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 PRESIDENTIAL ADDRESS 
 
 DEUVBKBD AT THB 
 
 ANNUAL MEETING 
 
 OF THB 
 
 CANADIAN MEDICAL ASSOCIATION 
 
 OTTATVA, SEPT. IS, 188S. 
 
 BT 
 
 GEOEGE ROSS, A.M., M.D., | T 
 
 Profkssob of Clinical Medicine, McGJill Bnivkr81tt. 
 
 MONTREAL : 
 GAZETTE PRINTING COMPANY. 
 
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 RE-PRINTED FROM THE "MONTREAL MEDICAL JOURNAL," OCT.. 1898. 
 
 4 
 
 
 I 
 
 $ 
 
 ■I 
 
 PRESIDENTIAL ADDRESS. 
 
 Delivered at the Annual Meeting op the Canadian 
 
 Medical Association, at Ottawa, on the 
 
 12te September, 1888. 
 
 By George Ross, A.M., M.D., Montreal. 
 
 Gentlemen :—My first duty is to thank the members of the 
 Canadian Medical Association for the great, and I may add, 
 entirely unsought, honor .f being called upon to serve as its 
 President. Having been absent from last year's meeting, my 
 election to this important position at that time was still more a 
 source of surpri'^e, but, nevertheless, of much gratification. If 
 a simple loyalty to this Association as one of the rank and file, 
 and humble efforts to sustain it by regular attendance and an 
 occasional contribution, entitle one to any recognition, I may 
 fairly claim that much. To moi-o than that I lay no claim, and 
 I know it is only the indulgent goodwill of my friends and fellow- 
 members which has procured for me this great honor, one which 
 I can assure them I duly appi-eciate, and I shall always endeavor 
 to give them no reason to consider their kind confidence mis- 
 placed. 
 
 He whose duty it is to address officially an important meet- 
 ing of this kind may well claim to be overwhelmed by an em- 
 harras de richesses. No restriction is placed upon his choice of 
 a subject, and the field is practically limitless. To select is in- 
 deed diflScult, and even when that diflSiCulty has been overcome, 
 there remains the still greater one of so presenting it as to be 
 deserving of your attention. Following after so many eminent 
 predecessors, it is, I can assure you, no false modesty, but a 
 sense of genuine incapacity for the task which has been con- 
 stantly present with me. 
 
 It may not be amiss, on an occasion like the present, to take 
 a hasty sui-vey of the general standing and prospects of the pro- 
 
feesion in the Dominion, and to consider whether it be pro- 
 gressing as it should. In a young country like this, progress is 
 exceedingly rapid in almost every department of life — in trade 
 and commerce and agriculture — in the building of cities and 
 the opening of great lines of railway, extensive syp terns of 
 telegraphy, and other public works on a commensurate scale — 
 in the establishment of public schools and the foundation of 
 universities — in the consolidation of the professions and giving 
 them their proper status — and a comparatively few years 
 work changes which are rapid indeed in comparison with the 
 more steady ways of older and more settled parts of the world. 
 When we think that the Confederation, just like this Associa- 
 tion of ours, is only even now of age, — that, up to that time, 
 we were but a few weak provinces, with diverse interests, and 
 without any common bond — and that to-day, only twenty-one 
 years later, we are a vigorous and lusty young nation, with 
 territories extending across a whole continent and touching 
 on either side the two great oceans of the world, territories 
 with a climate of the most varied and salubrious character, 
 containing vast riches and unbounded possibilities for the 
 present and for future generations — temtories which are 
 rapidly increasing in population by natural increment and by 
 the yeai'ly addition of many thousands of settlers from other 
 lands — ^when we consider all this, it well concerns us to ask, 
 What has been the record of the medical profession during 
 this time ? It has been a time of wonderful activity in all the 
 centres of learning. A time during which an almost entire 
 revolution has been wrought in the science of medicine and in 
 the methods adopted for the teaching of the same. A time 
 during which the keenest minds have been directed to the 
 elucidation of innumerable problems in those sciences which 
 form the basis of medical doctrine and practice — Anatomy 
 Physiology, Biology and Chemistry. A time in which the 
 whole pj-actice of surgery has been changed — been based upon 
 principles entirely hew, but proved by the severest tests of 
 experience to be founded upon unalterable laws — a change bo 
 great that the accomplished student of twenty years ago would 
 find himself to-day committing the most egregious enormities 
 and sinning perpetually against the fii-st elements as now 
 
8 
 
 understood. A tirao in which a generous rivalry has been 
 kept up between the two groat departments of Medicine and 
 Surgery, and, great and startling as has been the progress in 
 the latter, it is doubtful if the advances in the former have not 
 been fully equal, or even greater. For, whilst Lister and his 
 followers have abundantly shown to the world the enormous 
 importance of what we now call " surgical cleanliness " (a 
 ti'uth till now never properly appreciated), Pasteur, Koch 
 and others have been searching for the true cause and preven- 
 tion of cholera, hydrophobia, and the other great scourges of 
 mankind. Animalcular life, and its bearing upon the diseases 
 of man and animals, has assumed an importance heretofore 
 undreamt of: and the science of Bacteriology has sprung at 
 once into the forefront as an absorbing pursuit, already fruit- 
 ful of wonderful results which have opened up a boundless 
 field for investigation, thought, and research I A time in 
 which Preventive Medicine has begun to occupy the place to 
 which its importance justly entitles it. Before this period, 
 sanitary science was but in its infancy, sanitary laws were 
 little understood, and sanitary regulations seldom enforced. 
 Now, the questions of sanitary legislation attract the attention 
 and occupy the minds of the highest statesmanship. The more 
 civilized the country, the more widely is knowledge of public 
 health matters disseminated, the more carefully are statistics 
 collected, the greater the skill and talent exhibited to cope 
 with the difficulties surrounding the sanitary legislator. In 
 fact, there is now no better test of the intelligence and real 
 civilization of a community than estimation of the attention 
 given to the enforcement of sanitary laws and the degree of 
 diffusion of sound sanitary knowledge. A time in which the 
 public have begun to appreciate the importance to themselves 
 of having a constant supply of thoroughly educated young 
 medical men— men learned in all the learning of the day-- 
 who, scattered throughout the land, may be ready to apply to 
 them in their need all the resources of modern medicine. 
 Wealthy laymen, acting upon this belief, have endowed hos- 
 pitals and schools of medicine with funds sufficient to enable 
 them to teach them medicine as medicine should be taught. 
 Bright examples of this are found in the great gifts to the 
 
Johns-Hopkins Hospital ivnd Univorwity in Baltimore and tho 
 munificont donations to the College ofPhyHicianH tmd Sur/^eons 
 of New York. The name sentiment douhtless animated tho 
 generous donoi-8 of the endowment fund to McCJill UidverHity, 
 and tho gentleman who has so mueh enhanced the teaching 
 capability of tho University of Toronto. Lot us hope that 
 these instances of far-seeing, public-spirited, and open-handod 
 men giving of their abundance for an object denigned to be of 
 service to the whole country, will notfail to direct many others 
 towards one way of doing much good in their generation. 
 
 It has been ii time when the system of medical education has 
 been undergoing a gradual change. Tho period opens with 
 the old-fashioned medical school — a few professors, a largo 
 number of didactic lectures upon a few subjects — practical 
 anatomy being the only branch taught in a truly demonstrative 
 manner— "walking the hospitals " beginning to be supplanted 
 by some clinical teaching. The transition stage is now — the 
 professors are numei-ous, the didactic lectures arc fewer, the 
 subjects taught have multiplied many times, practical anatomy 
 is thoroughly worked up, and the student is obliged to pass 
 through several other laboratories, and acquire a practical and 
 personal acquaintance with the other branches of the curricu- 
 lum. Old-fashioned "walking the hospitals " is a thing of the 
 past, and, instead, the greatest attention is paid to organizing 
 systematic attendance upon the wards, systematic case-taking, 
 and systematic lecturing upon the cases by a special staff. A 
 time during which we have witnessed the development within 
 the profession of a number of specialties. Specialism is an 
 accomplished fact, and on the whole, the profession has been 
 the gainer by its establishment. The advantages of division 
 of work and devotion to one branch of practice are great and 
 obvious, and, I believe, counterbalance to a great extent the 
 objections that are urged against specialism. Like many other 
 systems good in themselves, it is open to abuse, may readily 
 be overdone, or may be cultivated by uuAvorthy members. 
 
 Such are a few of the more striking changes which have 
 been accomplished during the time that this Association has 
 been slowly coming of age. At the time of its inauguration, 
 there was much enthusiasm, and all minds were full of 
 
■ I 
 
 tho groat poseibilltioH for the future from tho confederation of 
 the provinces. No narrow or provincial ideas were to bo 
 entertained, and all regulations concerning medical education 
 and tho practice of UK^dicine, it was expected, would be assim- 
 ilated for tlie wliole Dominion. This Association started bravely 
 forward on this basis, imbued with the idea tliat it had a groat 
 missii)!! to fulfil. Committees were appointed, and elaborate 
 reports prepared upon "The best moans for General Education," 
 upon "A Unif(u-m System of Licenses," upcm "Eegistration 
 and Vital Statistics for tho entire Dominion," and upon "A 
 Code of Ethics for the whole Profession." During several 
 years much labor was bestowed upon these subjects, and tho 
 greater share of time at the meetings was given to their dis- 
 cussion. It then, however, became apparent to tho members 
 that, in devoting their energies to working out schemes for 
 medical legislation, much valuable time was being absorbed, 
 and the results pi-oduced were by no means commensurate 
 thoi-owith. The Act of Confederation, by taking away from 
 the Federal authorities the governance of educational matters, 
 loft each province free to look after tlieso in its own way! 
 Thus, at the present time, we find a curious complexity of 
 medical legislation in Canada — there being no uniformity 
 amongst the provinces in regard to matriculation, to curricu- 
 lum, or to qualification for practice. 
 
 It is to be hoped that, bofoi-e long, some ari-angomont may 
 be come to by which, at least, a Dominion Medical Eogistor 
 may be established at Ottawa, so that, on entry therein, it will 
 be possible to practice medicine throughout the Dominion. 
 It is, pei-haps, possible that this can bo eifected without preju- 
 dice to the functions of the separate official bodies Avhich now 
 govern tho medical affairs of the different provinces. In some 
 such way alone can tho existing anomalies be remedied, and 
 the present undesirable confusion bo removed. 
 
 Compare tho general condition of the medical profession in 
 Canada with that prior to the time wo are speaking of, and, 
 in so doing, look just for a moment at the condition then and 
 now of the leading medical schools of this country. The num- 
 ber of students in attendance was often sufficiently large, per- 
 haps sometimes nearly as large as even in some recent^years. 
 
The curriculum was by no moans short, for it covered four 
 full years, but it wtis compoHcd almost entirely of didactic lec- 
 tures and some clinics upon genorul medicine and surgery. 
 The courHc was not distinctly graded, but divided only into a 
 primary and a tinal department. Now, the staff of teachers 
 presents a long array— the subjects are divided up bo as to 
 allow each one to devote his attention exclusively to a parti- 
 cular department. Many special departments have been added, 
 and skilled teachers placed in charge. Above all, the impor- 
 tance of laboratory work is lully recognized, and in every year 
 a full share of time and attention is exacted for practical work 
 on the part of every student. Hospitals have been enlarged and 
 extended and the work divided and specialized. Carefully-con- 
 ducted cliniques are the ordei- of the day, and the material, both 
 interne and externe, is fully utilized for teaching purposes. 
 Summer sessions — some voluntaiy, some compulsory — have 
 been established at nearly all the schools, and several months 
 of the best kind of teaching is thus placed at the disposal of 
 the student of to-day. The standard of examinations is high, 
 as shown by the percentage of rejections and by the excellent 
 standing so generally attained by Canadian students both at 
 the examinations of our local provincial boards and also 
 abroad. Is it not certain that, with such marked advance in 
 the facilities for sound medical education, the graduates of 
 recent years must bo correspondingly more competent and 
 more thoroughly fitted for their important duties than those 
 who preceded them ? 
 
 In the general profession there have been many evidences of 
 a better condition of things than formerly prevailed — of a 
 greater interest in the scientific side of medicine and a desire 
 not to practice our Art fi-om a purely perfunctory or purely 
 financial point of view. The best evidence of this is the for- 
 mation of medical societies. These have sprung up on every 
 side — provincial, county and local societies, — and it is most 
 encouraging to observe how actively and energetically many 
 of these are maintained, — good papers read, good discussions 
 held, and a spirit of emulation evinced in correct observation 
 the thoughtful care of cases, and their systematic and accui'ate 
 recording. The difficulties encountered in keeping up such 
 
i 
 
 societies are often groat. Our population is still a mostly 
 scattered one, and mombers have often to go long dintances 
 and saci-itico mu(!h time in order to attend : — but the gain is 
 worth it all. The best men of every town and every country 
 side will always be found the keenest supporters of their own 
 medical society. Our Canadian physician.s, too, are beginning 
 to write more than formerly— not, perhaps, even yet as much 
 or as often as they should— but they maintain medical journals 
 which are alive and active and are a credit to their country 
 and to their contributors. There are now in Canada nc less 
 than four English and two French monthly journals, all appa- 
 rently prosperous. Nor are the contributions of Canadian 
 writers confined to this country. Many of our prominent men 
 are frequent and valued contributors to, and correspondents of, 
 the best of the American journals. 
 
 It may be said that, in drawing this comparison between the 
 condition of the profession now and that when this Association 
 began, I have presented an optimistic view and one not alto- 
 gether warranted by the facts, but I think not so. I believe 
 that, great as has been the progress of science in these years, 
 great as has been the progress of the country in material pros- 
 perity, the medical profession may fairly claim that it has not 
 lagged behind :— that it has always had such leaders to frame 
 its policy and Huch earnest and devoted and able men in its 
 schools as have kept it fully abreast of the busy and stirring 
 times in which we live. Has this Association done its share in 
 secui'ing such a state of things ? The programme it laid out 
 for itself at the outset, as I have already shown, was very ex- 
 tensive ; it was too extensive for any society to carry out. This 
 was soon perceived, and from the time that the Association got 
 away from the business of framing bills which were never to 
 be enacted, and discussing schemes which came to naught, and 
 settled down to its legitimate work of fostering a scientific 
 spirit in its members, encouraging them to produce good liter- 
 ary work, urginjs them to original observation, helping them 
 to good understanding amongst themselves, assisting in the 
 maintenance of a high standard of ethics, promoting sociability 
 and good-fellowship— then it succeeded, its meetings were in- 
 structive, useful in many ways, and thoroughly enjoyable. It 
 
a' 
 
 has no feeling of rivalry towardH any other society, and I trust 
 none is felt by them towards it. Each has its own sphere of 
 usefulness, and can accomplish its own good ends, without de- 
 tractmg in any way from the necessity for a general re-union 
 of this kind. This Province of Ontario has successfully organ- 
 ^ed an active and thcrougLlj admiraole society; other of the 
 Provinces Iiave done the same, and it is only a source of regret 
 to many of us from the old Province of Quebec, that circum- 
 stances have not favored our following their excellent example. 
 This Association, I am convinced, has done much good, and 
 will, I nope, continue to do much more in the years to come 
 For instance, though failing to carry through such compre- 
 hensive measures as were at first contemplated both in educa- 
 tional matters and in matters of State medicine, yet this Asso- 
 ciation has been again and again occupied in considering the 
 important subject of general hygiene ; and, at many of its 
 meetir . discussions which have taken place and the reso- 
 
 ution, i have aided very materially in promoting such 
 
 legislat.- ..s has been secured bearing upon the public health. 
 Indeed, it must needs be that expressions of opinion from a 
 meeting of the profession, representing all sections of the 
 country, should command the attention of those who control 
 these matters. The need still existing for further exertions in 
 this direction is emphasized by the lamentable apathy ex- 
 hibited in so many cases where the public health is in ques- 
 tion. The etiology of typhoid fever may be said to be pretty 
 thoroughly understood ; but, even in the face of violent out- 
 bi-eaks of that di.^ea.e in some of our Canadian cities, wnat 
 want of intelligence, and what unwillingness to be governed 
 by competent medical opinion ! What incapacity to realize 
 the extent of injury done to the community-, the cruel, unne- 
 cessary loss of life, with all the suffering attendant thereon ! 
 A town near Montreal was recently thus affected to a most 
 alarming extent, diarrhoea was almost universal, typhoid fever 
 was very pi-evalent and deaths were numerous. The visitation 
 became notorious, and was much commented upon in the press. 
 The facts were amply sufficient to show two things : 1st, That 
 the water supply was contaminated with sewage. 2nd, The 
 manner in which the contamination was effected. Local health 
 
 r 
 
9 
 
 board there was none, and the disease for months continued 
 Its ravages to such an extent that the locality was shunned by 
 every intelligent traveller, while the poor inhabitants suffered 
 and died. It is a reflection upon the intelligence of the age 
 that such a thing could be, and it is a i-eflection upon some of 
 our sanitary organizations that no sufficient pressure was ex- 
 erted to remedy the evil as soon as its cause was fairly deter- 
 mined. It is the duty of every member of this noble profession 
 to render all the assistance in his power towards the further- 
 ance of good and effective legislation bearing upon local and 
 general sanitation, and to aid in the dissemination of sound 
 literature upon hygienic subjects. Many examples similar to 
 the above might be quoted to show that we are yet very far 
 from the position in which we should be, in accordance with 
 the advanced teachings of the present day. 
 
 One subject which, it will be observed, from the very founda- 
 tion of the Association, commanded its attention, and upon 
 which much time and labor has been bestowed by individual 
 members at different times, is that of a Dominion Registration 
 Act. It would be futile at the present day to offer arguments to 
 show the importance of accurate and reliable vital statistics. 
 A good deal has been accomplished in this direction, here and 
 there by local efforts, and in some instances by provincial 
 action, but we are very far indeed from the attainment of that 
 comprehensive system which this Association decided at its 
 early meetings to endeavor earnestly to obtain. It is indeed 
 active members of this Association who have been largely in- 
 strumental in educating public opinion on the subject, and in 
 pushing forward such measures of reform as have been reached • 
 and It IS to hoped that the same members, with many others 
 to assist them, will continue their laudable efforts until much 
 better i\;iults are obtained. 
 
 The Association adopted a Code of Ethics, and a very good 
 code It IS. There is only one point to which I would allude in 
 connection with the attitude of medical men towards each 
 other, and that is with reference to cases of alleged malprac- 
 tice. Nothing is more injurious to the best interests of the 
 profession than the wretched lawsuits of this kind which are 
 so lamentably common in certain sections of this country— only 
 
10 
 
 in certain sections, for I am happy to say that elsewhere they 
 are of very rare occurrence, and in some favored localities are 
 practically unknown. There can be only one explanation of 
 this striking difference, viz., that such contentions are origin- 
 ated and fomented by unworthy physicians who adopt this 
 means of harassing and injuring a competitor. Everyone knows 
 that, if medical men were true to each other, these unhappy 
 disputes would hardly over be begun— that, if rancor and ill- 
 feehng were jealously guarded against, and only fair and rear 
 sonable opinions expressed, we should not be called upon to 
 witness those painful exhibitions of a house divided against 
 itself. This is a sore blot upon the boasted claims of the medi- 
 cal profession to engender feelings of mutual charity and good- 
 will. The main remedy for this consists in the cultivation of 
 the true scientific spirit, in keepinp- up connections with our 
 medical societies, in indulging our natural social tendencies 
 and preserving that natural pride which produces the desire 
 to stand well with our fellows, especially those whose good 
 opinion is worth having. I am sure it is the earnest wish of 
 every member here present that the scandal of these malprac- 
 tice suits may yearly become fewer in this Canada of ours, to 
 the great advantage of the whole profession. 
 
 Again. Has this Association advanced in membership and in 
 influence as it should during the course of these years ? As 
 regards the first of these questions, it is not possible to give an 
 answer in figures, for the reason that the method of recording 
 our membership has been very loose j but, on looking at the 
 minutes of the early meetings, it is seen that the attendance 
 was large, and that the distant provinces were extremely well 
 represented. As much cannot be said for the later meetings 
 at which, though the actual number present has been good, 
 yet the attendance from the maritime provinces is noticed as 
 having greatly fallen off. It is also matter for regret, that our 
 French-Canadian confreres, many of whom were amongst the 
 founders, and who came in large numbers to the early gather- 
 ings, have gradually ceased attending till, now, a very few 
 only of the more literary-minded and enthusiastic of them 
 unite with us in keeping up our national Association. It may 
 be that the difficulty of using two languages has had some- 
 
 A 
 
f"5 
 
 11 
 
 thing to do with this. I should like to see this difficulty over- 
 come, and the Association strengthened by the hearty support 
 of oui- brethren from the old Province of Quebec. It should 
 be remembered that, at the International Congress, three 
 languages— French, German and English— were recognized, 
 and a speaker could address the meeting in any of these. 
 
 A suggestion made in the presidential address of last year 
 deserves, I think, to be repeated, as no action was taken upon 
 it, and it seems feasible and promises to be useful. It was pro- 
 posed that a committee might be named to take into considera- 
 tion a scheme arranging for a closer connection of some kind 
 being brought about between this Association and the various 
 provincial and local societies already in existence. Any sugges- 
 tion which will add to our membership and increase the inter- 
 est taken in our work, is worthy of being carefully considered. 
 Without having looked into the question, I am not prepared to 
 say just how this can be accomplished, but, if the meeting 
 think with me in the matter, it will be competent for it to 
 take action in that direction. 
 
 Another task which it has been thought suitable for this As- 
 sociation to undertake, and which was fully laid before the 
 meeting last held in this city, was, to bring before the proper 
 authorities the questien of medical experts at coroners' inquests, 
 lam not aware that anything was done, though the importance 
 of it was strongly dwelt upon by the reader of the address. The 
 value of such expert evidence would probably be admitted by 
 any educated layman ; but we medical men apj)reciate much 
 more fully the difference between the opinion of the average 
 practitioner and that of a thorough pathologist who is con- 
 stantly making autopsies and conducting pathological inves- 
 tigations of various kinds: and when we think of the 
 enormous interests so often hanging upon such opinions, we 
 might well consider it a duty te seek some means for skilled 
 evidence being furnished when the object is to determine the 
 cause of death in a doubtful case. 
 
 My predecessor in this chair offered, in his address, some 
 timely advice to his confHres upon the necessity for allowing 
 themselves a due amount of recreation at reasonable intprvals, 
 and he draws a disheartening, but perfectly true, picture of the 
 
12 
 
 results of neglecting this important matter. In accordance 
 with such sound doctrine, I last month rested from my labors 
 and npent twenty days m our Great North- West. There is 
 something particularly attractive to the Eastern city-man in 
 seeing sometliing of the open and free life of our great plains, 
 ranches, mountains and Western coast. Having myself derived 
 much pleasure, profit, and 'renewed health from this short tour 
 in the Western Provinces, I would say to any of my medical 
 friends who feel jaded or overworked, try the tonic eifect of a 
 combination of fresh lake breezes, balmy prairie winds, keen 
 mountain air, and soft ozone draughts from the Pacific Ocean. 
 The variety is charming, and whilst the body is being refreshed 
 and renovated, the mind is being delighted with some of the 
 finest scenery in the world. Upon the route, one spot in par- 
 ticular engages the attention and excites the interest of all 
 medical visitors. I refer to the hot sulphur springs at Banff, 
 which are only now becoming known, and are not nearly as 
 well known as their merits entitle them to be. The springs, 
 as every one is aware, are situated in the heart of the Rocky 
 Mountains, and in one of the most picturesque parts of that 
 wonderful region. The gteaming water, clear as crystal, bursts 
 forth in unlimited quantities high np on a grand mountain 
 side, some four thousand feet above the sea-level. It is strongly 
 sulphurous and its medicinal properties are of a high grade. 
 Such springs are sufficiently rare, there being but two or three 
 of any note even in the whole of the United States, and, most 
 assuredly, none of these possess the additional attractions of 
 this choice locality— exquisite lofty mountains, affording a sur- 
 rounding panorama of truly Alpine character, and a lovely 
 valley containing a broad blue river which has well been com- 
 pared to the great Ehone of European fame. The natural 
 attractions of Banff would alone suffice to draw multitudes of 
 pleasure-seekers there, and, as the value of these natural waters 
 becomes more appreciated, it is certain that more and more of 
 our patients will be sent there every year. Apart even from 
 those who would go to drink the waters, there is another class 
 of invalids that I believe could be sent to this high region with 
 the happiest results. The Davos-Platz in Switzerland has been 
 gaining greatly in favor in England and elsewhere as a winter 
 
y 
 
 13 
 
 resort for cases of phthisis in an early stage, and for those who 
 may be looked upon as disposed to tubercular disease on ac- 
 count of family tendencies or defective physique. This resort 
 is high in the Alps, and the winter is rather severe, with an 
 abundance of snow, but there is plenty of sunlight. Neces- 
 sarily, our information concerning the meteorology of Banff is 
 yet extremely deficient, but, from all I could learn, the condi- 
 tions are very similar to those which have been found to 
 operate so beneficially in the case of Davos-Platz and such-like 
 Alpine sanitaria. As there is now an excellent hotel, with 
 every comfort, there is no difficulty as regards accommodation. 
 A proposition has actually been made by some members of this 
 Association that our meeting next year should take place at 
 the Eantf Springs, an idea which has much to commend it, but 
 will need to be carefully considered. The Nominating Com- 
 mittee will, as usual, take this matter up and report upon it to 
 the general meeting. 
 
 It is often asked. What becomes of all the medical graduates? 
 Lot any of you pass through that enormous extent of fertile 
 country traversed by our transcontinental railroad and observe 
 the villages and towns springing up like magic from one end 
 of it to the other— let him take note of the solid settlement of 
 large areas even away from the beaten track of the railway- 
 let him step off at any station and, more likely than not, he 
 will meet some young confrere who is quietly located there and 
 is growing up with the healthy growth of the town or the 
 country-district. The important mines in various parts, the 
 advancing railways, the great ranching posts, require the ser- 
 vices of still more medical men, and in connection with some 
 of these are to be found positions of trust and value unsurpassed 
 in the Dominion. In this way can be accounted for a large 
 number of the graduates from the l^]astorn schools, and it is 
 pleasant to find good opportunities thus opening out for Cana- 
 dian doctors in their own country. 
 
 It is my melancholy duty to have to refer to some distin- 
 guished members of our Association who have been called 
 away from amongst us during the past year. Of these, two 
 wore from the roll of oui' f -rmer Presidents, viz.. Dr. Marsden 
 of Quebec, and Dr. Botsloiv of St. John, N. B., both oriirinal 
 
 ft rt 
 
14 
 
 founders, regular attendants, and well worthy of the hiffh 
 honor bestowed upon them. Dr. Marsden was a man of strong 
 individuality and remarkable tenacity of purpose. Taking a 
 lively interest in the affairs of this Association, his opinion 
 and assistance was much valued on account of his long expe- 
 rience and intimate acquaintance with all matters pertaining 
 to the medical profession. His outspoken expressions, and his 
 example of unswerving loyalty to the best interests of the pro- 
 fession, made him a prominent dgure at many meetings An 
 old man of keen intellect and without garrulity, full of anec 
 dotes concerning a now fast-fading generation, Dr. Marsden 
 will long be missed by those who had the good fortune to be 
 intimate with him. Everyone will remember the massive form 
 and fine head of our late friend, Dr. Le Baron Botsfoi-d. One 
 of our founders, and imbued with a lively faith in the possibil- 
 ities for good of this Association, he was always one of the 
 genuine workers, and was eager to assist in all good works 
 His greatest delight was to participate in discussion destined 
 to promote correct views about, and legislation upon, public 
 health and state medicine. A very noble, whole-souled gentle- 
 man, whose best thoughts and much of whose time were devo- 
 ted to the good of his fellow-man. Dr. Henry Howard, that 
 kindly and gentle physician— retiring, thoughtful, and given 
 to abstruse metaphysical enquiries, the best years of whose 
 life were given to the study of mental disease and to the care 
 of the mentally-afflicted. He it was who had the manliness to 
 condemn flagrant abuses in some of our public institutions and 
 at the risk of his official position, to call upon a timid govern- 
 ment to correct them. For this alone, if for nothing else his 
 country owes his memory a debt of gratitude. Amongst others 
 I may mention Dr. Eichard Zimmerman, for some time an 
 official of the Association and one of its warmest friends- Dr 
 John H. McCollom, Dr. W. N. Woodill. and Dr. Brouse, worthy 
 gentlemen all, who worthily served their generation, each in 
 his separate sphere, and reflected credit upon the high calling 
 of the physician. 
 
 You have, gentlemen, many and important subjects to engage 
 your attention. I trust that this Ottawa meeting, this coming, 
 of-age meeting, may long be remembered as one at which some 
 
15 
 
 good scientific work was done, and something accomplished to- 
 wards forwarding the general interests of the profession, pi-o- 
 moting its dignity, and elevating it in the estimation of the 
 public. 
 
 In closing, I should like to say that it is always a great plea- 
 sure at these meetings to receive some of our canfrtres from 
 across the line. As members of a sister Association, we give 
 them a hearty welcome, and we are glad to have them partici- 
 pate in all our proceedings. Without prejudice to the political 
 leanings of any one, I am sure I express the views of all 
 when I say that in intei-national visiting and in scientific dis- 
 cussion, all we desire is the most absolute "unrestricted 
 reciprocity," and I am equally certain, from what I know of 
 their hospitable character, that our American cousins are 
 correspondingly pleased when we "retaliate" by joining the 
 meetings of the American Association.