COLUMBIA LIBRARIES OFFSITE 
 
 HEALTH SCIENCES STANDARD 
 
 HX00030570 
 
 THE UNIVERSITY OF PENNSYLVANIA 
 
 THE OPENING 
 
 OF 
 
 THE NEW BUILDING 
 
 OF THE 
 
 HENRY PHIPPS INSTITUTE 
 
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HENRY PHIPPS 
 
THE UNIVERSITY OF PENNSYLVANIA 
 
 AN ACCOUNT 
 
 OF THE 
 
 EXERCISES ON THE OCCASION 
 
 OF THE 
 
 OPENING OF THE NEW BUILDING 
 
 OF THE 
 
 HENRY PHIPPS INSTITUTE 
 
 Seventh and Lombard Streets, Philadelphia 
 May lo, 1913 
 
INTRODUCTION 
 
 For ten years after its organization on February i, 1903, the 
 work of the Henry Phipps Institute was carried on in two re- 
 modeled dwellings at Nos. 236-238 Pine St. In 1907 Mr. Phipps 
 acquired a number of small properties at the northeast corner of 
 Seventh and Lombard Streets, extending north to Addison, 
 as a site for a permanent building. 
 
 The architect, Mr. Grosvenor Atterbury, of New York, made 
 preliminary studies of the building, and the plans were exhibited 
 at the Congress on Tuberculosis in 1908. In the year following 
 the Institute was placed in charge of the trustees of the University 
 of Pennsylvania, the arrangement taking efTect July i, 1910. 
 The study of building plans, which had been dropped during the 
 period of transition, was resumed with vigor; a year later ground 
 was broken, and the work of erection was begun. On March i, 
 1 913, the laboratory wing was occupied, and by May i all the 
 work of the Institute was housed in the new building. 
 
 The exercises marking the opening were held Saturday, May 
 10. In the afternoon, at a meeting of the trustees of the Univer- 
 sity of Pennsylvania and in the presence of a distinguished as- 
 semblage, including visitors from many States, degrees were con- 
 ferred upon Mr. Henry Phipps and Dr. Edward L. Trudeau; 
 addresses were made by the Provost of the University, Edgar 
 F. Smith, Dr. Lawrence F. Flick, and Dr. Herman M. Biggs. 
 In the evening a dinner was given at the Hotel Bellevue-Stratford, 
 at which the speakers were Mayor Rudolph Blankenburg, Dr. 
 S. Weir Mitchell, Dr. William H. Welch, Dr. Theobald Smith and 
 Dr. Alfred Stengel. The speeches on both occasions are embodied 
 in this volume. 
 
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THE NEW BUILDING OF THE 
 HENRY PHIPPS INSTITUTE 
 FROM THE SOUTHWEST 
 
WAITING ROOMS FOR MEN AND 
 WOMEN ON THE MAIN FLOOR, WITH 
 CLINICAL LABORATORY AND LARYNGO- 
 LOGICAL CLINIC AT END OF CORRIDOR 
 
PORCH AND OPEN DECK ADJOIN- 
 ING WARDS FOR ADVANCED 
 CASES ON THE THIRD FLOOR 
 
KIOSK AND OPEN DECK AD- 
 JOINING WARDS FOR EARLY 
 CASES ON THE FOURTH FLOOR 
 
SOLARIUM ON THE FIFTH FLOOR 
 
OPENING EXERCISES 
 
 Dr. Edgar F. Smith, Provost of the University of Pennsyl- 
 vania, presided. 
 
 The Provost: 
 
 The Rev. Dr. Floyd W. Tomkins will now invoke the blessing 
 of Almighty God upon the exercises of this hour. 
 
 Dr. Tomkins: 
 
 Let us pray. O Lord our God, unto Thee we come, for in 
 Thy name we would do all things and upon all that we do 
 we ask Thy blessing. We are Thy children and, we beseech 
 Thee, bless all of our undertakings. We thank Thee O Lord 
 that Thou hast put it in the heart of Thy servant to erect 
 this building for the saving of the bodies of men from suffering 
 and sickness. Send Thy blessing upon it, we beseech Thee, and 
 the work it is to do. Bless the physicians, bless the patients, 
 bless those who have made this building possible. Send Thy 
 blessing upon those broad-minded, far-seeing men and women 
 who desire to fulfil the Divine obHgation and bring Thy Kingdom 
 to earth by saving the bodies of men and so making easier the 
 salvation of their souls. Grant, we beseech Thee, that all things 
 undertaken in Thy name and for Thy sake may come to such 
 success as Thou seest best. Send Thy blessing upon the exercises 
 of this hour, that we may be filled with new courage and hope 
 through the words spoken on this occasion. We ask these bless- 
 ings in the name of Him who taught us to say: Our Father who 
 art in Heaven, hallowed be Thy name. Thy Kingdom come. 
 Thy will be done on earth as it is in Heaven. Give us this day 
 
 17 
 
our daily bread and forgive us our trespasses as we forgive those 
 who trespass against us, and lead us not into temptation but de- 
 liver us from evil, for Thine is the Kingdom and the power and 
 the glory for ever and ever, Amen. 
 
 The Provost: 
 
 "Medicine is my wife; science is my mistress; books are 
 my companions; my study is my grave; there I lie buried, 
 the world forgetting, by the world forgot." Thus spake Ben- 
 jamin Rush, and I wonder and have been wondering since 
 entering this building, after hearing the remarks of my associates 
 upon all sides, just what that grand old physician would say could 
 he sit with us this moment. Surely he would promptly recognize 
 that he was not by the world forgot and that the dread disease 
 from which he suffered from his eighteenth until his forty-fifth 
 year had been receiving untold attention in the century which 
 has just passed, since his departure to that bourn whence no 
 traveller returns. As I recall it. Dr. Rush maintained that the 
 only cure for consumption would be found in remedies which act 
 upon the whole system. He thought that the symptoms of its 
 early stage should be most carefully studied, not only by physi- 
 cians, but by parents and by friends, and maintained that the 
 remedies for the early stage were extremely simple, such as de- 
 sertion of sedentary employments, the quitting of damp or cold 
 situations, the seeking out of dry places, reveling in country air 
 distant from the sea, — the higher and drier the place, so much the 
 better, — and then he recommended change in climate. The re- 
 turn of the complaint, he wrote, might be prevented by exercise, 
 depending upon the state of the disease and the strength of the 
 patient. Observations of all these points, we are to believe, 
 effected his own cure more than one hundred years ago, but what 
 inroads and terrible ravages the disease has made and committed 
 since the days of Rush, one hundred years ago ! For we learn that 
 now 200,000 persons die annually in the United States from open 
 ulcerated tuberculosis; hence it is not surprising that the most 
 brilliant medical talent has devoted itself to the experimental 
 
study of the disease in its many forms. Grateful should we be 
 for the efforts of these saviors of perishing humanity. Grateful 
 and proud should we be that in our own commonwealth the most 
 patient and at the same time the most strenuous and persistent 
 endeavors have been put forth by noble heroic souls in the mighty 
 struggle to win out against this insidious foe, and most thankful 
 should we be for those grand benefactors who, Hke Mr. Henry 
 Phipps, in the overflowing love of their great hearts, create 
 foundations properly equipped with means for the care and the 
 cure of the sadly afflicted ones. The University of Pennsylvania, 
 keenly alive to the significance and deeply appreciative of Mr. 
 Phipps' unique foundation, including this wonderful Institute, 
 bids me here publicly express to him its most sincere thanks for 
 the gift, a gift which in itseK proclaims him before the whole 
 civilized, applauding world, to be indeed my brother's keeper. 
 
 The Secretary of the University: 
 Candidates for degrees will now be presented: 
 Edward L. Trudeau, Doctor of Laws. 
 
 The Provost: 
 
 Edward Livingstone Trudeau, founder of the first sanita- 
 rium for the treatment of incipient consumption in working- 
 men and women, founder of the first research laboratory in 
 the United States for the experimental study of tuberculosis — 
 director today of these two institutions — active, earnest, esteemed 
 author — beloved physician, pioneer veteran in a sacred cause — 
 fondly thought of as one of our own, we write thy name upon 
 these waUs, and I, the Provost of the University of Permsylvania, 
 by virtue of the authority committed to me by the mandamus of 
 its trustees, confer upon you the honorary degree of Doctor of 
 Laws, admitting you to aU the rights and privileges which, 
 throughout the world, pertain to this degree. In testimony 
 whereof I now present this diploma, signed by the Provost and 
 Vice-Provost and confirmed by the corporate seal of the Uni- 
 versity of Pennsylvania. 
 
 19 
 
The Secretary of the University: 
 Henry Phipps, Doctor of Laws. 
 
 The Provost: 
 
 Henry Phipps, ironmaster, man of affairs, philanthropist — 
 unswervingly devoted to the amelioration of disease-stricken 
 himianity, with a sympathetic zeal and ardor which have won 
 the approbation of the wise and good the world over I Who 
 heals the body can best heal the heart, and I, the Provost 
 of the University of Pennsylvania, by virtue of the authority 
 committed to me by the mandamus of its trustees, confer upon 
 you the honorary degree of Doctor of Laws, admitting you to all 
 the rights and privileges which, throughout the world, pertain 
 to this degree. In testimony whereof I now present this diploma, 
 signed by the Provost and Vice-Provost and confirmed by the 
 corporate seal of the University of Pennsylvania. 
 
 I am further charged by all interested in this Institute, to 
 express to the architects, represented by Mr. Atterbury, our 
 very sincere thanks. 
 
 And now permit me to present to you one who is famiHar with 
 the work of the Phipps Institute from the day of its birth. Dr. 
 Lawrence F. Flick. 
 
 20 
 
AN HISTORICAL SKETCH OF THE HENRY 
 PHIPPS INSTITUTE 
 
 Dr. Lawrence F. Flick 
 
 The opening of the permanent abode of the Henry Phipps 
 Institute is perhaps a fitting occasion for putting on record its 
 inception and early history and its work during its years of pro- 
 bation. Its years of probation may be said to be from the time 
 of its inauguration to the time when its permanency was definitely 
 determined upon and it was handed over to the University of 
 Pennsylvania. The beginning and end of this period are Febru- 
 ary I, 1903, and January i, 1910. 
 
 The Institute had its inception in the contact of two impulsive 
 men, one a physician who in the behef that tuberculosis could be 
 wiped out worked himself up into a high state of enthusiasm, and 
 the other a retired business man who had made money and was 
 burning with a desire to spend it in the interest of humanity. 
 On October 23, 1902, Mr. Henry Phipps wrote me: "I am waiting 
 with interest to hear further about the little clinic in the smaU 
 house I am to buy for the purpose you explained when I saw you. 
 Mr. Gordon will go over to Philadelphia to look at the premises 
 and can arrange with the Title Insurance Company to attend to 
 the matter of proper transfer and he wiU pay the Company the 
 check when you advise me the proper amount. What alterations 
 and improvements, painting, etc., would be necessary to properly 
 fit the building for the purpose intended?" The houses here 
 referred to, for there were really two, were small buildings at No. 
 719 and No. 721 Lombard Street, which I had hoped to be able to 
 rent and where I had prospects of opening a httle clinic on a capital 
 of $1000 which some kind lady had offered me. 
 
 21 
 
On October 25th, instead of sending Mr. Gordon, Mr. Phipps 
 came himself to talk over the Httle clinic with me. After dis- 
 cussing the subject for a while in my sitting-room at No. 736 Pine 
 Street, he became so enthused that he said: "Doctor, go out 
 and buy the block; I'll pay for it." When I told him that I 
 might not be able to pick things up so easily, he repHed: "Do not 
 stand too much on prices, but buy. We want to do this work; 
 get the property and we will talk things over on the way to 
 Europe." 
 
 Of course, I was not able to buy the block and, greatly to my 
 chagrin, I was not even able to rent the houses of which I felt so 
 sure; for when the people found that I really wanted them, they 
 refused to let me have them. I went to Europe with Mr. Phipps, 
 however, a;nd we talked things over. Before going, I employed 
 a real estate agent to get us either that block or some other block 
 during my absence. 
 
 Mr. Phipps before leaving for Europe set aside enough money 
 to finance the new institution during his absence, as he himself 
 was starting upon a trip around the world to be gone for a year. 
 We sailed on November 4th and I returned home on December 
 23d after inspecting various institutions in Europe. When I 
 got back, my agent had not been able to buy even a foot of 
 ground. 
 
 He had, however, found an empty building at No. 238 Pine 
 Street which had been without a tenant for years and could be 
 rented. Unfortunately, another obstacle loomed up, for there 
 was a law upon the statute books of Pennsylvania which pro- 
 hibited the estabUshment of hospitals in the built-up portions of 
 the city. The legislature was in session and when appealed to 
 removed this obstacle by promptly and unanimously repealing the 
 law. The house was rented and before any other obstacles could 
 be placed in our way was open for work. The Institute began its 
 career on February ist in this building with a few chairs and a 
 good many patients. The publicity which the newspapers had 
 given the undertaking brought patients from every quarter, so 
 that it was difficult to meet the demands for help and treatment. 
 
 22 
 
With Mr. Phipps' liberal backing, however, all difficulties were 
 promptly overcome, and in a relatively short time the old building 
 was equipped with fifty-two beds, a small laboratory, and facilities 
 for running a large dispensary. An earnest, zealous staff of well- 
 trained young men was soon organized and worked with zeal 
 and enthusiasm. 
 
 When Mr. Phipps returned from his trip around the world, 
 he found a well-established institute operating along the lines 
 which had been forecast in our discussions. The fifty thousand 
 dollars which he had left to begin the work with had been used 
 up. He was well pleased and promptly set aside a much larger 
 sum to be drawn against in amounts of fifty thousand dollars a 
 year. "When this amount is exhausted, I will give more," were 
 his encouraging words. 
 
 The purposes and objects of the Institute as determined by 
 Mr. Phipps and myself on our trip to Europe were announced in 
 the Philadelphia Medical Journal of January 21, 1903, immedi- 
 ately upon my return in the following words : " The Henry Phipps 
 Institute for the Study, Treatment and Prevention of Tubercu- 
 losis is to be an institution devoted exclusively to the work of ex- 
 terminating tuberculosis. Prevention will be the ultimate object 
 of everything that is done in the institution and the establishment 
 will be planned and operated with that aim foremost in mind. 
 The Institute will consist of pavilions with a cap'acity of one 
 hundred beds, well-equipped laboratories, facihties for hydro- 
 therapeutic and phototherapeutic work and of such other acces- 
 sories as may be necessary for carrying out the plans of the 
 Institute. There will be a dispensary connected with the Insti- 
 tute from which will be given treatment and aid to the consump- 
 tive poor who are unable to give up employment or who cannot 
 gain admission into some institution. The pavilions will be 
 built with balconies and a roof-garden so that the patients can 
 be kept in the open air as much as possible. The wards and 
 balconies will be so constructed that every bed can be run out on 
 a balcony and the patient kept in the open air day and night if 
 necessary. The beds of the Institute will be used exclusively for 
 
 23 
 
advanced cases, the object being to take these patients out of 
 their homes and thus prevent the spread of the disease. The 
 house patients will furnish the clinical material for scientific re- 
 search in the laboratories and in the various departments which 
 will be attached to the Institute. Facilities will be given for 
 testing all new ideas in the treatment of tuberculosis which have 
 a scientific basis. . . . Patients will be treated both at the 
 dispensary and when too far advanced to corqe to the dispensary 
 at their homes. Medicine and food will be supplied when neces- 
 sary, as also disinfectants, spit-cups, and paper napkins. They 
 will be taught the use of these things and they will be kept under 
 supervision so as to insure the carrying out of proper preventive 
 measures. Printed instructions will be furnished them as to what 
 to do in order to prevent the spread of the disease and an effort 
 will be made to enforce the rules which are laid down. A Hterary 
 bureau will be established in the Institute. . . . An effort 
 to stimulate activity in the crusade against tuberculosis will be 
 made through this bureau and aid will be extended in efforts at 
 organization wherever such aid is called for. . . . The hold- 
 ing of conferences and congresses on the subject of tuberculosis 
 for the purpose of stimulating thought and action will be encour- 
 aged and patronized. . . . With a view of bringing clinical 
 and laboratory work as close together as possible only men will 
 be appointed to the staff who are equipped for both clinical and 
 laboratory work." As this program indicates, the Institute 
 started out to set the world aflame with a burning zeal to stamp 
 out tuberculosis. 
 
 After Mr. Phipps had had time to think over what had been 
 done during the first year and to talk it over with some of his 
 friends, he was somewhat shaken in his purpose of going on with 
 the work laid down and again thought of taking up the sana- 
 torium work, which had been his original purpose. To him, as to 
 most people, a house full of dying consumptives with a lot of 
 enthusiastic medical men trying to extract a boon for humanity 
 out of them was a melancholy sight not well calculated to pull 
 fifty thousand dollars a year out of one's pocket. He wrote 
 
 24 
 
from Europe that he would like us to find a site for a sanatorium 
 so that he might devote at least a part of the money to sanatorium 
 work. We looked for such a site and had a number of favorable 
 locations in view for his inspection on his return. After going 
 over the entire subject with me again, however, and hearing what 
 was to be said on the side of caring for dying cases and using ma- 
 terial which was available in this way for elucidating the subject 
 of tuberculosis, he said: "We will go on, for this seems to be the 
 better work." We abandoned the idea of establishing a sana- 
 torium, and he commissioned me to persevere in my efforts to 
 secure a site for the permanent home of the Institute. 
 
 The task of finding a site for a permanent home proved to be 
 a difficult one; not only because people objected to the location 
 of the Institute near them, but also because conscienceless specu- 
 lators when they got even a suspicion that a wealthy man was 
 looking for ground upon which to establish an institution in the 
 interest of humanity put up their price to a forbidding figure. 
 Besides, in the old part of the city where it was desirable to locate, 
 titles to property were sometimes much involved. For these 
 reasons, it took seven years of painful effort and much chagrin 
 and annoyance to get the ground upon which the present building 
 stands and even for some of it exorbitant prices had to be paid. 
 A number of sites were looked at during that time and options 
 were taken on some of them, but in the end the ground upon 
 which this building stands was selected and we found ourselves 
 located just one square away from the original block which Mr. 
 Phipps had directed me to buy. 
 
 Many have wondered why this site was selected. There were 
 two impelling reasons: one because it was situated in the slums 
 where an institution of this kind is needed, and the other because 
 it was perhaps the most degraded spot physically, sanitarily, 
 and morally in the city of Philadelphia. Placing the Institute 
 here accomplished a twofold purpose, tearing up by the roots a 
 center of sin, sorrow, and degradation and putting in its place 
 an institution consecrated to the uplift of man. For nearly a 
 hundred years, at least beyond the memory of living man, this 
 
 25 
 
place reeked with human depravity too foul to be spoken of and 
 extended its polluting influence in every direction throughout the 
 city; for all time to come it will radiate its beneficent influence 
 not only throughout the city, but over the entire world, making 
 men good by making them healthy — the noble act of a God- 
 fearing man making perpetual reparation for the foul deeds done 
 in the past. For this alone will the Recording Angel have made 
 a record for Mr. Phipps in the Doomsday Book which is worth 
 while. 
 
 During the seven years of my stewardship of the Phipps Insti- 
 tute, Mr. Phipps expended upward of $350,000 in the work. 
 What has the world gotten out of his generous act? Let me give 
 a brief inventory of it. 
 
 (a) The Institute gave the world a new idea in the concentra- 
 tion of all available forces for the accomplishment of a single 
 purpose in the field of preventive medicine. It is the first organi- 
 zation, so far as my knowledge goes, which was brought into exist- 
 ence for the specific purpose of studying and working with one 
 disease with the view of wiping it out. It introduced into pre- 
 ventive medicine a rational policy and accurate business methods. 
 The same idea has since been put into operation in the Koch 
 Institute in Berlin, the Royal Edward Institute of Canada, both 
 devoted to tuberculosis; the Phipps Psychiatric Clinic of Balti- 
 more, and the Institute for the Study, Treatment and Prevention 
 of Cancer estabhshed in Liverpool, England, by Mr. McFadden 
 of Philadelphia. 
 
 (b) It brought to the United States the International Congress 
 on Tuberculosis. Whilst the Institute was not the only agent 
 concerned with bringing over this Congress, without the Institute 
 the Congress would not have come here. In March, 1902, nearly 
 a year before the Institute was organized, I tried to induce the 
 Marine Hospital Service of the United States to lead a movement 
 for bringing over the International Congress on Tuberculosis but 
 failed. When I discussed the subject with Mr. Phipps on our 
 way to Europe, he told me to take whatever preliminary steps 
 were necessary to bring over the Congress and that he would stand 
 
 26 
 
back of me financially. In Berlin, I called on Dr. Pannwitz, 
 the Secretary-general of the International Society for the Study 
 and Prevention of Tuberculosis, and laid my project with its 
 backing before him. He at once fell in with the undertaking and 
 from that time on gave his most cordial support to it. At the 
 meeting in Paris, in 1905, it was tacitly understood that the Con- 
 gress was to come to the United States for its next session, and 
 though Japan and other countries offered great inducements for 
 the holding of the Congress in other countries the invitation from 
 the United States was promptly accepted. 
 
 Not only did the Institute play the chief role in bringing over 
 the Congress, but it also played a very important part in making 
 it a success. Three members of the staff of the Institute were on 
 the delegation to Paris that invited the Congress, and five mem- 
 bers of the staff held important positions on various committees 
 which organized the Congress. For three years a great deal of 
 the energy of the staff of the Institute went into the organization 
 of the Congress to a degree indeed that prevented the Institute 
 from presenting its own work to the best advantage in the exhi- 
 bition of the Congress. Nevertheless, it took two gold medals 
 and four silver medals for its work. 
 
 (c) It brought the seventh session of the International Tu- 
 berculosis Conference to the United States. The International 
 Tuberculosis Conference is made up of workers in the tuberculosis 
 field and meets annually. During the year in which the Inter- 
 national Congress on Tuberculosis meets it is customary for 
 the International Tuberculosis Conference to convene in the 
 country in which the Congress convenes. When at its meet- 
 ing in Vienna in 1907, it was found that no provision had 
 been made for bringing it to the United States, I cabled the 
 situation to Mr. Phipps and he promptly cabled back that I 
 invite the Conference to Philadelphia at his expense. The Con- 
 ference came here as the guest of the Henry Phipps Institute 
 and Mr. Phipps met all expenses, including the cost of pubhcation 
 of the transactions over and above what was contributed by the 
 citizens of Philadelphia and the city of Philadelphia for the enter- 
 
 27 
 
tainment of the Conference. The meeting of the Conference 
 just before the Congress was an excellent introduction to the 
 Congress itself and did much for the education of the people in 
 tuberculosis work throughout the entire country. 
 
 (d) It brought about the organization of the National Associa- 
 tion for the Study and Prevention of Tuberculosis of the United 
 States. Organized leadership of tuberculosis work in the United 
 States had fallen into questionable hands and the best men in the 
 country kept aloof from it. The necessity of reorganization was 
 apparent to every one, but it was not easy to find a plan of doing 
 it. The Institute made the reading of a paper prepared by Pro- 
 fessor Maragliano, of Genoa, Italy, the occasion of bringing to- 
 gether the foremost men in tuberculosis work in the United States, 
 and after the paper had been read assembled the men for the 
 purpose of organization. Formal organization was made and 
 an adjournment was taken to meet again in Atlantic City some 
 time subsequently for the purpose of making by-laws and electing 
 officers. The organization of this society was part of the scheme 
 of the Institute for bringing over the International Congress on 
 Tuberculosis, since the existence of such an organization was 
 practically a condition upon which the Congress would come. 
 The Society iromediately took its position with international 
 societies of other countries, and has since been the successful 
 leader of the crusade against tuberculosis in the United States. 
 It is at present perhaps the largest and strongest organization 
 of its kind in the world. 
 
 (e) The Institute originated and developed the idea of making 
 special nurses for tuberculosis work out of girls who had recovered 
 from tuberculosis. When the Institute was opened, it was 
 practically impossible to secure reliable nurses for tuberculosis 
 work on account of the universal fear of the disease, not only by 
 the laity but by physicians and nurses. In its dilemma, the 
 Institute bethought itself of using cured girls from White Haven 
 Sanatorium for ward-maids, and, finding them unusually well 
 fitted to minister to consumptives by the sympathy which they 
 felt for them, hit upon the thought of making special nurses of 
 
 28 
 
them. From the very beginning the scheme was successful and 
 proved to be a boon to the crusade against tuberculosis. The 
 idea has been taken up by other institutions and has been suc- 
 cessfully carried out wherever tried. The women who have 
 thus been brought into the practical work of the crusade against 
 tuberculosis have shown themselves not only to be good nurses, 
 but zealous missionaries in their chosen field. 
 
 (f) It demonstrated the feasibility and practicability of treat- 
 ing tuberculosis successfully anywhere and in any climate. 
 American physicians had in recent years come to look upon tu- 
 berculosis as incurable except by climatic changes. So universally 
 had this view come to be held that it was heresy to differ from it. 
 The fifty-two beds in the Institute were given over to advanced 
 cases, but it was found that many of these advanced cases im- 
 proved very much and were again restored to a life of usefulness. 
 Most of the members of the staff of the Institute were also on the 
 White Haven staff and treated cases simultaneously in the two 
 institutions. They discovered that they could treat severe 
 cases more successfully at the Phipps Institute than at White 
 Haven Sanatorium, and they very often transferred their cases 
 from the White Haven Sanatorium to the Phipps Institute. In 
 the last analysis, strict discipline and accurate supervision counted 
 for more than any other factors and where these could be best 
 carried out the best results were obtained. It was not long before 
 every member of the staff felt confident that tuberculosis could 
 be as successfully treated in the slums of a large city as in a moun- 
 tain resort. The experience of the Institute pubUshed to the 
 world through its reports went far toward convincing the scien- 
 tific world of this fact. 
 
 (g) It inaugurated the social service work in the crusade 
 against tuberculosis in the United States, taking for its model 
 the Emile Roux Dispensary of Lille, estabhshed and directed by 
 Dr. A. Calmette. It sent its nurses out systematically to visit its 
 dispensary patients not only for the purpose of helping them to 
 carry out the treatment, but also to bring about improved home 
 conditions and show other members of the family how to avoid 
 
 29 
 
contracting the disease. It systematically distributed preventive 
 measure supplies to the families which it supervised and gave 
 milk to those patients who could not buy the necessary food. 
 It expended on an average about ten thousand dollars a year in 
 this kind of work. Out of this work, it demonstrated the limita- 
 tion of dispensary and social service work as a factor in the pre- 
 vention of tuberculosis and, in consequence, toward the end of the 
 seven-year term lessened its expenditures for material aid. The 
 world has come to recognize that for the prevention of tubercu- 
 losis it is necessary to bring under control and close supervision 
 the cases passing through the terminal stage of the disease. 
 
 (h) It placed tuberculosis in the category of curable diseases, 
 worthy of the attention of the practising physician. By carefully 
 training men for clinical work in tuberculosis, teaching them 
 accurate methods of history taking, physical examination and 
 treatment, it leavened the entire medical profession through the 
 influence of these men until all practitioners of medicine made an 
 earnest effort to do something for their tuberculous patients to 
 bring about recovery; whereas formerly they had either aban- 
 doned them to a hopeless lot with the advice that they change 
 climate, or had soothed them with ameliorating treatment to 
 their final exodus. The history sheets which were so carefully 
 worked out by the staff of the Phipps Institute have been used as 
 models for other institutions throughout the entire country. 
 
 The scientific work of the Institute during the seven years 
 has been in part published in five volumes of records, making a 
 total of about twenty thousand octavo pages. Over five thousand 
 cases treated in the hospital and dispensary, of which more than 
 four thousand were tuberculous cases, form the basis of this work. 
 Nearly all of the patients who died in the hospital were studied 
 pathologically and histologically. Careful statistics on the clini- 
 cal and sociological phases of tuberculosis were taken in all of the 
 cases. The disease was studied in some of its by-paths, such as 
 those which lead to amentia, insanity, and social dependence. 
 Not only were the most complete autopsies made, but every case 
 was carefully analyzed and studied in its clinical relations to the 
 
 30 
 
autopsy findings. Statistically, the five volumes of reports give 
 the most reliable and noteworthy data upon the subject of tu- 
 berculosis clinically, sociologically, and pathologically that have 
 ever been published. 
 
 Some of the important problems worked out by the Institute 
 during those years are : (i) The elimination of tubercle bacilli 
 by the kidneys; (2) the etiological relationship between secondary 
 infections and hemorrhages; (3) the influence of tuberculosis in 
 the production of nephritis; (4) the relationship between tu- 
 berculosis and insanity; (5) the extraordinary part which tu- 
 berculosis plays in the production of social dependence; (6) 
 the danger of contagion from the frequent change of residence of 
 the tuberculous poor; and (7) the relationship between alcohol 
 and tuberculosis and tobacco and tuberculosis. 
 
 On November i, 1909, I resigned as medical director and 
 president of the Institute and I was relieved of duty on the ist 
 of January, 1910. The Institute was given over to the University 
 of Pennsylvania, under whose management it has been since. 
 This step was taken to secure permanency for the Institute. 
 
 How well the Institute has succeeded in setting the world 
 ablaze with zeal for the extermination of tuberculosis is best 
 shown by the nineteen million dollars expended in the United 
 States during the year 1Q12 for this purpose. The whole world 
 is now in arms against the White Plague, and the fight wiU not 
 lag until victory has been won. When that day has come and the 
 history of the combat will be written, the name of Henry Phipps 
 will be one of the most conspicuous in the book. 
 
 The Provost: 
 
 Dr. Herman M. Biggs, of New York City, a distinguished 
 and an enthusiastic member of our Advisory Council, will now 
 address you. 
 
 31 
 
INDUSTRIAL COLONIES FOR THE 
 TUBERCULOUS 
 
 Dr. Hermann M. Biggs 
 
 The completion of the buildings of the Henry Phipps Institute 
 for the study, treatment, and prevention of tuberculosis, and their 
 dedication to the purposes intended by their generous founder, 
 constitute an event full of significance to modern work in pre- 
 ventive medicine. Ten years of successful work of the Institute 
 have been completed and the buildings opened today will form an 
 important landmark in the progress and development of pre- 
 ventive work, in the most important period in its history. 
 
 It is difficult even for those who have been entirely conversant 
 with all of the developments in medicine during the last thirty 
 years, and who have taken part, in some measure, in these de- 
 velopments, to gain any adequate comprehension of their full 
 significance and bearing on the industrial progress of the civilized 
 world and on the reduction in the rate of sickness and death and 
 the consequent improvement in the general welfare of the race. 
 
 The preventive work in tuberculosis is only one typical phase 
 of the preventive work which has been going steadily on in many 
 lines. Mention may also be made of the campaign for the re- 
 duction of infant mortality, fbr the improvement in the health 
 and the prevention of disease in school children, for the prevention 
 of mental disease, for the prevention of ophthalmia of the new- 
 born and of blindness, and more recently of the movements for 
 the prevention of venereal disease, of cancer, and of alcoholism. 
 In tropical and subtropical countries, too, we have similar activi- 
 ties of more recent date looking to the prevention of diseases 
 peculiar to these regions, such as the hookworm disease, the 
 
 32 
 
sleeping sickness, the malarial fevers and yellow fever, tropical 
 dysentery, etc. Because of its early inception, its popular 
 character, and its world-wide extent, the tuberculosis work has 
 attracted more attention than any of the other phases of this 
 general movement. It may not be without profit, if we pause 
 for a moment and look back over the accomplishments of the 
 recent past and try to measure somewhat their value. 
 
 During the past fifty years, the death rates in the great cities 
 of the world have been reduced fully 50% and the mean duration 
 of human life has been increased by more than 25%. In some 
 great cities, where the sanitary conditions were formerly extremely 
 unfavorable and where the greatest progress has been made, even 
 more than this has been accomplished. It may be safely said 
 that at least ten thousand years have been added to the average 
 duration of life of each one thousand babies born in many of the 
 great cities of the world, and that the mean lifetime of each 
 individual has been increased from less than forty years to over 
 fifty years. In a city like New York the decrease in the death- 
 rate means a saving of more than eighty thousand lives a year, 
 and, with the present population of the United States, if the death- 
 rates prevailing before the Civil War, or even forty years ago, 
 still obtained, a million additional lives would be sacrificed each 
 year to disease. This decrease in deaths naturally indicates an 
 enormous decrease in the amount of sickness. 
 
 It has been estimated by some authorities that for every death 
 taking place in a community, twenty cases of serious illness occur 
 which terminate in more or less complete recovery. In other 
 words, in the United States in 191 2 there were twenty million 
 less instances of serious illness than would have occurred if the 
 conditions existing forty years ago still obtained. It is not easy 
 to gain any adequate comprehension of the economic significance 
 of this change. It would be difficult to estimate the value of the 
 loss in time, wages, and efficiency and the cost of nursing, medical 
 attendance, and medicines, which such illness would entail. 
 
 It is not necessary before this audience to more than refer to 
 the extraordinary results which have followed the scientific, 
 
 33 
 
clinical and educational work of numerous organizations through- 
 out the country whose purposes are similar, in part at least, 
 to those of the Phipps Institute, nor is it necessary for me to 
 consider in detail the character or scope of this work. 
 
 I desire, however, to refer to one subject of fundamental 
 importance coimected with tuberculosis which has recently en- 
 gaged the time and interest of the Directors of this Institute, 
 and concerning which but Httle progress has been made anywhere. 
 I refer to the provision of employment for patients discharged 
 from tuberculosis sanatoria with their disease arrested or 
 apparently cured. The lack of suitable occupations under proper 
 conditions for such patients has been the great stumbling-block 
 in the way of more lasting and substantial progress in the efforts 
 for the permanent arrest of the disease especially as it occurs in 
 the working class. Experience has sho\vn that a large proportion 
 of the cases described, when they return to the conditions and 
 occupations under which their disease originally developed, tend 
 to relapse and ultimately die of the disease. 
 
 The difficulties in the provision of suitable and lucrative occu- 
 pations for such persons in a favorable environment are very great 
 and have not been satisfactorily met on a large scale anywhere in 
 the world. The suggestion must at once come to every one that 
 as an outdoor life is especially favorable to the arrest of pulmonary 
 tuberculosis, outdoor occupations, such as farming, gardening, 
 horticulture, etc., should be the natural occupations of choice 
 for persons who have been or are affected with the disease. In 
 fact, the most definite and systematic attempts to provide occu- 
 pation for these persons have been along these lines, as, for ex- 
 ample, the Farm Colony of the Royal Victoria Hospital in Edin- 
 burgh; but experience in the large cities in this country has shown 
 that a very large percentage of the cases of pulmonary tubercu- 
 losis come from the indoor workers who have no knowledge of 
 or experience in such occupations, who do not like them, and who 
 are not only mentally and temperamentally unfit to undertake 
 them, but generally have not the physical strength and endurance 
 to do so. 
 
 34 
 
It is well known that in arrested or apparently cured cases of 
 pulmonary tuberculosis physical endurance is the very last feature 
 of restored health to return and the one which often enough is 
 never regained. On the other hand, these individuals are usually 
 quite able and willing to undertake less laborious occupations 
 indoors identical with or similar to those which they have previ- 
 ously followed. 
 
 For a long time I have had in mind the estabHshment of in- 
 dustrial colonies in the country, preferably in connection with the 
 sanatoria, where the climatic conditions are favorable for tu- 
 berculous patients, where land is cheap, where sanitary workshops 
 and dwellings can be erected, and where the workmen can spend 
 the unemployed hours of the day — at least twelve or fourteen 
 hours — out-of-doors. Dwellings with outside sleeping porches 
 would be provided, and patient-employees and their families 
 would be kept under continued supervision as to all of the 
 conditions of life, including their food and dietary, so that 
 the most favorable conditions would surround them and the 
 earliest indications of a return of disease would be immediately 
 recognized. Such a plan, if it could be properly carried out, 
 would, in my judgment, not only meet the humanitarian de- 
 mands, but would result in an enormous economic saving to the 
 community, both directly and indirectly, and would become a 
 most influential factor in the eradication of this disease. 
 
 Some of the difficulties in carrying such a plan into effect are 
 evident enough: The difficulties in finding suitable and lucra- 
 tive occupations, in marketing the products produced by tubercu- 
 lous workers, the difficulty in finding capital to establish and 
 maintain such colonies, and in their subsequent conduct and 
 supervision. I feel confident, however, that these difficulties 
 can be and will be overcome, and it may not be amiss to indicate 
 briefly the immense economic gain such a plan, if successfully 
 carried out, would afford. 
 
 It has been the poHcy at the New York Municipal Sanatorium 
 at Otisville, since its establishment, seven years ago, to give em- 
 plo)anent to as large a number of ex-patients as possible, and to 
 
 35 
 
utilize the services of in-patients during their treatment in the 
 conduct of the institution. At the present time, with over five 
 hundred patients, there are less than thirty non-tuberculous 
 employees engaged in non-productive occupations in connection 
 with the institution. We have over one hundred tuberculous 
 employees, some of whom have been engaged for a number of 
 years in various capacities. Experience there has shown that a 
 large percentage of the discharged patients would gladly remain 
 in the country if they could be furnished with suitable work. 
 Further, it has been found that a large number of patients, even 
 many of those well advanced in the second stage of the disease, 
 are able to do nearly a full day's work after six months in the insti- 
 tution, if only the conditions under which they work and live are 
 satisfactory. A number of men who when admitted had quite 
 advanced disease, after discharge from the institution moved 
 their families to Otisville, and have been able to support them 
 in comfort there without detriment to themselves. The recital 
 of a single case of this sort will indicate the economic possibilities 
 of this procedure : 
 
 About four years ago a driver was sent to the Sanatorium at 
 Otisville with tuberculous disease of the lungs. His family con- 
 sisted of a wife and nine children, of whom the oldest was a girl 
 of twelve years, who also had tuberculosis and accompanied her 
 father to the Sanatorium. Two of the younger children who were 
 in poor physical condition, showing a positive tuberculin reaction, 
 were sent to that admirable institution, the Tuberculosis Pre- 
 ventorium for Children at Farmingdale, New Jersey. The mother 
 and the remaining six children were cared for largely by the 
 Women's Auxiliary of the Tuberculosis Clinics of the Department 
 of Health during the father's stay in Otisville. At the end of six 
 months his disease was apparently arrested, he had gained thirty 
 pounds in weight, and both he and his daughter, whose disease 
 was also arrested, returned to New York. He presently found 
 occupation as a taxicab driver, but after a few months, as a result 
 of irregular hours, exposure, and unhygienic living, he commenced 
 to do badly and had difficulty in earning sufficient to maintain his 
 
 36 
 
family. It was evident that if he remained in New York his 
 disease would soon become again active, and that the charitable 
 organizations and the city would have, not only the father and the 
 eldest daughter to care for in tuberculosis institutions, but pos- 
 sibly also some of the younger children, and that it would then 
 soon become necessary for some one to provide for the whole 
 family of eleven. I therefore determined to find a home and 
 occupation for him at Otisville. A small house was fitted up, 
 and a large sleeping porch and a tent were provided where a 
 number of the children and the father slept. He was given a 
 position as watchman on the sanatorium property at fifty dollars 
 a month. His condition soon improved, and he now has an ex- 
 cellent garden and a small poultry plant, and is able to entirely 
 support in comfort his whole family. The older children attend 
 the district school. The entire family is prosperous, happy, and 
 contented. 
 
 It may safely be said that, under ordinary conditions, with the 
 almost certain return of the disease in the father, this family 
 would have cost the community at least twelve or fifteen hundred 
 dollars a year, would have been eventually broken up, several of 
 them would probably have died from tuberculosis, and a number 
 of the children would have been reared in institutions. A tu- 
 berculosis industrial colony would effectually deal with such 
 cases as this. 
 
 At the last session of the New York State Legislature a bill 
 was passed at my request authorizing any municipahty maintain- 
 ing institutions for tuberculosis to establish and maintain work- 
 shops, for the employment of persons who are or have been in- 
 mates of such institutions, for the manufacture of articles and sup- 
 plies to be used in such institutions or in other institutions con- 
 ducted by the municipality or in the departmental work of the 
 municipality. In other words, for the manufacture of practically 
 everything which the municipality buys or uses. The products 
 of such shops would not be sold in open market, and would not, 
 therefore, come into competition with other workers. In my opin- 
 ion this authorization opens up great possibilities for the solution 
 
 37 
 
of this, the most fundamental factor in the whole tuberculosis 
 problem, and without which our elaborate program for the pre- 
 vention of this disease will fail of its real purpose. One can readily 
 see that such a plan, if it can be successfully carried into effect, 
 has possibiUties in the way of municipal socialism of the first mag- 
 nitude. When the New York Municipal Sanatorium at Otisville 
 is completed, it is intended to provide for from twelve hundred 
 to fifteen hundred patients, and as the average residence in the 
 institution is about six months, from twenty-five hundred to 
 three thousand persons will pass through it each year. A large 
 proportion of the discharged cases are wiUing to remain and 
 should remain ill the country for several years or perhaps for a 
 lifetime. The families of many of these patients would also move 
 to the country, so that the total yearly addition to the colony 
 might equal or even exceed this number. After a time such a 
 colony would become self contained and would supply its own 
 needs of nearly every kind. It would have cooperative stores, 
 shops, gardens, farms, etc., and might easily become a town of 
 no mean size. We hope in New York city that the financial 
 authorities may soon make provision for carrying this act into 
 effect. If a solution of this problem can thus be found, the last 
 great obstacle to the success of the tuberculosis campaign will 
 have been removed. 
 
 I wish to briefly recall an incident which preceded the estab- 
 lishment of the Henry Phipps Institute in Philadelphia. Mr. 
 Phipps had become interested in tuberculosis and its relief and 
 consulted several friends in New York in relation to the work 
 which he had in view. I did not, at that time, have the honor 
 of Mr. Phipps' acquaintance, but was much interested at the 
 prospect of a new tuberculosis institution in New York city. In 
 the course of his investigations Mr. Phipps came to Philadelphia 
 and talked to Dr. Flick, and was soon so carried away by 
 Dr. Flick's enthusiasm that he determined to establish this 
 work in Philadelphia and to place this Institute in his charge. 
 I well remember our disappointment in New York when we 
 learned that we were to lose what Philadelphia had gained. But 
 
 38 
 
we bear no envy, for the Phipps Institute has contributed largely 
 to the general advancement of the tuberculosis movement, and, 
 in the larger sense, it little matters whether such an institute is 
 located in New York or in Philadelphia or in Baltimore, which 
 latter city has also received such generous benefactions from him. 
 
 This Institute occupies an extremely important and even 
 unique position in the tuberculosis campaign. It was not only 
 the first scientific institution founded solely for the purpose of 
 assisting in the solution of the tuberculosis problem, but it is 
 still, so far as I know, the only institution or organization in the 
 world which attempts to deal with all phases of the problem. 
 It includes in its scope the social and economic features surround- 
 ing the development and existence of cases of tuberculosis in the 
 home and the extension of relief there; the clinical aspects of the 
 disease with the application of treatment to ambulant cases, 
 and the provision of institutional care; laboratory investigations 
 into the etiology, pathology, and specific treatment of the dis- 
 ease; provision for training nurses, medical students, physicians, 
 and research workers, in all matters appertaining to the economic, 
 scientific, and clinical problems connected with tuberculosis, and 
 finally, facilities and provisions for carrying on a general educa- 
 tional propagandum. It stands in relation to the tuberculosis 
 problem where the Rockefeller Institute for Medical Research 
 and the Rockefeller Hospital stand in relation to general medicine, 
 with the added social, economic, and educational features which 
 the latter do not include. 
 
 I do not know of any medical or philanthropic institution 
 which has so comprehensive a grasp of the problem with which 
 it is designed to deal as has this institution, and when we recall 
 the fact that this problem relates to tuberculosis, which constitutes 
 one of the three great factors which most seriously affect the 
 health, happiness, industrial progress, and general welfare of the 
 whole human race, we appreciate more fully the foresight and 
 wisdom of the founder and his medical counselor, Dr. Lawrence 
 Flick, in those earlier days, only a dozen years ago, when the 
 world-wide movement for the study and prevention of this dis- 
 
 39 
 
ease was but just beginning. Of Dr. Flick and his associates 
 we may well say "they builded better than they knew." It 
 remains for their successors, you who now control the future 
 and the destiny of this Institute, to determine fully the realiza- 
 tion of their hopes. 
 
 Most earnestly we extend today our felicitations and con- 
 gratulations to the wise and generous benefactor of this Institute, 
 Henry Phipps, and we may well cherish a noble envy toward 
 him, because it was given to him to confer so great a blessing on 
 his fellow-men. 
 
 I wish also to extend our warm congratulations to the Uni- 
 versity of Pennsylvania, which will have in the new buildings of 
 the Henry Phipps Institute such unrivaled opportunities for the 
 instruction of its students in a most important subject, and still 
 more I would extend our hearty congratulations to the people of 
 Philadelphia, to whom this Institute has been for the past ten 
 years such a benefaction, because of the larger opportunities and 
 wider scope which it will now offer; and, finally, I wish to offer 
 my sincere thanks to the committee in charge of these exercises, 
 which has given me the opportunity to express my personal 
 obligations to the Institute for its work in the past, in a field which 
 to me has, for more than twenty-five years, been one of absorbing 
 interest. 
 
 The exercises closed with a benediction by The Rev. Dr. 
 Tomkins. 
 
 40 
 
SPEECHES AT THE DINNER 
 
 THE HOTEL BELLE VUE-STRATFORD 
 
 Dr. J. William White, Toastmaster. 
 
 The Toastmaster introduced Hon. Rudolph Blankenburg, 
 Mayor of the City of Philadelphia. 
 
 Mayor Blankenburg said in part: 
 
 I am more than delighted to be with you and I thank you 
 very much for the compliment you have paid me. There is one 
 thing we boast of in Philadelphia that I don't believe any city in 
 this country or the whole world can boast of with equal absolute 
 propriety, and that is, our institutions to help those in distress, 
 the sick and the poor, and our educational institutions. Now I 
 don't want to make any invidious comparisons, but I am very 
 proud of the University of Pennsylvania. The Provost is here 
 and I hope he will applaud that sentiment. And I am very 
 proud of a great many other of our institutions. I am proud of 
 Girard College: there is nothing in the world equal to it. Here 
 we have a new institution, the Phipps Institute, dedicated to the 
 people of Philadelphia, to those suffering from tuberculosis, by one 
 broad-minded, liberal-spirited individual, Mr. Henry Phipps. I was 
 exceedingly sorry that I could not be at the opening of the Insti- 
 tute this afternoon, but unfortunately I cannot be in more than one 
 place at one time, otherwise I would have been there to enjoy with 
 the rest of you the inspection of that really wonderful institution. 
 This afternoon we dedicated and opened an Orphans' Home built 
 
 41 
 
by the Odd Fellows; that's a new institution. It is built to help to 
 educate, to give shelter, and to clothe two hundred orphan boys 
 and orphan girls there, children of Odd Fellows. Now it is really 
 remarkable; if anybody comes to Philadelphia and wants to see 
 all our educational institutions, — institutions like Girard College, 
 like the Phipps Institute, — it would take him weeks and weeks to 
 go over them, not to speak of West Philadelphia — the Almshouse 
 and the Municipal Hospital and the Home for the Indigent at 
 Hohnesburg and other places. Well, I tell you, gentlemen. Dr. 
 Neff is making good and he wiU make good there. That is one 
 of the difficulties that we are laboring under in Philadelphia. 
 If you do good work, people pay very little attention to it, and if 
 a mistake is made, no matter how sHght it may be, they make a 
 mountain out of a molehill; that is what Philadelphia has been 
 suffering from. Now, I am a booster: I want to boost Phila- 
 delphia in every possible way, but I want Philadelphia to de- 
 serve to be boosted, and there, gentlemen, I appeal to you for 
 your help, every one of you. I don't know that there is any class 
 of citizens that can do more in that direction than the doctors 
 and educators. You enter home after home every day in the 
 week. You naturally become acquainted and become on good 
 terms with your patients, the fathers and mothers and children; 
 and the 3,000 or 3,500 doctors in Philadelphia, if they only will, 
 can be made an agency for good that it has never yet been known 
 it's possible for them to be. Now I should like very much to have 
 you gentlemen bear that in mind. I am only one poor individual. 
 I have a task before me, — I think Hercules' was simply kinder- 
 garten alongside of what I have here in Philadelphia, but with the 
 aid of the good citizens of Philadelphia, — ^with the aid of the 
 intelligent citizens of Philadelphia, I hope to be able to assist — 
 because I can't do it alone — in making Philadelphia the best 
 governed municipaHty in our country. 
 
 I have spoken to these gentlemen in my native tongue and I 
 have said to them: "If we can only succeed in giving municipal 
 government in our country such as they have in England and 
 Germany and France and other countries, the whole question 
 
 42 
 
of a republican form of government will be solved, for good gov- 
 ernment in nation and in State depends upon good municipal 
 government." If you will give me good municipal government, 
 the question of good State and national government is solved; 
 and is there one city in this country that should take the first 
 step in that direction sooner than the city of Philadelphia? We 
 have done more in Philadelphia for this great country than any 
 other community or any other municipahty, I don't even except 
 New York. Now, gentlemen, here is the plain proposition before 
 us; we can do these things if we will. Will we do them? If you 
 will help me, these things will be accompUshed and Philadelphia 
 will stand as the guiding star for all municipalities in our beloved 
 country. 
 
 The Toastmaster, proposing the health of Mr. Phipps : 
 About fifteen years ago, in the middle of the winter, when I was 
 on my way to Palm Beach, I left the dining-car of the train in a very 
 bad humor because I had not succeeded in getting any food that 
 was fit to eat. I went into a smoking compartment and found a 
 gentleman there, the only occupant of it, a gentleman of about 
 my own age, who was just beginning a very appetizing looking 
 cold lunch that he had providently provided himself with. To 
 my surprise and gratification, he asked me to join him, and after 
 a period of more or less hypocritical pretense at hesitation, I did 
 so. My benefactor on that occasion was Mr. Henry Phipps, and 
 that was my first experience of his willingness to help the poor and 
 unfortunate. I have met him since then in many parts of the 
 world, on the North Atlantic, in New York, in London, in Aber- 
 deen, but wherever I have met him and under all circumstances, 
 I found this same willingness to help out of his abundance any one 
 who might chance or whom he thought might chance to need it. 
 The little incident with which our acquaintance began was really 
 deeply significant and illustrated one of Mr. Phipps' most notable 
 characteristics. 
 
 It is quite impossible adequately to express our appreciation 
 of the splendid charity, the latest development of which has 
 
 43 
 
brought us together here this evening. We hope and believe, 
 all of us who are interested in it, that in the good which it will do, 
 in the aid it will bring to suffering humanity, in the light it will 
 cast on the places where death and disease lurk, it will be second 
 to none of the many magnificent benefactions of Mr. Phipps. 
 The University of Pennsylvania and all of us who are privileged 
 to share in this work are trying, with the unselfish help of the 
 noble men from all over the country who are good enough to act 
 as our Advisory Council, to secure the largest possible practical 
 results from the opportunities that Mr. Phipps has given us. We 
 trust that time may justify our hopefulness, and that the Phipps 
 Institute will not be the least among the many splendid monu- 
 ments that Mr. Phipps has so wisely erected. He is unfortunately 
 not here tonight to listen to our expression of appreciation and 
 gratitude, but a number of his immediate family are here who 
 can convey to him what we say and think and feel, and all that 
 we can do now is to drink the health of Mr. Henry Phipps, as 
 I beg you to rise and do. 
 
 The Toastmaster, introducing Dr. S. Weir Mitchell: 
 I have always noticed that toastmasters are apt to talk either 
 too much or too little, though I confess to a very kindly feeling 
 for the latter class. They have, however, many good excuses. 
 Sometimes they suffer for lack of material for their introductions 
 which must, perforce, be laudatory no matter what their personal 
 opinion of the introducees may be. It happens, far less fre- 
 quently, that they are embarrassed by an excess of material; and 
 yet such happens to be my case this evening. 
 
 When one is unfortunate enough to have on his hands, in the 
 person of one individual, a distinguished physician, an original 
 investigator in medicine and the allied sciences, a pioneer in the 
 non-medicinal treatment of disease, a novelist of world-wide repu- 
 tation, a poet of distinction, a wise counselor and kindly friend 
 of all the youthful and struggling, whether of his profession or not, 
 a successful administrator of funds contributed by others and a 
 liberal giver of his own, a man who, in fact, if he had also been a 
 
 44 
 
surgeon, would have left no heights unsealed, it is obvious that 
 all that remains to the toastmaster is to say, — Dr. Weir Mitchell, 
 of Philadelphia and the rest of the universe, — and sit down. 
 
 Dr. Mitchell: 
 
 Mr. Chairman, and you, Mr. Phipps, who honor us with your 
 presence here: I accepted with unusual anxiety the invitation to 
 say something at this dinner. It seems impossible for the 
 Anglo-Saxon to do anything on a large scale without pledging a 
 certain number of people to make themselves uncomfortable with 
 the prospect of an after-dinner address. Nor is my task an easy 
 one, since this is not a time for the usual post-prandial jesting. 
 The occasion is unique in the history of this city — almost equally 
 so in the history of assisted science; and you may know, of course, 
 that the splendid gift which we saw this afternoon and celebrate 
 this evening was indirectly brought about by the wonderful self- 
 sacrificing researches of Dr. Flick, to whom I am glad to pay 
 this honest tribute of admiring respect. 
 
 It is a melancholy fact that one cannot talk to you after dinner 
 without using the grim text tubercle. There is no escape. More 
 easy and more pleasant would it have been to find gracious words 
 with which to thank a public benefactor for material aid to the 
 art of medicine and the sciences on which it is founded. I do not 
 see why I have been chosen as the first speaker to-night. So 
 far as I am concerned, cases of tubercle have, for the most part, 
 disappeared from my medical horizon, and I naturally turn back 
 to memories not without interest. I have lived through certain 
 phases of popular belief in regard to consumption, so called. 
 When I was a young man, nobody feared personal infection from 
 tubercle. There came, then, a few years ago, a time of unreason- 
 able terror, which was wholesomely disposed of by so educating the 
 public as to let it understand what was to be dreaded and how very 
 small was the peril, provided certain precautions were taken. Such 
 education is still to be a part of the duties of the Phipps Hospital. 
 
 In Latin countries, as you all know, the behef in tubercle 
 being communicable in unexplained ways was strongly held. 
 
 45 
 
In 1 85 1, when in Rome, I wished to see the room in which the poet 
 Keats died of pulmonary tubercle. It had become an object of 
 interest to the EngHsh and Americans, and this had so revived 
 the memory of his disease and death that my old Roman guide 
 had some disinclination to go into the room where this death 
 occurred, although thirty years had passed, the poet having died 
 in 182 1. The circumstances surrounding the death of this gifted 
 man are interesting as evidence of the popular fear of infection in 
 Rome. The police, as soon as possible, collected all of Keats' 
 personal clothing, his bed-clothes, the bed and all the furniture 
 of the room, and burned them in the Piazza di Spagna in front of 
 the house. The piano was saved with difficulty. Their pre- 
 cautions also included whitewashing and repainting the chamber 
 in which the death took place. If these radical measures were 
 carried out after every death from consumption in Rome, it must, 
 of course, have helped to deepen the feeling of terror with which 
 the people regarded all tubercular sufferers. 
 
 We are well informed of the gross natural history of this 
 disease, but no man will dare to say that there is as yet any serum 
 or any drug that is directly victorious in our battle with this 
 bitter foe. The costly mechanism for research which you saw 
 this afternoon is the silent affirmation of this sad confession. 
 The closed hands of the future hold this secret. Now — today — 
 the therapy of tubercle consists in hygienic conditions, too well 
 known, too completely understood, to need restatement here; 
 and yet this is all we now know in the way of relieving agencies. 
 It is not all that nature knows today! In the lungs of men who 
 have Hved hard lives in unwholesome surroundings, ill fed, are 
 found, after death, in at least 80 or 90% of them, inert tubercular 
 deposits, arrested in their growth no man knows how. Solve 
 that mystery of nature's therapeutics; learn to imitate what acted 
 so beneficially against terrible odds in these cases, and you of this 
 new Phipps Hospital will have won for it and yourselves immortal 
 renown. 
 
 There have been many generous endowments of hospitals, 
 but the endowment on this new plan of laboratories with a few 
 
 46 
 
hospital beds for definite purposes of medical study of the diseases 
 which have baffled us is the last inspiration of the great bene- 
 factors of modern medical research. Two such institutions stand 
 to the credit of the guest who honors us with his presence tonight. 
 What I have longed for through many disappointing hours of 
 my busy life is put unsolicited at the disposal of the University 
 of Pennsylvania. I congratulate Mr. Phipps on his large- 
 minded thought for the future of men, who will in the years to 
 come profit by his notable gift. 
 
 And now, for you of the hospital and laboratory staff, I have, 
 too, a word of congratulation. Many times in my life I have 
 been bitterly defeated by the lack of what has fallen lavishly to 
 your share. Over and over I have wanted what you have got — 
 the endowment of an opportunity. You will have learned 
 through the newspapers in any one month that there is no disease 
 on earth that is not being easily cured; but the thoughtful medi- 
 cal scholar, the man of experience in my profession, the soldier 
 of many defeats, knows well that it is good sometimes to be frank 
 and to confess that the radical treatment of insanity, of epilepsy, 
 of cancer, and, above all, of tubercle, is at a standstill. The 
 most hopeful of these problems is yours to solve. Mr. Phipps 
 has understood what was needed, and will ask of you only the 
 fertile use of his appreciative gift. 
 
 And what else is wanted? I asked lately a distinguished 
 student of physics how he had won his way to a really great dis- 
 covery. "Oh," he said, "you must have a suggestive mind and 
 listen to its every whisper. You must live with your problem, 
 think of it, dream of it, be over and over beaten, but never tired 
 and never routed." The first discovery every laboratory has to 
 make is a man who possesses this true scientific madness, this 
 temperamental, eager, unending curiosity. The most important 
 piece of mechanism in a laboratory is the hrain of a man. 
 
 Mr. Phipps' name has been on my lips two or three times 
 casually during this short address, but I have not been able any- 
 where to say fully what I and other thoughtful scientific students 
 of disease think of the quality of the gift he has made. It is such 
 
 47 
 
a very uncommonplace charity! It has so many outstretched 
 hands of giving! There is the tubercle class, the teaching of men 
 how to live in the slums and yet not die, the helpful personal rela- 
 tion of families who have tubercle among them, and last — not 
 least — Oh! first of all — the outlook into a future of research 
 glorious with hope and not bewildered in the twilight of despairing 
 therapeutics. A day will come when the blow of the percussion 
 hammer at the top of the lung and its deadly dull response will be 
 an unimportant thing, and we shall be able to say to a man, here 
 at home you shall get well and not be an exile condemned by 
 disease to flight and a dislocation of family associations and 
 business relations. 
 
 What a mere yearning dream is that today! But what is 
 life worth without the splendid prophecy of dreams? We have 
 conquered yellow fever, are routing typhoid, and everywhere our 
 therapeutic hopes are brightening. When years ago Ronald 
 Ross found at last the zygotes in the stomach of the malaria- 
 bearing mosquito, he knew what his seven years of labor in the 
 heat of India had won, and that he had found what up to that 
 hour had been known to God alone. Some day — here, I hope, 
 in the Phipps laboratory — another man will be able to record a 
 similar triumph over tubercle. Ah! then, well may he quote those 
 lines which, throbbing with feeling, Ross wrote that Sunday of his 
 final victory and of the countless lives it would save: 
 
 "This day relenting God 
 
 Hath placed within my hand 
 A wondrous thing; and God 
 Be praised. At His command, 
 
 "Seeking His secret deeds 
 
 With tears and toiling breath 
 I find thy cunning seeds, 
 O million-murdering Death. 
 
 "I know this little thing 
 A myriad men will save. 
 O Death, where is thy sting. 
 Thy victory, O Grave!" 
 48 
 
The Toastmaster, introducing Dr. William H. Welch: 
 The purpose of our work, present and projected, at the 
 Phipps Institute is to advance the sum of human knowledge re- 
 lating to tuberculosis on pathological, cHnical, and sociological 
 lines, and at the same time to educate as many medical men 
 and medical students as possible in the recognition and care 
 of the disease. That is a fairly ambitious but a perfectly reason- 
 able program. It would seem dijQBcult, however, to find any one 
 who could adequately represent all of these diverse fields of effort. 
 But we are fortunate in having here this evening the most dis- 
 tinguished pathologist of America, the teacher who has probably 
 trained the largest number of successful investigators, the writer 
 who has consistently fostered and encouraged and contributed 
 to the science of preventive medicine, and the citizen who has been 
 active in every important movement in this country to promote 
 the public health. I have the pleasure of introducing to you 
 Dr. William H. Welch, of Johns Hopkins University. 
 
 Dr. Welch: 
 
 Mr. Toastmaster, Mr. Phipps, and Gentlemen: Dr. Mitchell, 
 by his words of singular charm and eloquence, makes it embar- 
 rassing for any one to follow him. Nevertheless, I should 
 regret not to have the opportunity of bringing to the University 
 of Pennsylvania and to Philadelphia a word of greeting and of 
 congratulation from that other beneficiary of the generosity of 
 Mr. Phipps. We of Baltimore and of the Johns Hopkins 
 University rejoice, and rejoice in a very personal and sympa- 
 thetic way, with the University of Pennsylvania in this large 
 opportunity which has come to you. All who know Mr. Phipps 
 know that he is a man whose heart is overflowing with kind- 
 ness and with the desire to benefit his fellow-men. I have 
 never known one more imbued with this spirit of himianity and 
 more eager to find ways of relieving human suffering. It is, I 
 think, of no little interest that he has chosen particularly for 
 his generous gifts to medicine the support of investigations and 
 of the care of the two diseases which make the strongest appeal 
 
 49 
 
to human sympathy, namely, tuberculosis and mental disorder. 
 He became interested in tuberculosis largely through the efforts 
 of a dreamer to whom Dr. Mitchell has referred, a man of vision, 
 a man who early saw what a great discovery meant for the future 
 of mankind. I can recall my first acquaintance with Dr. Flick 
 years before the Institute was established through those Uttle 
 popular leaflets which he issued, which he sent to me. No one 
 could read them without feeling that here was a man who had, 
 ahead of his day and generation, a vision of what it all signified 
 for the future of mankind. His name is one which should always 
 be cherished in connection with the history of this important 
 institution. 
 
 Dr. Mitchell has referred to the Phipps Institute as offering 
 a great opportunity, and so it does. Its connection with the 
 University of Pennsylvania is of advantage to the University and 
 it is of advantage to the Institute. The service which this 
 Institute can render to the University is not expressed solely by 
 the opportunity for the study of cases of tuberctdosis; the pre- 
 vention and cure of tuberculosis have a bearing upon the welfare 
 of mankind far beyond what is signified by the mere name of the 
 disease, the reason being, as has so often been said, that the disease 
 is as much a social disease as it is a mere physical ailment, and 
 you cannot begin to express the benefits to mankind merely in 
 terms of diminution in the amount of tuberculosis. 
 
 There has been no agency so effective in stirring up the people 
 to the importance of preventive medicine and of public hygiene 
 as that resulting from the interest in the prevention and cure of 
 tuberculosis. When you consider that social conditions play 
 such a very important part in the causation of the disease, and 
 that the eradication of tuberculosis means an uplifting in living 
 conditions, in the social and economic conditions of mankind, 
 you can realize how broad and significant is this opportunity to 
 which Dr. Mitchell has referred and which is rendered available 
 to this city and to this University by Mr. Phipps' generosity; 
 so the students of the University will learn not merely how to 
 diagnose tuberculosis and the best methods of treatment, but 
 
 so 
 
they will be brought into relation with most important problems 
 of society and of preventive medicine. This Institute has already 
 done a great service, as was indicated in the interesting and 
 admirable address of Dr. Flick this afternoon. He did not ex- 
 press, I think, all that is to the credit of the Institute, but 
 the past, great as it has been, is only a measure, a slight index, 
 of all the good that will flow from the establishment of this 
 Institute. It is almost unique in its scope. There are sana- 
 toria greater than the Phipps Institute; there are hospitals 
 for the care of advanced cases of tuberculosis of more elaborate 
 character and larger than the Phipps Institute; there are dis- 
 pensaries for the treatment of tuberculosis; there are opportuni- 
 ties for social study which are perhaps more elaborate than 
 anything which exists here, but there is no other institute 
 which combines all these directions, all these opportunities, all 
 these phases of the subject in equal measure, and what is admir- 
 able is the lack of rigidity in the constitution of the Institute, its 
 elasticity, its opportunity to adjust itself to new problems, to 
 be able to lead, no matter in what Hne may be the proposed 
 direction of advance. I conceive, therefore, that the character of 
 the Phipps Institute, unique as I have attempted to indicate, 
 gives the most certain augury of success. The debt which we 
 owe to Mr. Phipps is not a debt of Philadelphia or of the Uni- 
 versity of Pennsylvania alone: it is a debt of the nation, it is a 
 debt, indeed, of humanity. 
 
 The Toastmaster, introducing Dr. Theobold Smith : 
 Closely allied to our Phipps Institute work is that which 
 is being carried on all over the world by the men who are 
 studying, investigating, experimenting in relation to those 
 diseases of animals that have an economic interest or that 
 may affect the health of the public at large. Through the 
 laborious and skilful work of one of these investigators, the sig- 
 nificance, the cause and the mode of transmission of Texas cattle 
 fever were first demonstrated; the distinction between the bacillus 
 which causes bovine tuberculosis and that responsible for the 
 
 SI 
 
disease in man was first pointed out; and much light was thrown 
 on such vitally important questions as intoxication, auto-intoxi- 
 cation, the mechanism of infection, and similar subjects. It is 
 impossible, however, to mention more than these few of many 
 notable achievements resulting from a quarter of a century of 
 faithful and unremitting work by Dr. Theobald Smith, Professor 
 of Comparative Pathology in Harvard University, whom I now 
 have the pleasure of introducing to you. 
 
 Dr. Smith: 
 
 Mr. Toastmaster: Granted that some of the things you have 
 said are true, you should have known that such a man is not a 
 good after-dinner speaker and you should not have chosen me. 
 When you asked me to say a few words, I did not expect to 
 talk to such a distinguished assemblage as has been brought 
 together here this evening. You have heard such a wealth 
 of good speaking this afternoon and this evening that I can 
 do very little more than simply bring you congratulations, the 
 congratulations of Harvard University and of Boston, sincere 
 good wishes for the development of this great institution which is 
 now going into its second stage of evolution, the stage of owning 
 and occupying a permanent home. It is difl&cult to realize, unless 
 we spend our days in the four walls of a laboratory, how good it is 
 to have a new and well-equipped home. I remember the years 
 that I spent under the attic roof of the Department of Agri- 
 culture, working at a difficult problem. I remember those years 
 as years of great happiness, and yet I should not wish that any 
 other person should undergo the same trials which I underwent, 
 should endure the heat of the summers and the cold of the winters. 
 
 When Fliigge, whom you all know at least by reputation, 
 pubHshed his collected researches on the droplet infection, he was 
 met by a colleague on the streets of Berlin, a colleague in medi- 
 cine I believe, who said to him, "Why do you get out such a 
 large book on tuberculosis? I thought that question had been 
 entirely settled when Koch discovered the bacillus." Now, we 
 have had work done all over the world in tuberculosis for the past 
 
 52 
 
thirty years, and yet it is difficult to go into any assembly of 
 physicians, of health officers, of sanitarians, without learning 
 that even the fundamental problems of tuberculosis are not yet 
 understood. That was apparent in our recent Washington meet- 
 ing. The intimate development of the tubercle in the body is 
 still a mystery to us. Undoubtedly, we have done a great many 
 things in the past thirty years. We have learned a great many 
 facts, but they are fragments — they are like the stones of a mosaic 
 which we try to put together into a picture and find that some im- 
 portant stones are missing, or even like a picture puzzle which we 
 try to put together and find that we have many pieces, but they 
 do not fit properly, and that is the situation today with refer- 
 ence to the fundamental facts relating to tuberculosis. The 
 warfare between the tiny bacillus and the cells of the body 
 which goes on in what we know as the tubercle, a thing that 
 is smaller than the point of a needle, holds the secret of the 
 struggle between man and the tubercle bacillus. Why is it that 
 sometimes the bacillus is checked at the very beginning? Why 
 is it that at other times it multiplies without resistance? Why is 
 it that in some individuals it can find no foothold and cannot 
 multiply? Why is it that in others it can multiply ad libitum and 
 destroy life? These are the questions which, it seems, we ought to 
 answer, but which we are really unable to answer at the present 
 time, and here is a great work for the Henry Phipps Institute 
 to do, and I make a plea this evening for the more thorough 
 theoretical investigation of these problems. The practical work 
 will surely be done; there is plenty of stimulus, plenty of pressure 
 for doing the immediate practical work, or at least doing the work 
 which seems to end in some practical results, but the work which 
 goes to the foundation of tuberculosis is apt to be put aside, it is 
 apt to be crowded away when these seemingly more pressing 
 problems are presented to us. All the important questions in 
 tuberculosis look for their answer to this struggle between these 
 tiny organisms, the cell of the host and the bacillus. Again, the 
 question of environment in relation to infection starts with the 
 evolution of the tubercle. All of you know that the treatment 
 
 53 
 
for tuberculosis at the present time is one of environment. It is 
 a hygienic treatment. We also know that, owing to certain oc- 
 currences, there are large numbers of people in our country today 
 who believe that this long road to recovery can be shortened by 
 some remedy which will promptly and thoroughly cure the disease 
 and release the prisoner from his infection. Now, is there any- 
 thing in our study of tuberculosis of the past thirty years which 
 gives us the courage to believe what the public today is looking 
 for and believes? Some would say that it would be a miracle if 
 it should come to pass that tuberculosis in its various stages can 
 be cured by a vaccine. They would say that it would be like 
 converting the alchemist's brass or baser metal into gold. Others, 
 perhaps, would have more hope and would say that the future 
 holds the possibility for such a remedy. This is another great 
 problem for the Henry Phipps Institute and its workers to look 
 into and to study carefully. The staff of the Institute is not 
 biased by any view which they hold at present, which they have 
 to maintain, as is the case so often with the institutions in Europe 
 where some pet theory of the director is in the foreground most 
 of the time. They are free to go ahead and to work in any pos- 
 sible direction. We should also remember that although this 
 great Institution is designed for the study of one disease, what- 
 ever discovery is made in connection with that disease will prove 
 illuminating with reference to a number of other diseases related 
 to it. The Institute is not doing work for one disease alone, 
 but is doing work to reveal the causes and the workings of a 
 group of infectious diseases. 
 
 Now, there is one word more that I wish to impress upon you. 
 There is at present going on a great movement among the pubhc 
 in the interest of sanitation. The people are aroused to insist 
 upon a great many more things for the health, for the improve- 
 ment of their physical condition, than has ever been the case 
 before. Now, this movement, however salutary it may be, may, 
 of course, also do harm. There is a possibility that the public 
 think that they know more about the subject of disease than do 
 the experts who have given their life to investigation, but we 
 
 54 
 
know that truths cannot be settled by a show of hands, and we 
 also know that important questions and important problems can- 
 not be solved by a referendum or a recall; this is the work of 
 experts. Now the Phipps Institute will act as a governor and 
 leader in this great movement of the people. As an institute 
 which has a great deal of force and momentum, it will be able 
 to guide them into proper channels. It is for the trustees to see 
 that the men who are there engaged to do work are not hampered 
 by any demands from the outside to put to one side the important, 
 thorough, fundamental work which they are doing for the transi- 
 tory, superficial affairs of the day. It is the business of the 
 Institute to see that its men go straight ahead with this goal in 
 view that their great object is to release man from the bondage 
 of the tubercle bacillus. 
 
 The Toastmaster, introducing Dr. Alfred Stengel: 
 If I wanted to try to be humorous, I might pretend that now 
 comes the strain on the veracity and the imagination of the toast- 
 master that I alluded to earlier in the evening. But that would 
 scarcely be fair to the next and last speaker, who has for years 
 been a teacher of practical medicine, an author of success and 
 renown, a director of a most useful clinical laboratory, a pathologist 
 who has studied deeply and taught clearly the great fundamental 
 facts linking together the structural changes and symptoms caused 
 by disease, a former director of a State dispensary for the study 
 and treatment of tuberculosis, in medicine a broad-minded pro- 
 gressive — I can think of no more complimentary term — ^in civic 
 life ever identified with all movements for the betterment of the 
 conditions under which we live; let me introduce Prof essor Alfred 
 Stengel, of the Department of Medicine of the University of 
 Pennsylvania. 
 
 Dr. Stengel: 
 
 Mr. Toastmaster, Mr, Phipps, Gentlemen: Notwithstanding 
 your toastmaster's attempt to identify me with whatever polit- 
 ical movement he himself may be interested in, I shall accept 
 
 55 
 
his designation as a progressive with due humility. By the 
 accident of my oflScial position as the head of a Depart- 
 ment of the University closely related in its work to the Insti- 
 tute, I am called upon tonight to speak on behalf of my colleagues 
 of the faculty. In a much broader sense, however, I feel that 
 my remarks should represent the appreciation of all teachers 
 of medicine that this splendid Institute has been associated with 
 a medical school. I am perfectly certain that all of us here 
 have appreciated the foresight of the generous founder of this 
 Institute, in associating it, as well as the tuberculosis dispensary 
 and the psychiatric clinic of Johns Hopkins, with universities 
 already well established and equipped in other departments, and 
 I feel that it is my particular duty tonight to refer to this relation- 
 ship of an institution of this character with a university and 
 with a medical school, and to allude somewhat to the reciprocal 
 advantages of such a relationship. 
 
 I know that it is unnecessary for me to speak at any length now 
 of the advantages which will accrue to the University of Pennsyl- 
 vania from this association of the Phipps Institute with that 
 corporation. We all of us here have seen the magnificent equip- 
 ment and facilities which have been placed at our service there, 
 and we all of us, I am sure, appreciate the care and the thought — 
 and I want to say particularly here the care and the thought on 
 the part of the architect in the construction and in the arrange- 
 ment of that Institute. A splendid opportunity and an un- 
 equaled equipment have been placed at the disposal of the 
 University of Pennsylvania for its use, and we should be singu- 
 larly myopic if we failed to see the advantage of these facilities 
 and failed to utilize them to the uttermost. The problem of 
 tuberculosis is a broad one, — wide as himaanity itself, — and all 
 over the world agencies of all kinds are devoted to the attack 
 upon this dread disease. Sanatoria, hospitals, laboratories, 
 solitary workers, social investigators, public officials, health de- 
 partments — all these are engaged in the combat against this 
 devastating disease, and in one way or another are contributing 
 toward the solution of the ultimate problem, the relief of suffering 
 
 56 
 
and the cure of the disease. There are three ways m which insti- 
 tutions may make an attack upon tuberculosis or any other disease 
 of this kind: first, the direct care of the patient; second, educa- 
 tion, and third, scientific discovery. Of the direct value to the 
 patient of such a philanthropy as this I need say very little. 
 We all have seen the splendid building and the equipment that 
 is there. It is impossible to doubt that, with this equipment 
 and with the trained staff of physicians that will be there engaged, 
 it will succeed in its purpose of relief to suffering mankind so far 
 as it will be available to patients in this vicinity or who may come 
 to its doors. In a striking way this Institute, as I look at it 
 today, recalls to my mind a commonplace of medical observation, 
 that only the very poor and the very rich are in a position to enjoy 
 the best of medical attention. So far as the care and the 
 treatment of individual patients who apply here are concerned, 
 it matters very little whether this Institute is associated with a 
 university or a medical school or not. The work of the Institute 
 could doubtless be as well done if it were an independent organi- 
 zation, but the extent of its influence and usefulness would in 
 that case be narrow and restricted compared with that which 
 will result from its affiliation with a great University, whose 
 graduates go out to all parts of the world carrying with them 
 the knowledge they have acquired here, and becoming active 
 agents in the dissemination of such knowledge and, incidentally, 
 speaking the fame of the institution in which they have received 
 their training. Those of us here who are familiar with the Uni- 
 versity of Pennsylvania know that her graduates are scattered all 
 over this continent and in many foreign lands, and it will be a sat- 
 isfaction to us hereafter to know that every one of our graduates 
 going out in this wide way to all parts of the world will carry with 
 them an accurate training in modern investigation of this im- 
 portant disease, and will be disseminators of knowledge and 
 probably, in their own community, will establish institutions of a 
 similar character that will further the campaign against this 
 disease. There is no better educational program that could be 
 inaugurated than this of associating an institute of this sort with 
 
 57 
 
a medical school whose students would get their training within 
 its walls, and this, I beUeve, is the best of reasons for the asso- 
 ciation. I need not say to any of those who are medical teachers 
 that the presence and the daily attendance of students in 
 the institute will be an active aiding cause for greater effort 
 on the part of those who are engaged in the work here, and that, 
 if any other reason were to be thought of, this would be the reason 
 for associating the Institute with a medical school. In another 
 sense, the educational value of this Institute will be far reaching; 
 I refer to the publication of its staff, to the lectures which they 
 will deliver within and without its walls, to the social service 
 work that will be done by those connected with it, and to the ob- 
 ject-lessons which it win bring to all those who inspect it and to 
 all those who know of its work and of the results achieved here. 
 This, too, could be accompUshed without an association with a 
 teaching institution, but again here we must realize that the work 
 will be better done, that the staff will be more earnest and 
 more eager in their work, having students about them in daily 
 attendance. 
 
 The third of the objects or the purposes of such an insti- 
 tution, that of discovery, is, after all, the highest of all. Eventu- 
 ally it will be given to one, and if history repeats itself in this 
 particular, as it has in other matters, probably to two or three 
 simultaneously, to discover the cure for this disease. In the mean 
 time, however, many workers in many places in many lands will 
 be engaged in studying out intermediary problems, in elaborating 
 the steps toward the eventual solution of the great problem, and 
 those who are working here in this Institute will find it of ad- 
 vantage to be associated with scientists engaged in other depart- 
 ments of a great university, and they will receive encouragement, 
 aid, and material advantage from this association with others 
 in different departments of the University. The close relation- 
 ship with these workers with others in the University, and the 
 association of the Institute with the University, will serve in a 
 way as a check upon any too enthusiastic or too eager pronounce- 
 ment of results, and at the same time it will be useful also in sup- 
 
 58 
 
porting them when results have been achieved and publication 
 is ready. I foresee, therefore, that the University of Pennsyl- 
 vania will be able to repay in some small measure the debt which 
 it stands in toward the Institute, and that in the end we may 
 be able to say that we have in some measure returned to the 
 Institute some recompense for what it has brought to us. I trust 
 and I feel confident that the future will justify us in this hope. 
 
 The Toastmaster: 
 
 Gentlemen, I am sorry to detain you now, even for a moment, 
 but I don't think that this gathering ought to disperse without 
 some expression on the part of the trustees of the University 
 of their feeling of obligation toward three persons. It may seem 
 invidious to pick out only three persons of the many who have 
 been concerned in the work, but I think that it is incumbent upon 
 me to repeat and to emphasize the obhgation we feel ourselves 
 under, first, to the architect, for the magnificent and original way 
 in which he has solved many of the problems that have been pre- 
 sented to him for the first time in connection with the establish- 
 ment of this Institute. 
 
 In the next place, we feel under similar obHgations to Mr. 
 Gordon, who has so faithfully represented Mr. Phipps, who has 
 met us in all our wishes and desires in the most kindly, generous, 
 and sympathetic way; who has come over here from New York 
 repeatedly to watch over and look after the interests of the 
 Institute, and without whose aid we never would have succeeded 
 in having the plant to show you today nor had the successful 
 opening that I think I may say we have had. 
 
 And, finally, I want to mention our own Dr. Hatfield who 
 has given to this whole matter, and is giving it daily, such a 
 degree of self-sacrificing, unselfish, thoughtful interest that I 
 know he does not leave himself sufficient time to give to his own 
 affairs. We are all of us, every trustee and every Philadelphian, 
 under the deepest obligations to all three of these gentlemen. 
 
 59 
 
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