did not take place until the succeeding meeting. On December 14, 1883, the Philadelphia Clinical Society was organized as an offspring of the Xorthern Medical Association, but at the time of the re-organization of the latter on May 29, 1884, the two became merged under the original name, and the association has since continued in an active and flourishing condition, steadily increasing in members and promising to occupy its previous prominent position among the medical societies of Philadelphia. The Philadelphia County Medical Society held its first stated meeting January 16, 1849, although its true birthday may be traced to December 11, 1848, when a meeting of physicians was held at the College of Pharmacy, which was then situated on the south side of Zane Street above Seventh. A subsequent meeting was called for and held on December 18th, when it waa agreed by those present to "resolve themselves into the Philadelphia County Medical Society." At the stated meeting in January, Dr. Samuel Jackson was elected 56 882 Medical Societies and Journals President and Dr. Prancis Condie, Secretary. This society was formed as a constituent part of the medical society of the State of Pennsylvania, which was organized in April, 1848. Both of these organizations owe allegiance to the American Medical Association, which also had its origin in Philadelphia in May, 1847. Throughout its history, the Philadelphia County Medical Society has shown a keen interest in the welfare of the medical pro- fession, and during recent years it has instituted an active crusade against quackery and the sale of nostrums. The membership now numbers about 1,200, making it the largest, and through its influence, the most powerful organization in the city. In January, 1899, the society fittingly celebrated its fiftieth anniversary. Dr. J. Chalmers Da Costa delivered the oration on the fourteenth, the sermon was preached by Eev. Kerr Boyce Tupper on the day follow- ing and on Monday, the sixteenth, a dinner at Horticultural Hall ended the festivities. Probably the greatest act of this body in recent years was the establishment of the branches of the central society throughout the city. A resolution to change the by-laws for this purpose was introduced by Dr. Albert M. Eaton at the business meeting in April, 1901, and at the meeting in June of the same year, action was taken changing the by-laws and thus permitting the establish- ment of the branches. On September 19, 1901, the North Branch, the first of its kind, was formed with Dr. Eaton as chairman and Dr. Eobert 1ST. Pittfield, clerk. These sub-organizations, as they might be called, have been powerful factors in building up the member- ship in the central body and developing keener interest in the scientific meetings. In 1901, the membership of the society was 600, while in 1908, it was double that number. In 1901, the num- ber of scientific meetings of the society were 20 per year, but to-day, the six branches — the North, the South, the West, the Kensington, the Northeast and the Germantown — with their 60 meetings, have raised the number to 80. A further indication of the interest manifested by the society in the welfare of its members was demonstrated in 1902, when a legal defense for the protection of members against suits for alleged malpractice was instituted. An Aid Association is also connected with the central body and has for its object the financial relief of widows and orphans of medical men. It also has facilities for aiding aged and sick The Medical Societies of Philadelphia 883 physicians and for affording them medical attendance and hospital treatment. The association was originally called the Mutual Aid Associa- tion of the Philadelphia County Medical Society, but on December 8, 1902, its charter was amended by striking out the word "Mutual," thus changing the name to "The Aid Association of the Philadelphia County Medical Society." The change in its charter enables it to afford relief to physicians outside of the Philadelphia County Medical Society and to those dependent upon them ; thereby making the work of the association broader in scope. Although its members must belong to the Philadelphia County Medical Society, it grants annuities and benefits to medical men and to those dependent upon them who are not members of the society. The association was organized on May 6, 1878, and incor- porated on September 25, 1878, as the result of a resolution offered by Dr. William T. Taylor, at a meeting of the Philadelphia County Medical Society on February 27, 1878. Dr. Henry H. Smith, who was then President of the latter society, was the active spirit in the new enterprise. Under the resolution offered by Dr. Taylor, a committee was appointed which studied the question of the estab- lishment of a "Beneficiary Fund" for the relief of the families of members of the society who require its fostering care. It was con- sidered by those interested in the project, wiser to create a new organization under its own charter, composed of such members of the Philadelphia County Medical Society as desired to join, than to make the movement part of the work of the parent society. The latter was to remain a purely scientific body. Since the institution of the Aid Association it has slowly accumulated a permanent fund, the income from which is dis- tributed by the directors through the Committee on Benevolence. Applications for relief in the form of benefits or annuities are investigated by the Committee on Benevolence without the names of the applicants being disclosed. The officers, who serve without salary, have been able to go to the rescue of physicians temporarily when their families have suffered during the sickness of a parent, and have been enabled on various occasions to pay annuities for long periods to minor children and widows of deceased physicians. Also, under the auspices of the Philadelphia County Medical Society the first number of "The Weekly Poster" was able to make its appearance on the second day of September, 1905. This pub- 884 Medical Societies and Journals lication was suggested by Dr. A. B. Hirsh, and he was by a unanimous vote of the society appointed editor. The Pathological Society of Philadelphia, the second oldest pathological society in America, was organized at a private meeting held at the office of Dr. J. M. Da Costa on September 29, 1857, for the purpose of "cultivating and promoting the study of pathology, by the exhibition and description of specimens, drawings, and other representations of morbid parts." The first public meeting took place in the Picture House of the Pennsylvania Hospital on the fourteenth of October, 1857. The first officers chosen were: President, Dr. S. D. Gross; Vice-Presidents, Dr. Bene La Eoche and Dr. Alfred Stille ; Treasurer, Dr. Addinell Hewson ; Secretary, Dr. J. M. Da Costa; Assistant Secretary, Dr. T. G. Morton. Dr. S. Weir Mitchell, the only survivor of the original members, pre- sented the first specimen. In 1860, the society began publishing its transactions in book form, and continued to do so until 1897, since which time the transactions have appeared in monthly fasciculi known as the "Proceedings of the Pathological Society." The earlier meetings were held at the Pennsylvania Hospital, but on March 13, 1867, the society moved to the present hall in the College of Physicians. On May 10, 1907, the society celebrated its semi-centennial with a splendid exhibition of gross and microscopic specimens in the Mutter Museum of the College of Physicians and a scientific meeting at the college, at which addresses were delivered by Dr. Simon Plexner, of New York and Dr. A. E. Taylor, of California, both former members of the society, and by Dr. F. G. Novy, of the University of Michigan. A commemorative meeting was also held in the Picture House of the Pennsylvania Hospital, at which an oration was delivered by Dr. William Osier, of Oxford University, a former active member of the society. A banquet at the Bellevue- Stratford Hotel in the evening completed the celebration. The Pathological Society is the arena where those engaged in research usually make the results of their work first known, and where the great problems of the science of medicine are earnestly discussed. The list of officers, throughout its years of existence, comprises nearly all the great names in the medical history of Philadelphia and constitutes a roster of the teachers, physicians and surgeons who have made this city a center of medical teaching and medical practice. The Medical Societies of Philadelphia 885 The society's meetings, which take place twice a month, except during the summer, are well attended, especially by the younger men of the profession. At the second meeting in April, which is known as the Conversational Meeting, some distinguished path- ologist, usually from another city, is invited to address the society on any topic of original investigation. During the many years that this practice has been in vogue nearly all the great pathologists of the country have been the Society's guests. The present membership is 351 resident members, 41 non-resi- dent members and 9 corresponding members; the last chiefly foreigners chosen for their achievements in pathology. The Obstetrical Society of Philadelphia ranks well up in the years of existence. While it was organized in 1869, with Dr. Francis Gurney Smith as its President, it was not until April 14, 1877, that it became incorporated. Among the corporate members were some of the most public-spirited and philanthropic citizens of the period, many of whom proved to be pathfinders in obstetrics and diseases of women and children. Of these may be mentioned Dr. John H. Packard, the first President of the corporate organiza- tion; Drs. John P. Meigs, Eobert P. Harris, Albert H. Smith, W. H. Wallace, Elwood Wilson, William Goodell, T. Hollingsworth Andrews, James Tyson, Poland G. Curtin, De Forest Williard, James C. Wilson, William Pepper, John Ashhurst, Jr., John M. Keating, Nathan Hatfield and John Guiteras. The purpose of the society is the advancement of the study of of obstetrics and diseases of women and children by the presentation of specimens, the publications of essays, the free discussion of sub- jects of interest properly belonging to these several branches of medical science, and at certain times the offering of prizes for papers, essays or experiments relating to these subjects. The meetings are held monthly, excepting July, August and September. The membership is divided into resident, associate, corresponding and honorary, the latter two including some of the best known teachers in obstetrics and gynecology in Europe and America. The Philadelphia Academy of Surgery, which is one of the oldest, if not the oldest, distinctly surgical organization in America, owes its origin to that great American surgeon, Samuel D. Gross. The first meeting for the organization of the academy was held at Dr. Gross's residence on April 21, 1879. There were present at this 886 Medical Societies and Journals meeting Drs. D. Hayes Agnew, E. J. Levis, Addinell Hewson, T. G. Morton, William H. Pancoast, John H. Packard, John H. Brinton, Samuel D. Gross and J. Bwing Mears. Excepting Dr. Mears, all of these men are now deceased, and each of them, including Dr. Mears, achieved distinction in surgery and have been recognized abroad, as well as at home, as authorities in one or another line of surgical work. The establishment of the academy was followed promptly by the formation of the American Surgical Association, which also owes its existence to Dr. Gross. The academy has been a very active factor in the development of surgery not only in Philadelphia, but in the United States, and has been the means of disseminating throughout the country a great deal of valuable surgical literature. Its meetings have been held regularly since its organization, and its membership has always included the most active teachers and enthusiastic surgical workers in Philadelphia. Its membership now numbers about fifty, and fellowship in this organization has always been looked upon as an honor. Article II of the constitution describes the object of the academy to be "the cultivation and improvement of the science and art of surgery, the elevation of the medical profession, the promotion of public health, and such other matters as may come legitimately within its sphere." The first two of these objects have ever been most prominent before the academy, and in pursuing them the organization has added considerably to the reputation of Philadel- phia surgery. Samuel D. Gross, in his will, left a sum of money for the establishment of a Prize Fund and Library. The library constitutes a part of the Library of the College of Physicians, and the interest of the Prize Fund is used for the purpose of stimulating original research in surgical fields. Competitive essays are regularly sub- mitted to the trustees of the Prize Fund, and prizes of varying amounts have been regularly awarded. The successful essay is always published and widely distributed. The competitors for the prize are not limited to the Fellows of the Academy of Surgery, but any medical man in the United States is eligible to compete. The following are those who have won the Samuel D. Gross. Prize in the past: Dr. Oscar H. Allis, of Philadelphia; Dr. E. H. M. Daw- barn, of New York ; and Dr. James Homer Wright, of Boston. The Medical Societies of Philadelphia 887 Those who have served as President of the Philadelphia Academy of Surgery are: Samuel D. Gross, D. Hayes Agnew, William Hunt, Thomas G. Morton, J. Ewing Mears, De Forest Willard, Eiehard H. Harte, Henry E. Wharton, John B. Eoberts and William J. Taylor. In November, 1883, several physicians met in the office of Dr. Charles K. Mills, to discuss the forming of a local Neurological Society and a little later a call was issued to members of the pro- fession, requesting a meeting of those interested in forming such a society. In response to this, the first formal meeting of The Phila- delphia Neurological Society was held in the College of Physicians on December 13, 1883. A committee on organization was appointed and reported at a meeting held on January 8, 1884. At this meet- ing Dr. S. Weir Mitchell was elected President; Dr. Charles K. Mills, Vice-President j and Drs. Sinkler, Jones and Eskridge, Coun- cillors. Subsequent Presidents have been : Drs. H. C. Wood, P. X. Dercum, Charles K. Mills, Wharton Sinkler, James Hendrie Lloyd, Charles W. Burr, William G. Spiller, James Tyson, J. K. Mitchell, H. A. Hare, Charles S. Potts, Joseph Sailer, D. J. McCarthy, Alfred Gordon, J. W. McConnell and T. H. Weisenburg. The society meets once a month, eight months of the year. During the twenty-five years of its existence many important con- tributions to the science and literature of neurology and psychiatry have been made before it, which shows the interest and industry which have characterized the society during its life of a quarter of a century. The Medical Jurisprudence Society, devoted entirely to medico- legal questions, was organized January 18, 1884, at a meeting held in response to a circular letter sent out December 24, 1883, by Dr. Henry Leffmann and Hampton L. Carson, Esq., and addressed to about 100 members of the medical and legal professions in Phila- delphia. The first stated meeting, however, was not held until March 11, 1884. The rules of the society provide that "any person in good standing in the medical or legal professions shall be eligible to mem- bership, but the society may, from time to time, determine to what extent persons interested in its objects, but not members of either of these professions, may be admitted to membership." The latter portion of this clause has been liberally interpreted, and although the bulk of the membership has always been from the ranks of the 888 Medical Societies and Journals professions named, some not so included have always been on the roll. In the early part of its existence the society began to take up questions of public interest, and to advocate proper legislation for medico-legal matters. Among the topics thus considered and in the final solution of which the society exercised considerable influence were : The poison laws, the regulation of the practice of medicine, the care of insane women exclusively by women physicians, and legislation in regard to persons addicted to the excessive use of intoxicating drugs. For a number of years the society was very active, its meetings were well attended, and its membership continued to increase, but a period of reaction followed, and it was not until 1903 that new life was engendered and the society again assumed active interest in medico-legal matters. A few years prior to the formation of the Medical Jurispru- dence Society, a similar organization, The Medico-Legal Society, was formed for practical protective purposes of a professional and semi-legal character, and has since the correction of the abuses it attacked, taken on more of a purely professional character along medico-legal lines. The society was organized October 25, 1877, and incorporated December 30, 1884. Its membership at the present time consists of some 86 physicians and 14 lawyers. At the instigation of Dr. J. P. Crozer Griffith, and mainly as the result of his efforts, a meeting was held at the College of Physi- cians, December 22, 1896, for the purpose of organizing a society, especially for the study of diseases of children. At this meeting the constitution and by-laws prepared by Drs. Griffith, P. A. Packard and E. E. Graham, were adopted and Dr. Griffith was elected the first President of the newly formed organization, the Philadelphia Pediatric Society. The first regular meeting of the society was held January 12, 1897, since which time they have been held monthly, except during the summer, when cases are exhibited and papers read, followed by an informal discussion of the same. In January, 1899, the first steps were taken to form a Milk Commission with the idea in view of protecting innocent children from an impure supply, and thus eliminating one source of disturbance in digestive disorders. The commission, which became active in April, 1899, issues certificates to such dairymen fulfilling the conditions imposed, certifying that The Medical Societies of Philadelphia 889 the milk and cream supplied come up to the standards and are clean. With such careful scrutiny this certified milk and cream hare become the best to be obtained in the city. Throughout the city are many organizations more or less local in character and formed chiefly for the benefit of physicians in the immediate neighborhood, although nearly all, if not the entire number, extend a cordial invitation to physicians from other sec- tions to attend the meetings. One of the foremost of this number is the Southwark Medical Society, which had its origin about three years ago, when a body of physicians, mostly of Eussian birth or extraction and practicing in the southeastern section of the city, gathered together for the purpose of establishing a medical society in that vicinity. The organization started with a membership of about forty physicians and was named the Eastern Medical Society. Scientific meetings were held twice a month and were, as a rule, well attended, but owing to a change in the policy of the organization, its growth began to lag, with the result that at the end of its third year, another medical society was formed under the name of the South- eastern Medical Society, the first meeting of which was held Septem- ber 29, 1908. On November 5, 1908, however, the two societies amalgamated forming the Southwark Medical Society with a com- bined membership of sixty-five. This new organization has already exerted a beneficial influence in the southeastern section of the city by its crusade against tuberculosis. "Under its auspices meetings of an educational nature are held from time to time and lectures are given by its members. About sixteen years ago a number of the physicians of the northwest section of the city decided to organize a society, to be called the Northwestern Medical Society, for the purpose of scientific investigation and the spreading of good fellowship among the profession. Dr. Cuvier Marshall, one of those most active in the movement, was elected President and Dr. N. D. Byers, Secretary. The first enrollment consisted of about 15 names, but during the sixteen years of the society's existence, the membership roll has increased until at present the list is in the neighborhood of 250, among which are some of the best known physicians in the city. Meetings are held once a month when scientific papers, prepared by various members and invited guests, are read and discussed. The society is aggressive and doing splendid work along scientific 890 Medical Societies and Journals lines. Social intercourse has been a prominent feature from the very beginning, when the meetings were held at the homes of the various members. Even now, although the meetings are held in a hall, the society still caters to the social element by serving a luncheon at each meeting, by holding a yearly banquet, and a yearly summer outing. An organization decidedly liberal in its benefits and quite unique in the length of its existence is the West Philadelphia Medical Book Club. It was organized October 18, 1870, mostly through the efforts of Dr. S. S. Stryker, to whose office a number of physicians of West Philadelphia were invited to consider the forma- tion of a permanent organization. The first regular meeting, how- ever, was not held until December 1, 1870. The object of the society is indicated by its name. Numerous medical journals of the first quality are yearly subscribed for, and time has evolved a system which is precise in its regularity for their distribution among the members. Various societies have sprung up in connection with the different medical schools and hospitals of the city. The Society of the Alumni of the Medical Department of the University of Pennsylvania was organized to unite the alumni as a working force for the university and to give open expression against the manifestations of ill-will which were prominent among medical practitioners. In 1892, a number of the alumni realizing the limited oppor- tunity afforded by the annual meeting of the society to foster the spirit of good-fellowship and loyalty to their Alma Mater among the graduates of the university, resolved to organize a local society composed of the graduates living in and near Philadelphia. A meeting was called at the University Club, 1316 Walnut Street, March 26, 1892, to effect an organization. A second informal meeting was held April 2, 1892, at the same place, when the con- stitution and by-laws reported by a committee having the matter in charge were adopted. These provided for the election of officers; the payment of dues and that there should be four meetings annually, devoted to entertaining distinguished members of the profession, members of the faculty, and also to entertainments cal- culated to promote sociability ; and that members of the graduating class intending to locate in or near Philadelphia should be invited to become members of the society. The Medical Societies of Philadelphia 891 On May 14, 1892, the society met at the Colonnade Hotel and perfected a permanent organization. The officers elected were: President, Dr. Eoland G. Curtin ; Vice-Presidents, Drs. E. L. Duer, S. D. Eisley and Henry Beates, Jr. ; Recording Secretary, Dr. B. E. Kirby; Corresponding Secretary, Dr. B. Franklin Stahl; Treas- urer, Dr. J. P. Tunis. The society now has a membership of 425 and has done incal- culable good in promoting the objects for which it was founded. Another society connected with the University of Pennsylvania commanding some attention is the Society of Normal and Path- ological Physiology. It was organized by several members of the staff of the University on October 10, 1904, the object being the advancement and discussion of subjects relating to physiology and the allied sciences, pharmacology, physiocliemistry and biology. Meetings are held monthly at which are reported manj r experimental investigations of great scientific value and of great usefulness to the development of science. The Alumnae Association of the Woman's Medical College was formed in March, 1875, just twenty-five years after the college was incorporated, as the result of the efforts of Dr. Emeline H. Cleve- land and Dr. Mary J. Scarlett-Dixon. The first annual meeting was held on March 17, 1876, when $50.00 was voted toward a proposed Pharmaceutical Exhibit at the Women's Parlors at the Centennial Exhibition. The association has met annually since its organization on the two days following the yearly commencement about the middle of May. At these gatherings scientific papers are read and discussed by the members and the medical guests. The social features are the luncheon served at the college on the days of the meetings and the banquet on the evening of the first day. The Medical Society of the Woman's Hospital of Philadelphia was organized in 1904. Its membership comprises physicians in good standing who are or have been connected with the medical work of the hospital. Five meetings are held during the year, at each of which a scientific program is carried out, consisting of the presenta- tion of patients and specimens and the reading of papers. The Samaritan Hospital Medical Society was organized May 6, 1905, at the home of Dr. Wilmer Krusen. Its purpose as expressed in the constitution is to "advance the interests of the Medical Department of Temple University, including the Samaritan and 892 Medical Societies and Journals Garretson Hospitals, to encourage scientific medical work, and to foster a more intimate social and professional relationship among those interested in these institutions." Its membership consists of all physicians connected in any way with the institutions above named, and at present numbers about seventy. The associate mem- bership is composed of the alumni of the medical department of Temple University and ex-residents of the Samaritan and Garretson Hospitals. The Wills Hospital Ophthalmic Society was founded in 1901, for the cultivation and promotion of ophthalmology. The active members are the Emeritus and present surgeons of the Wills Hos- pital with their assistants, clinical clerks and resident surgeons, past and present, while practitioners interested in the study of ophthal- mology are eligible to associate membership. The meetings of the society are held at the hospital once a month in the afternoon, when cases under treatment at the hospital are presented and set papers are discussed. The average attendance at the meeting has been forty. A Laryngological Society was organized in 1880, by Dr. J. Solis-Cohen and others, but it is now extinct. From time to time medical societies have been organized in Philadelphia with objects in view other than those purely scientific. Probably the most prominent one of this class existing to-day is the Medical Club of Philadelphia. The idea of a social club for medical men originated with Dr. T. Chalmers Fulton at a little dinner he gave to some professional friends in 1891. At this dinner the fact that professional jealousies were there and then happily buried and the utmost good fellowship prevailed among medical rivals suggested to him the possibility of such an undertaking. The first meeting of the club was held in Warner's Hall, at Broad and Wallace Streets, on November 16, 1892, with about 175 members of the profession present; the charter, however, was not taken out until 1900. The motive for such an organization was for the purpose of encouraging among its members social intercourse and a free discus- sion of matters affecting physicians, elevating the standards of medical ethics, and aiding in all movements tending to increase professional skill and efficiency in the treatment of disease. With the greatest interest and enthusiasm, the medical men fell in with The Medical Societies of Philadelphia 893 the new idea, and from that time to this, the club has had a steady growth. Its membership includes the majority of doctors who occupy positions of prominence in Philadelphia, while the guests have been men of international reputations. The West Philadelphia Physicians' Business Association aims to publish, for the exclusive use and reference of the members, a list of "delinquent and non-paying patients," to have an official collector of out-standing bills of members and as far as possible, to assist and to affiliate with similar bodies throughout the city. Its wide development depends on the practical service rendered its members, and warrants its enthusiastic officers in their determination to include in its ranks every practitioner in the western section of the city. In 1892, the Association of Hospital Physicians and Surgeons was formed for the purpose of giving professional visitors to the city every facility for attending hospital clinics. Eecently the Independent Order of the Sons of ^Esculapius was organized to render mutual assistance to its members in case of illness or adversity. Several foreign societies are in existence in Philadelphia. The Wiener Verein was formed about eight years ago and is composed of American physicians who have studied medicine in Vienna. The Philadelphia branch of the Union of Former Students of German Universities had its origin in October, 1907. Its member- ship list includes not only physicians, but also those who have studied in Germany or in German-speaking institutions. In the spring of 1908, the Lega Medica Italiana di Phila- delphia was organized "to maintain the dignity of the profession in the Italian section of the city, and to root out the physicians who practice the most despicable methods of contract practice at ridiculously small fees." The only other organizations composed of physicians and existing in Philadelphia at the present time, so far as can be ascer- tained, are: The West Philadelphia Medical Association, North- eastern Medical League, Philadelphia Medical Examiners Associa- tion and the Medical Association of the Southern Dispensary. 894 Medical Societies and Journals History of the Medical Journals of Philadelphia By C. E. de M. SAJOUS, M.D., LL.D. PHILADELPHIA occupies a unique position among the cities of the country as a seat of medical learning. In his address on Medicine and Medical Progress in the United States, at the Medical Congress held in Philadelphia, in 1876, Dr. Austin Flint, remarked: "At the time to which our survey of the history of medicine has extended, Philadelphia was the acknowledged seat of medical education. This pre-eminence she has held from that time to the present. In the number of medical men who have been educated at her schools, in the great preponderance of her medical literature, and in her large proportion of the distinguished repre- sentatives of the different departments of medicine, she has had no compeer in the new world. To the influence of her example is to be attributed much of the activity of progress in other cities of the Union. If, in future, she should cease to preserve the relative posi- tion which she now deservedly holds, it will be, in no small measure, from the spirit of honorable emulation awakened and sustained by her admirable example." The three decades that have elapsed since these words were spoken have not modified her relative position to other American cities in the sense implied by the distinguished New York clinician. Abroad her name is that first recalled by inquiring scholars ; as the cradle of that independence which ultimately gave the country a leading position among nations, they have learned to adopt her as the starting point of American attainments, and as the general center whence originated the initial energy of all things which now excite admiration. In no branch of human knowledge has her influence been greater on extra-mural development than in that of medicine. Just as her Benjamin Franklin stood as a beacon which cast a radiant glow in all directions in the realm of physical science, so did her Benjamin Push, the first truly great American physician, her Philip Syng Physick, the "Father of American Surgery"; her John Morgan, the founder of the first American Medical School; her John K. Mitchell, "the first to approach in a scientific spirit the nature of infective diseases" (Hirsch) ; her great pupil, J. Marion Sims, the father of gynecology; her Samuel D. Gross and Joseph Pancoast, "among the foremost surgeons of their day" ; her Joseph The Medical Journals of Philadelphia 895 Leidy. one of the greatest of comparative anatomists of all times; her Horatio C. Wood, the "father of experimental therapeutics"; cast wares of erudition throughout the land, which hare urged latent powers into activity and converted the noblest aims into accom- plished facts. Dr. Chaille, of Xew Orleans, also at the Centennial Congress, referred to Philadelphia, as the "greatest medical center in the first century of American medical history." This title will ever remain her own. She will always retain the honor of having initiated the movement which at the end of the nineteenth century enabled the whole country fittingly to undertake the second step in its medical career, that of earning in matters medical a rank worthy of her greatness among the scientific nations of Europe. A potent contributory factor to the enviable position thus gained by Philadelphia in the world of science, is the interest taken by her prominent men in her medical journals. Xot only did they contribute liberally to their pages, thus disseminating far and wide the fruits of their labors, but in many instances they took an active part in their editorial management. Early last century for example, we find Xathaniel Chapman editing the Philadelphia Journal of the Medical and Physical Sciences: George MeClellan, the founder of Jefferson Medical College, one of the editors of the Medical Review and Atmleciic Journal; Hugh L. Hodge and Charles D. Meigs, renowned obstetricians, and rranklin Baehe, an equally prominent chemist and pharmacologist, editors of the Xorth American Medical and Surgical Journal; Bobley Dunglison, the lexicographer, one of the editors of the American Medical Intelli- gencer and John B. Biddle, the therapeutist, with William W. Ger- hard, "of world-wide fame, .... the greatest exponent of the new scientific pathological methods of France who must alwavs be associated in Philadelphia with the introduction of the scientific methods of to-day," 1 co-editors of the Medical Examiner. The second half of the century showed no abatement of the interest of Philadelphia's best men in practical journalism. Thus we find Samuel D. Gross senior editor of the Xorth American Medieo-Chirurgical Review, and another great surgeon, E. J. Levis. editor of the Medical and Surgical Reporter, succeeded in turn by D. G. Brinton, a renowned anthropologist and Edward T. Eeichert. l Henry: "Standard History of the Medical Profession of Philadel- phia." l c 97. 896 Medical Societies and Journals the present distinguished professor of physiology in the University of Pennsylvania. The early seventies found L. A. Duhring, now America's most eminent dermatologist, co-editor of the Photographic Review of Medicine, and during the fourth quarter of the century, the late William Pepper and James H. Hutchinson, and James Tyson and Horatio C. Wood as editors of the Philadelphia Medical Times. All these periodicals have long been dead; most of them, in fact, are buried in the dust of oblivion; but all have contributed their share to the good work. Led by master hands, they distributed to all parts of the Union the thousands of scientific articles which, while disseminating knowledge, served to illustrate not only the erudition of her men, but the educational value of the Philadelphia medical schools. The journal which has accomplished by far the most in this direction, however, still exists — the American Journal of the Med- ical Sciences, founded in 1827, by Dr. Isaac Hays, one of the earliest of Philadelphia's distinguished ophthalmologists. Articles by Samuel Jackson, William E. Horner, Jacob Eandolph, John K. Mitchell, George W. Norris, Joseph Carson, Washington L. Atlee, William Wood Gerhard, to mention only its earlier contributors, betoken the class of material it contained, and the part it has played in insuring Philadelphia its preponderance as a medical center. Dr. Isaac Hays edited it for forty-two years, and was succceeded by his son Dr. I. Minis Hays, who sustained its high standard — a state- ment which applies equally well to his successors, Drs. Edward P. Davis, Alfred Stengel and Francis E. Packard, and to the present incumbent of the editorial chair, Dr. Aloysius 0. J. Kelly. Dr. John S. Billings says in his Centennial History of American Med- ical Literature : "The ninety-seven volumes of this journal need no eulogy. They contain many original papers of the highest value; nearly all the real criticisms and reviews that we possess ; and such carefully prepared summaries of the progress of medical science, and abstracts and notices of foreign works, that from this file alone, were all other productions of the press for the last fifty years destroyed, it would be possible to reproduce the great majority of the real contributions of the world to medical science during that period." Still, in the early eighties, the number of periodicals through- out the medical world increased apace with the rapid development The Medical Journals of Philadelphia 897 of all the departments of medicine and surgery, under the influence of the epoch-making labors of Pasteur, the importance of which were being finally and fully recognized. Practically all the work being done in Europe, the American journals proved inadequate to supply our investigators and clinicians sufficient data to enable them to contribute their share to the general progress. But few of them were familiar with foreign languages and what articles they did publish, covered very imperfectly, with rare exceptions, the litera- ture of the subjects treated. A comprehensive periodical, the Annual of the Universal Medical Sciences, in five yearly octavo volumes, was founded in 1888, to modify this state of things, and thus to enhance, if possible, the value of the work done in this country. With such men as D. Hayes Agnew, N. D. Davis, William Goodell, Edward L. Keyes, Joseph Leidy, Alfred L. Loomis, Hunter MeGuire, H. Newell Martin, W. H. Howell, Charles K. Mills, Charles Sedgwick Minot, Paul P. Munde, Theophilus Parvin, Edward C. Sequin, J. Solis-Cohen, Frederick P. Henry, Nicholas Senn, Lewis A. Stimson, James Tyson and many other authors of equal standing, besides a large staff of correspondents in all parts of the world, including Baginsky, of Berlin; Bossbach, of Jena; Obersteiner and Politzer, of Vienna; Milner Fothergill and Fan- court Barnes, of London ; Dujardin-Beaumetz, Bourneville, Cham- pionniere, of Paris; Baelz, of Tokio; Guye, of Amsterdam; Levison, of Copenhagen, etc., all taking an active part in the editorial work, success could not but be assured. Indeed, the reception of the Annual of the Universal Medical Sciences by the profession of the United States alone was such that over 100,000 series (500,000 volumes) were subscribed for during the nine years it was published. Unfortunately, the panic of 1893-97 so reduced the income of the medical profession that the sales steadily declined and the 1896 issue was the last published, to the sorrow — frequently expressed, let it be said — of all those who had the welfare of the country at heart. Yet, the mission of the Annual had been accomplished. It had started as it were, in the American pro- fession, the habit of consulting the literature of the whole scientific world, and this habit has endured. A foreign reviewer grasped the full meaning of the Annual of the Universal Medical Sciences when he wrote : "It leaves the impression of the infinite greatness and variety of nature, studied in her highest aspects, and the innumer- able resources placed at the disposal of those who are willing and 57 898 Medical Societies and Journals capable of using them for the benefit of their fellow-creatures." That it has contributed its share to the development of American Medicine during the nineteenth century, it must be left to others than the writer to decide. The cessation of the Annual was followed by the appearance of smaller publications, having a kindred object in view. George A. Gould published, in 1896, with the collaboration of twenty-seven editors, the American Year-Booh of Medicine and Surgery, which aimed to mention "only those things that are, or may be, contribu- tory to the progress of medical science and art." Although this program was faithfully carried out, the publication was discontinued in 1905. In 1899, Hobart A. Hare also founded Progressive Medicine, a quarterly digest, the aim of which, as stated in the preface, was to aid the "busy practitioner," by placing at his disposal "a well-told tale of medical progress in all its lines of thought, told in each line by one well qualified to cull only that matter which is worthy of his attention and necessary to his success." The eighteen editors, all experts, who have undertaken this task have performed it most ably and Progressive Medicine is still current. Of the periodicals that are current, two are devoted to special lines. The work of American surgeons has reflected more credit upon the profession at home and abroad than that of workers in all other fields of medical science combined — with the exception, perhaps, of their "next of kin," the gynecologists. Under the able management of Lewis S. Pilchner, of Brooklyn, and J. William White, of Philadelphia, the Annals of Surgery, published in St. Louis until 1892, and since then in Philadelphia, has thoroughly kept up with the immense strides made in this field, and has become one of the foremost journals of its kind in existence. The Amer- ican Journal of Orthopedic Surgery, formerly published in Boston, but since 1905, in Philadelphia, is another excellent periodical, which includes among the members of its editorial staff a Phila- delphia surgeon, H. Augustus Wilson. The University of Pennsylvania Medical Bulletin, a monthly started in 1888, as the University Medical Magazine, and now edited by Charles H. Frazier and William Pepper, is an admirable example of what a journal published under the auspices of an educational institution should be. Though free from advertisements, its columns are replete with valuable contributions to medical science The Medical Journals of Philadelphia 899 and information concerning the medical alumni. This is rendered possible by the fact that it is sustained financially by the Board of Trustees of the university it represents. Published by students and for students, is the Jeffersonian, a monthly periodical started in 1899, which reflects the happenings of interest during the scholastic year of Jefferson Medical College, the alma mater of a large proportion of the country's notable men, among whom are J. Marion Sims, Austin Flint, Samuel W. Gross, S. Weir Mitchell and many others. Each number contains besides topics of social interest, two or more excellent papers by some member of the teaching staff which give the journal considerable scientific value, not only for the undergraduates, but for the alumni as well. The Jeffersonian is edited by undergraduates, the editor- in-chief being for the current year, Mr. John H. H. Scudder, of California. Much on the same order is the Bulletin of the Medico- Chirurgical College, a quarterly founded in 1905, but edited by members of the united faculties: Seneca Egbert, medicine; I. Norman Brommell, dentistry; and I. V. Stanley Stanislaus, phar- macy. It also contains excellent articles and news of special interest to undergraduates and alumni. Standing by itself among journals is Medical Notes and Queries, a monthly founded by Henry W. Cattel, in 1905. Created for the purpose of affording "an opportunity for the interchange of ideas by those interested in laboratory work and the advancement of modern medicine," it has carried out its object to a great extent — doubtless as far as practicable. Able critical notes on various topics of special interest to practitioners, mainly by Dr. Edward Willard Watson, seem to be getting the upper hand, however, thus insuring what the journal really merits — a circulation which strict adherence to its original plan would hardly have insured. With the exception of the American Journal of the Medical Sciences, the oldest of Philadelphia medical journals is the Medical Bulletin, founded by J. V. Shoemaker, Henry Leffman and J. T. Eskridge, in 1879. Its aim is to furnish information calculated to aid the practicing physician, a role which it has faithfully carried out under the editorial management of Dr. Shoemaker, its sole editor since 1880. The Medical Bulletin has been published, bound up with the Monthly Cyclopaedia, since May, 1908, but retains its editorial autonomy. Younger by four years only, is the Medical World, founded in 1883, by its present editor and publisher, Dr. C. 900 Medical Societies and Journals F. Taylor. Besides supplying abstracts of the current literature, the Medical World is an open arena, as it were, in which its sub- scribers can briefly report cases, ask advice and exchange views. In its own way this journal disseminates considerable practical knowl- edge. The Medical Gouncil founded in 1896 by Dr. J. J. Taylor, the Medical Summary by E. H. Andrews, and Albright's Office Practitioner, have much the same object in view. Finally, the writer founded, in 1898, the Monthly Cyclopaedia, intended to act as auxiliary to his "Cyclopaedia of Practical Medicine," and to furnish as such to the readers of the latter, a monthly review (alphabetically arranged), of the important contributions to current literature. So many journals had taken up this line of work in recent years, how- ever, that in 1906, a department for original articles was added which, under the able editorial management of Dr. J. Madison Taylor, has met, judging from its success, the approval of the pro- fession at large. The Homoeopathic School is represented by the most important of its journals, the Hahnemannian Monthly, founded in 1865, by Adolph Lippe and J. H. P. Frost, and edited since then by some of the most prominent homoeopathists of the country. Its present editors are Clarence Bartlett and C. Harlan Wells. The articles, abstracts, editorials, reviews, etc., indicate that a broad and generous concept of the whole field of medicine is taken as guide, irrespective of any school — a fact which coincides with the growing harmony among men who are physicians above all, and not the abject slaves of their prejudices. Hahnemann College is represented by the Hahnemann Institute, edited by its undergraduates. It contains original articles, abstracts from general literature, class and clinical notes, making altogether an excellent showing. Once upon a time Philadelphia was the proud owner of weekly journals, the Medical News, the Philadelphia Medical Journal and American Medicine — all brilliantly edited. The first two have been "consolidated" with the New York Medical Journal, which politely bears their names — as epitaphs — on its cover page, while the last- named has also drifted to New York reduced to the rank of a monthly. But the time has passed for regrets on this score ; Phila- delphia has fulfilled her part as the country's medical center during the first century of the nation's existence. Her duty, henceforth will be to labor as one of many for the common good, and true to her traditions, she will not be found wanting. Ind ex Abbot, Geo. Maurice, 6. Academy of Natural Sciences, 153: Origin, 153; founders, 154; first president, 155; first recording secretary, 156; first collection of minerals, 157; incorpora- tion, 157; the Journal 158; purchase of building at Twelfth and Sansom Streets, 158; purchase of lot at Broad and Sansom Streets, 159; exempted from taxation, 160; publication of the Proceedings, 160; ornithological col- lection, 161; building again enlarged, 163; biological department, 163; pur- chase of lot at Nineteenth and Race Streets, 169; biological and micro- scopical section, 170; conchological section, 170; entomological section, 171; botanical section, 171; legacy of Joshua T. Jeanes, 173; Mary Jeanes' museum fund, 173; minera- logical section, 173; gift of Rev. Henry C. McCook, 175; endowment of memorial by Mrs. Emma W. Hayden, 175; appropriation from the Legisla- ture, 176; ornithological section, 176; anthropological section, 178; bequests from Mr. Meigs and Dr. R. H. Lamborn, 178; revision of by-laws, 179; appropriations from the Legis- lature, 180.— The library, 180: its origin, 180; first catalogue, 181; gifts of Thomas B. Wilson, Edward Wil- son, and Isaiah V. Williamson, 181. — Museum, 182; publications, 183; ap- pointment of professors, 185; evening lectures, 185; ofllcers, 185. American Hospital for Diseases of the Stomach, 847: Origin, 847; purchase of building, 847; additional building, 848; formal opening, 848; Dr. Tyson's address, 848, 849; board of managers, 849; medical staff, etc., 849, 850. American Philosophical Society, 105: Original members, 105; Benjamin Franklin, first president, 107; observa- tions of the transit of Venus, 108; first volume of Transactions, 109; meetings interrupted by Revolution, 110, 111; address to Gen. Washington, 111; grant by State of lot in State House Square, 112; David Ritten- Amer. Philosophical Society, (Continued) : house, second president, 113; Thomas Jefferson, third president, 113; Presi- dents subsequent to Jefferson, 114. Library, 115; Franklin papers, 115; rare manuscripts, 117; portraits, 120; busts, 120. Franklin bi-centennial celebration, 122; calendar of the papers of Benjamin' Franklin, by Dr. I. M. Hayes, 123. Anders, Dr. James M., address on the development of practical medicine in Philadelphia, 39-63. Asylums, Homes and Training Schools, 854. Board of Health (Development of Public Health Work in Philadelphia), 563: Act of 1794, 563; keeper of hospitals, 563; ordinances of Councils relating to public health, 564; "Palatine fever," 565; pest house on Province Island, 565; putrid sore throat, 565; yellow fever in 1747, 566; typhus in 1754, 566; small-pox in 1756, 566; yellow fever epidemic of 1793, 567; Bush Hill, 568; Stephen Girard, 568; mortality of epi- demic of 1793, 569; abortive attempt to build a hospital for contagious dis- eases, 570; epidemic of 1798, 570; in- corporation of the Board of Health, 571; purchase of Tinicum Island, 571; act of 1818, the foundation of pre- ventive medicine, 571; yellow fever in 1820, 572; inoculation of small-pox prohibited, 572; public vaccination, 573; public water works, 573; sewage system, 574; Poudrette committee, 576; abatement of nuisances, 576; in- terest in municipal sanitation, 577; vital statistics, 577; Registration Act, 578; hospitals for contagious diseases, 578, 579; morbidity records, 579; Act of 1895,580; house drainage, 580; abattoirs, 581; inspection of meat, 581; Pure Food Act, 582; milk inspection, 583; division of bacteriology, etc., 583; tene- ment house bill, 584; disinfection, 584; diminution and disappearance of epidemic diseases, 585; first recorded deaths from typhoid fever, 585; epi- (901) 902 Index Board of Health, (Continued) : sode of the Christian Street Hospital, 587; reduction of death rate, 588; birth rates, 588; first report of the Board of Health, 589; expenses of the Board of Health, 5b9; new positions created, 590; pay roll in 1907, 590; Bureau of Health, 592; Department of Public Safety, 592; Department of Public Health and Charities, 592. Brumbaugh, M. G., 6. Charity Hospital (The Charity Hospital of the City of Philadelphia), 659: In- corporation, 660; first location, 660; removal to Hamilton Street, 660; pur- chase of present site, 660; board of trustees, 661; medical board, 661; number of patients, 662; list of ad- ministrators, 662. Chestnut Hill Hospital, 737: Location and charter, 737; first board of trustees, 737; purchase of Norrington, 738; equipment, 738; trustees, officers and staff, 738. Children's Homoeopathic Hospital of Phila- delphia, 821: Charter, 821; organiza- tion, 821; Ladies' Auxiliary Society, 822; first location, 822; second location, 822; purchase of present site, 822; ad- ministration building, 823; alterations and improvements, 823; north wing, 824; nurses' home, 825; training school for nurses, 825; officers, 825. Children's Hospital of Philadelphia, 770: Origin, 770; various sites, 771; country branch, 771; managers, etc., 772; staff, 772; training school for nurses, 772; capacity, 772; statistics, 773, 774; babies' ward, 775; editor's note, 776. College of Physicians of Philadelphia, 1E4: Date of founding, 124; first officers and fellows, 124; address of the first president, 125; ori- gin of the library, 126; protest against illumination of city, 126; recommendations to prevent spread of yellow fever, 127; meetings interrupted by epidemic of yellow fever, 128; pre- vention of the execution of John Zim- merman, 130; committee on the Pharmacopoeia, 131; committees, 131; removal to building of the Mercantile Library Company, 132; removal to the "picture house," 133; beginning of the museum, 133; proposition of Dr. Mutter accepted, 134; removal to Thirteenth and Locust Streets, 134; addition of third story, 135; list of College of Physicians, (Continued) : Mutter lecturers, 135; origin of the council, 136; deposit of the S. D. Gross library, 136; celebration of the college centennial, 138; committee on cholera, 138, 139.— Funds: Weir Mitchell, en- tertainment fund, 136; George B. Wood, 137; William F. Jenks, 137; John D. Griscom, 139; H. R. and Wal- ter Hatfield, 139; Oliver A. Judson prize, 139; Henrietta Rush Fales Baker, 140; W. W. Keen, 140; legacy of Dr. J. M. DaCosta, 140; Andrew Carnegie, 140. — Purchase of lot at Twenty-second and Ludlow Streets, 141.— Gifts of C. C. Harrison, W. W. Frazier, Clement B. Newbold, and John K. Mitchell, 143. — Directory for nurses, 143. — Li- brary, 144: Origin of, 144, 145; pre- sentation of French theses, 145; origin of Lewis library, 145; Weir Mitchell library fund, 146; office of honorary librarian created, 146; Weightman fund, 146; Rodman fund, 147; legacies of books from Dr. John Ashhurst, Jr., 147; the Hough collection, 148; gifts and legacies of books, 148; exchanges with the Faculty de MSdecine de Paris effected. 148. — Building fund, origin of, 149: Gifts from Dr. J. M. DaCosta and Mr. George W. Childs, 150.— Mem- orable dates in the history of the Col- lege, 151; lists of officers, 151, 152. Committee appointed by the Mayor, 2; report of, 2-6. Committees: Executive, of Fifty, 6; general, 8; finance, ways and means, 8; publications, 8; societies, scientific and medical journals, 8; credentials, 9; historical exhibit, 9; medical day, 9. Curtin, Dr. R. G., address at reunion of staffs, past and present, of Philadel- phia General Hospital, 66. Editor, report of, 15. Episcopal Hospital (Hospital of the Protestant Episcopal Church in Phila- delphia), 632: Date of charter, 632; Dr. Caspar Morris, 632; Bishop Stev- ens, 633; gift of property by Miss Ann Leamy and Mrs. Stout, 633; list of first contributors, 634; Jenny Lind and Mrs. Latimer, 634; opening day, 634; first board of managers, 635; growth of the hospital, 635, 636; plans for new building, 636; laying of corner-stone, 636; hospital during the Civil War, 637; Dr. Richard A. Cleemann, 637; cost of construction. 637: description of Index 903 Episcopal Hospital, {Continued) : buildings, 637, 638; State appropria- tion, 639; nationality and religion of patients, 639; board ol managers, 640; medical board, 640; dispensary staff, 641. Founders' Week Reunion at Philadelphia General Hospital, 64. Fox, Dr. L. Webster, report of, 17. Frankford Hospital, 735: Origin, 735; Frankford Dispensary, 735; charter, 736; purchase of property, 736; first board of trustees, 736; additions to staff, 736; change in board of trustees, 736; new buildings, 736; State appro- priations, 736; "Fete of Nations," 737; removal, 737. Franklin Institute, The, 187: Its origin, 187; first charter, 188; professors elected, 189; corner-stone laid, 189; institution of the Journal, 190; changes in the title of the Journal, 192, 193; joint report of the American Philosophical Society and Franklin In- stitute, 194; list of officers since foundation, 195; list of benefactions and endowments, 197; cost of main- tenance, 198; outgrowths from the Franklin Institute, 198; exhibitions, 200, 201; prizes, 201, 202, 203; contribu- tions from Mr. Alfred C. Harrison, the Baldwin Locomotive Works, and Mrs. Penfield, 204, 205. Frederick Douglass Memorial Hospital and Training School, 725: Incorpora- tion, 725; board of directors, 725. Friends' Asylum for the Insane, 854: Ori- gin, 855; location, 855; original purpose, 855; sectarian restriction removed, 855; description of ground and buildings, 856; training school for nurses, 856; gymnasium, 856; nature of the treat- ment, 856; corporation, 857. General Hospitals and Dispensaries, 593. German Hospital (The German Hospital of the City of Philadelphia), 652: In- corporation, 652; incorporators, 652; first officers, 652; purchase of Penn Brook, 653; Ladies' Aid Society, 653; Turner's Lane Hospital, 653; purchase of adjoining property, 653; medical board, 653; John D. Lankenau elected president, 654; Joseph G. Rosengarten, 654; purchase of present site, 654; dis- pensary opened, 654; library, 654; pathological museum, 654; presenta- tion of buildings by John D. Lanke- German Hospital, [Continued) : nau, 655; deaconesses, 655; office of chief resident, 655; Mary J. Drexel Home, 655; Dr. George A. Bodamer, 655; Dr. Carl Frese, 656; Mr. Martin I. Wilbert, 656; Dr. Alfred Stengel, 656; change in medical service, 656; services during Spanish War, 656; Dr. A. D. Whiting, 657; training school for nurses, 657; death of John D. Lankenau, 657; Mr. Hermann Hessen- bruch, 657; hospital plant, 657; present officers, 657; board of trustees, 658 hospital staff, 658; medical board, 658 officers of the board of trustees, 658 chiefs of hospital staff, 659; assistants to hospital staff, 659. Germantown Dispensary and Hospital, 682: Location, 682; buildings, 682; tent dispensary, 682; Mrs. Pauline B. Henry, 682, 684; pay patient building, 682; nurses' house, 683; central plant, memorial building, etc., 683; Dr. James B. Rhoads, 683; founders, 683; incorporation, 684; gift of lot and building by Mrs. Henry, 684; amend- ments to charter, 684; chronological story of hospital's growth, 685, 686, 687, 688, 689; statistics for 1908, 689; sources of income, 689; officers, 690. Gynecean Hospital, 831: Origin, incor- poration and charter, 831; board of governors and medical staff, 832; suc- cessive locations, 832; changes in staff, 832; present governors, officers and staff, 832; statistics, 833; State appropriations, 834. Hahnemann Medical College and Hospital of Philadelphia, 291: Foundation, 291; American Institute of Homoeopathy, 291; act of incorporation, 292; first meeting of corporators, 292; first an- nouncement, 292; first public com- mencement, 293; requirements for graduation, 294; purchase of building, 294; publications, 294, 295: schism and opening of new college, 295; consolida- tion, 295; corner-stone of new build- ing laid, 296; teaching corps and cur- riculum, 296, 297; golden jubilee, 297; museum, 298; library, 299; the hospital, 299; difficulties and dissensions, 300, 301; merger of hospital with college, 301; women's hospital association, 301; school for nurses, 302' nurses' home, 303; maternity building, 303; dispen- sary, 303; alumni association, 304. Hays, I. Minis, 6. 904 Index Hicks, G. W. B., 1, 6. Home for Consumptives, 869; City mission, 869; House of Mercy, 870; origin and location of home, 870; nature of work, 870; medical management, 871; diet, 871; description of buildings, 872; benefactors, 873; outside relief, 873; cooperation with Visiting Nurse Soci- ety, 873. Home for Incurables (The Philadelphia Home for Incurables), 863: Origin, 863; locations, 863; additions, 863; cancer annex, 864; house for children, 864; statistics, 865; cost of mainte- nance, 865; sources of income, 865. Home of the Merciful Saviour for Crip- pled Children, 866: Location, 866; in- corporation, 866; nature of the work, 866; description of buildings, 866; of- ficers and medical staff, 867. Hospitals and Allied Institutions under Municipal Management, 419. Howard Hospital, 642: Western Infirm- ary, 642; list of presidents, 642; first location, 643; removal to Christian Street, 643; purchase of property on Lombard Street, 643; purchase of prop- erty on Broad Street, 643; Anna H. Wilstacb. Memorial, 644; additions to property, 644; report of cases treated, 645; board of managers, 645; medical staff, 646; officers and assistants, 646; Women's Visiting Committee, 647. Introduction, 1. Jastrow, Jr., Morris, 6. Jefferson Medical College of Philadel- phia, 265: Origin, 266; first faculty, 266; acquisition of property at Tenth and Sansom Streets, 266; changes in the faculty, 267; independent charter, 267; dissolutions of faculty, 268, 269; growth of the clinic, 269, 270; resigna- tion of Prof. Mutter, 270; election of Prof. S. D. Gross, 270; other changes in the faculty, 271, 272; election of Prof. J. M. DaCosta, 273; appropria- tions from the State, 273; completion of hospital, 274; elections of Profs. Bartholow and Chapman, 274, 275; new laboratory building, 275; trial of Prof. Forbes, 275; resignation of Prof. S. D. Gross, 276; faculty changes, 277, 278; clinical professors, 279; four years' course, 279; institution of sal- aries, 280; maternity department, 281; State appropriations, 282; hospital an- nex, 282; hospital laboratories, 283; Jefferson Medical College, (Continued): death of Prof. Parvin, 283; other fac- ulty changes, 284; death of Prof. Forbes, 284; the new main building, 285; new laboratory building, 286; new hospital, 286; old amphitheatre, 288; statistics of hospital work, 289. Jordan, John W., 6. Jewish Hospital (The Jewish Hospital Association of Philadelphia), 663: Statistics showing development since foundation, 664; Abraham Sulzberger, 664; provisional committee, 664; organ- ization of Jewish Hospital Association, 665; first officers and managers, 665; purchase of property in West Phila- delphia, 665; Asylum for Destitute, Aged and Infirm, 665; building com- mittee, 666; gift of Mrs. Mary D. Brown, 666; accommodations inade- quate, 666; purchase of property on Olney Road, 667; exemption from taxa- tion, 668; cost of new building, 668; Lazarus Morgenthau, 668; State appro- priation refused, 669; Mathilde Adler Loeb Dispensary, 669; first endowed bed, 670; Home for Aged, 671; pur- chase of adjoining property, 672; training school for nurses, 672; san- itary tower, 673; sale of West Phila- delphia property, 673; Lucien Moss Home, 673; Mrs. Rose Frank, 674; new operating room, 675; Federation of Jewish Charities, 675; State appro- priations, 675; Meyer Guggenheim Private Hospital, 676; additions and improvements, 676; Eisner Home for Nurses, 677; isolation building, 677; State appropriations, 677; solarium, 678; protection against fire, 678; gift of land by Felix Isman, 678; Penn- sylvania building, 679; State appropria- tions, 679; surgeons and physicians, 680; officers, 680, 681; medical and surgical staff since opening of hospital, 681; resident physicians, superintend- ents, etc., 681. Kensington Hospital for Women, S26: Dr. Howard A. Kelly, 826; successive locations, 826; capacity, 826; incorpora- tors, 826; officers, surgeons, etc., 826, 827; work of the hospital, 827; train- ing school for nurses, 828; State ap- propriations, 828; real and personal property, 828; character of the work, 828, 829; contributions to surgery, 829, 830. Index 905 Maternity Hospital, 803: Object, S03; meeting of physicians in 1872, 803; board of managers, 803; obstetricians and surgeons, 804; title, 804; charter, 804; first location, 804; struggle for ex- istence, 804; ladies' committee, 804; removal, 805; change of title, 805; amendment of charter, 805; gift of Henry C. Lea, 805; training school for nurses, 805; statistics, 805; cooperation with other institutions, 806; State ap- propriations, 807; board of governors and medical staff, 807. Mat6s, Wm. W., 1. Medical Day, Program, 10; opening ad- dress, 11. Medical Journals of Philadelphia, 894: Philadelphia as a medical centre, 894, 895; Philadelphia Journal of the Medical and Physical Sciences, 895; Medical Review and Analectic Journal, 895; American Medical and Surgical Journal, 895; American Medical Intel- ligencer, 895; Medical Examiner, 895; North American Medico-Chirurgical Review, 895; Medical and Surgical Re- porter, 895; Photographic Review of Medicine, 896; Philadelphia Medical Times, 896; American Journal of the Medical Sciences, 896; Annual of the Universal Medical Sciences, 897; American Year-Book of Medicine and Surgery, 898; Progressive Medicine, 898; Annals of Surgery, 898; American Journal of Orthopaedic Surgery, 898; University of Pennsylvania Medical Bulletin, 898; Jeffersonian, 899; Bul- letin of the Medico-Chirurgical Col- lege, 899; Medical Notes and Queries, 899; Medical Bulletin, 899; Medical World, 899; Medical Council, 900; Med- ical Summary, 900; Office Practitioner, 900; Monthly Cyclopaedia, 900; Hahne- mannian Monthly, 900; Hahnemann In- stitute, 900. Medical, Pharmaceutical, and Dental Col- leges, 223. Medical Societies of Philadelphia, 880: First Medical Society, 880; Academy of Medicine of Philadelphia, 880; North- ern Medical Association, 881; Philadel- phia Clinical Society, 881; Philadel- phia County Medical Society, 881; Mutual Aid Association, 883; Patholog- ical Society of Philadelphia, 884; Ob- stetrical Society of Philadelphia, 885; Philadelphia Academy of Surgery, 885; Neurological Society, 887; Medical Medical Societies, (Continued): Jurisprudence Society, 887; Medico- Legal Society, 888; Philadelphia Pedi- atric Society, 888; Southwark Medical Society, 889; Northwestern Medical Society, 889; Medical Book Club, 890; University Alumni, 890; Woman's Medical College Alumnae, 891; Woman's Hospital, 891; Samaritan Hospital, 891; Wills Hospital, 892; Laryngological Society, 892; Medical Club, 892; Mis- cellaneous Societies, 893. Medical Societies and Medical Journals of Philadelphia, 880. Medico-Chirurgical College and Hospital, 319; remarkable growth of, 319; graded courses, 319; Dr. George P. Oliver, 320; original charter, 321; original Medico-Chirurgical Society, 321; transformation into a medical college, 322; first faculty, 322; reor- ganization, 322, 323; first site, 323; spring and autumn terms, 323; first commencement, 324; faculty changes, 324, 325; Dr. Goodman, 325; Drs. Pan- coast, Shoemaker, and Montgomery, 326, 327; afllliation with Philadelphia Dental College, 327; Dr. James B. Gar- retson, 327; removal to Cherry Street, 328; additions to buildings, 329; clin- ical amphitheatre, 329; maternity and children's hospital, 330; chronological list of professors, 331; present fac- ulty, 333; new board of trustees, 335; dental department, 336; depart- ment of pharmacy, 337; optional five- year course, 340; college club, 340. Mercy Hospital and School for Nurses, 742: Women's Auxiliary, 742; pur- chase of property, 742; description, 743; resident physicians, 744; school for nurses, 744. Methodist Episcopal Hospital in the C.ty of Philadelphia, 713: Dr. Scott Stew- art, 713; extract from will, 714; in- corporation, 715; litigation, 715; en- dowment fund, 716; purchase of site, 716; description of buildings, 716; ad- visory board, 717; administration building, 717; opening day, 717; Couls- ton building, 718; dispensary building, 718; nurses' home, 718; isolation build- ing, 718; Stephen Greene, 718; T. Com- ly Hunter, 718; William Clare Allison, 718; restrictive provision of Dr. Stew- art's will, 719; board of trustees, 719; medical staff, etc., 720. Milligan, W. J., 6. 906 Index Mills, Dr. Charles K., report, 15; address at reunion at Philadelphia General Hospital, 68. Montgomery, Thomas L., 6. Mount Sinai Hospital, 731: Beth Israel Hospital Association, 731; Union with Franklin Free Dispensary, 731; legal difficulties, 732; law amended, 732; purchase of site, 732; out-patient de- partment, 733; staff, 733; training school for nurses, 733; expense and sources of income, 734; Jacob D. Lit, 734; State appropriations, 734; new building projected, 734; officers, 734. Municipal Hospital for Contagious and Infectious Diseases, 517: Legislative enactments relating to public health, 517; Bullitt Bill, 519; Department of Public Safety, 519; Department of Pub- lic Health and Charities, 519; origin of the Municipal Hospital, 520; Act of 1794, 520; Wigwam Hotel, 521; Bush Hill, 521; Sugar House, 522; Islington Lane Hospital, 522; temporary hos- pital at the Lazaretto, 525; synoptic table, 526; new hospital erected by the city, 526; first patient, 526; loca- tion, 526; dedication, 527; description of building, 527; first attending physi- cian, 529; first matron, 529; Dr. J. Howard Taylor, 530; cholera in 1866, 530; inadequate water supply, 530; relapsing fever epidemic, 531; yellow fever at the Lazaretto, 532; transfer- ence of Dr. Taylor and election of Dr. "Welch, 532; malignant epidemic of small-pox, 532; efficacy of vaccination, 533; inadequate equipment, 533; first disinfecting plant, 534; communication with the hospital by means of dial apparatus, 535; appointment of a stew- ard, 536; successive stewards and matrons, 536; small-pox in 1876, 537; yellow fever in Philadelphia, 537; three great epidemics of small-pox, 538; extract from report of Director Stokley, 539; remarks of Dr. Ford upon the work of the hospital, 540; diseases other than small-pox treated at the Municipal Hospital, 5411; trained nurses introduced, 541; death of an interne from diphtheria, 541; leper building, 542; commission to select new site, 542; resolutions of the Board of Health, 543; commission appointed by Hon. Edwin S. Stuart, 544; report of commission, 544; pre- sentation of adjoining property by Dr. George Woodward, 545; purchase Municipal Hospital, (Continued) : of adjoining property by the city, 545; diphtheria pavilion, 646; William H. Ford pavilion hospital, 547; temporary building for small-pox, 547; steam dis- infecting plant, 548; lodge house, 549; steam heat introduced, 549; appoint- ment of a pharmacist, 549; additions and improvements, 550; clinical in- struction, 551; rules regulating clinical instruction, 551; case of small-pox in student, 553; private rooms, 553; en- largement of main building, 553; ap- pointment of Dr. Schamberg, 554; small-pox epidemic of 1901, 554; effi- cacy of vaccination, 555; MacAllister farm, 556; Department of Public Health and Charities, 556; changes in the management of the hospital, 556; increased appropriation, 557; tribute to vaccination, 558; synoptic table, 560. New Philadelphia Hospital for Con- tagious Diseases, 559; cost of the new hospital, 561. Neff, Dr. Joseph S., address at reunion at Philadelphia General Hospital, 70. Northern Dispensary, 751: Date of found- ing, 751; object, 751; charter, 751; first location, 751; suspension of work, 752; purchase of building on Spring Garden Street, 752; rapid growth, 752; removal to present site, 752; special departments, 753; board of managers, 753; staff, 754. Oncologic Hospital (The American On- cologic Hospital for the Study and Treatment of Cancer and other Tu- mors), 844: Origin, 844; charter, 845; first board of trustees, 845; location, 845; statistics, 846; sources of income, 846; capacity, 846; purchase of lot, 846. Orthopaedic Hospital and Infirmary for Nervous Diseases (The Philadelphia Orthopaedic Hospital and Infirmary for Nervous Diseases), 794: Dr. Thomas G. Morton's address, 794; Dietrich W. Kolbe, 795, 796; first location, 796; first staff, 796; organization, 797; open- ing day, 798; first board of managers, 798; department for nervous diseases, 798; removal to present site, 799; State appropriation, 799; change of title, 799; opening of new building, 799; Dr. S. Weir Mitchell's address; 800; purchase of adjoining property, 800; William B. Garrett, Jr., 800; new Index 907 Orthopaedic Hospital, (Continued): building, 801; total cost of new build- ing, 801; purchase of adjoining prop- erty, 801; psychopathic department, 801; training school for nurses, 801; statistics, 802; chronological list of presidents, 802; officers and managers, 802; surgical and medical staff, etc., 802. Pennsylvania College of Dental Surgery, 409: Origin, 409; charter, 409; first lo- cation, 409; original corporators and faculty, 410; first commencement, 410; first change of location, 410; first woman dentist in Philadelphia, 412; second change of location, 412; instal- lation of dissecting room and chem- ical laboratory, 413; National Associa- tion of Dental Faculties, 414; third change of location, 414; three years* course, 414; eponymic societies, 415; golden anniversary, 416; eminent graduates, 416; board of corporators, 417; faculty and auxiliary instructors, 417. Pennsylvania Home Teaching Society and Free Circulating Library for the Blind, 867: Origin, 867; Dr. William Moon, 867; John P. Rhoads, 867; ob- jects, 868; cooperation with Free Li- brary, 868; statistics, 868; free postage, 868; home teaching, 869; sources of in- come, 869; State appropriation, 869; officers and managers, 869. Pennsylvania Hospital, 593: Erection of almshouse, 593; founding of Pennsyl- vania Hospital, 593; question of pri- ority, 593; Benjamin Franklin's "brief account," 593; relations between Penn- sylvania Hospital and Almshouse, 595; appointment of physicians to the almshouse, 596; resignation of Dr. John Morgan, 597; story of the found- ing, 598; volunteer staff, 599; first offi- cers, 599; first site, 599; rules, 599; seal, 599; permanent site, 600; corner- stone, 601; Franklin elected president, 601; removal from Market Street, 601; donations, 601, 602; grant from the As- sembly, 602; Benjamin West's pic- ture, 602; statue of Penn, 603; the hospital in Colonial days, 604; the hos- pital during the Revolution, 604; War of 1812, 605; Civil War, 605; Spanish- American War, 606. Care of the in- sane, 606, 607; lying-in department, 607; cavalry fund, 608: donations of skeleton and other anatomical prepa- rations, 608, 609; apprentices, 609; Pennsylvania Hospital, (Continued) : clinical lectures, 609; admission of women students to the clinics, 610; foundation of library, 610; training school for nurses, 611; nurses' home, 611; hospital publications, 611, 612. Pennsylvania Institution for the Deaf and Dumb, 858: Origin, 858; David G. Seixas, 858; first board of directors, 859; State appropriation, 859; succes- sive locations, 859; total cost of build- ings and land, 859; description of buildings, 859; nature of the work, 860; oral instruction, 860; trade teach- ing, 861; successive officers, 861; Dr. Crouter, 862; present officers, etc., 862. Pennsylvania Institution for the Instruc- tion of the Blind, Editors Note, 879. Philadelphia, date of founding of, 1. Philadelphia College of Pharmacy, 377: First apothecary shops in America, 377; origin of "prescriptions" in America, 377; formative period of pharmacy, 378; founding of the Phila- delphia College of Apothecaries, 379; degree of master of pharmacy, 379; meeting at Carpenters' Hall, 380; earliest movement for pure drugs, 382; permanent organization, 382; in- corporation of the Philadelphia Col- lege of Pharmacy, 382; college build- ings and laboratories, 383; advances and curriculum, 383; first laboratory, 384; analytical chemistry, 385; mi- croscopical laboratory, 385; minor branches, 385; special and post-gradu- ate instruction, 386; course for food and drug chemists, 386; college li- brary, 387; museum and herbarium, 388; relation to the Pharmacopoeia, 389; contributions to science and lit- erature, 391; graduates, 391; presidents, 393; Charles Marshall, 393; William Lehman, 394; Daniel B. Smith, 394; Charles Ellis, 397; Dillwyn Parrish, 398; Charles Bullock, 399; William J. Jenks, 400; Howard B. French, 402; teachers, past and present, 404. Philadelphia Dispensary, 745: Date of opening, 745; object, 745; "appeal to the public," 745; rules, 746; managers and staff, 747; first report, 747; pur- chase of lot, 748; restriction of field of work, 748; resident physicians, 749; obstetrical department, 749; eye and ear department, 749; enlargement of building, 749; statistics, 749; presi- dents, 750; secretaries, 750; treasurers, 750; character of the work, 750, 751. 908 Index Philadelphia General Hospital until 1S54, 419: Quaker almshouse, 420; first hos- pital in America, 423; first hospital in the United States, 424; first resi- dent apothecary, 424; first almshouse and hospital, 426; overseers of the poor, 427 ; first visiting physicians, 428; Bettering house, 429; almshouse "shinplasters," 430; Philadelphia Hos- pital in the Revolution, 431; Evan- geline, 435; letter of Henry W. Long- fellow, 438; chronology of visiting physicians, 438; "Perkinism," 440; re- moval to Blockley, 443; the "Wood- lands, 443; Blockley township, 444; completion of buildings, 445; descrip- tion of buildings, 447; title of "Phila- delphia Hospital" adopted, 449; chro- nology of visiting physicians continued, 450; resident-in-chief and chief resi- dent physicians, 452; resident physi- cians, 453; senior and junior pupils, 454; house physician and house sur- geon, 455; resident physicians, 455; residents' fees, 455; board of resident physicians, 456; certificates and diplo- mas, 457; obstetricians and instruction in midwifery, 458 ; first division of medical staff, 459; epidemics, 460; Blockley prejudices, 460; the Blockley smell, 461; martyrs to duty, 461; esti- mate of number of Blockley students, 463. Philadelphia General Hospital, from 1854 to 1908, 465 ; its subdivisions, 465 ; "Outwards," 465; nomenclature, 465; memorial to the Legislature, 465; at- tempts at change of name, 465; nomen- clature settled, 466; buildings and grounds at different periods, 466; chronological list of buildings and im- provements since 1854, 470; sales and transfers of land, 472 ; the Byberry purchase, 473; consolidation of alms- houses, 474; changes in methods of administration, 475; board of "buz- zards, " 475 ; Bullitt Bill and its amendment, 476; Directors of the De- partment of Charities and Correction, 476; stewards and superintendents, 477 ; hospital warden and resident physlcians-in-chief, 477; presidents of the Department of Charities and Cor- rection, 479; directors, 479; the home for the indigent, 480; removal of male indigent to Philadelphia Mu- seum building, 482; wards for alco- holics, 483; detention ward, 484; psychopathic and alcoholic wards, Phila. General Hospital, (Continued): 484; the feeble-minded, 485; subdivision into special departments, 486; increase in the staff, 487; special departments created, 487; children's asylum and pediatric department, 488; pathological department, 489; catalogue of patho- logical specimens, 490, 491; patholo- gists, 490; instruction in pathology and microscopy, 491; chronological list of special departments, 491; neuro- logical department, 492; ophthalmolog- ical department, 494; dermatological department, 496; training school for nurses, 497; bacteriological depart- ment and clinical laboratory, 500; laryngological department, 500; isola- tion department, 501; ortnopsedic de- partment, 502 ; Roentgen laboratory, 503; oral surgical department, 504; genito-urinary department, 505; de- partment for tuberculosis, 506; women physicians and women students, 507 ; first women visiting physicians, 507; first woman resident, 508 ; regis- trars, 508; resident physicians, 509; Philadelphia Hospital Medical So- ciety, 510 ; Association of Ex-Resi- dent Physicians, 510 ; officials of the medical board, 511; contributions from the Philadelphia Hospital to medical literature, 511; historical, de- scriptive and bibliographical litera- ture, 513. Philadelphia Lying-in Charity, 757: Dr. Joseph "Warrington, 757; charter, 758; organization, 758; Philadelphia Nurses' Society, 758; supplement to charter, 758 ; nurses' home, 759 ; successive sites, 759; medical directors and staff, 760; cost and description of building, 760' statistics, 761 ; cost of mainte- nance and source of income, 761; State appropriations, 761, 762; succes- sive presidents and corporation, 762; consulting staff, 762; hospital staff, 762 ; board of managers, 762. Philadelphia Museums, 214 : Site, 214 ; board of trustees, 214; origin, 214; ob- jects, 215; Dr. W. P. "Wilson, 215; sources of material, 216; Philippine, Chinese, and Japanese exhibits, 216; South Sea Island collection, 217; his- tory and development of commerce, 218; educational work, 218; bureau of information, 219; library, 219; depart- ment of translation, 220; publications, 220, 221; administration and staff, 221. Index 909 Philadelphia Polyclinic and College for Graduates in Medicine, 366: Its ob- ject, 366; origin, 366; first site, 367- first trustees, 367; first removal, 367 ! second removal, 368; corner-stone laid] 368; Polyclinic Medical Society, 369; Ladies' Aid Society, 369; publication! 369; change of management, 370; care of soldiers during Spanish War, 370; laboratory department, 371; depart- ment of phototherapy, 371; training school for nurses, 371; dispensary build- ing, 372; growth of the institution, 372; statistics of cases, 373; board of trustees, 373; house officers, 373; emer- itus professors, 374; professors, etc., 374, 375, 376. Phipps Institute (The Henry Phipps In- stitute for the Study, Treatment and Prevention of Tuberculosis), 840; In- corporation and incorporators, 840; de- scription of present building, 840; divi- sion and nature of the work, 841; capacity, 842; requirements for admis- sion, 842; laboratory, 842; case records, 842; educational department, 842; train- ing school, 843; medical staff, etc., 843. Piersol, Dr. George A., address on the medical schools and allied institutions, 18-38. Presbyterian Hospital in Philadelphia, 690: First suggestions of hospital, 690; committee on hospitals, 690; prop- osition from Charity Hospital, 691; proposition of Professor Saunders, 691; description of property, 692; act of incorporation, 694; original board of trustees, 694; seal and by-laws, 694; services of Dr. Saunders, 694, 695; gift of $300,000 by John A. Brown, 696; opening day, 697; first medical board, 697; death of Dr. Musgrave, 697; election of Dr. Dickey, 697; chronological list of buildings, 698; Ladies' Aid Society, 698; benevolent -work, 699; tuberculosis class, 699; Richardson Home for Convalescents, 700; Eliza Cathcart Home, 700; ambu- lance service, 701; training school for nurses, 701; nurses' home, 701; labora- tories, 702; statistics, 702; board of trustees, 703; medical board, 705. Preston Retreat, 781: Dr. Jonas Preston, 781; gift of silver vase by Schuylkill Navigation Company, 783; address of Eli K. Price, 784; extract from Dr. Preston's will, 785; amount of bequest, 785; incorporation, 786; first board of managers, 786; conference with Col- Preston Retreat, (Continued): lege of Physicians, 786; selection of site, 787; Dr. James Bryan, 787; let- ter of instructions from the College of Physicians, 787; committee of the College of Physicians, 788; extract from Dr. Bryan's report, 788; comple- tion of building, 789; delay in opening the retreat, 789; depreciation of se- curities, 789; Foster Home Associa- tion, 789; financial ease, 790; election o£ Dr. William Goodell, 790; formal opening, 790; board of managers in 1866, 790; statistics, 790; election of Dr. Joseph Price, 791; election of Dr. Richard C. Norris, 791; mortality statistics, 792; character of cases ad- mitted, 792; list of officers, managers, etc., 792; visiting physicians, etc., 793; alterations of building, 793; chrono- logical list of officers, etc., 794. Program, official, of the seven days' cele- bration of Founders' Week, 74: Mil- itary day, 76; municipal day, 80; in- dustrial day, 85; medical day, 88; his- torical day, 94; athletic and Knights Templar day, 97. Remington, Joseph P., Ph.M., report, 16. Reunion of staffs, present and past, of Philadelphia General Hospital, 64. Reyburn, Hon. John E., 2: Remarks at reunion at Philadelphia General Hos- pital, 72. Rush Hospital for the Treatment of Con- sumption and Allied Diseases, 837: origin, 838; charter, 838; first location, 838; removal to present site, 838; addi- tions, 838; country branch, 838; State appropriations, 839; description of new building, 839. St. Agnes' Hospital, 706: Sisters of the Order of St. Francis, 706; purchase of property, 706; bequests and donations, 706; corner-stone, 707; staff, 707; first sister in charge, 707; sources of revenue, 707; State appropriations, 707; consecration, 708; endowed beds, 708; services during war with Spain, 709; medical directors, 709; staff, 709. St. Christopher's Hospital for Children, 808: Location, 808; cooperation with Children's Seashore House, 808; incor- porators, 809; charter, 809; temporary quarters, 809; removal to Diamond Street, 809; "Aunt Sophie," 810; trans- ference of patients in summer, 810; pur- chase of lot, 810; completion of build- 910 Index St. Christopher's Hospital, (Continued): ing, 811; purchase of adjoining lot, 811; State appropriation, 811; addi- tional building, 812; gift of Lawrence Lewis, 812; additional wards, 812; fur- ther additions, 812, 813; milk supply, 813; St. Christopher's Aids, 813; ca- det nurses, 814; nurses' home, 814; growth of St. Christopher's, 815; spe- cial donations and legacies, 815, 816; staff, 816; board of managers, 817; superintendents, etc., 818; lady visit- ors, 818; wards for infants, 819; cost of buildings, 820; endowment fund, 820; State appropriations, 820. St. Joseph's Hospital, 613: Reasons for its foundation, 613; Friendly Sons of St. Patrick, 613; Hibernian Society, 613; St. Joseph's Society, 614; physi- cians of St. Joseph's Society, 615; first meeting of the board of man- agers, 615; act of incorporation, 616; Ladies' Auxiliary Society, 616; seal, 617; purchase of Green Hill property, 617; first staff, 618.— First decade, 618: Dispensary opened, 619; first attending surgeons, 619; purchase of adjoining property, 619; medical board organized, 619; St. Joseph's Hospital Beneficial Society, 619; first obstetrician, 620; first legacy, 620; first pathologist, 621; death of Dr. Horner, 621; Dr. Alfred Stille elected president, 621; change of administration, 621; causes of hos- pital's decline, 622; lease of hospital to Sisters of Charity, 622; resignation of Dr. H. H. Smith, 623.— Second dec- ade, 623: Death of Bishop Neumann, 623; Bishop Wood elected president, 623; corner-stone of west wing, 623: private patients, 624; increase of staff, 624; Dr. Robert Blake Cruice, 624; death of James M. Smith, 624; bequest of Mason Hutchins, 624.— Third decade, 624: Additions to buildings, 624; obstetrical department discon- tinued, 625; death of Sister Ignatia Casey, 625. — Fourth decade, 625: Death of Archbishop Wood, 625; death and bequest of Francis A. Drexel, 625; specialization of out-patient depart- ment, 625.— Fifth decade, 626: Be- quest of George S. Pepper, 626; sal- aried offices, 626; additions to build- ings, 626; death of Dr. William V. Keating, 626 ; death of Dr. Robert Blake Cruice, 626; training school for nurses, 627; women's board of St. Joseph's Hospital, 627.— Sixth decade, 627: Death St. Joseph's Hospital, (Continued) : of Sister Angeline Davis, 627; exten- sive alterations, 628; St. Edmond's an- nex, 628; Ex-Resident Association, 628; summary, 629; printed reports, 629; statistics of operations, 629; cost per patient, 629; capacity of hospital, 629; gifts, bequests and State appropria- tions, 629, 631; statistical table, 630. St. Luke's Homoeopathic Hospital of Philadelphia, 726: Origin, 726; first site, 726; charter, 726; Germantown Auxiliary, 726; State appropriation, 727; closure, 727; purchase of new property, 727; additional buildings, 728; State appropriations, 728; train- ing school for nurses, 728. St. Mary's Hospital, 648: Third Order of St. Francis, 648; foundation of hos- pital, 648; original site, 648; present site, 648; original building, 648; ad- ditions to buildings, 649; description of hospital, 649; nurses' home, 650; State appropriations, 649, 650; ambu- lance station, 650; sisters in charge, 651; medical directors, 651; statistics, 651. St. Timothy's Memorial Hospital, 720: Founders, 720; dedication, 720; endow- ment fund, 721; hospital plant, 721; training school for nurses, 721; Ladies' Aid, 721; board of managers, 721; med- ical board, 722. Scientific Institutions, 105. Shoemaker, Dr. John V., opening address on medical day, 11; report of, 14; re- marks at reunion at Philadelphia Gen- eral Hospital, 72. Solis-Cohen, Dr. S., 9, 10, 18. South Eastern Dispensary, 850: Origin, 850; successive locations, 850; nature of work, 850; yearly expenditure, 851. Southern Dispensary, 754: Date of char- ter, 754; origin, 754; first board of managers, 755; location, 755; list of physicians and managers connected with the dispensary, 756; present board of managers, 756; means of support, 756. Special Hospitals and Dispensaries, 757. State Dispensary for Tuberculosis, 851: Origin, 851; site, 851; first staff, 851; additions to staff, 851; description of work, 852; statistics, 853; present staff, 853; nursing staff, 853. Stengel, Dr. Alfred, remarks on clinical teaching in the Philadelphia Hospital, 72. Index 911 Stetson Hospital of Philadelphia, 739: Opening of dispensary, 739; Union Mis- sion Hospital, 740; addition of wards, 740; charter, 740; statistics, 740, 741; officers and directors, 741; medical and surgical staff, 741. Temple University, 341; Organization, 341; charter, 341; theological depart- ment, 342; law school, 342; school for training of kindergartners, 344; physi- cal education, 345; departments of pharmacy and medicine established, 345; civil engineering, 345; pedagogy, 345; affiliation with Philadelphia Den- tal College, 345. — Medical Department, 345: Standards, 345; correlated system of teaching, 346; title of Temple Uni- versity granted by court, 347; affilia- tion with Philadelphia Dental College and Garretson Hospital, 347; medical school transferred to Eighteenth and Buttonwood Streets, 347; requirements for graduation, 347; faculty of the de- partment of medicine, 348.— Philadel- phia Dental College, 350: Organiza- tion and charter, 350; trustees and (faculty, 350; changes in the faculty, 351; changes in the deanship and presidency, 352; development of the curriculum, 353; course in oral sur- gery, 353; Drs. McQuillen and Garret- son, 353; changes of location, 354; affiliation with Temple University, 354.— Garretson Hospital, 354: Origin, 355; union with Medico-Chirurgical Col- lege, 355; severance of relations with Medico-Chirurgical College, 355; incor- poration and change of name, 356; di- rectors and staff, 356; State appropria- tions, 356; completion of building, 356. —Samaritan Hospital, 357: Periods in its history, 357; origin in North Phila- delphia Hospital, 358; dedication, 358; arrangement of wards, 359; objects, 359; rules, 360; endowments, donations, etc., 361; management, 361; growth, 362; State appropriations, 362; statis- tics of cases and operations, 363; spe- cial surgical work, 364; staff and its reorganization, 364, 365. Thompson, John, 6. University of Pennsylvania, 223: Title, 223; periods in its history, 224; founda- tion of medical school, 224; first lec- tures on anatomy by Dr. Cadwalader, 225; Dr. Shippen's anatomical lectures, 226; proposal for the establishment of University of Pennsylvania, (Continued): medical courses by Dr. John Morgan, 227; first medical professorship, 227; second medical professorship confer- red on Dr. Wm. Shippen, Jr., 228; Morgan's inaugural address, 227; first clinical lecture at Pennsylvania Hos- pital by Dr. Thomas Bond, 228; first medical degrees, 228; additional profes- sorships, 229; first medical commence- ment, 229; effect of the revolution on medical teaching, 230; faculty dis- solved, 231; reorganization of medical school, 231; two separate medical schools, 232; their union, 234; election of professors, 234; new location on Ninth Street, 235; first law lectureship, 236; law lectures discontinued until 1817, 236; law department permanently established in 1850, 237; department of natural sciences, 237; abolished, 239; school of mines, arts, and manufac- tures, 240; prominence of the medical department, 241; relation of the medi- cal department to the Pennsylvania and Philadelphia Hospitals, 243; course in pharmacy, 243; first dispen- sary clinic, 243; auxiliary department of medicine, 244; removal to West Philadelphia, 245; rapid growth of the university, 246; dormitories, 247; uni- versity library, 247; authority of the provost, 248, 249; university hospital, 252, 253; William Pepper clinical labor- atory, 253; department of dentistry, 254; veterinary department, 255, 256; 257; biological school, 257; department of hygiene, 259; Wistar Institute of anatomy and biology, 259, 260; publi- cations of the Wistar Institute, 261; medical laboratories, 261; extension of the medical course, 262; endowment for medical research, 264. Wagner Free Institute of Science of Philadelphia, 206: Its founder, 206; act of incorporation, 206; first meet- ing place, 207; first faculty, 207; re- moval to present site, 207; proposed polytechnic course, 208; mechanics' in- stitute, 209; death of founder, 209; reorganization, 210; department of re- search, 210; "Extension Courses," 210; free public library, 211; publications, 211; list of trustees and faculty, 213; statistics of teaching in 1908, 213. West Philadelphia General Homoeopathic Hospital and Dispensary, 722: Origin, 722; description of property, 722, 723; 912 Index W. P. Gen'l Homceop. Hos. (Continued): additional buildings, 723; State appro- priations, 723; trustees, 724; lady managers, 724. West Philadelphia Hospital for Women, 834; Dr. Elizabeth Comly-Howell, 834; first location, 834; first staff, 835; first managers, 835; training school for nurses, 835; Anna T. Jeanes, 835; pur- chase of present site, 835; Woman's Auxiliary, 835; donations and additions, 836; nurses' home, 836; statistics, 836; officers, physicians, etc., 837. Widener Memorial Industrial Training School for Crippled Children, 874: Origin, 874; purchase of property, 875; cost of grounds and buildings, 875; endowment, 875; description of build- ings, 875; qualifications for admission, 876; nature of the work, 876; home training, 877; manual training, 877; trades, 878; discipline, 878; religion, 878; capacity of school, 879. Wills Hospital, 763: Anthony Benezet, 763; James Wills, 763; James Wills, Jr., 764; bequest of James Wills, Jr., 765; committee on the Wills legacy, 765; purchase of lot, 765; original be- quest, 765; total cost of hospital, 765; corner-stone, 765; first surgical staff, 765; design of testator, 766; board of directors of city trusts, 766; growth, 767; legacies, donations, and appro- priations, 767; sale of adjoining lots, 767; additions to building, 767; increase in staff, 767; description of work, 768; influence as a school of ophthalmol- ogy, 769; plans for reconstruction, 769; chronological list of surgeons, 769, 770. Woman's Hospital of Philadelphia, 776: Origin and charter, 776; location, 777; corporators and original contribu- tors, 777; relations with Woman's Med- ical College, 777; Anna B. Broomall Maternity, 778; additions to buildings, 778; nurses' home, 778; Spanish- Ameri- can War, 779; statistics, 779; training Woman's Hospital of Phila. (Continued): school for nurses, 779; State appro- priations, 779; Dr. Susan Hayhurst, 780; statistical table, 780. Woman's Medical College of Pennsylva- nia, 305: Incorporation, 305; first graduating class, 305; first annual an- nouncement, 305; Dr. Emmeline Cleve- land, 305; charter of Woman's Hos- pital of Philadelphia, 306; establish- ment of college hospital, 306; mater- nity department, 306; attendance of women students at the clinics of the Philadelphia and Pennsylvania Hos- pitals, 306, 307; resolutions of man- agers of Pennsylvania Hospital, 307, 308; Dr. Alice Bennett, 309; appoint- ment of Drs. Marshall and Croasdale to the staff of the Philadelphia Hos- pital, 309; Dr. Pauline Root appointed interne to the Philadelphia Hospital, 309; resolution of County Medical So- ciety with reference to women doc- tors, 309; letter of Dr. Ann Preston in reply to resolution of County Medical Society, 309-315; women made eligible to membership in County Medical So- ciety, 315; removal to present build- ing, 315; establishment of maternity hospital, 315; Barton dispensary, 316; faculty and auxiliary instructors, 317. Woman's Southern Homoeopathic Hos- pital of Philadelphia, 729: Origin, 729; first location, 729; purchase of Spruce Street property, 729; convalescent home, 729; improvements and altera- tions, 730; training school for nurses, 730; ambulance, 730; bequests, 730; appropriations, 730; statistics, 731; offi- cers, 731. Women's Homoeopathic Association of Pennsylvania, 710: Origin, 710; char- ter, 711; donations, 711; maternity building, 712; bequest of Mary Jeanes. 712; isolation ward, 712; Spanish War, 712; additional building, 712; home for nurses, 712; State appropriations, 712. ,■ ■"■■■ . •" m A frr h -