R) HX64096793 R1 54. P6 P94 Proceedings and addr RECAP IN HONOR OF LEWIS STEPHEN PILCHER 12 MAY, 1916 Columbia Winihtxsiitp in ttie Cit j» of ^eto l^orfe CoUege of ^ftpsficiang anb ^urgeong 3^ef erence Xitirarp IN HONOR OF LEWIS STEPHEN PILCHER 12 MAY, 1916 Digitized by the Internet Archive in 2010 with funding from Open Knowledge Commons http://www.archive.org/details/proceedingsaddreOOphil PROCEEDINGS AND ADDRESSES AT THE RECEPTION AND BANQUET IN HONOR OF Dr. Lewis Stephen Pilcher IN CELEBRATION OF THE COMPLETION OF HIS SERVICES OF FIFTY YEARS AS A DOCTOR OF MEDICINE, BY THE MEDI- CAL SOCIETY OF THE COUNTY OF KINGS, U. S. GRANT POST NO. 327, OF THE DE- PARTMENT OF NEW YORK, GRAND ARMY OF THE REPUBLIC, AND THE MONTAUK CLUB OF BROOKLYN ON FRIDAY EVEN- ING, THE TWELFTH OF MAY, NINE- TEEN SIXTEEN, AT HOTEL BOSSERT, BROOKLYN, NEW YORK PRINTED BY J. B. LIPPINCOTT COMPANY Washington Square Press, Philadelphia 1916 I BIOGRAPHICAL MEMORANDA OFFICERS OF THE U. S. STEAMER PENOBSCOT, MAY, 1 868 I, PAYMASTER HURLBUT; 2, SURGEON PILCHER; 3, ENSIGN DORTON; 4, ENGINEER morgan; 5, CHIEF ENGINEER MELVILLE; 6, NAVIGATING OFFICER NELSON; 7, MASTER KENNISON U. S. STEAMER PENOBSCOT, IN THE HARBOR OF KINGSTON, JAMAICA, IN MAY, 1868. ONE OF THE 90-DAY GUN-BOATS BUILT FOR BLOCKADE DUTY DURING THE WAR FOR THE UNION BIOGRAPHICAL MEMORANDA, 1845-1916 Lewis Stephen Pilcher was born in Adrian, Michigan, July 28, 1845, son of Elijah Holmes Pilcher and Phoebe Maria (Fisk) Pilcher. He entered the University of Michigan in 1858, at the age of thirteen, and was graduated as Bachelor of Arts in June, 1862, in his seventeenth year. He is the youngest graduate on the records of the institution. He pursued post-graduate studies at his Alma Mater and received his degree as Master of Arts in June, 1863, at the age of seventeen. He then took up medical studies at the University of Michigan. These were interrupted by his enlistment as a hospital steward in the U. S. Army in February, 1864. He served in that capacity in Virginia and in Missouri until September, 1865, when he was mustered out of service by reason of the close of the war. He then resumed his medical studies at the University of Michigan and received the degree of Doctor of Medicine on the 28th of March, 1866. After a brief period of service as House Surgeon in the Harper Hospital, at Detroit, Mich., he came to New York City and pursued post-graduate medical studies, until April, 1867, when he was commis- sioned as an Assistant Surgeon in the United States Navy. He remained in the medical service of the Navy until April, 1872, when, after having been promoted to the grade of Past-Assistant Sur- geon, he resigned to enter private practice in the city of Brooklyn. During his naval service he spent two years in the West Indies and received special commendation for service on board the United States frigate Saratoga during an epidemic of yellow fever on board that ship in the spring of 1869. While yet in the naval service, in June, 1870, he was married to Martha S. Phillips of Brooklyn. They have had five children. His oldest son, Lewis F. Pilcher, is State Architect of the State of New York. His two younger sons, Paul M. Pilcher and James T. Pilcher, both surgeons, are at present associated with him in his work. One daughter, Martha Eleanor, died in infancy; one, Mrs. Charles I. DeBevoise, died in 1916. In 1872 he was appointed one of the attending physicians at the Brooklyn Central Dispensary, a position which he retained until the following year when he gave it up to become one of the surgeons in the Outdoor Department of the Long Island College Hospital, which position he retained for ten years. 9 From 1872 to 1879 he occupied the position of Lecturer on Anatomy in the Reading Course of the Long Island College Hospital, and from 1879 to 1882 that of Adjunct Professor of Anatomy in the Long Island College Hospital. In 1883 his first book was published under the title of " The Treat- ment of Wounds," issued by Wood & Co., of New York. In 1885 he was appointed Professor of Clinical Surgery in the New York Post Graduate Medical School and Hospital, which position he held until 1895. From 1879 to 1884 he maintained a private anatomical laboratory in collaboration with others of his medical confreres by whom the society termed the Brooklyn Anatomical and Surgical Society was formed. As the result of the activities of this society during the years 1880, '81, '82 and '83 a monthly publication termed the Annals of Anatomy and Surgery was carried on. In 1881 he was one of the incorporators of the hospital founded by the gifts of Mr. George I. Seney, under the name of the Methodist Episcopal Hospital of Brooklyn. He prepared the preliminary plans and instructions to the architects that were adopted, and remained as a member of the Board of Managers from its organization up to 1907. Upon the formation of the Medical Board of the Hospital in 1887 he was made one of the attending surgeons and President of the Medical Board, a position which he occupied until 1907. In 1884 he began the publication of a monthly journal devoted to surgery under the title of The Annals of Surgery, which has continued to appear without intermission from that time to the present and is now in its 62nd volume. He was elected President of the New York State Medical Society for 1892. He was a member of the Council of the Surgical Section of the Third International Congress of Medicine held in 1887. Was Honorary Chairman of the Section of Anatomy of the Pan- American Medical Congress in 1893. Was Vice-President of the American Surgical Association in 1893 and again in 1914. He was President of the Medical Society of the County of Kings in 1900. He has contributed chapters to the following encyclopaedic medical works : " American System of Diseases of Children," Keating, 1889. " Reference Hand Book of Medical Science," Wm. Wood & Co., 1887. " The American Text Book of Surgery," Keen & White, 1892. 10 " The American System of Surgery," Dennis, 1895. " The International System of Surgery," Warren-Gould, 1900. " Text Book of Surgical Diagnosis and Treatment," Ochsner, 1916. Author of many monographs and pamphlets on medical and surgical subjects. Has published two volumes of essays and addresses : " Odium Medi- cum," J. B. Lippincott Company, 191 1, and " The Commander's Year," J. B. Lippincott Company, 1914. Surgeon to the German Hospital from 1900 to 1908. Consulting Surgeon since 1908. Consulting Surgeon to St. John's Hospital ; to the Norwegian Hos- pital ; to the Jewish Hospital ; to the Bethany Deaconess Hospital ; to the Skin and Cancer Hospital of New York; to the Methodist Episcopal Home for the Aged of Brooklyn. Member of the Aertzliche Collegium of the German Hospital of Brooklyn, since 1900. Member of the Advisory Committee of the Greenpoint Hospital. Member of the Board of Medical Examiners of the State of New York since 191 3. Was the Anniversary Orator before the New York Academy of Medicine in 1899. In 1900 was honored by the degree of Doctor of Laws both from his Alma Mater, the University of Michigan, and from Dickinson College of Pennsylvania. Fellow of the American Surgical Society. Honorary Fellow of the American College of Surgeons. Honorary Member of the New York Surgical Society. Honorary Fellow of the Philadelphia Academy of Surgery. Honorary Fellow of the National Association of Railway Surgeons. Associate Fellow of the College of Physicians of Philadelphia. Member of the Brooklyn Surgical Society. Member of the Societe Internationale de Chirurgie. Member of the New York State Medical Society. Member of the Medical Society of the County of Kings. Member of the American Medical Association. From 1900 to 191 3 Member of the Borough Council and President of the Board of Education and of the Board of Health of the Borough of Hopatcong in New Jersey. Companion of the Military Order of the Loyal Legion. Comrade of the Grand Army of the Republic. Commander of Grant Post, No. 327, Department of New York, G.A.R., in 1913. Surgeon-General of the Grand Army of the Republic, 191 5. 11 Member of the Montauk Qub. Member of the Charaka Club. Has found time to travel and accompanied by his wife has travelled over Europe from Trondhjem, Norway, in the north, to Assuan, Egypt, in the South ; and in America from Miami, Florida, to Lake St. John in Canada, and from Arizona to Alaska, and has made repeated visits to the West Indies. In 1908 after retiring from general hospital work, established with the help of his sons a private surgical hospital for their personal work, in which his work has been carried on to the present time and from which annual volumes have been issued giving the studies and observa- tions made in the institution. Retirement from general practice and devotion to surgery wholly, in 1890. Periods into which professional life has been divided : Military period, 1864-1872, eight years, excluding one year devoted to medical studies, 1865-1866. General practice, 1 872-1 890. Surgery exclusively, 1890-1916. 1893 PRESIDENT OF THE MEDICAL SOCIETY OF THE STATE OF NEW YORK II THE INAUGURATION OF THE CELEBRATION, 1916 THE LEWIS STEPHEN PILCHER SEMI- CENTENNIAL CELEBRATION The Inauguration of the Celebration Resolutions adopted by the Medical Society of the County of Kings, December 21, 1915, by a unanimous vote: Whereas Dr. Lewis Stephen Pilcher will, in March, 191 6, have completed fifty years of labor in the profession of medicine, and Whereas, During all these years he has stood among us an exem- plar of sturdy manhood, unflagging industry, rich scholarship and uncompromising integrity, and Whereas, In his versatile attainments as soldier, surgeon, teacher, author and editor, he has received not only national but international recognition. Resolved, That the undersigned, deeply conscious of Dr. Pilcher's contributions to manhood and to medicine and believing that this unique event presents a rare opportunity for the medical profession of Brooklyn to honor itself by a public recognition of its most dis- tinguished colleague, do hereby request that the Medical Society of the County of Kings appoint a committee of three with power to arrange for a suitable celebration of the " Lewis Stephen Pilcher Semi-Centen- nial," that this committee be authorized to add to its number as many as may be deemed necessary to properly represent the various medical interest of this borough ; and further That the appointment of this committee be the first act of the President-telect for 191 6. J, BiON Bogart H. Beekman Delatour William Francis Campbell W. B. Brinsmade J. Richard Kevin John Cowell MacEvitt Walter A. Sherwood J. W. Fleming Russell SL Fowler P. M. Pilcher Chas. N. Cox Henry A. Fairbairn O. A. Gordon Raymond P. Sullivan John A. Lee Ralph H. Pomeroy William Linder John Osborn Polak A, M. JuDD O. P. Humpstone 17 LETTER FROM THE DIRECTORS OF THE MONTAUK CLUB November 28, 191 5. My dear Dr. Pilcher : At a meeting of the Directors of the Montauk Club, held the 20th inst., it was unanimously resolved that a reception and dinner be ten- dered to you at our Qub House on the evening of March 28, 191 6, in celebration of the 50th Anniversary of your admission to practise in the noblest and highest of all professions. It is needless to add, my dear doctor, that the Montauk Club, with its many friends in your profession and in Grand Army circles, will honor itself in honoring one whose skill has been working wonders in the past and creating new hope for to-morrow. Yours very truly, B. A. Greene, Secretary. ACTION BY U. S. GRANT POST, NO. 327 Department of New York, Grand Army of the Republic From Minutes of Encampment of March 14, 1916 The Commander stated that the Post had been invited to practici- pate in a testimonial dinner to be given May 12th to Comrade Pilcher by his professional friends, and that he had designated Comrades Peckham and Parsons to act with himself upon the Committee of Arrangements. Comrade Peckham moved that the Post co-operate in this dinner, which motion was carried by a unanimous vote. W. C. Peckham, Adjutant. in THE COMMITTEES APPOINTED THE LEWIS STEPHEN PILCHER SEMI-CENTENNIAL COMMITTEES Chairman Dr. William Francis Campbell Secretary Dr. Walter Aikman Sherwood Treasurer Dr. John Osborn Polak THE HONORARY COMMITTEE Rev. Chas. Carroll Albertson, D.D. Dr. Oscar H. Allis Dr. George E. Armstrong Mr. Charles D. Atkins Col. Andrew D. Baird Prof. Dr. Raffaele Bastianelli Rev. John L. Belford Hon. William Berri Dr. Arthur Dean Bevan Surgeon-Gen. Rupert Blue Mr. Edward C. Blum Rev. Nehemiah Boynton^ D.D. Right Rev. Frederick Burgess, D.D., LL.D. Rev. Joseph D. Burrell, D.D. Rev. S. Parkes Cadman, D.D., LL.D. Hon. William A. Calder Sir Watson Cheyne Hon. Frederick E. Crane Dr. George W. Crile Hon. William Dickey Dr. Charles N. Dowd Mr. Percy S. Dudley Mr. William H. English Mr. E. Ericksen Hon. John H. Finley Mr. Crighton B. French Dr. Frederic H. Gerrish Dr. Arpad G. Gerster Dr. W. Stanton Gleason Sukgeon-Gen. William C. Gorgas Prof. Dr. Henri Hartmann Mr. Frederick E. Heitmann Rev. St. Clair Hester, D.D. Rev. Newell Dwight Hillis, D.D. Rev. James E. Holmes, D.D. Mr. Arthur Howe Dr. Thomas W. Huntington Dr. Henry M. Hurd Dr. Abraham Jacobi Mr. Henry C. Jahne Dr. Walter B. James Hon. Walter H. Jaycox Dr. William W. Keen Rev. W. V. Kelley, D.D. Prof. Dr. Theodor Kocher Rev. Nathan Krass, D.D. Dr. Robert G. Le Conte Dr. Frederick B. Lund Very Rev. Mons E. W. McCarty, D.D. Very Rev. Mons. Joseph McNamee, D.D. Sir William Macewen Dr. Rudolph Matas Dr. William J. Mayo Rev. J. Howard Melish, D.D. Dr. Robert T. Morris Sir Berkeley Moynihan Dr. John B. Mltrphy Sir William Osler Hon. Lewis H. Pounds Hon. William A. Prendergast Dr. John B. Roberts Prof. Dr. Thorkild Rovsing Rev. Frederick F. Shannon, D.D. Dr. Stephen Smith Hon. Luke D. Stapleton Dr. Albert A. Vander Veer Dr. Victor C. Vaughan Rev. N. McGee Waters, D.D. Dr. William H. Welch Dr. J. William White Rev. Andrew C. Wilson 20 THE EXECUTIVE COMMITTEE Dr. L. Grant Baldwin Dr. Dr. Calvin F. Barber Dr. Dr. Eli as H. Bartley Dr. Dr. Bruce G. Blackmar Dr. Dr. Silas G. Blaisdell Dr. Dr. Arthur H. Bogart Dr. Dr. J. BioN Bogart Dr. Dr. William B, Brader Dr. Dr. William B, Brinsmade Dr. Dr. Samuel S. Brown Dr. Dr, Glentworth R. Butler Dr. Dr. William Francis Campbell Dr. Dr. Charles N. Cox Dr. Dr. H. Beekman Delatour Dr. Dr. John G. Dickert Dr. Dr. Robert L. Dickinson Dr. Dr. James M. Downey Dr. Dr. Warren L. Duffield Dr. Dr. Roger Durham Dr. Dr. Charles Eastmond Dr. Dr. Henry A. Fairbairn Dr. Dr. Mathias Figueira Dr. Dr. Edwin H. Fiske Dr. Dr. James W. Fleming Dr. Dr. Henry P. de Forest Dr. Dr. Russell S. Fowler Dr. Dr. Thomas R. French Dr. Dr. Charles P. Gildersleeve Dr. Dr. Charles H. Goodrich Dr. Dr. Onslow A. Gordon Dr. Dr. Burt D. Harrington Dr. O. Paul Humpstone John E. Jennings Albert M. Judd James C. Kennedy J. Richard Kevin John A. Lee William Linder John A. McCorkle John C. MacEvitt William H. Maddren Earl H. Mayne Henry B. Minton Burr B. Mosher Paul M. Pilcher John Osborn Polak Ralph H. Pomeroy John F. Ran ken William H. Rankin Dudley D. Roberts John D. Rushmore John H. Schall Walter Aikman Sherwood Warren S. Simmons Thomas B. Spence John D. Sullivan Raym^ond p. Sullivan Henry A. Wade James P. Warbasse Cassius H. Watson Henry G. Webster Richard W. Westbrook THE U. S. GRANT POST COMMITTEE Mr. Birt F. Parsons Mr. Crighton B. French Mr. William C. Peckham THE MONTAUK COMMITTEE Mr. Wiluam H. English Mr. Bartholomew A. Greene Mr. Jesse L. Hopkins Mr. James G. Shaw Dr. J. Scott Wood 21 RECEPTION COMMITTEE Former Presidents of the Kings County Medical Society James W. Fleming, Chairman Elias H. Bartley John Richard Kevin William Browning John O. Polak Glentworth R. Butler Ralph H. Pomeroy William F. Campbell Jonathan S. Prout Walter B. Chase John C, MacEvitt Charles N. Cox John A, McCorkle Z. Taylor Emery Alexander R. Matheson Henry A. Fairbairn Frank E. West Russell S. Fowler Joshua M. Van Cott Onslow A. Gordon James MacFarland Winfield TOASTMASTER WILLIAM FRANCIS CAMPBELL, A.B., M.D. SPEAKERS VICTOR C. VAUGHAN, M.D., LL.D. PROF. WILLIAM C. PECKHAM, M.A. WILLIAM W. KEEN, M.D, LL.D., F.R.C.S. {Eng.) HON. JOHN H. FINLEY, LL.D. WILLIAM J. MAYO, M.D., LL.D., F.R.C.S. {Eng.) REV. S. PARKE9 CADMAN, D.D., LL.D. CHARLES L. DANA, M.D., LL.D. Presentation of Medal JAMES PETER WARBASSE, M.D. IV LETTERS OF REGRET AND APPRECIATION LETTERS RECEIVED FROM SIR WILLIAM OSLER Regius Professor of Medicine in the University OF Oxford, England 13, NoRHAM Gardens, Oxford, qth. To the Chairman of the Committee of Arrangements : I will do so with the greatest pleasure as I have always had a warm appreciation of Dr. Pilcher as a man and a surgeon. Yours, Wm. Osler. FROM DR. THEODORE A. McGRAW ( Ufider whom, as Attending Surgeon at the Harper Hospital of Detroit, Dr. Pilcher served as Interne in 1866.) Tryon, N. C, May 19, 1916. Dear Dr. Pilcher : I have just received an invitation to attend the reception and ban- quet to be given in your honor on the twelfth of this month. It is with great regret that I find it impossible to be present at an event which would yield me so much pleasure as this. It would enable me to express my high regard for one whom I have been accustomed to think of as an old friend and, in addition, the great appreciation which I have for the services you have rendered during many years to your profession and to humanity. Please accept my hearty congratulations on the fiftieth anniversary of your entrance into the profession. Very sincerely yours Theodore A. McGraw. FROM PROFESSOR DR. THEODOR KOCHER Of Berne, Switzerland, Professor of Surgery in the University OF Berne Professor Kocher, of Berne, wishes to express his warmest appre- ciation of the services which Dr. Lewis Stephen Pilcher has rendered to the medical profession as Chief Editor of that excellent periodical 27 the Annals of Surgery. The art of gathering in one journal such a lot of scientific worl-c from the best men of a large country points not only to a great skill, but still more to great wisdom and kindness of the editor to the medical profession. I am sure that such work has been a great part in the wonderful progress of surgery, which has been accomplished in the United States and which will make it true what an excellent friend in Boston told me once : " Now we Americans come to see and study your work, but time will come when European surgeons will do the same in coming to see what we do," I can only say for myself, that the Annals of Surgery when they arrive have not to wait long on my writing table till I look through the many excellent articles they contain. May Dr. Pilcher continue for many years to contribute to the scientific progress of surgery by his own work and that of his col- leagues and friends. Th. Kocher. To the Fiftieth Anniversary of the Doctorate of Medicine of Dr. Lewis Stephen Pilcher, 26, 3, 191 6. FROM SIR WILLIAM MACEWEN Of Glasgow, Professor of Surgery in the University of Glasgow 3 WooDSiDE Crescent, Charing Cross, Glasgow, 9, 2, 1916. I rejoice to hear from your letter of 25th of Jan'y just received, that the Professional Colleagues and friends of Dr. Lewis Stephen Pilcher, Editor of the Annals of Surgery, who will have attained the Fiftieth Anniversary of his Doctorate on 28th March, 19 16, are to honor the event by a Banquet. My present duties as Surgeon-General R. N. preclude me from being with you on that occasion, but, though absent in body, I join you in spirit as Lewis Pilcher is one of my oldest and staunchest American friends. I have known and admired his Surgical and his Literary work since the days of the Annals of Anatomy and Surgery, through all the struggles of the earlier volumes of the Annals of Surgery until, in the fullness of time, the Annals has emerged into the foremost rank of Surgical journals of the world. The labour involved in such an undertaking, only those who have attempted literary work can con- ceive, but the result attained is monumental. All honour to him ! 28 It is unnecessary for me to refer to Lewis Pilcher as a distinguished Surgeon of world-wide renown, especially at a meeting of his Surgi- cal friends and Colleagues, though I see him now as I saw him twenty years ago, in the Methodist Hospital of Brooklyn, performing a gastro- enterostomy with the ease and elegance of an accomplished artist who, with a few deft strokes, produces a finished picture. Will you kindly give for me to your honoured guest a hearty hand- grip and a straight look through the fundus into his soul and wish him health and happiness and many more years of fruitful life and prosperity. Yours faithfully, William Macewen. FROM PROFESSOR DR. THORKILD ROVSING Of Copenhagen, Denmark, Professor of Clinical Surgery in the University of Copenhagen My dear Doctor Lewis Stephen Pilcher : I am very sorry that my duties here prevent me crossing the ocean to bring you personally the homage and the warmest greetings in the name of European Surgery and in my own at the banquet, which I learn shall be held on the evening of the Fiftieth Anniversary of your Doctorate in Medicine. Many years I only knew you through the Annals of Surgery , which I always found the best conducted, the most dignified surgical periodical in the world. From the qualities of the Annals I made at distance something like a diagnosis of the editor's character. As I met him the first time personally, having the pleasure of seeing him as my guest here in Copenhagen, I found my diagnosis confirmed, but I found much more I did not dream about. I found a man of noble, gentle, utmost modest appearance, under which I discovered the most cultivated, scientific intelligence, fully laden with knowledge not only of modern medicine but as well of the entire history of medicine, interested in every scientific problem as well as in every problem of humane and ethical nature. In your presidential address, delivered before the Medical Society of the State of New York, 1893, " The Evolution of the American Surgeon," you said the remarkable words : " The surgeon of the present day, therefore, if we are correct in the statement of the conditions that have attended his evolution, is necessarily a physician in the broadest seme." 29 Even such a physician in the broadest sense are you and I con- gratulate your patients on having such a doctor, but still more I con- gratulate all the pupils whom you have educated. For I diagnose in you a great teacher, a great educator. * * * As well as author as in your quality of editor of Annals of Surgery, you have had a great educating influence not only upon the American surgeons, but upon us European surgeons too. Through the always utmost critical selection of papers and authors, admitted to the columns of Annals of Surgery, you created a great, never shaken confidence in the readers and opened our eyes as to how much we have to learn from American Surgeons. Through the Annals we got a true picture, a vivid impression of the evolution of the scientific American surgeon up to his very high standing of to-day ! To this evolution you have sacrificed fifty years of indefatigable, un- selfish and very important work and therefore seems the demonstra- tion of honors, brought you to-day from your American colleagues, most justified and well deserved. Allow me to join my American colleagues and in the name of all your European friends and admirers to bring you our most cordial thanks for the great and noble work, which you through fifty years have devoted to the development of Medicine in the broadest sense — to Surgery, the noblest of all professions ! May you still for many years enjoy the same happiness in your work and in your wonderfully harmonious family-life ; may we, your friends and admirers, still for many years enjoy your friendship and your genius ! Truly yours, Thorkild Rovsing. Copenhagen, Julienne Mines, Vei 2. FROM PROFESSOR DR. HENRI HARTMANN Of Paris, France, Professor de Clinique Chirurgicale a Universite de Paris February 14, 191 6. Mr. President: Allow me to join the pupils and friends of Dr. L. S. Pilcher and bring him, on the fiftieth anniversary of his graduation, the homage of his French colleague. I need not recall the numerous publications that have made his name illustrious ; you know them better than I, and have been able to measure their value ; but, having been a constant reader of the Annals 30 of Surgery for thirty years, I wish to say how much this work, directed by Dr. L. S. Pilcher since its inception, has meant to the surgeons of the whole world, by enabling them to know the important work of their Anglo-American colleagues. I am all the more delighted to join you in the present celebration, as the banquet of April ii, 19 14, given by the University Club of Brooklyn, at which I had the honor of being present, has left in my mind the most charming recollections. It is therefore with sincere joy that I beg you to bring to Dr. L. S. Pilcher the most sincere regards and congratulations of Yours devotedly, Hartmann. FROM SIR WATSON CHEYNE Of London Royal Naval Hospital, Chatham, March 2, 1916. To THE Chairman of the Committee of Arrangements : I am very interested to hear of Dr. Pilcher's anniversary on March 28th and I shall be glad if you will convey to him my sincere felicita- tions. In editing the Annals of Surgery he has carried out a very great work and one of the greatest value especially to the English speaking world. Owing to the great care and skill which have been bestowed on it, the Annals has taken the premier place among journals of its kind and has done much to advance the Science and Art of Surgery. It must be a great pleasure to Dr. Pilcher to feel that he has idone so much for our science and to know that his labours are highly appreciated by all the world. Yours sincerely, W. Watson Cheyne, FROM PROFESSOR DR. RAFFAELE BASTIANELLI Of Rome, Italy I am thinking with great pleasure of the day which will collect the Medical profession of Brooklyn and many fellow surgeons of U. S. A. to celebrate the fiftieth anniversary of Dr. L. Stephen Pilcher's Doc- torate of Medicine. His services to Surgery have been of such a kind that every one must feel deeply indebted to him. For many, many years the Annals of Surgery have spread all the Medical world through the teaching and the experience of English speaking surgeons, contributing widely to the exchange of thoughts between America and Europe. The high scientific and moral character of this journal for 31 which Dr. Pilcher deserves a great credit has given to it one of the first and permanent positions in the surgical literature of the world. Besides the high appreciation in which I hold the man through personal acquaintance, I feel as a constant reader of the journal a great indebtedness. I wish to send to him through you on this occasion my deepest feelings of appreciation and of gratitude together with the strongest certitude that his work will remain forever. He is a jolly fellow. May he live happy and long ! With many thanks to you, I remain, Yours truly, Dr. Raffaele Bastianelli. Roma, March 5, 1916. FROM J. WILLIAM' WHITE, M.D., LL.D. Of Philadelphia, Pa., Professor of Surgery in the University OF Pennsylvania Philadelphia, January 28, 1916. To the Chairman of the Committee of Arrangements: Your note of January 26th finds me in the fourth month of an obscure lumbar spondylitis, with associated neuritis and excessive pain. 1 am unable to leave my room and altogether unfitted for any duty of any sort ; but if you think it would in the slightest degree gratify Dr. Pilcher to have my name added to the Honorary Committee, and if it is really to be Honorary, so that I may not find myself in the position of leaving work for others to do, I shall certainly be glad to go upon it. Will you be good enough to explain the circumstances to Dr. Pilcher and at the same time to give him my very warm regards and best wishes, and my congratulations on his having completed a so distin- guished and noteworthy period of service to our profession and to humanity at large ? Yours truly, J. William White. FROM RUDOLPH MATAS, M.D. Of New Orleans, La., Professor of Surgery in Tulane University February i, 191 6. To THE Chairman of the Committee of Arrangements : I hasten to express my great appreciation of the honor of your invitation to form part of the Semi-Centennial Committee appointed to co-operate in the celebration of Dr. Lewis Stephen Pilcher's Fiftieth Anniversary of his Doctorate in Medicine. I rejoice at the opportunity 32 to testify, in some way, to my admiration of his splendid accomplish- ments and his great career of inspiring activity in behalf of the medical profession and especially of the advancement of Surgery; and, in addition, my personal respect and friendship for him as a man, whose example is so eminently worthy of recognition as a model for the present and coming generations of American Surgeons. While it may not be possible for me to attend the celebration in person, I feel a deep and sincere interest in the success of so notable an occasion and you may count upon my good will and enthusiastic support at all times in any way that I may be called upon to co-operate with you. Again with heartiest and best wishes for a long continuance of Dr. Pilcher's career of exemplary citizenship and professional useful- ness, in perfect health and happiness, I am. Yours very sincerely, R. Matas. FROM FREDERIC HENRY GERRISH, M.D., LL.D. Of Portland, Me., Professor of Surgery in the Medical Department of Bowdoin College Portland, Me., 7, February, 1916. To the Chairman of the Committee of Arrangements. My Dear Sir : Your very kind letter, announcing the celebration of Dr. Pilcher's fiftieth anniversary of his doctorate, and expressing his wish that my name be placed upon the Honorary Committee, thrills me with sym- pathetic emotions. I wish that I could do a great deal more to show my genuine interest in the occasion than merely to grant this request, which, in itself, is so complimentary to me. I can never forget what I owe to Dr. Pilcher's personal regard and thoughtful kindness; and I always remember him with gratitude and affection. Long may he live to enjoy the blessings of the multitudes, to whom his skill has brought health, and his benign presence courage and strength. Of course, my cordial compliance is the only possible answer to his most friendly desire. Very sincerely yours, Frederic Henry Gerrish. 33 FROM THOMAS W. HUNTINGTON, M.D., LL.D. Of San Francisco^ Cal., Professor of Surgery (Emeritus) in the University of California San Francisco, Cal., March 22, 19 16. My dear Doctor Pilcher : I take this occasion to congratulate you upon having attained to the fiftieth anniversary of your doctorate in medicine. This event, in your life, is the more notable because you have come up to a ripe age, after a lifetime of earnest and devoted work in your chosen profession, while in the possession of all your faculties and with the prospect of added years of honorable usefulness. A host of friends, myself included, throughout the civilized world, join in the wish that your future, as your past, may be attended with prosperity and happiness. Very cordially yours, Thomas W. Huntington. FROM ARTHUR DEAN BEVAN, M.D. Of Chicago, III., Professor of Surgery in the University of Chicago Chicago, III., January 28, 1916. To the Chamnan of the Committee of Arrangements. Dear Doctor : Received your letter of January 26th in regard to Dr. Lewis S. Pilcher. I shall be delighted to be one of the committee. Dr. Pilcher's work deserves proper recognition from the surgeons of the United States. He has done more than any other man to develop American surgical literature and secure for it international recognition. Very truly yours, Arthur Dean Bevan. FROM ABRAHAM JACOBI, M.D., LL.D. Of New York New York, N. Y. January 27, 1916. To the Chairman of the Committee of Arrangements, Dear Doctor : My thanks are due you for your invitation to join you in doing honor to our distinguished friend. I never thought he was old or getting old. I shall always be pleased to be mentioned in connection with him. Very truly yours, A. Jacobi. 34 FROM ALBERT VANDER VEER, M.D., LL.D. Professor of Surgery, Albany Medical College, President of the American Medical Association April 26, 191 6. To the Chairman of the Committee of Arrangements : In reply to your kind letter would say it gives me great comfort to accept your invitation, and I am looking forward with much pleasure to being with you at the 50th Anniversary of Dr. Pilcher's practice. I am so happy to note you are paying him this tribute of respect, for no man is more worthy. With my very best wishes, Affectionately yours, A. Vander Veer. FROM STEPHEN SMITH, M.D., LL.D. Of New York 260 West 76th Street, May 5, 1916. My dear Dr. Pilcher : I regret very much that I shall be unable to attend your reception and banquet, owing to the fact that at the age of 93 I find it a matter of prudence to pass my evenings at home. I am thereby deprived of many enjoyable occasions of a professional and social character, as your banquet would be ; but I must yield to the inevitable. I am delighted that you are to receive this public honor, which has been richly earned by a life intensely devoted to conserving the welfare of the people. Believe me, dear Dr. Pilcher, as sincerely. Thy friend, Stephen Smith. FROM HON. LEWIS H. POUNDS President of the Borough of Brooklyn Brooklyn, February 3, 1916. To THE Chairman of the Committee of Arrangements : I was very glad to receive your letter announcing that there would be a celebration of the fiftieth anniversary of Lewis Stephen Pilcher's Doctorate in Medicine, on March 30th. It is a celebration in which all good Brooklynites will be happy to join, and I accept with pleasure your invitation to serve on the Honorary Committee, and to co-operate with the medical profession in paying tribute of esteem to Dr. Pilcher. There is no doubt that the celebration will be one which will reach far beyond the borders of the city. Such a distinctive event should 35 arouse interest in the medical profession throughout the entire United States. It is a fitting recognition of the excellent work that Dr. Pilcher has done. He has contributed, in a large measure, to the surgical advance in this country. I am happy indeed to be numbered among his friends. It will be most agreeable to me to be a part of this event, except that I cannot spare much, if any, extra time. I presume this will not be necessary. sincerely yours, L. H. Pounds, President, Borough of Brooklyn. FROM REV. JOSEPH DUNN BURRELL, D.D. Pastor of the Classon Ave. Presbyterian Church of Brooklyn Brooklyn, New York, May 9, 1916. My dear Dr. Pilcher : I regret very much that I am disappointed in my hope to be with your many appreciative friends at your dinner Friday night. It will be a splendid and deserved tribute to your commanding work, and I am sorry not to share in your triumph. It must be a great satisfaction to you to look back over your life's achievement and realize how deeply you have the gratitude of the multitudes you have served. There is no work in the world more truly Christian than that of the physician and surgeon, and this community honors itself in honoring such men. Faithfully yours, Joseph Dunn Burrell. Dr. Lewis S. Pilcher, 802 Carroll St. REV. H. G. MENDENHALL, D.D. Moderator of the Presbytery of New York 311 West 75th Street, New York, May 10, 1916. Dr. Lewis Pilcher, Brooklyn, N. Y. Dear Dr. Pilcher : Permit me to join your host of friends in extending to you my congratulations at this very important time in your life. I do not forget, and never can, the splendid work you did in my home almost twenty-five years ago, and this act has been duplicated, I am sure, hundreds of times in other homes. It is a very joyous thing for a man of your position to come to this period in his life with the respect, confidence and the love not only 36 of his professional friends but from those to whom he has ministered. May your years long be lengthened and be filled with good deeds and the blessings which they bring. Sincerely yours, H. G. Mendenhall. FROM DR. ROBERT ABBE 13 West 50th Street, New York, May 10, 1916. My dear Dr. Pilcher : A bad attack of gout has kept me in bed for two weeks, and will prevent my helping to do you honor, at the reception of the twelfth. My affection and esteem go out to you on this semi-centennial of your beautiful lifework. I share with all who know you the feeling that honors that are showered upon you are nothing to the inner con- sciousness of maintaining the high standard of scientific work, of pioneer effort, of that beautiful sense of honor, and sustained effort to uphold the glory and dignity of our profession which are your just claim. Affectionately yours, Robert Abbe. FROM DR. JAMES S. REEVE 572 Oneida Street, Appleton, Wisconsin. Dr. John Osborn Polak, Brooklyn, N. Y. My dear Doctor : I feel much gratified at the invitation to attend the banquet in honor of Dr. Pilcher's fifty years of service in the practice of medicine. It will be impossible for me to attend the banquet, but I should be glad to have you tender to Dr. Pilcher my regrets that distance forbids my accepting the invitation, and my congratulations on the occasion. My acquaintance with Dr. Pilcher was due to my service under him as interne in the Methodist Hospital, in Brooklyn, more than twenty- five years ago, but time has not lessened my admiration for him as a surgeon and as a man, and I cherish a lasting gratitude for his sym- pathy and counsel to all of us internes, who^ learned much more than they realized at the time, through contact with one possessing such rare discrimination, full knowledge, and broad outlook. It would give me the greatest pleasure to be present at the banquet, and to meet Doctor Pilcher once more, but although it will not be possible I shall cherish the hope that I may see him again some day, and present my congratulations in person, even if they are delayed. Sincerely yours, James S. Reeve. 37 FROM HON. ALFRED B. BEERS Past Commander-in-Chief of the Grand Army of the Republic Bridgeport^ Conn., May ii, 1916. John Osborn Polak, M.D., 287 Clinton Ave., Brooklyn, N. Y. Dear Sir: I acknowledge the honor of an invitation to the Lewis Stephen Pilcher, M.D., Semi-Centennial Banquet, May 12, 1916. The eminent services of Dr. Pilcher in behalf of his country during" the War for the Union, his long and successful career in his chosen profession as a Doctor of Medicine, his well-earned eminence in his profession, his years of faithful and conscientious service in behalf of suffering humanity, his freely-given efforts in behalf of his fellow-men in every walk of life, his interest and work in behalf of his comrades of the Grand Army of the Republic, his high character as a professional man, a husband, a father and as a citizen, and his genial qualities as a friend, have combined to make him loved and respected by all who have the honor of his friendship. I regret that temporary physical conditions will not permit me to be present to pay my respects and to do honor to one whom I esteem, so highly as Dr. Pilcher. Kindly present my congratulations to him and my wish that he may live long to enjoy the honors of a well-spent life and the society and companionship of his family and of that multitude of admiring: friends and comrades of whom I have the honor to subscribe myself as one. Very sincerely yours, Alfred B. Beers, Past Commander-in-Chief, Grand Army of the Republic^ This letter from Sir Victor Horsley was received in New York August 21, some weeks after the death of its distinguished author, and after this volume was in print. The melancholy interest which attaches to the tragic fate of this gifted surgeon under the burning sun of Mesopotamia in the service of his country would make its omission to be deplored. It is therefore inserted. FROM SIR VICTOR HORSLEY 112 Ind. Field Ambulance, The Front, Mesopotamia, July i, 19 16. Dear Dr. Pilch er: I am sorry that I have only just received the charming invitation from the Committee which have done you the honor of a Jubilee banquet and in which they very kindly asked my participation. Had I been at home, I fear that my work would have prevented my taking such a very pleasant share in appreciating the value of the services you have rendered to surgery and our profession. As it is I have been moved from France to Gallipoli and now from Gallipoli to this inferno of 120 degrees in the shade and India, so I am unable to personally testify what I feel. I hope that in spite of the present crime against Civilization and humanity you are enjoying life as actively as you have worked in it. With kindest regards and good wishes, I remain, Yours sincerely, Victor Horsley, Col. AMS. V INTRODUCTORY REMARKS BY WILLIAM FRANCIS CAMPBELL, A.B., M.D., PROFESSOR OF CLINICAL SURGERY IN THE LONG ISLAND COLLEGE HOS- PITAL; FORMER PRESIDENT OF THE MEDICAL SOCIETY OF THE STATE OF NEW YORK INTRODUCTORY REMARKS By Dr. William Francis Campbell Doubtless many of you have heard of the famous traveller, Arsene Houssaye, vi^ho after travelling to the ends of the world, and w^ondering where else he might go, bethought himself to look out of his own window. It's a curious psychology that affects our mental vision and permits us to appreciate the distant, seldom the near; we are all more or less affected with a sort of mental hypermetropia — we don't see the great things of life when they are too close to us ; the great people all live in another town or a past century; the great surgeons all live in distant cities. We worship at the shrine of every saint save the saints of our own household. It's a rare privilege we have to-night of remaining at home, and looking out of our own windows. We have assembled here to-night not for the feast or the social hour ; all that is incidental — we have come to express the deepest feelings that one man can express to another — we come to offer a tribute of esteem and affection to Lewis Stephen Pilcher — the man, the soldier, the citizen, the author, the surgeon, the comrade and friend. But that isn't enough, this occasion holds a far deeper significance. Lewis Stephen Pilcher has walked among us for fifty years, and amid the shifting scenes of time he has crystallized a personality that stands for something very permanent. When we think of him we recall not merely the staunch citizen, the prolific author, the great surgeon — he means much more than that to us. When we think of Dr. Pilcher, we think of integrity and solidity, we think of one who has held fast to a great conception of a great pro- fession, of one who in every relationship of life has played the part of a real man. And so in its deepest significance this occasion celebrates the supremacy of character and the triumph of worth. If I were to choose a text to fit the occasion I would select it from one of Kipling's later masterpieces — the last verse of his poem entitled " If." If you can talk with the crowd and keep your virtue. Or walk with Kings nor lose the common touch ; If neither loving friends or foes can hurt you, If all men count with you, but none too much : If you can fill the unforgiving minute With sixty seconds' worth of distance run, Yours is the Earth and everything that's in it, And — which is more — you'll be a man my son. 41 That's the text that interprets this occasion, and our guest is the living sermon ; and if to-night his heart is stirred by this splendid testi- monial, Hke the alchemists of old, he is finding in the crucible of experi- ence only the gold which he himself has poured into it. I had the honor and privilege of being one of Dr. Pilcher's boys in the days of the old Seney Hospital. I confess I never had anyone quite so disturb my natural complacency as did he^ — for he was disci- pline incarnate, and we boys often thought things we dared not say. And yet in the light of the passing years we realize that he put iron into our moral fibre, and added a brace to our spinal column ; and we bless him for the discipline that remains our most valued asset. And later on when we crossed the sea and visited the great clinics of the world, it was a source of satisfaction to find that Dr. Pilcher's name was an open sesame to the courtesy, hospitality, and friendship of the great masters of surgery among whom he was an acknowledged peer. And so for the first time we realized that our Dr. Pilcher was not only a citizen of Brooklyn, but a citizen of the world. And to-night in the larger sense we doctors are all Doctor Pilcher's boys, for he's taught every one of us by precept and example, and the fine and fragrant atmosphere that distinguishes this occasion is born not merely of the tributes of friend and comrade, but of the lofty relationship that exists between Master and Scholar. Friend, Comrade, Master! On this your golden anniversary we present you the finest gift we can offer — the golden homage of loyal hearts. Friends, Comrades, Scholars! in token of a debt we can never repay, arise ! and salute the Master. VI GREETINGS FROM THE UNIVERSITY OF MICHI- GAN, BY PROF. VICTOR C. VAUGHAN, M.D., LL.D., DEAN OF THE MEDICAL FACULTY OF THE UNIVERSITY OF MICHIGAN GREETINGS FROM THE UNIVERSITY OF MICHIGAN By Professor Victor C. Vaughan , I have come to bear to Dr. Pilcher the greetings and best wishes of his Alma Mater. Dr. Pilcher is thrice a graduate of Michigan Uni- versity, A.B. '62, M.D. '66, and LL.D. 1900. If the University of Michigan has any other degree which might be an honor to Dr. Pilcher the University will be glad to bestow it. Dr. Pilcher comes of good stock. His father, who was a pastor of a church in Ann Arbor in the boyhood days of Lewis, had a deep thirst for knowledge. While fulfilling his duties as pastor, Pilcher Sr. en- tered the Medical School, took the full course and graduated. From such stock as this only good could come. Many of Dr. Pilcher 's class of 1862 immediately after graduation volunteered in the United States Army. They were ready to offer their services and many of them gave their lives to their country. I believe that this spirit of patriotism still is dominant among the students in Micnigan University and if the country should call for men again I believe that the response would be as prompt and as hearty as it was in ^62. While we love our University, we recognize the fact that we could honor it in no better way than by serving our country in time of need. It is not my purpose to speak of Dr. Pilcher as a surgeon. There !are at this table men more competent to do this than I. Fifty years in the practice of medicine means much. When Dr. Pilcher graduated Villemin was carrying on the experiments which demonstrated beyond controversy that tuberculosis, both medical and surgical, is a contagious disease. The brilliant work of Pasteur had scarcely begun. Many years were to elapse before Koch isolated the bacillus of tuberculosis. Ten years after Dr. Pilcher graduated in medicine and surgery, sur- geons, their patients and their assistants, were standing in carbolic acid sprays being poisoned in attempts to sterilize the air surrounding the man being operated upon. What wonderful strides have been made in both surgery and medicine during the half century of professional life of this man ! Human life in this country has been prolonged on the average quite 15 years. Infantile mortality has been reduced more than half. A man forty years of age to-day is younger actually than his father was at thirty. The whole science of preventive medicine has 45 been developed. Indeed, preventive medicine has become the keystone in the great arch of modern civihzation and its strength has not been broken by the heavy blows of the most gigantic war the world has ever known. Dr. Pilcher, to you I bring from Michigan University, its faculties, its graduates and its students, love and congratulations on this the cele- bration of your semi-centennial in medicine and surgery. 1 864 HOSPITAL STEWARD, U.S.A. i ^^^^^^^^v ^^9 mm ' H Mm ^R^Pp^^ ^l^^l ^^^^^Hl>- ^«k^H 'T^^^H k ''*^- ^;_^^mK 1 p^^^^^^^l ^^^^^■li'*^ M J^ i lljl I9I3 COMMANDER U. S. GRANT POST, NO. 327, DEPARTMENT OF NEW YORK, GRAND ARMY OF THE REPUBLIC VII MESSAGE FROM THE GRAND ARMY OF THE REPUBLIC, BY PROF. WILLIAM C. PECKHAM, M.A., ADJUTANT AND PAST COMMANDER OF U. S. GRANT POST, NO. 327, DEPARTMENT OF N. Y., G. A. R. MESSAGE FROM THE GRAND ARMY OF THE REPUBLIC By Professor William C. Peckham Past Commander and Adjutant of U. S. Grant Post, No. 327, Department of New York, Grand Army of the Republic It is my pleasant task to bring to the guest of the evening the felici- tations and congratulations of his Comrades of the U. S. Grant Post, Department of New York, Grand Army of the Republic, in whose name I have the honor to speak to-night. We rejoice with him in all the exquisite satisfaction which an occa- sion like this must bring. We count him happy in having so lived as to deserve so much from his professional associates and from us his com- rades in the service of his country. And he has deserved it all to the full. When a few weeks ago in the encampment of the Post I called the attention of the Comrades to the fact that on that very day jfifty years ago our Comrade Pilcher had taken his degree in Medicine the announcement was received with much enthusiasm. I moved that the congratulations of the Post be extended to him, and this motion was seconded by one after another who declared that their lives had been saved by his skilful assistance and who expressed the deepest gratitude for his kindly attentions. Should you call the roll of the twenty-five or more veterans in blue with brass buttons who are sitting in a group before me probably more than half, and many others who are not here to-night, have had their lives prolonged and their old age made green by his loving services. Grant Post has honored him with its best gift. He has been its Commander, and has done distinguished service for it. He has thus honored Grant Post. He has honored the Grand Army by serving it as its Surgeon-General. If I mistake not other honors await him there. The comradeship of the Grand Army is unique. It was born amid the common sufferings of field and hospital. It has been cemented by common service through more than a half century to the Union which it saved. It stands to-day the exponent of a patriotism which knows no allegiance other than that to our starry banner. To such a devotion, gentlemen of the medical profession, your mem- bers have ever been true. Do you know that it was a doctor who planned and carried out the plan for Paul Revere to take his momentous ride? It was the same doctor who, holding a commission as a major 51 general, refused the command at Bunker Hill, took a place in the ranks with his musket, and, fighting to the end in that battle, fell at almost the last shot, making the name of Doctor and General Joseph Warren immortal. Many there were in our war whose records were just as worthy of remembrance. I doubt not that our loved Comrade to whom we do honor to-night gave as deep a devotion in his service for the Union in field and on ship- board, for he served in both the Army and the Navy, as ever knight of old in quest of Holy Grail or Sepulchre. It was such service which won the final victory. It was such service which knit the fibre of the souls of those men and gave this nation the generation of citizens who have so gloriously advanced it during the fifty years of its history since the war. And this, gentlemen, is a result ever to be expected from proper military training of our young men. And upon the medical staff in any future emergency must the great- est responsibilities rest. The tale of death in the war for the Union, of lives wasted by disease, was doubtless unavoidable, owing to the igno?-' ranee of its causes, but no such excuse can be made for such ruin in the future, God forbid that we should have war, though it does not look at this moment as if He would. But if it does come there is no doubt that your profession will discharge its duties with the highest fidelity. The manner in which the medical staff of the Japanese army preceded its march, tested the water, and forbade its use, if it was found unsafe, is a case in point. If I wished to compare Comrade Pilcher to any character in litera- ture, I should place him alongside of Great Heart in Pilgrim's Progress, the one whose good sense was always equal to any demand made upon him, who had always the right word for any occasion, and who guided his little party through all difficulties to the welcome end of their journey. My dear Comrade, we honor you for all you are, the complete exponent of our Fraternity. We honor you for what you have done in loving charity for our sick and suffering members. We honor you for your unswerving loyalty to us as Comrades, for your simple and straightforward espousal of every cause which you deem to be right, and for your rigid response to the dictates of your own conscience. And in token of this Comradeship, my dear friend and Comrade Lewis Stephen Pilcher, and in the name of the Comrades of U. S. Grant Post of Brooklyn, who fully share my feelings, I give you the Sign and the Grip of our Order. 52 VIII LEWIS STEPHEN PILCHER AND THE ANNALS OF SURGERY. REMARKS BY WILLIAM W. KEEN, M.D., LL.D., F.R.C.S. (ENG.), PRESIDENT OF THE SOCIETE INTERNATIONALE DE CHIRURGIE LEWIS STEPHEN PILCHER AND THE ANNALS OF SURGERY Remarks by Professor William Williams Keen The friendship between Dr. Pilcher and myself began forty years ago. I was about to say between myself and Dr. and Mrs. Pilcher, but a glance at the gallery will show you that she is too youthful in appear- ance for that possibility. We are celebrating the twenty-fifth anniversary of Dr. Pilcher's Professorship and the fiftieth of his graduation in medicine. Now I am almost blase in semi-centenaries, centenaries and sesqui-centenaries. In 1876 I helped to celebrate our first National Centenary; in 1887 the first centenary of the College of Physicians of Philadelphia. Fifty-two years ago I joined in celebrating the centenary of Brown University, my own Alma Mater, and two years ago her sesqui-centenary. But yesterday I " assisted " at the sesqui-centenary of the Medical Depart- ment of the University of Pennsylvania, our oldest American Medical School. Coming nearer home, four years ago I celebrated my own half century in medicine. My first birthday — my real entrance upon life — is so far behind me that I can scarcely see it with a telescope, while my one hundred and fiftieth is so much less far before me that I can easily descry it with a mere spy-glass. Dr. Pilcher and I intend to celebrate it with due pomp and circumstances and I extend to all of you a cordial invitation to be present. Dr. Pilcher, as we have heard, is a most careful surgeon, a strik- ing contrast to a certain other surgeon about whom this story was lately told by one of my grandsons at my dinner-table. I think he en- joyed the story all the more as it involved a sly thrust at his father and his grandfather, both doctors. Though a lad of twelve he has a keen sense of humor. You can see him as it were first tasting a joke, then an anticipatory smile diffuses itself over his as yet unfurrowed face and finally when the climax is reached he bursts. Two convalescent patients were discussing the demerits of their surgeon. One of them said " I have a grudge against him because when he took out my appendix he left a sponge in me." " That's nothing compared with what he did when he took mine out," said the other. " He left a pair of scissors in me." Just then the door half 55 opened and the culprit doctor, just showing his head inside the door and looking around anxiously, asked, " Does anybody know where I left my hat ? " I never think of Pilcher but that two ideas are correlated with his name. One is Dr. George Ryerson Fowler, his surgical twin, and the other is the Annals of Surgery, his surgical monument. The twins began to collaborate as early as 1878. They founded the Brooklyn Anatomical and Surgical Society with Pilcher as Presi- dent and Fowler as Secretary. In fact it might almost be said that they were " the whole show," for the twins did most of the work and wrote most of the early papers. When they had enrolled but 25 mem- bers they boldly launched the Annals of Anatomy and Surgery. I show you — for but few present I suspect have ever seen it — the first volume — if one may apply so stately a name to so slender a book. It consists of only 102 pages and this represented the accumulation of two whole years, 1 878-1 879. But value does not depend upon bulk. This little book has two noteworthy papers, one on a complete " Bifid Sternum " and the other is one of the early papers on a " Cervical Rib." I have always been glad that I helped them out with two papers in Vols. II and V. The next year, 1880, this rapidly growing infant had expanded into one good-sized volume and from then on — ^but alas ! not for long — there were two volumes in every year. In January, 1884, Vol. IX began bravely with its first number, but chill winter's blast was fatal. With this one gasp it gave up the ghost. As no postmortem was held I cannot give you the bibliographical cause of death. But like the fabled Phcenix from its ashes arose the Annals of Surgery. This for many years was the only and is still the best Surgi- cal Journal in the English language. Even to-day it has but one rival, and I am glad to add a worthy rival, the British JournoJl of Surgery. Instead of one volume for two years we have had year after year two impressive volumes of nearly 2000 pages filled with the best text and the finest " cuts " as befits a Surgical Journal. Any Surgeon who knows the contents of these 63 volumes from title-page to colophon is well equipped. This is Pilcher's monument, more enduring than brass. Other names have appeared on its title-page as his colleagues, but when all is said and done it is evident that Pilcher is the Annals. It typifies his own personality — four square to all the winds of heaven, accurate, scientific, practical, illustrated and illustrious, like its Editor, Lewis Stephen Pilcher, to whom I gladly express our admiration and our heartiest congratulations. 56 IX LEWIS STEPHEN PILCHER'S INFLUENCE ON SURGERY. REMARKS BY WILLIAM J. MAYO, M.D., LL.D., F.R.C.S. (ENG.), OF ROCHESTER, MINN. LEWIS STEPHEN PILCHER^S INFLUENCE ON SURGERY Remarks by Dr. William J. Mayo It is my pleasant privilege to speak of Dr. Pilcher's influence on surgery, not only the surgery of America, but that of the civilized world. What memories must be those of our honored guest who, in his fifty years of service, has seen surgical science in the making, who has seen it emerge from the fog of fancy and superstition to a sound basis in fact, and has played so great a part in enabling it tO' reach its present exalted position. In judging the worth of a surgeon, four points must be taken into consideration : First, originality ; second, ability as a teacher by word of mouth ; third, the value of teachings by the written word ; and fourth, ability as an operator and technician. The type of originality we call genius, to which discoveries marking epochs in surgery are due, is given to but few men. Of these Lister was a most notable illustration. The type of which Billroth was a distinguished example, and which perhaps does not rise to a height to be called genius, has been given to many men. The latter phase of originality may best be characterized as " scientific imagination, carry- ing with it a talent for work." Scientific imagination reasons from things known to things unknown, clarifying and solving problems by what may appear at first to be merely an hypothesis, a leap in the dark, but which is seen soon to have sound footing in fact. It is from men of this second type of originality that the great progress and the most practical results in surgery have come, and the labors of genius made profitable. It would be impossible to review here the remarkable advance that has resulted from the more or less concerted efforts of surgeons gifted with scientific imagination. Science knows no frontiers. Men of all civilized countries have played a part, Kuttner, Lexer, Trendelenburg and Bier in Germany ; Lane, Horsley, Robson and Moynihan in Great Britain, Schoemaker and Rotgans in Holland ; Tuffier, Hartmann, and Gosset in France ; Bastianelli and Alessandri in Italy ; Ott and Federoff in Russia; von Eiselsberg and Hochenegg in Austria; Eli Krogius in Finland; Nicholayson and Bull in Norway; Berg and Borelius in iSweden ; DePage and Lambotte in Belgium. These are but a few well- known examples of men who have played a part in this work. 59 It is curious that of the great number of men who have done high grade original work so few have attained distinction as public speakers. In general, surgeons are not orators. Pilcher, Murphy, Brewer, and DaCosta are exceptions to the common rule. However, teachers of the highest grade who have influenced a few students to great deeds — who have, so to speak, handed the lighted lamp of science to the select few — are not uncommon. Halsted developed a true school of surgery, as have also Bevan, Brewer, and the late Christian Fenger. To you physicians of Brooklyn, I need not say how great has been the part played by Dr. Pilcher and also the late Dr. Fowler. The assistants of these men and others like them will dominate the next generation of American surgeons as the students of Billroth and Volkmann dominate the German school of to-day. In the third group — the men who have taught by means of the written word — no man in this country occupies a higher place than Dr. Pilcher, the editor of the Annals of Surgery, the foremost surgical journal in any language. Under his fostering care this journal has grown from its small beginning in St. Louis to its present magnitude. On this occasion I wish to express my sincere appreciation of its worth. I have read every number from its beginning, and nearly every article. Many of these contributions, and I wish there had been more, were from the pen of Dr. Pilcher himself ; sane, sound, couched in the most beautiful and classical English, with a balance of expression giving just the right emphasis to each statement, and with a remarkable clear- ness of diction. I well remember the kindly way in which Dr. Pilcher corrected the subject matter and also the English and composition of the earher papers I sent to the Annals. By means of the printed word, Pilcher has not only taught us surgery through his own experience, but he has presented to us the results of the best surgical investigations of our own country and abroad. When we come to the fourth consideration on which we base the worth of surgeons, that is, ability as operators and technicians, Ameri- can surgeons stand high. Germany is the only country which has established a national school of surgery, and has been the least in- fluenced by outside opinion. By force of merit and cold logic, so to speak, Germany has forced acceptance of its views upon the world. However, the very national character of Germany's undertaking has been America's opportunity. American surgery is cosmopolitan. It represents the best in England, France, Italy and all countries, and, while modelled largely upon the German, has greater freedom of initia- tive and gives greater opportunity for creative work to men of genius and talent. As we travel about the country we find hospitals widely distributed 60 and note that surgical work is being done not only in the centres of population but also in the smaller cities and towns and even in the villages. During a recent trip to the South I was very much impressed by organizations composed of only a single practitioner and two nurses, one to give the anaesthetic and the other to assist in the operation. These organizations are doing a high grade of surgical work, particularly in meeting emergency conditions. No country in the world but America could have developed a sufficient number of able surgeons so that every hamlet might have a competent man, in no other country are the possi- bilities so great. In the diffusion of the surgical knowledge necessary for such remarkable results, no factor has been more important than Dr. Pilcher and the Annals of Surgery. For this and for his person- ality, that of a kindly modest gentleman, we pay Dr. Pilcher to-day the tribute of our highest respect and admiration. X AN APPRECIATION FROM THE CHARAKA CLUB, BY CHARLES L. DANA, M.D., LL.D. AN APPRECIATION FROM THE CHARAKA CLUB By Db. Charles L. Dana May 14, 1916. My dear Pilcher : I had this inscription ready for you the other night, but it seemed too trivial for so great an occasion and I disappeared with it into the night. I send it along now, however, because I know it will amuse you and perhaps help to restore you from the reaction after so much formal tribute of praise. I add again my congratulations to you and my admiration over the wonderful aggregation of friends your career and character brought out. Very sincerely yours, Chas. L. Dana, ad amicos In the fourteenth century the celebrated anatomist and surgeon, Mundinus of Bologna^ wrote a work on anatomy — and a very good one for its day. Two hundred years later, the book was getting out of date, and Jacob Berengarius Carpus of Modena, Teacher of Surgery, published a new edition with comments and illustrations. About four hundred years later still, Dr. Lewis S. Pilcher, of Brooklyn, rescued a copy of this work from a book shop in Florence. In the beginning of this work is a Latin poem written by Dr. Vergilius Hierardus of Bologna, and dedicated tO' the learned Dominus and Magister Jacobus Berengarius Carpus. This inscription, published in Venice in 1523, fits so well to the character and work of Lewis S. Pilcher that it was transcribed and adapted to the anniversary of this modern Teacher of Surgery, Dominus, Magister Pilcher by Dr. Charles L. Dana, of Manhattan, May 13, 1916. To Dr. Lewis Pilcher. " Grande Senis Choi decus et podalyria proles." " With what great piety and with what ardor wert thou impelled, O Carpus [Berengarius Pilcher], Great ornament and Podalyriac offspring of the Ancient Choir, to snatch Mundinus, gasping his last breath, and Save him joyfully from the pale shades [of Olski's Book Shop] Alas for me, how many and how great are the heroic writers of books 65 I have seen who have suffered loss of ancient honor And born for many years the cruel wounds of neglect ! And how much faithful study did the Fathers [Mundinus and Pilcher and Carpus] bring to The inner part of man, while opening it with a gentle Blade, showing to us the works of nature and the secrets of The unknown. Thou art that one, good Carpus [Berengarius Pilcher], thou art he to whom The land of Renegenus and the Latin race shall put up many vows And the sons of Galen sing praises, for you have greatly served Them, and have truly become the twin in glory with Mundinus." XI GREETINGS FROM THE UNIVERSITY OF THE STATE OF NEW YORK. REMARKS BY HON. JOHN H. FINLEY, LL.D., COMMISSIONER OF EDUCATION AND PRESIDENT OF THE UNI- VERSITY OF THE STATE OF NEW YORK GREETINGS FROM THE UNIVERSITY OF THE STATE OF NEW YORK By Hon. John H. Finley, LL.D. Dr. Pilcher and Friends of Dr. Pilcher: I have travelled a thousand miles to attend this dinner in honor of Dr. Pilcher. At this hour last night I was speaking on a platform beyond the Michigan, where Dr. Pilcher was born. Though I have arrived too late for the feast, I am glad to be able to say a word, even if a breathless and inadequate word, for this great State and its invisible and all-embracing University, in honor of Dr. Pilcher. I would seem to be like unto the dog referred to by my dear and eloquent friend, Dr. Cadman, a moment ago, for I did catch the Twentieth Century Limited. It remains for me to make the demonstration which the up-State local philosopher awaited, and show what I'll do with it now that I have caught it. We spend a great deal of energy running for trains and too often haven't much to show for the time we've saved in hurrying. I am glad that the distinguished guest of the evening is permitted or compelled at last to know the meaning of a " major operation " from the point of view of the patient. I assume that he has even declined the administration of an anaesthetic. This operation is one which is rarely performed. It is a heart operation, technically known as cardio- saltus ; and is performed by the use of words instead of scalpel, or other surgical instruments. And no license is required of the practitioner (though if we continue to exact licenses we shall some day come to after-dinner speakers as well). The nature of the operation is this: The heart of the patient is so stirred (by such words as those of Dr. Campbell, whom I once heard speaking with such eloquence in the Yellowstone Park that an eagle soaring in the empyrean paused in its wheeling flight to look and listen with envy) that it leaps into his throat (a phenomenon well known to public speakers but not generally known to surgeons). The next step is to take advantage of this absence of the heart and reline the pericardium with a coating that makes it imper- vious to worry or emotional unhappiness of any kind. The coating is a secretion obtained by tapping the hearts of honest friends, and is called hemo-cardi-amicus. 69 This operation, I ought to say by way of caution, cannot safely be performed on one who has not led a useful, honest and unselfish life. It is gratifying to know, as was anticipated, that our distinguished patient gives signs that in his case the operation has been successful. The savages have a notion that the valorous qualities of those whom they slay are added to their own and so their passion to kill is strength- ened. It is a more civilized and sensible theory to assume that all the years of happiness of the lives which a physician saves and prolongs are added to his. Applying this benign theory to the case in hand, we shall find that Dr. Pilcher has already lived longer than the sum of the years of the race since history began. It is not fifty, but ten thousand, years of practice that we celebrate, and for every year of his own added life a thousand years will be added. We who are not real doctors must all of us sometimes envy you your satisfactions — the satisfactions of knowing that you have actually saved and prolonged life. We who have to do with the psychic bacteria only or chiefly (such as bacillus parasiticus, spirillum tardum, micro- coccus egotisticus) can seldom know whether we have made an indi- vidual life better or nobler by all our practice. However, we go forward in faith. But I have come all this way not to express my personal felicitations, but to express the gratitude of the State for what you have done in the cause of your humane and learned profession. You have not only given a son to serve in high capacity this State, but for many years you have yourself given faithful and efficient and honorable service to this same State in determining who shall be set apart to this noble and sacred ministry of medicine, to the study and care of what Sir Thomas Browne, one of your own profession, in his Religio Medici, called, " that bold and adventurous piece of nature which he that studies wisely learns in a compendium what others labor at in a divided piece and endless volume.*' I give you as my wish for your after days the prayer of this same physician, eminent for all time, for your own : " Bless me in this life with but peace of Conscience, command of my afifections, the love of Thyself and my dearest friends. . . . These are, O Lord, the humble desires of my most reasonable ambition and all I dare call happiness on earth." XII "THE MAN!" REMARKS BY THE REV. S. PARKES CADMAN, D.D., LL.D., PASTOR OF THE CENTRAL CONGREGATIONAL CHURCH OF BROOKLYN THE MAN! Remarks by Rev. S. Parkes Cadman, D.D. I have seldom found myself so completely at fault as at the present moment, when I stand a solitary cleric surrounded by the foremost representatives of the surgical profession, and recall the long, needless and disastrous conflict between faith and organized knowledge. No elusive rhetoric will serve my turn, nor avail to conceal my dense igno- rance upon vital questions which are paramount with you. I could well wish it were otherwise, and that I was the fortunate possessor of suffi- cient information to do justice to this occasion. Yet I am greatly honored in being invited here, and I cheerfully add my feeble testimony to the glorious profession of which our honored guest has long been an illustrious member. It is in the direct line of succession from the Man of Galilee, and confers upon its followers a priesthood and a ministry which have received the grateful acknowledgment of civiliza- tion. Moreover, permit me to say that the antagonism between matters of religious belief and those of natural phenomena is largely a facti- tious one; fabricated, on the one hand, by zealots who have confused mortal creeds with the divine faith they were meant to embody and, on the other, by narrow theorists who forgot that science dealt only with the physical side of the universe. The crass philosophies and heathen survivals under which true spirituality has so often been interred and the raw rationalizings of ardent devotees who have been oblivious to the major fact that science, while supreme in its own sphere is impotent beyond it, have alike delayed the era of adjustment and reconciliation. Stripped of these sentimental and superfluous accre- tions, both the clerical and medical professions will eventually combine to win the goal of human progress in peace of soul and health of body. Nor do I forget that the functions of religion have been freed from the entanglements of superstition. Men of learning are entitled tO' the warmest admiration and appreciation from the saints. They have helped to moralize the thinking of the Church. Their discoveries, many of which have rocked in the cradle of biology, have grown apace and spread into widely separated areas. Evolution has escaped the hypothesis of Darwinism, and is now operative in history, in literature, in arts and in the discernment of those slow laborious processes by means of which man has achieved his present acquaintance with un- seen realities. The sense of our frailty, even at the best; the feeling that there is an open secret which we cannot penetrate, wherein lies the quintessence of all that is holy and universal, should himible and 73 chasten every seeker after truth. Yet he may look forward tO' that maturity of the race, when there will be one kind of knowledge, and one method for its acquirement ; when one Lord, one faith, one baptism, will symbolize our common heritage in God, wdth whom all truth, whenever found and followed, is forever one unity. Toward this end Dr. Pilcher has wrought in season and out of season. Concerning his reputation as a skilful and gifted practitioner, it is a subject of honest pride on our part that he sets the pace for you, and that his writings and his deeds conspire to assign him a place among the few who have eclipsed miracle, lighten toil in behalf of the reHef of suffering and the preservation of life. But constant reference has been made by previous speakers to his personal character. This they have enthroned because what a man is transcends anything he does. The robes of fame rest on a gentleman's shoulders, one fitted to wear them without discredit ; one who brings to his daily pursuits the conscience which governs intelligence ; who does not stultify the one by violating the other. As I understand it, character is our only real wealth, and furnishes all we can carry across the abysmal divide into eternity. In this respect, so superior and important, Dr. Pilcher has profoundly impressed his colleagues and his pupils. Had he been other than he is, we should not have been here. And in the final analysis, the virtues which have made him virile and enabled others to grow straight in the strength of his spirit are the momentous things. The law of hereditary influence should be dealt with in his case. For his father was one of the heroical band of itinerant preachers who followed that Bishop of the long road, the justly celebrated Francis Asbury. No nobler figure emerged from the chaos and strife of the Revolution than Asbury's. What Washington did for the nascenl commonwealth, this Bishop of Apostolic fire and fervor did for the infant Church. This fellow laborer imitated his example, and planted the fellowship of the Gospel in virgin territories. They rode along the Atlantic coast and over the AUeghenies to rescue and shepherd the multitudes who were without hope or faith. Not only the churches, but the cities and villages which arose on every side were in numerous instances planted by them. They built the schools and the colleges and endowed them out of their poverty. Hardship was their daily lot, upon which these scarred veterans of the Cross reckoned, despising the afflic- tions they endured because they were sustained by a radiant experience and a quenchless love. Such was the God-fearing, God-honoring ances- try from which the Doctor sprang. And who shall calculate his in- debtedness to the devotion, the piety, the prayers, the constraint of his parentage. Behind the man of culture, of attributes, of sagacity, of surgical power, stand these silent witnesses who are not far from us 74 now and whose quiet consecrated lives have been the explanation of their son's record. Qiaracter depends upon what we do not see. Its sources are ethereal, imponderable. They yield to no chemic test, no scalpel's sweep. They involve faith in a supreme righteousness, in the law of conduct, in the trustworthiness of moral instincts, in the validity of venerable and salvatory beliefs. What the gold standard is to financial stability, these beliefs are to a proportioned vision of exist- ence. We are made aware by them that human values do not rely upon the length of days, be they few or short, but upon what we have been and done and upon what we have aspired to be and to do. The whole probation of Time is but a preparation for further character and further service. Physicians who neglect these fundamental considerations, or who are so absorbed in material appearances as to forget they are noth- ing more than a muddy vesture of decay, can rest assured that they have forfeited the luster of their calling. I rejoice with all his brethren in our dear friend's genuine and lasting success, but I unhesitatingly ascribe it, first, to his hold on spiritual verities and next to the appren- ticeship to duty which has been his unfailing guide and guardian. One illustration must suffice. When he stood on the threshold of manhood, filled with those buoyant anticipations for which youth is the proper season, the nation became imperilled by a fearful war. Had Dr. Pilcher lingered in the rear, he might have been justified. Many who afterwards reached social distinction did not join the hosts on land and sea which resisted the destruction of American ideals. But he laid aside his dreams of preferment and station and risked everything for his country. His reward is with him, in that internal satisfaction which can only be purchased by sacrificial conduct, and in the loving appreciation of these veterans at the board and of the people he helped at a crisis. Moreover, " the lady with the flowers " to whom he has paid an exquisite literary tribute was found by him as he walked his appointed way, and she entered his life to give double benefit to all its offices and engagements. Children have been bestowed on them who have risen to call him blessed. Sorrow has poured out its bitter waters upon them. Yet a sorrow sweetened by memories and anticipations which death cannot hurt, indeed, can but dignify. The future is golden ! Dr. and Mrs. Pilcher come to their eventide bathed in a mel- low glow, which the night shall linger to disturb. Observing him as a husband, a father, a renowned physician, a soldier, a patriot, a scholar, and a gentleman, we honor God in honoring him, and we are conscious that whatever leaps to light he never shall be shamed. Those who supped with the sages had a rich taste in their mouths the next morn- ing. To-night we have been thus employed ; to-morrow we shall look back on what has been said and done here with contentment ; and in the great day, whenever it breaks, we shall be perfected. 75 xm PRESENTATION OF MEDAL, BY JAMES P. WARBASSE, M.D., SURGEON TO THE GERMAN HOSPITAL OF BROOKLYN .^ .•^- ^ - 'Y -y ^ / \ " " ! ,'- < ' /-> ~ \ PRESENTATION OF MEDAL By Dr. James P. Warbasse Doctor Pilcher: It is my happy privilege to present a token, which shall be an ex- pression of the love and loyalty of friends. I trust it is no surprise to you — no more than is this company, assembled here to do you honor. There are no surprises for him who lives a well-ordered life. Who sows seeds is not surprised when a harvest comes up. Who plants a rose-tree and nurtures it in his garden is not surprised when roses bloom. And he, who in a life of useful service is true to high ideals, need not be surprised at the love and loyalty of friends. We would not have you believe that we esteem you as a being created of different clay from ourselves. We are aware that you have struggled with the human qualities which are common to all of us. There have been occasions when you seemed, perhaps, dictatorial, un- compromising, assertive, inflexible. But these usually were evidences of strength, and of the character which dominates in the name of righteousness. You are loved because your hand that is strong is also tender. To commemorate the occasion which we here celebrate this gold medal has been made. On one side is a relief portrait of yourself, as true as art can reproduce human expression. Around it are the words : " Lewis Stephen Pilcher." On the obverse side is the simple legend : " To commemorate fifty years of medical practice. Surgeon, Author, Editor, Patriot." Surgeon, because you are the master of a beneficent art ; Author, because your pen has enriched and illuminated the litera- ture of surgery; Editor, because you have created and maintained a great surgical journal; Patriot, because you have loved your country and your fellow-men, and desired for them life in greater abundance. This medal is the conception of loving hearts and the product of skilled hands. A few copies have been made in bronze, which will be placed in the great libraries, and a few in the possession of your inti- mate friends. The die from which they were made has been destroyed. This medal is now already rare and without price. The destruction of the die signifies the mutability of things; the preservation of these impressions in gold and bronze signifies the imperishability of character, which you have exemplified. This is but an expression of our poor attempt to create for you 79 something of enduring significance — of the substances which the rust of time does not assail. But how far you have surpassed our efforts ! You have wrought for yourself, out of the plastic material of character, nobiHty of your own design, loftiness of purpose, fidelity to ideals; and the die is not destroyed. You have created an immortaHty in the souls of men which is as enduring as mankind itself, transcending that of gold or bronze, imperishable, which fire nor flood may not destroy nor time corrupt. This medal is the expression of our gratitude. You have done so much for us! You have given us courage when we faltered. You have never abandoned the search for truth. You have ever taught us that the little things should be done as though they were great. You have honored the details which are the seeds of success. May we be inspired to rededicate ourselves to these ideals for which you stand. Your precepts have squared with your actions. After all, the only things in which we have any property rights are our actions. Our thoughts may produce no fruit. Friends, fortune, health, reputation may all be swept away. But our actions prevail against everything. Of them alone it cannot be said that we go out of the world naked, for they clothe us as a vestment, of which we cannot be disinherited. And it is upon your actions, upon the things that you have done, that we now bestow our tribute. In presenting this medal to you in the name of those who are here and in behalf of the countless numbers who are not here — an admiring profession and a grateful humanity — there goes with it the wish that your future years may be as happy as your past have been fruitful and glorious. 80 XIV RESPONSE BY DR. LEWIS STEPHEN PILCHER RESPONSE BY DR. LEWIS STEPHEN PILCHER This golden medallion is a form of testimonial than which none could be more highly appreciated by me. I accept it gratefully as a possession which I shall hold dear, not only for its intrinsic worth and its artistic merit, but especially as a token of your esteem, of your confidence and your affection. Canvas will perish ; a print is but for a few years at longest, but a sculptured portrait preserved in untamish- able metal is everlasting. It is only to be surpassed by the subtle spiritual influence of character by which a man becomes his own sculp- tor and which remains forever a monument more enduring than brass. What can I say at such a time as this? After so many years of strenuous life to find that I have Friends is a joy indeed. The gener- ous meed with which the gifts of friendship and the expressions of esteem have been bestowed upon me commands my deepest gratitude. I know that far beyond my personal deserts these gifts have been bestowed, so that whatever of elation such applause may have excited has been more than counterbalanced by the sense of humiliation which comes from my knowledge of how far short I have come of having de- served it. Rather would I regard these commendations as given chiefly to the noble profession of which I am a member, realizing that only in the measure, however faulty, with which the individual may have exempli- fied in his career the traits which universal opinion assigns to the pro- fession as a whole could the most complacent of physicians claim to begin to merit the plaudits you have bestowed. In the morning of March 17, 1866, as a very young man about to graduate from the Medical School of the University of Michigan, I came to Brooklyn as an applicant for appointment to the Medical Service of the U. S. Navy to present myself before the Examining Board, then in session at the Naval Hospital of Brooklyn. I still retain a vivid recollection of how beautiful the morning was with the sunshine and the waving of flags and the " wearing of the green," for it was St. Patrick's day. One year later, having received the coveted position, I found myself assigned to the same Naval Hospital as one of its medical staff. Thus began an association with Brooklyn, which was to become more intimate as the years passed by and which has cul- minated in these greetings from my neighbors and friends, fifty years later. I cannot help but feel that the promising omens of that St. Patrick's morning so long ago have been fully realized by the fortunes which tlie later years have brought me. 83 I will not detain you with further reference to the years of my naval service nor to the first years spent in the efforts to establish myself in private work as one of Brooklyn's physicians. Eighteen strenuous years, afloat and ashore, had passed thus quickly when in 1885 I was confronted by an important crisis. I had recently been appointed to the chair of Clinical Surgery in the Post-Graduate Medical School of New York, which had been made vacant by the death of James L. Little. With this appointment came the temptation to transfer my residence to Manhattan, for if I went to Manhattan I would have back of me the influence of the institution in which I had been given so prominent and honorable a position. It was urged plausibly also that a wider field of influence would attend residence in the centre of metropolitan affairs. These arguments gave me pause and many hours of careful thought. Moreover, any expecta- tions of local advantage which I may have been indulging from my connection with a new hospital in Brooklyn, already well advanced in its building, had suddenly been checked and nearly extinguished by the financial reverses of its patron, which had compelled him to leave it an incompleted and unendowed institution upon the hands of an astonished and dismayed Board of Managers. Which was better ? To plunge into the vortex of professional strife in Manhattan with all its brilliant possi- bilities, but with its special drawbacks as regards those important ele- ments of life which include the growth and development of the home and the enjoyment of a more quiet and meditative life, the formation of personal friendships and the development of local civic spirit, or to choose the latter, and continue to devote myself to the building up of the crippled hospital enterprise which I had already made the chief object of my endeavors and which I believed could, by earnest and intelligent labor, be lifted out of its difficulties and placed upon a secure and per- manent foundation as one of the great charities of the city? The final decision was for the Brooklyn home. Over thirty years have passed since the last of those days of per- plexity, and I have never had reason to regret the decision then made. The hospital to which thenceforward for twenty years more I gave all the energy there was in me as the chief object of my devotion steadily developed ; its doors were opened to the sick, and when I finally retired from its service over 30,000 patients had already been treated in its wards and an endowment of nearly one million of dollars had accumulated for its support ; it had won a high position among the scientific and charitable foundations of this country, and from it had gone forth a body of medi- cal alumni who are now occupying many of the chief positions of profes- sional responsibility in this community. To have had an influential part in the founding and early shaping of the work of such an institution will 84 X K z ^ [/) ^^ p EC S s ^ M n o r ever remain a source of the highest satisfaction to me as one of the en- during achievements of my work in Brooklyn, but it is the careers of my old assistants and internes that give me the most gratification as I review the years that have gone. They may have learned something from me, I certainly learned much from them. If there is anything now left of vigor and spirit and enthusiasm in the "old man " it is largely due to his association with such young men. As I see and know of the great work they are doing, not alone in this community but in many other widely separated communities, I like to think that I still have, and shall always have, some share in the results that they are accomplishing, and that in the measure in which they shall transmit their qualities and knowledge to succeeding generations of medical successors, I shall enjoy the highest privileges of immortality ! To be able to open the door of opportunity to a group of eager young men is a privilege to be envied to any man; to open the door of surgical opportunity and to add counsels and knowledge, and perhaps example, that shall give a more adequate appreciation of the best and noblest aspects of surgical effort, what could be finer ! It has been often and truly said that the surgeon's life is full of tragedy. During much of his time his faculties are keyed up tense, and though physical tire go hand in hand with mental exhaustion, he can never lay down the sense of responsibility. Moreover, the period during which he, as a rule, can be expected to do satisfactory work is but short. At thirty-five he has just begun to earn that public recog- nition and that degree of reputation which are essential for professional success. At sixty-five, should he be fortunate enough to live to see that age, as a rule his hand is no longer steady, nor his eye so keen, as to enable him to discharge fully the responsibilities of his work. Who then should grudge to the surgeon the fees which he may earn during the brief period of his activity. Indeed, an altogether mistaken idea is quite prevalent as to the extent of the income which attends the work of a surgeon. Large fees are the exception ; small fees, or no fees at all, are the rule. That quality of mind which tends to make a man a successful surgeon is not one that is likely to make him a money accumulator, and, however high an appreciation he may put upon his services, he is ever ready to brush it all aside at any cry of need, and give himself unreservedly, without money and without price, for the relief of a fellow-man. Why then should anyone adopt surgery as a profession? Or, rather, why do so many young medical men at the outset of their career aspire to become surgeons ? While it is true that the influences that determine the choice of a profession or avocation of any kind among men are often complex, difficult to determine or to estimate, it may be said, in general, 87 that any choice is the result of environment, aptitude and opportunity. As to the first of these the social atmosphere is certainly now surcharged vnth a surgical element — the surgeon has come into his own! The broadening of the fields of surgical effort has opened new and marvellous possibilities to the man who has the aptitude and can secure the needed training for such work, and the attractions and compensations of a surgeon's life have equally increased with its possibilities and its triumphs. By compensations I do not mean the money return, that is the least of the rewards that wait upon surgical effort. It is in the positiveness of the result and the certainty that such result is the direct product of the thing that he himself has done in which is found the first compensation for the surgeon's risks and responsibilities. I do not know of anything that is finer, or more certain to arouse the enthusiasm of a sensitive mind, than, by the application of all the diagnostic resources of the present day, added to sound inductive reasoning, to have arrived at an opinion as to the nature of an obscure disability or disease in a deeply hidden region or organ of the body and then, by a well-planned and skilfully executed series of operative procedures, unerringly pass through successive layers of tissue and among vital organs in a living body to the point determined, and there lay bare and remove the offending substance or condition ! And then to think of the cases whom one knows to have been other- wise hopelessly lost, confronted by immediately impending death or condemned to a lingering torture steadily progressing to a fatal end, — and yet who by the application of your knowledge and skill you with equal certainty know to have been restored to health and usefulness ! It is in the consideration of such experiences — and they are numerous — that some of the highest compensations for the trials of a surgeon's career are found. The ideal surgeon ! No wonder the world pays him honor ! What- ever there is of laborious research, whatever of judgment and caution, whatever of courage, of enthusiasm and energy, whatever of tact and reason and honesty, whatever of boldness and pertinacity, of gentleness and fine consideration, whatever of self-forgetfulness and devotion to the good of a fellow-man there may be, these we see realized in such a man! It cannot be other than a source of no little satisfaction and of some justifiable pride to any man who feels that he has had any part of the surgical development of the past fifty years, the most fruitful in progress and achievement of all the centuries. It is not needful or pertinent at this time to recite in any detail the changes that these years have brought about in the field of medicine and surgery. To do them any degree of justice would require volumes 88 for record and days for listening. It is of importance to realize, however, by layman as well as physician, and it is proper for it to be recalled at this time and in this presence that, to-day, because of these changes, no man leaves his domicile to engage in the toils of shop or office or farm or to share the opportunities of travel without enjoying a greater degree of security of life and a greater certainty of preser- vation from pain and of speedy restoration to usefulness, should accident or disease overtake him, than did his father fifty years ago. In internal medicine the change has been no less marked. Specu- lation has given way to demonstration. In the autopsy room and in the laboratory an innumerable host of workers, animated by a divine enthusiasm for the truth, have been searching for the hidden secrets of life and the causes of disease. An entirely new conception of the character of those processes which constitute life has been revealed, and a nearer approximation to ultimate truth has been reached in our knowledge of what leads to disease and of what the meaning is of those symptoms by means of which we have been wont to recognize it, and of what is needed to secure a restoration to health of the sick body itself. So we are seeing creeds and sects in medicine fade away and a new generation of medical men coming upon the arena of the world's activities, tolerant and generous, animated by the one heaven- born instinct, a search for the truth ! And now to my colleagues of the medical profession of Kings County a special word. Although more than forty years have passed since I began my work among you in Brooklyn, it is a source of great satis- faction to find so many who were then active as physicians in this community still pursuing their beneficent work. I may mention William H. Bates, '63, and Frederick W. Wunderlich, '64, with whom I have had the special tie that a common service in the U. S. Navy gives; Jonathan Prout, most venerable of all, who, well advanced into the eighties, is still active and interested in his fellows ; Skidmore Hendrickson, who graduated in medicine the same year as I did, in '66; John D. Sullivan, who had been a fellow-student with me at the University of Michigan in '65 and '66; and George A. Ostrander, '58, James R. Bird, '58, J. Lester Keep, '60, William A. DeLong, '63, Nathaniel Matson, '64, Arnold W. Catlin, '65, Jerome Walker, '68, Samuel B. Childs, '69, J. H. Steriing, '69, A. Ross Matheson, '70, and J. J. LaMadrid, '71, all of whom were my neighbors and from all of whom I received many kindnesses in my early venture among them in civil work ; and Henry N. Read, '70, and John D. Rushmore, '70, who became members of the Kings County Medical Society simultaneously with myself, these form an " Old Guard " with whom I gladly share the honors of this evening. The changed and changing conditions of 89 professional work to-day have not diminished our interest in the work which we assumed as young men, nor lessened our appreciation of the high ideals of professional conduct and aims which we received from our fathers. The amount of technical knowledge required of the physi- cian to-day is enormously greater than was required of us when we entered upon our work here. The necessity of associating ourselves together in groups, each member of the group bringing to it special knowledge in a particular field, is becoming more apparent every day. If we would secure for men the best that modern medicine can bring them, such groups must take an important place in the medicine of the future. This, while it makes our work more certain, will also make it more impersonal, and thereby will perhaps deprive it of some of the finest characteristics that have attached heretofore to the closeness and sacredness of the relation between physician and patient. On the other hand, it will remove much of the occasion for oversensitiveness that always accompanies intimate personal service. As known to most of those present, for twenty years the more im- portant part of my surgical work was done in that part of Brooklyn of which the Montauk Qub is the social centre. For but a short time, however, has it been my privilege to enjoy a residence in that most attractive section of the city. You have made no stranger of me, Gentlemen of the Montauk Club, and in the honor which you have done me in extending to me such felicitations at this golden period of my professional life, I recognize a spirit of neighborly kindness and of appreciation of earnest and honest devotion to the welfare of humanity which commands a most grateful response from myself. The prob- lems of civic betterment, of social expansion and development, of the regulation and stimulation of what shall be best for city and citizen alike, in all the multitude of phases which the present offers and the future shall hold, may well engage the constant and serious attention of such an influential body of Brooklyn's citizens, and I shall always hope to be numbered among its active workers. In a special degree do I thank you for the way in which you have made me one of yourselves to-night. Finally, to my comrades of the Grand Army, who have joined in this evening's jubilee, I return Greeting and Heartfelt Love. It is more than fifty years since, in the enthusiasm of youth and the glow of patriotic ardor, we answered our country's call and followed its flag to preserve its integrity. The memory of those days and the conscious- ness of a common devotion to a high cause, for the sake of which life itself, if need be, was to be laid down, has formed a tie that has bound us together in bonds of fraternity than which none earthly can be stronger. We have since been permitted to live through a period of 90 our country's history, characterized by profound peace at home, and unexampled material prosperity. In the midst of such conditions that always inevitably make for softness of individual character, for the exaggeration of the value of luxury, for indolence and apathy as to duty to the State, it has been the privilege and unremitting effort of the Grand Army to keep burning the fire of Patriotism on the altar of our country. What a stirring among the dry bones of unconcern, of self-satisfaction and of pursuit of selfish ease and gain that were filling the valleys of our land do we now hear, as the observation of an old world at war and the rumblings from our own Southern border warn the citizens of the new world that in time they must also meet the inevitable, and emphasize the importance of being prepared to defend their firesides and their ideals. Although " the sad threshold of old age " may separate some of us now from active participation in the duties and burdens of the responsi- bilities of to-day, I know that in the heart of every old soldier of the War for the Union prevails the most intense interest that adequate and permanent preparation be speedily made by this nation that it may be able against all comers ever to protect its citizens, no matter where they may be, on land or sea! Though our years may be many, my comrades, our spirits are still youthful, and the flag which we followed in the sixties is still our talisman, and the object of our devotion ! Our point of view, however, has changed. The horizon of seventy-one differs from that of twenty-one. We were then animated by the spirit of expectation and of enthusiasm. We had a glorious contempt for the difficulties of the present and an inspiring hope for the future. We had unlimited confidence in the possibilities of life, we had trust in men, we had joy in friendship. We were dreamers, conscious that all the great achievements of the past had first entered the minds of men as dreams. We were enjoying the stimulating rays of the morning light, the light that illumines the morning of life, which, however faint at first, we were confident had the hues of an aurora that with its increasing rays was to light up for us the whole vault of heaven. Now at seventy- one, though we may look back on years saddened by some unrealized hopes and expectations, and by the remembrance of many dreams that have never come true, years the record of which is punctuated by the asterisks that mark the procession of comrades who, one by one, have dropped by our side during the battle of life, nevertheless the evening sky is equally aglow with its own sunset tints. We have enjoyed much ; we have transformed opportunity into accomplishment; we have had experience, possession, satisfaction ; even in some degree triumph. We have no illusions ; we know that the tints of the evening sky are gradually and surely fading, but we are content, we have lived ! 91 XV LIST OF THOSE PRESENT AT THE JUBILEE DINNER LIST OF THOSE PRESENT AT THE DINNER IN HONOR OF LEWIS STEPHEN PILCHER Allen, Herbert C. . . . Anderson, C. A Armstrong, George E, Aten, William L. . . . . Atkins, Chas. D Ayres, H. M , Ayres, H. M. (Guest) Bailey, Fred D Bailey, Fred R. . . . Baird, Andrew D. . Baker, Alfred E. . . Baker, P. J Baketel, H. S Balch, a. C Baldwin, L. Grant Ballard, Cora M. . . Barron, W. H Bates, W. H Bauer, J. L Bayles, Wm. H Beach, Ralph M Beatty, Geo Beck, A. W Beebe, Frances P. . . Beers, N. T Bell, Alfred Bell, H. K Benedict, Charles S. BlEREAUER, B. W. . . . Bill, P. W Bird, James R Bishop, Eliot Blaisdell, Silas H. . Blatteis, S. R Bliss, Robert F Block, Siegfried . . . Blum, Edward C. . . Bogart, a. H BOGART, J. B BOLGER, Wm Brady, William G. . Brant, Cornelia D. . . . Brewer, George E Brinsmade, W. B Brown, Frank E Brown, Geo. R Brown, S. S Browning, William . . . Brundage, a. H Brush, George W Buchanan, I. I bulkley, l. d Butler, Glent worth R. Butler, William E. . . Cadman, S. Parkes . Campbell, W. F Canfield, J. F Cardwell, John A. . Casey, W. H Chase, Walter B. . . Childs, S. E Clark, Raymond . . . . Cohen, Nathan COLEY, W. B Coughlin, Robert E. Cox, C. N Crane, C. G Cross, F. B Cruikshank, E. a. . Cruikshank, Fred A. Cruikshank, W. J. . Da Costa, J. C Dana, Charles L Davis, W. H Deaver, John B De Bevoise, Charles I. De Forest, H. P Delatour, H. B De Lorme, M. F De Long, William A. De Yoanna, Aurelius 95 De Yoanna, G Dickey, William D Dickinson, R. L Dixon, Thomas Douglas, William Downey, J. M Dudley, P. S duffield, w. l Durham, Roger Early, J. H Eastmond, a. H Eastmond, Chas Eastmond, John E Elsberg, Charles A English, Wm. H English, Wm. H Epstean, Ed Evans, Evan Faikbairn, H. a Feltman, C. L Figueira, M Finlay, George D Finley, John H Fisher, Henry A FiSKE, Edwin H FiSKE, E. Rodney Fleming, James W Fleury, George E Fogarty, John L FosDiCK, Raymond B Fowler, Roy ale H Fowler, Russell S French, C. B French, C. M French, T. R FuHs, Jacob Gallagher, Wm Gardner, Chas. E Genthner, N. C Gerster, Arpad G Gibney, V. P Gibson, Gordon GiLDERSLEEVE, C. P GiLM'ORE, W. G Gleason, W. Stanton Goodrich, Chas. H Goodrich, Chas. H. (Guest) Goodwin, N. C Gordon, O. A Gordon, O. A. Jr , Gordon, O. A. Jr. (Guest) ., Graham, H. F , Hale, Harriet W , Hancock, James C Harrington, Bart D Harris, Burton : Harris, Thos. J Heitman, Fred E HOLDEN, F. C Holmes, James E HoNAN, William F, Hopper, M. T HoRNi, John Howard, Tasker Hubbard, William S Huffman, Otto V Huffman, Otto V. (Guest) HULSE, W. A Humpstone, O. P HuRD, Henry M Huntington, Thos. W Ingalls, James W Ives, Robert F Jacobi, Abraham Jahne, Henry C Jameson, P. C Jennings, J. E Joerg, Oswald Jonas, A. F Jonas, A. F. (Guest) JUDD, A. M Keen, W. W , Keep, J. Lester Kerr, LeGrand Kevin, C. D Kevin, J. Richard Keyes, J. J King, S. T Klein, Abram Kline, Ardolph Knight, Frank H KOERNER, Wm. F Kruskal, J, D Lamadrid, J. J Langworthy, H. T Lazansky, Edward Le Conte, Robert G. Lee, John A Leeds, James Lewi, Maurice J. LiNDER, John Linder, William, LiNDRIDGE, Wm. E. . . . Longstreet, Robert N. Loud, George B LouRiA, Leon Lovett, Geo. E LUDLUM, W. D Luhrsen, Ernest F. . lundbeck, c Lynch^ Leo A MacEvitt, John C. . . McCafferty, James A. McChesney, H. F. ,, McDonald, Edgar . . . McLeer, J. Crooke . . . Mangan, D. C Marshall, J. H Matheson, a. Ross . . Matson, Nathaniel . Matthews, H. B Mayne, E. H , Mayo, Wm. J Meagher, J. F. W Merzbach, Joseph Meyer, Willy Meynen, George K. . . . Miller, George I Mills, Henry M'. Minton, Henry B MOOREHEAD, RoBT. M. .. Morrison, R. J MoscHcowiTz, Alexi.s . Mosher, B. B MosHER, B. B. (Guest) Mosher, Eliza Murphy, John Murphy, Joseph P Murray, Archibald . . . Murray, Foster Murray, Thomas Napier, Charles D. . . . Nealley, W. G Onderdonk, George A. . O'Reilly, Miles OSTRANDER, GeORGE A Otis, F. B Parsons, Birt F Pascual, William V Patterson, Thos. V Pearson, L. W Peck, Charles H Peckham, Wm. C Peele, Grace D Pendleton, Judson P Pfeiffer, William PiLCHER, James T Pilcher, Lewis F PiLCHER, Lewis F. (Guest) Pilcher, Lewis S Pilcher, Paul M Platt, Willard H POLAK, J. O PoMEROY, Ralph H Potter, Mary E Price, George A Price, Henry R Price, Wm. H .' . Prout, Jonathan Ranken, John F Rankin, W. H Rathbun, N. P Reed, Geo. Ed Reichers, George H Reynolds, W. G Riegelman, Laura M RiscH, Otto Roberts, D. R Roberts, John B Robinson, Nathaniel Rogers, Robert Ronalds, J. H Rush MORE, John D Sachs, B Sammis, E. F Satterthwaite, Thos Sauer, C. T Sauer, C. T. (Guest) Schenck, H. D SCHMITT, Mr SCHONDELMtelER, C. T Schwartz, Leo S scofield, c. e Search, Charles J 97 Shaffer, Newton M. Shepherd, F. J Sherwood, W. A Shoop, F. J SiMiSTER, James Simmons, E. A Simmons, Warren S. . . Simmons, W. S. (Guest) Simmons, W. S. (Guest) Simmons, William Sloat, Horace N Smith, Heman P , Smith, J. Foster Smith, W. S SoMERs, James A - Spence, T. B , Stapleton, Luke D , Stewart, J. A Stickle, C. W Stone, C. L Strasser, Mr , Stratton, William A. . . . Sturges, p. H Sullivan, J. D , Sullivan, Raymond P. . . , Summers, William Syms, Parker Tait, George F Tarbox, H. R Taylor, J. M Teale, Charles T Terrell, A. B Terry, W. R Thompson, Alec N Thompson, Alec N. (Guest) Torek, Franz Van Cott, J, M Van Cott, J. M. (Guest) ... Vander Veer, A Vander Veer, Edgar A. . . Vaughan, Victor C Walker, Jerome Walker, John B Warbasse, James Peter Warren, Luther F , Waterman, James S Waugh, D. W , Webb, J. B Webster, H. G Wesenberg, Paul E , Westbrook, R. W , Wight, J. Sherman , Williams, Herbert F Williams, John G Wilson, A , Wilson, Christopher W. . . . . Wilson, Frank E , Winfield, J. M WoLFSON, William Wood, H. H Wood, J. Scott Wood, Walter C Wooden, M. E Woolsey, Wm. C Wright, E Wunderlich, F. W APPENDIX XVI SOME OF THE FINER CHARACTERISTICS OF THE MEDICAL LIFE AND THE INFLU- ENCES THAT MAKE FOR THEM. AN AD- DRESS DELIVERED BY INVITATION OF THE FACULTY OF THE LONG ISLAND COLLEGE HOSPITAL BEFORE THE STU- DENTS OF THAT INSTITUTION, MARCH 28, 1916, BY DR. LEWIS STEPHEN PILCHER, IN THE MORNING OF THE FIFTIETH ANNIVERSARY OF HIS ENTRANCE INTO THE PRACTICE OF MEDICINE SOME OF THE FINER CHARACTERIS- TICS OF THE MEDICAL LIFE AND THE INFLUENCES THAT MAKE FOR THEM Gentlemen: It is an important and unquestioned truth that the greatest thing which a student takes from a class-room is not the facts which he may have learned there, but the spirit which he may have imbibed there. The great value of a university education consists not in the details of knowledge which it may communicate to a student, but in the interest in knowledge which it has awakened and in the ideas that are conveyed of how knowledge is to be gained and to what use it is to be put. If this were not so, the tutor and the quiz-master would be far greater personages in the intellectual world than the thinker, the savant and the magister, the man with the capacity for details than the one who, grasping broad principles, enjoys wide visions and ambitions for high endeavor. One of the advantages of the preceptorship and apprentice systems in the medical training of former years was the prolonged and close companionship which the system called for between the young student and the mature practitioner. Many things the younger man learned from the elder besides diagnosis and practice. Especially must he have been impressed by the professional spirit of his master in whatever degree it was possessed by him, for it is chiefly as such a spirit is incarnated in a living man that it is impressed and perpetuated. This truth is well illus- trated in what we call the religious spirit, for do we not know that it is only when this spirit is presented to us concretely in a living individual that it produces an impression ? What are all the teachings and methods of the religions of the world but an exemplification of the truth of this statement ? The high esprit de corps of any body of men, family spirit, national spirit, patriotism in all its manifestations, is but an expression of this same influence. The ideal is embodied in a man and, lo, a hero, a prophet, a saint is created and a world-spirit is engendered or changed because a man has lived ! Medicine, too, has had its heroes, prophets and saints who have left a permanent impress upon mankind, whose lives in varying degrees remain as models for their successors to imitate and the study of whose characters, lives and works is a most potent inspiration to the men of the 103 present day and a most valuable safeguard against assaults of the crass materialism and commercialism with which our modern life is so strongly tinctured. I am inclined to think that it is true that in America the conditions are such as to give an especially dominating influence to the business side of medical life. Let us not blind our eyes to the facts that on this side of the Atlantic the absence of permanent class distinctions, the want of traditions strengthened by time and usage, the rapid development and extension of population and of large business interests, giving undue prominence to vigor and hustle and push in the affairs of life and relegating to a minor place the things that make for grace and courtesy, art and refinement, the rawness and newness of much of our social state, the importance of immediate material success to be secured by the special activity of the individual, the small place for the hereditary influence of transmitted position and spirit, — all these things and many more that might be enumerated really do tend to accentuate among us as a people the commercial spirit, the gospel of hustle and of material success. Since the character and attainments of the physicians of any age or nation are always determined by and reflect the average char- acter and attainments of the people from whom they spring and among whom they labor and a part of whom they are, it follows inevitably that the physicians of this land cannot escape wholly the commercial spirit of the age and the methods of individual push which dominate their environment. What should not be overlooked, however, is that on the other hand, here as elsewhere, in the pursuit of medical study and practice, there are special refining and elevating influences which are continually and insensibly moulding the characters of medical men, so that in America, quite as much as in other lands, in their maturity, as a class, they, least of all classes, present the picture of selfish greed and absorption in money getting. Accepting, therefore, the fact that there are special conditions in- herent in our twentieth century surroundings which do tend to blunt the finer aspects of medical life among us, it would seem to be especially important that hereafter in the training of our medical men, more marked emphasis than ever before should be put on all those things and influences which may serv^e to antidote such commercializing tendency ; that liberalizing influences should be sought out, developed and nurtured, so that to the robustness, vigor, practicalness, earnestness, aggressiveness and open-mindedness, which are the characteristics of American man- hood in general, there may be added in the physician such finer qualities as a high spirit of serv^ice to his fellow-men because they need it rather than because they can pay for it, of fraternity, of culture, devotion to duty, self-forgetfulness, thirst for knowledge and regard for absolute 104 truth, producing by the combination a type of physicians the highest, as a class, the world has ever known. That such men abound among us even now, I have no hesitation in asserting. They can be found in every community to the honor of our profession and the credit of our common humanity. Such has certainly been the case in the past ; it remains our duty to secure its continuance in the future. If what I have just said is true, then the study of and familiarity with the careers of those men, who in the past have especially exem- plified in an eminent degree the finer characteristics of the medical life, must be a most important part of this liberalizing culture. The consideration of the struggles and achievements of other men has meant more to most men who have contributed to the progress of the world than anything else. The contemplation of the life of a great man has two distinct results — it gives faith in times of discouragement ; it tends to the creation of higher ideals. It leads naturally to hero worship ; a hero is an ideal embodied in a man; one is inspired to imitate his virtues, to adopt his aims and to fashion one's life on the pattern of which he is the model Hence, the value to the physician of a knowledge of medical history and especially of that phase of it which has to do with the lives an;d cliaracters of its great men. One need not go to the ancients, to ^sculapius, Hippocrates, Galen and Celsus for one's heroes, nor even so far back as Vesalius and Pare and Gui de Chauliac, nor to the later Harvey, Sydenham and Boerhaave, but in our own day and time, even in our own generation, we can and do find lives dwelling upon which one can realize the truth of the proverb that " as one lamp lights another, nor grows less, so nobleness enkindleth nobleness." The statue of Joseph Warren on Bunker Hill, the obelisk in memory of Ephraim McDowell in Danville, Kentucky, the statues of Samuel D. Gross and of Benjamin Rush in Washington, of William Pepper in Philadelphia, of Hunter McGuire in the grounds of the State Capitol at Richmond, Virginia, of Benjamin Silliman in New Haven, and of Marion Sims in Bryant Park, New York City, and the bust of Alexander J. C. Skene, a name ever illustrious in these halls, with its backgroimd of marble opposite the entrance to Prospect Park in Brooklyn — con- templation of these cannot fail to arouse, in the minds of young men who are entering the profession which they adorned, sentiments of the loftiest character. Medicine in America is already rich in the possession of such men. To these names could be added many more who, though their merits have not been commemorated by marble and bronze, are equally worthy of honor and remembrance, and a knowledge of whose work and character would ever awaken sentiments of admiration and emulation in men of the same calling. I count it among the greatest 105 privileges of my life that I have known so many of them. Even of those I have mentioned by name, I knew personally Gross, Pepper, McGuire, Sims and Skene, and some of them I have had reason to esteem as my friends. I speak feelingly, therefore, when I urge upon the attention of my younger colleagues the attainment of a knowledge of the character, spirit and aims of the leaders of the past, as an heritage of the greatest value in creating in them the spirit which should char- acterize their own careers. I pass on now to the second of the elements which I would present as of value in the training of medical men — familiarity with the litera- ture of medicine. The library of a physician should include other things than journals and medical text-books, vade mecums and manuals. These are important and invaluable in their place. They are the daily bread and working tools of the physician and are to be kept in con- stant use. Their value, however, is but a present and ephemeral one ; those of yesterday are supplanted by those of to-day, and these in turn will give place to those of to-morrow. Those books which contribute to culture and a familiarity with which exerts an elevating influence on the scholar have a wider and more permanent interest. In the fields of history and biography, in discussions of medical life and ideals, in essays, even in poetry and romance, they tend to awaken lofty senti- ment, to broaden views of life, to introduce a more correct perspective into one's estimates as to the value of present things, and to create in the student a mental attitude which makes him more worthy to be classed as a member of a learned profession, rather than the mere practitioner of a useful trade. There are certain great works and writings v/hich mark in a special manner the progress of medicine. These have a permanent interest not only as memorials but still more as historical records of the development of medical knowledge. No man can be considered a medical scholar who does not know about them, their place in literature, and the part which their writers played in the evolution of medicine, although he may not read in detail the books themselves. Such are the books of Hippocrates, of Celsus and Galen among the ancients; of Avenzoar and of Avicenna among the Arabians; of Mundinus and Gui de Chauliac, marking the class of the Dark Ages and the beginning of the Renaissance in anatomy and in surgery; of the Regimen Sani- tatis Salemi, preserving the memory of the great mediaeval medical school at Salernum; of Benivieni, the morning star of pathology; of Berengarius da Carpi, who demonstrated the practical use of illustra- tions in anatomical treatises ; of Vesalius, the Flemish knight-errant of anatomy who revolutionized that department of medicine and made his name immortal before he was thirty years of age; of Paracelsus the 106 medical iconoclast ; of Pare, the practical thinker and wise constructor in surgery ; of Harvey, the devoted Royalist, who first grasped the idea and demonstrated the fact of the perpetual circuit of the blood; of Sydenham, the grim puritan, the English Hippocrates ; of Boerhaave, whose aphorisms, and of Albinus, whose plates, marked the high point of the Dutch school at the close of the seventeenth and beginning of the eighteenth century; the books of Cheselden, of Monro and of Hunter, signalling the rise of the English school at the close of the eighteenth century. These are by no means all the names worthy of being mentioned in this connection, but I content myself with these few examples of what I mean now to enforce. These are great mountain peaks of the medical world that stand out the more clearly as a wider historical horizon is attained. Familiarity with the careers of such men and knowledge of such books should early be brought into the experience of every medical student. Even more fruitful for medical culture and delightful for moments of relaxation from strenuous material effort is the field of medical his- tory and medical biography. The most attractive and inspiring field is that presented by medical biography. Here the field is illimitable and reaches every age and land. I will mention as examples the spark- ling essays of Sir Benjamin Ward Richardson, entitled " Disciples of ^sculapius " ; the many charming biographical essays of Osier ; the volumes containing the work of the Charaka Club, and the series of volumes published by Longmans, Green and Company, entitled "Masters in Medicine," having as their subjects John Hunter, William Harvey, Edward Jenner, Sir James Simpson, Herman von Helmholtz, William StokeSy Claude Bernard, Sir Benjamin Brodie, Thomas Sydenham and Andreas Vesalius. Around the personalities of such men as Vesalius, Pare, Harvey and John Hunter there has gathered a large amount of historical and biographical material that is of intense interest. I can imagine nothing more stimulating or elevating to the young physician than to become immersed in the study of such records. It is sure to result in a sort of hero-worship. But are not all men with enthusiasm hero- worship- pers ? And do not the characteristics of the heroes men worship become reflected to some degree in the worshippers themselves ? And now in conclusion, a word to these young men who have chosen the practice of medicine as a calling, and are now fitting them- selves to enter upon it. What is it ? I would say that in its highest development it is a possession. There is such a thing as a medical instinct as positive and compelling in its influence on the man as is the artistic, the musical, or the inventive instinct, or that of spiritual 107 ministry on those thus endowed. Not all who practise medicine are driven by it, nor do all of those influenced by it have it in equal degree. It is an instinct which makes the problems of health and disease of supreme interest. It makes the drudgeries and responsibilities of prac- tice to be full of pleasure — a reward to its possessors. To those who have it not, the peculiar trials and duties of the medical profession seem repellant, and the higher aims and aspirations of its votaries are incomprehensible. It has little in common with the ordinary ideas and methods of commercial life, and, tried by the standards of the business world, its ideals seem visionary and fanciful. Possessed by this instinct, the student is carried through all the peculiar and prolonged conditions of his preparatory work; possessed by this instinct, the young practitioner is sustained through the labors, the responsibilities, the trials, which attend the full development of his work. Possessed by this instinct, the aged physician, as his declining years bring him down towards the close of his career, looks back with intense satisfaction upon the work which he has done for his fellow- men, and finds himself universally acclaimed by all his fellow-citizens as a benefactor of mankind. John Brown, the author of " Rab and His Friends," has proposed six Latin words in which to sum up what the practice of medicine requires from those who would bear to men the gifts which it offers. May I recite them to you ? These are, first, verax — he must be true, sincere and honest; second, capax-^he must be capable, well- trained and equipped ; third, sagax — he must be wise and sagacious in his judgment of men and in his applications of means to ends ; fourth, perspicax — ^he must be gifted with insight, an insight the result of the knowledge of the processes of life, the signs of diseases, and the pecul- iarities of men; fifth, eMcax — ^he must be efficient in his application of knowledge, with knowledge ever at hand ready for use, mind, heart and hand working together for a common aim ; sixth, tenax — insistent and positive^ tenacious of truth as it has been revealed to him. Verax, capax, sagax, perspicax, efficax, tenax — these are the cardinal points of the medical compass by which the physician may surely be guided across the limitless and trackless sea of professional life to the harbor of success in the accomplishment of his great purpose for the relief of men, and for the attainment of a final reward in the love and esteem of his fellows. "^ "^^ - \ V Vc\t fe>^.