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THE AMERICAN ACADEMY OF MEDICINE. 
 
 ANNUAL ADDRESS OF THE PRESIDENT, 
 
 F^EDE^IC GEt^ISH, fl.JVL, 
 
 DELIVERED AT 
 
 NEW YORK, 13th NOVEMBER, 1888. 
 

 
 
 
 
 
 
 
 
 
 
 
 \ 
 
 
 
 
 
 
 
 

THE 
 
 SPECIAL FUNCTION 
 
 OF THE 
 
 AMERICAN ACADEMY OF MEDICINE 
 
 ADDRESS OF THE PRESIDENT, 
 
 DELIVERED AT THE 
 
 ANNUAL MEETING IN NEW YORK, 
 
 13th NOVEMBER, 1888, 
 
 FREDERIC HENRY GERRISH, A.M.,M.D., 
 
 OP PORTLAND, ME. 
 
 PRINTED BY ORDER OF THE ACADEMY. 
 
 PHILADELPHIA : 
 
 1889. 
 
“The American Academy of Medicine is not 
 
 RESPONSIBLE FOR THE SENTIMENTS EXPRESSED IN 
 ANY ADDRESS OR PAPER READ AT ITS MEETINGS.” 
 
THE 
 
 SPECIAL FUNCTION OF THE AMERICAN 
 ACADEMY OF MEDICINE. 
 
 ADDRESS OF THE PRESIDENT, 
 
 Delivered at the Animal Meeting in New York, 13th November, 1888. 
 
 BY FREDERIC HENRY GERRISH, A.M., M.D., 
 
 OF PORTLAND, ME. 
 
 There would seem to be no need of argument to persuade any 
 reasonable person of the necessity of something better than a mere 
 grammar-school education as a preparation for the study of the 
 science and art of medicine. One is not trusted to weigh our coal, 
 to measure our fire-wood, to keep account of the provisions which 
 we buy, without at least as much intellectual training as this; how 
 much more ample should be the mental discipline of him who 
 aspires to give us rules for the preservation of health, and to restore 
 it, when disease has prostrated us ! And yet, instead of there being 
 no necessity for argument, it is a lamentable and astonishing fact 
 that very many persons, who are generally considered rational 
 beings, require prolonged and powerful argumentation before they 
 will accept this truth, which ought to be almost axiomatic ; and the 
 great majority cannot be persuaded by any means whatever. The 
 medical opinions of the highly cultured and the densely ignorant 
 are strongly tinctured with superstition. The great unwashed think 
 to ward off disease by means of amulets and the burning of tapers, 
 to cure it with consecrated water and incantations ; the people at 
 
 3 
 
4 
 
 the other end of the social scale are the chief patrons of the latest 
 therapeutical lunacy, which proclaims that knowledge of anatomy 
 and physiology is not only useless, but is positively injurious. Those 
 who know that they would court well-merited ridicule by putting 
 their disordered watches for repair into the hands of a mechanic 
 who had not devoted years to the careful observation and practical 
 management of these comparatively simple machines, will intrust 
 the cure of their bodies, the most wonderfully intricate mechanisms 
 known, to creatures who boast of their absolute ignorance, and 
 blasphemously lay claim to powers which no human being can 
 possess. It seems hopeless, therefore, in this generation, to attempt 
 to convince the people that medicine should be regarded as a science, 
 to be mastered only by prolonged application, and that, before 
 entering upon its technical study, one should have had a prelimi- 
 nary course, designed to prepare the mind to grasp and appreciate 
 its facts, its theories, and its methods. 
 
 THE MEDICAL PROFESSION INDIFFERENT TO PRELIMINARY 
 EDUCATION. 
 
 There is one class of men, however, to whom the amazed and 
 dejected observer of the attitude of the public will turn with full 
 confidence that from them he will derive cheer and encouragement. 
 The medical profession, composed of men who have received the 
 doctorate from institutions of repute, will, he is certain, declare with 
 prompt and cordial unanimity that, before entering upon his pro- 
 fessional pupilage, every student of medicine must have an amount 
 and kind of schooling which will fit him to acquire his technical 
 education. They have opportunities to know, better than any other 
 class, the sad results of ignorance in physicians; and, consequently, 
 he thinks no one of them will do aught to favor the project of a 
 man who designs to begin medical study with inadequate equip- 
 ment. He entertains an idea that something approaching a liberal 
 education ought to be required ; but, of course, the least demanded 
 of the applicant will be a competent knowledge of his mother tongue, 
 the ability to write clearly and to solve ordinary arithmetical and 
 algebraic problems with accuracy, a familiarity with the outlines of 
 political and physical geography, an acquaintance with the elements 
 of Latin, upon which the nomenclature of medicine is so largely 
 based, and with the fundamental facts and principles of natural 
 
5 
 
 philosophy, without which physiology is an impenetrable mystery. 
 How dumbfounded will be this innocent seeker after truth, when he 
 learns, as inevitably he must, that a very large proportion of physi- 
 cians, who possess respectable diplomas, consider this minimum 
 preparation in large part unnecessary; well enough, but far from 
 essential to practical men, such as they are proud to esteem them- 
 selves ! And they live up to their expressed belief. A youth well 
 advanced in his teens applies to the typical physician of this sort 
 for admission to his office as a student of medicine. The young- 
 ster, we will suppose, has been brought up on a farm, has had a few 
 winter terms of schooling, can read and spell indifferently, cipher 
 a little, and achieve a cramped chirography with laborious exertion 
 of the muscles of his right upper limb and his face. The precep- 
 tor takes the accomplishments for granted, and, if the boy has the 
 reputation of honesty, without question admits him as his student. 
 
 THE INSUFFICIENT EQUIPMENT OF MOST MEDICAL STUDENTS. 
 
 It is unimportant here to dwell upon the career of the youth 
 during his professional pupilage; the incompleteness, the utter 
 inadequacy of his equipment for the study of medicine is the feature 
 demanding our present contemplation. 
 
 He immediately discovers that his reading leads him into a region 
 whose inhabitants speak a language of which he knows practically 
 nothing. Untrained in intellectual processes, he either never dis- 
 covers the only true method of learning the new tongue, or indo- 
 lently decides that he can absorb all that he needs by association 
 with physicians and by reading books. The dictionary, which 
 should be the constant companion of every student, particularly 
 during his first year of medical life, lies neglected, or, perhaps, is 
 never purchased; and the novice flounders about in his desultory 
 course, splashing up technical terms as recklessly as if their only 
 use were to impress the ignorant with the idea of the learning of a 
 man, who can utter these ponderous words so glibly. It is this kind 
 of physician, who always employs “pulse” as a plural, of which the 
 singular is “pult;” who drops the final letter from “forcep,” when he 
 means one instrument of the kind ; who discourses with such apparent 
 erudition over the most trivial malady, that his patient marvels at the 
 skill of the doctor who has quickly restored him to health, even 
 though “ all his Latin parts were diseased.” Very many of our 
 
6 
 
 Fellows are professional teachers, and know from much observation 
 that a slovenly conception of language by students — most conclusive 
 evidence of a haphazard style of thinking — is a chief obstacle in 
 the work of instruction. Having no habits of study, the pupil 
 struggles along in an unmethodical way, and, consequently, wastes 
 much of his time, even though he is industrious. From lack of 
 logical training, he fails to follow the course of reasoning in many 
 of the books which he reads, and gets perverted notions of important 
 truths. Ignorance of the branches which are the proper prelude 
 to medical study continually obstructs his progress, and at frequent 
 intervals he is obliged to leave great gaps unbridged, for lack of 
 material to span them. When he finally obtains a diploma, as he 
 readily can, containing so extravagant a certification of his intel- 
 lectual and moral worth, that, if he could translate it, even his 
 exuberant conceit would blush at the untruthfulness of the recital, 
 he enters upon his career of imposing upon a credulous public, and 
 bringing legitimate medicine into undeserved disrepute. 
 
 Doubtless this description will appear to many minds as a gross bur- 
 lesque, an intemperate and exaggerated account of a blemish in the 
 body medical, infrequently seen and of trivial moment. But, unhap- 
 pily, the story is entirely true. The public demands no education 
 in those from whom it seeks medical advice ; and the profession 
 itself, by which is meaut the great body of physicians, who are deco- 
 rated with the degree of doctor, while insisting upon some technical 
 training iu those who seek admission to it, is content with a low 
 standard for this requirement, and considers the exaction of a pre- 
 liminary drill a matter of small consequence, to be evaded whenever 
 possible. That the methods of teaching in the majority of our med- 
 ical schools are strikingly faulty, the amount of instruction given far 
 below reasonable limits, and the attainments demanded of candidates 
 for graduation wretchedly insufficient, are facts not difficult of dem- 
 onstration, and peculiarly within the domain of discussion in this 
 society. But, at the present moment, it is well to concentrate our 
 attention upon the indifference of the profession in the matter of 
 education preparatory to medical study. 
 
 ATTEMPTS AT REFORM BY MEDICAL SOCIETIES. 
 
 The deficiency was long ago recognized by thoughtful men, indeed 
 has always been appreciated in some degree ; and the dissatisfac- 
 
7 
 
 tion of those who saw clearly its lamentable results found frequent 
 expression in various channels. National, state and other societies 
 were often addressed on the subject by their presidents and orators, 
 committees were appointed to devise plans for reform, and resolutions 
 were adopted generally, if not invariably, without dissent. But the 
 desired change did not appear. It is not difficult to induce an asso- 
 ciation to put itself on record to the effect that the standard of pre- 
 paratory education must and shall be elevated ; it is quite another 
 thing to persuade the individuals composing the organization to act 
 in accordance with this declaration. To the greater number of mem- 
 bers, the idea presented by one or two earnest men seems commend- 
 able, and they vote with that display of enthusiasm which good- 
 natured people are wont to show for a project in which they do not 
 feel themselves especially concerned, and for which they are under 
 no obligation to make any exertion. The echoes of their applause 
 hardly die away before they disperse to their homes, and being 
 removed from the sustaining atmosphere of the meeting, most of 
 them lapse into their old slipshod ways. Their behavior reminds 
 one of the riotous demonstrations of delight of the occupants of the 
 galleries, when the hero of the drama pronounces some virtuous 
 platitude. We hope that they are actuated in their daily lives by 
 the holy motives for which they evince such admiration ; but we 
 have our fears that their practical morals are not blameless. Few 
 men have the hardihood to array themselves openly on the side of 
 convicted ignorance, and therefore those members who inwardly dis- 
 sent outwardly agree; but they wilfully persist in their vicious 
 courses in private. 
 
 It is well that societies take such action. A main reason for their 
 not effecting more is that the intervals between their declarations 
 are too long, and the impression made at one time is nearly or quite 
 effaced before another blow is struck. And so the reform is 
 deferred. 
 
 EFFORTS AT REFORM BY SOME MEDICAL SCHOOLS. 
 
 Until a very recent period, any male of the human species, who 
 was apparently not less than seventeen years old, who would pay 
 the stated fees, and whose complexion was sufficiently Caucasian, 
 found no difficulty in entering even our most celebrated schools. 
 Only females, children, the moneyless and negroes were excluded. 
 
8 
 
 Candidates for admission were not compelled to show the possession 
 of the slightest knowledge. A few years ago, a small number of 
 schools, after a prudent period of warning to those who contem- 
 plated medical study, established a preliminary examination. Gen- 
 erally, no pretence of a high standard was made : a grammar-school 
 education only was required. But, though it was so insignificant an 
 exaction, it made a difference in the attendance which is almost 
 incredible to one not entirely familiar with the attainments of the 
 average medical student. So great was this falling off that one of 
 the largest schools in the country, for many years so prosperous 
 that it evidently thought itself entirely secure in the affection of the 
 profession, found its patronage shrunken in one year so alarmingly 
 that it beat a hasty and ignoble retreat to its former position, and 
 thereafter, as previously, put a premium on incapacity and dullness. 
 The executive officer of one of these schools, which adhered to its 
 advanced professions, says that he receives more letters of inquiry 
 about the examination than about all other matters relating to the 
 school. The number who are rejected at the examination is small 
 compared with that of those who refrain from coming for fear of 
 rejection. And thus the school has to witness the growing material 
 prosperity of a rival institution, which requires only cash of appli- 
 cants, while its own classes are dwindling. 
 
 The movement toward a better preparation for technical training 
 made little progress for some time, when, all at once, the circulars 
 of many schools burst forth with the announcement that students 
 must demonstrate their fitness for medical study. Had the leaven 
 been working all these years, and suddenly displayed these effects? 
 Had the eyes of so many faculties simultaneously been opened to 
 the exceeding sinfulness of their former practices ? Perhaps so ; 
 and yet, by a curious coincidence, these advertisements appeared 
 not long after the Illinois State Board of Health proclaimed that, 
 if schools wished their diplomas to be recognized in that State, they 
 must have a preliminary examination. 
 
 THE INSINCERITY OF MANY MEDICAL SCHOOLS EXPOSED. 
 
 It is one thing to profess, quite another thing to practice. It may 
 be remembered that, at our last annual meeting, there were reported 
 the results of an investigation of the requirements for preliminary 
 education in the medical colleges of the United States. What the 
 
9 
 
 institutions announced was readily learned from Dr. Rauch’s elab- 
 orate report ;* but to ascertain what they really required was much 
 more difficult. It seemed necessary to adopt detective methods, and 
 a little child, who had but just learned to write with a pen, was 
 the principal medium through which the desired information was 
 obtained. Letters were written to most of the schools, confessing 
 ignorance of some study which was advertised as essential to admis- 
 sion, and asking if that would be an impediment to entrance. “ If 
 a school declined to modify its rules for such a correspondent, there 
 would still be no conclusive evidence that it might not do so in the 
 case of a person who was exceptionally prepared in other branches, 
 and lacking in a single one; but, if a school, publicly announcing 
 that it admitted pupils only after they had proved themselves edu- 
 cated in certain lines, on such an appeal agreed to ignore an impor- 
 tant branch of preparatory study; still more, if it eagerly besought 
 the patronage of this evidently unfitted candidate, it may be fairly 
 claimed that the institution had demonstrated the hollowness of its 
 professions and the utter insincerity of its position. The plan 
 adopted cannot be regarded as a test of the measure of virtue of a 
 school, but rather as a test of its capacity for vice. The result of 
 the investigation showed that about one-quarter of our medical col- 
 leges make no pretence of requiring any real preliminary education 
 in their pupils ; a few hint vaguely at the desirability of some 
 knowledge; and about two-thirds announce an examination or its 
 equivalent, as shown by a certificate. Of these last one-half adhere 
 to their published rules, and the other half evidently do not mean 
 what they say and stand detected in their abominable fraud. The 
 actual standard is extremely low. A very few schools require a 
 preliminary education which is an approach to an equipment for 
 medical study ; a considerable number insist upon a knowledge of 
 the ordinary grammar-school branches, with a mere trifle of natural 
 philosophy; the most will admit any man who can write an intel- 
 ligible letter of inquiry and pay his tuition fee, however deficient he 
 may be intellectually.”'!' 
 
 * Annual Report of the Illinois State Board of Health, 
 f Extract from my report, presented at the Washington meeting of the 
 Academy, 3d September, 1887. 
 
 As this report has not been published, it is pertinent to insert in this place 
 
10 
 
 v 
 
 It would appear that the Illinois law has done much to stimulate 
 the timid and reluctant schools to activity in a desirable direction ; 
 but it is evident that law alone will not accomplish all that is 
 needed. Some will obey through fear ; others will be set thinking 
 as never before, and will acquiesce with the grace which waits on 
 judgment; and others still will “keep the word of promise to 
 the ear, and break it to the hope.” No law will succeed which is 
 not sustained by public approval. To be sure, the existence of a 
 law helps in creating a supporting sentiment, but the major part of 
 this work must be done by different means. 
 
 THE NECESSITY FOR A SOCIETY ON THE BASIS OF THE 
 AMERICAN ACADEMY. 
 
 Just here, it seems to me, opens the field of the Academy. In 
 1876, the year of its birth, when the seven founders were assembled 
 in Philadelphia, Dr. R. Lowry Sibbet read a paper entitled “ The 
 necessity of an organization which shall encourage a higher stand- 
 ard of' qualifications in the medical profession.” The keynote 
 sounded that day is ringing still. The other societies of physicians 
 
 some of the answers received from schools which made haste to confess that 
 their public announcements were fraudulent, and clamored, as it were, for 
 the patronage of a person whose letter of inquiry bristled with evidences of 
 illiteracy. 
 
 “ The examination is not difficult. No one has as yet failed to pass.” 
 “We do not propose to make our entrance examination a bugbear to 
 applicants.” 
 
 “ Our preliminary examination is very simple. We don’t require much 
 philosophy— just a few elements. But I don’t think you need worry about 
 that.” 
 
 “You will experience no difficulty in entering.” 
 
 “Natural philosophy is not required, but is a suggestion as to a line of 
 liberal education. You will have no trouble in passing the entrance exami- 
 nation.” 
 
 “ You need not worry over the examination.” 
 
 “ You need not be burdened by any fear of the examination.” 
 
 “The preliminary examinations are not difficult or technical, and no 
 deserving applicant is rejected on account of not being able to pass them.” 
 
 “ Never mind about the natural philosophy ; that will be all right.” 
 
 “Call and see me, when you reach the city, and I will arrange matters 
 for you, so that there will be no trouble.” 
 
11 
 
 were established largely or wholly to promote technical knowledge, 
 and only incidentally do they touch the interests of education. We 
 have seen how futile are their spasmodic attempts at improvement 
 of the quality and amount of teaching, how imperfect are the 
 results of statutes on the subject, how essential it is that the pro- 
 fession itself should be converted to the belief that men who are to 
 study medicine should have good minds, well trained and richly 
 stored. How can this conversion be accomplished as speedily, as 
 thoroughly, or, I would almost say, at all, except by means of a 
 special society ? It is thus chiefly that men are persuaded in matters 
 of religion and politics. The experience of ages has demonstrated 
 that these objects are not attained but through the agency of power- 
 ful organizations, which toil unceasingly to achieve their peculiar 
 ends. How ineffectual would be the church, if it relaxed for a 
 moment its hold on its votaries, or diminished its watchfulness for 
 opportunities to augment its power ! What utter defeat awaits 
 the political party which fails to reach and constantly to impress the 
 remotest hamlet with its arguments, and to keep in hand the whole 
 body of its constituents! In these familiar examples we have our 
 lesson. We have not sufficiently appreciated the need of incessant 
 agitation. Rarely is opinion changed by a single presentation of an 
 argument, however powerful ; but repetition at short intervals finally 
 succeeds. Non vi, sed scope cadendo. As in the training of animals, 
 and the education of children, so is it also in the persuasion of men 
 — line upon line, precept upon precept, here a little and there a 
 little. 
 
 THE WORK OF THE ACADEMY STRICTLY PHILANTHROPIC. 
 
 It is evident that this work is purely philanthropic, and, conse- 
 quently, is far less likely to attract a large following than that of 
 other medical societies. One may say that their object, also, is the 
 benefit of humanity : that they aim at the improvement of their 
 members in medical science, and that thus mankind is helped to 
 greater health, increased comfort and longer life. True ; but, 
 while they are thus learning how better to aid their fellow-men, 
 they are perfecting themselves in the particular line of work by 
 which they get their living. There is not this double incentive to 
 labor in the Academy. Striving to elevate the standard of medical 
 education does not make one more skillful as a physician or surgeon ; 
 
12 
 
 on the contrary, it consumes time and strength which, if given to 
 his regular labor, will make him a better practitioner and a richer. 
 Our cause, therefore, calls for sacrifice, for unselfish devotion, for a 
 spirit which is satisfied only with ideal results, for souls “ alert with 
 noble discontent, and upward yearnings of unstilled desire.” And 
 doubt not that it has them — not all in our company at present, but 
 willing to join us, and eager to have a hand in the task. 
 
 But it is doubtless in your thoughts that we should do other 
 things than this; we should investigate scientific problems, and 
 report our results at our meetings, proving by the superior quality 
 of our contributions that a classical education has enabled us to 
 surpass others not thus favored, and, in this way, to present an 
 object lesson in support of our main proposition. In this view Ido 
 not agree ; not that I have the slightest fear that the college-bred 
 physician will not justify the claims that are made for him, as man, 
 practitioner, investigator, author ; but because the most conspicuous 
 efforts of the Academy should be, according to the original design, 
 in a purely educational direction, and it is impossible that, to any 
 large extent, men who have original scientific conceptions will first 
 announce them at our meetings, where there will be at any one time 
 so few who are competent to appreciate the merits of the new ideas. 
 The inventor of a novel operation for removing the uterus, how- 
 ever enthusiastic a Fellow of the Academy, will carry his paper 
 describing the process to the Gynaecological Society, where he is 
 sure of a large company, capable of estimating its worth. The 
 neurologist will take his discovery to the association of specialists 
 whose daily experiences qualify them to hear him with full under- 
 standing ; and so for all the rest, whether they cultivate limited 
 portions of the great domain of medicine, or distribute their ener- 
 gies over it all. In the line of scientific work, we are handicapped 
 from the start ; we can offer no inducements which will, as a rule, 
 attract the best efforts of the leaders. 
 
 GREAT INCREASE OF FELLOWSHIP NEEDED. 
 
 The first step in our undertaking is the adoption of a plan for 
 securing the fellowship of all who are eligible under our rules, and 
 would be creditable associates. There is an unpleasant implication 
 in these closing words, but it is unavoidable. We not only recog- 
 nize the great attainments and generous culture of many men who 
 
13 
 
 have never graduated at a college, but we are compelled to admit 
 that many who have received the baccalaureate degree possess little 
 ability, and are not entitled to respect. The lion’s hide has no 
 monopoly in clothing the braying quadruped ; too often we are cha- 
 grined to find that the sheepskin covers an ass. But the great 
 majority of college-bred physicians would be welcome, and ought to 
 be with us ; and, with proper effort, we can win them. 
 
 Three years ago, Dr. Gihon, in his brilliant presidential address, 
 after stating that the Academy had but 291 Fellows, asked: “Is 
 that much of a harvest after nine years’ tilling ? ” What tilling, 
 pray? What large effort was ever made to increase our numbers? 
 In my State there has long been a respectable percentage of doctors 
 of medicine, who are also bachelors of arts and men of deservedly 
 good repute; but their fellowship had not been sought, when our 
 good friend discouragingly wrote his reasons “why this bantling 
 has not made greater progress, and why it has no reason to expect 
 it.” That these worthy men were not indifferent to the purposes of 
 our society, and only needed to be invited in the right way to 
 engage in the unselfish task which it had set for itself, is sufficiently 
 proven by the fact that, while there were but two Fellows in Maine 
 at that time, there are forty-one to-day. I do not believe that “ the 
 time has come when every limitation to fellowship should be 
 removed, except the solitary requirement that the candidate shall 
 be in fact, as in title, learned in medicine, and in all else that that 
 implies.”* Before we alter essentially the conditions of fellowship, 
 we should gather under our banner all the eligibles who can be 
 enlisted. Unless it is possible to demonstrate in this way that most 
 college-bred physicians are so thoroughly convinced of the useful- 
 ness of their preparatory education that they are interested in the 
 attempt to persuade others to pursue a like course, it is not probable 
 that a large accession to our numbers will be made from among 
 those who have had no such privileges in their youth. Though 
 many of these last mentioned deeply deplore the meagreness of their 
 early schooling, and make many sacrifices in order to give their sons 
 a classical and scientific training, they could not be expected to 
 wish admittance to a body which was avoided by those whom it was 
 organized to include. 
 
 Dr. Gihon’s presidential address, 1885. 
 
14 
 
 There are some physicians, however, though probably not many, 
 who would be glad of an opportunity to enter the Academy on the 
 passage of an examination, equivalent to that enforced in colleges 
 conferring the degree of A. B. In this connection a letter, recently 
 received by one of our Fellows, is of interest. The writer had been 
 invited to apply for fellowship, but was obliged to decline, not being 
 a college graduate. But he expresses deep interest in the Academy, 
 and thinks that many, now debarred, might strive for fellowship, if 
 it were possible to prove on examination the possession of such an 
 education as the holding of a degree in arts indicates. 
 
 This suggestion, which comes from a gentleman of culture “ whose 
 influence,” as the Fellow, who hoped to be able to recommend his 
 election, remarks, “ would be most useful to the Academy,” might 
 be adopted without the least danger of lowering the grade of require- 
 ments ; and it is not impossible that, in the future, when fellowship 
 in our society has become a greater honor than at present, and is 
 sought with anxious eagerness, the certificate of the Academy that 
 such an examination has been passed with credit will be everywhere 
 regarded as equal to a baccalaureate diploma. 
 
 A PLAN TO AUGMENT THE FELLOWSHIP. 
 
 Entertaining the views which have just been expressed, in disa- 
 greement with those pronounced here three years ago, I hoped to 
 demonstrate in my administration the correctness of my position. 
 It seemed to me that the Academy had a right to expect to make 
 greater progress, even in this matter of numbers; and, therefore, a 
 plan was formed to test the question. To a number of my medical 
 friends was sent the following circular, in which it will be observed, 
 no hope of personal advantage is held out as an inducement, no 
 opportunity to gratify a taste for display is hinted at, no benefit to 
 one’s self is even implied, save the satisfaction which must come 
 from the performance of duty ; and with the circular were enclosed 
 a blank for application and a brief letter, inviting to fellowship and 
 asking permission to stand as sponsor. 
 
 THE CIRCULAR, 
 
 “The American Academy op Medicine, founded in 1S76, is a society composed of 
 physicians of at least three years’ experience in practice, who, previously to gradua- 
 tion in medicine, received the degree of bachelor or master of arts, after a regular 
 collegiate course. Its purpose is not to establish an aristocracy in the medical pro- 
 
15 
 
 fession, but to advance the standard of requirements preliminary to technical study, 
 to elevate medical education to a plane far above that which it now occupies, and, by 
 other similar means, to promote the welfare of the profession. 
 
 “Already the purely scientific interests of medicine are provided for, as far as soci- 
 eties can further the cause, by organizations devoted to the development of the various 
 specialties ; but no other association has concentrated its attention on the field which 
 the Academy was established to cultivate. It is believed that its purposes only need 
 to be stated in order to arouse the hearty sympathy of those physicians whose pre- 
 paratory studies and honorable standing make them eligible to its fellowship. The 
 necessity for the work which the Academy is equipped to perform is too obvious to 
 require demonstration, and it is in the highest degree desirable that every qualified 
 physician should participate in this labor, not simply by using his individual efforts 
 to influence those with whom he comes personally in contact, but also by uniting with 
 those of his professional brethren who entertain the same opinions and are actu- 
 ated by the same high motives. Only by the combined and persistent endeavors of 
 such men can medical education in this country be made what it ought to be, and 
 this task is of the nature of an obligation, which the nobility of culture imposes upon 
 all who bear its insignia. 
 
 “ It is earnestly hoped that each physician who receives this circular will display 
 his willingness to share in this great undertaking by entering the Academy at an 
 early date. 
 
 “ A blank application for fellowship is enclosed herewith.” 
 
 The replies came so promptly and were so cordial that it seemed 
 wise to propose the plan to my associates ; for, if it was efficacious 
 in the hands of one, why should it not prosper with all? Con- 
 sequently, to nearly every Fellow was sent the following circular 
 letter, with three of the explanatory leaves, three blank applications, 
 a list of the Fellows in this State, a stamped envelope directed to 
 myself for reply, and a personal autograph letter asking his aid : — 
 
 American Academy of Medicine. Portland, Maine, August, 1S8S. 
 
 Dr 
 
 Dear Sir: The principal need of the Academy at present is a large membership. 
 It is of the highest importance that, practically, all of the college-bred physicians in 
 the United States should be entered on its rolls. To a great extent this result can be 
 accomplished speedily through the efforts of the present Fellows, and only thus. 
 Experience has demonstrated that few apply for membership without being invited ; 
 but it has also shown that, with proper urging, it is not difficult to induce men to join 
 our ranks. 
 
 Heretofore no systematic attempt has been made to increase our fellowship ; but 
 such a measure is now projected, and in it I beg to ask your earnest cooperation. 
 
 There are, doubtless, in your neighborhood (city, county, State), or, at all events, 
 among your acquaintances, some, I trust many, who will be induced by your personal 
 persuasion to apply for admission. The method which has proved most successful is for 
 the Fellow to write an autograph letter, stating the case, offering to stand as sponsor 
 
1G 
 
 requesting an early reply, and enclosing a blank for application, a circular setting 
 forth the objects of the Academy, and a stamped envelope for the answer. If a response 
 does not arrive in a fortnight, a second letter, calling attention to the first, is desirable. 
 When the applications are received, the Fellow should sign the recommendation, and 
 forward the papers to the president. 
 
 Three circulars and three blanks are enclosed herewith, and it will afford me much 
 pleasure to supply you with as many more as you shall request. 
 
 The service which the Academy asks of you calls for the writing of a number of let- 
 ters and the expenditure of some valuable time in the search for suitable candidates; 
 but, certainly, it is not greater than any Fellow is more than willing to devote to the 
 cause in which he enlisted by entering the Academy. 
 
 If every Fellow will do what he can to awaken the interest of his friends, our num- 
 bers will be immediately so augmented as to make the Academy a most powerful and 
 honored organization, and enable it to contribute in a hitherto unexampled manner 
 to the accomplishment of the reforms which it was instituted to promote. 
 
 Hoping for your support and encouragement in this work, and awaiting your reply 
 with eagerness, I am, Respectfully yours, 
 
 Frederic Henry Gerrish, President. 
 
 I am obliged to confess that the result has fallen far short of what 
 seemed moderate anticipation. That most of the letters were deliv- 
 ered would seem to be sufficiently attested by the return of only one 
 as uncalled for. Less than half were answered in any way, though 
 a second circular letter, requesting attention to the first, was sent to 
 all who had not replied. Forty-five applications were gathered by 
 twenty six Fellows, in addition to fifty-three, which were secured 
 by one other; so that we add ninety-eight to our membership — 
 more than in any two years previously. Probably this does not 
 represent the entire product of the scheme : some have reported 
 themselves as expecting to procure applications, and these will swell 
 the list of next year. My hope was to double our numbers; for I 
 thought that there could be few Fellows who had not among their 
 acquaintances some who were eligible and would accept an invitation 
 to fellowship. When one Fellow can obtain, without difficulty, 
 more than fifty applications — a number exceeding the entire admis- 
 sions in any former year — it is not reasonable to suppose that, the 
 other three hundred cannot procure an average of one apiece with 
 slight exertion. 
 
 The causes of so small a return for the prolonged and irksome 
 toil which it cost are doubtless, first, the fact that the vitality of the 
 Academy was almost suspended during the year immediately pre- 
 ceding: it was proposed to omit the annual meeting, and, when held, 
 it was almost spiritless ; the papers were few, hardly enough addi- 
 
17 
 
 tions were made to compensate for the mortality subtractions, and 
 nobody could have felt otherwise than depressed at the dismal per- 
 formance. It takes time aud powerful effort to regain so much lost 
 ground; and it is to be hoped that the Fellows will never again 
 allow themselves to be deluded with the notion that any society will 
 progress, or even keep alive, without the devoted care and constant 
 activity of its members. Health and vigor cannot be looked for in 
 the prolonged absence of nourishment and exercise — a commonplace 
 which ought not to be required in an assemblage of physiologists. 
 Second, it is unquestionably true of our association, as of every other 
 of which I have knowledge, that it contains many iudifferent mem- 
 bers, who are not inaptly called dead-wood. This is the kind of men 
 who are never willing to do anything but share in the success which 
 others have won, and administer caustic rebuke in the event of fail- 
 ure. Third, it was unfortunate in this regard, to have a president 
 of whom the Fellows knew so little. Finally, and more potent as 
 a reason for the failure of the scheme than all the foregoing, was the 
 fact that the Fellows had never been made to understand that each 
 of them was under obligation to promote the welfare of the 
 Academy. 
 
 The most useful, as well as most conspicuous feature of the plan 
 proposed is the inclusion of every Fellow in the proposed work. If 
 all the labor of a society is performed by a few members, that organi- 
 zation contains an element of weakness that may at any time destroy 
 it. But if every individual composing the whole makes a regular 
 contribution to its support, each must feel an interest in its pros- 
 perity, which is otherwise impossible. In the Academy we have no 
 annual tax of money, and, after paying his initiation fee, no Fellow 
 has been called upon for any services which he could consider 
 obligatory, unless he has accepted an official position. Conse- 
 quently, there has been no demand upon the loyalty or energy of 
 the members generally, and it is not wonderful that their interest 
 has been small. If they had been asked frequently to render some 
 aid to the cause, if in any way the necessities of the situation had 
 been kept before them, the attempt which has been made would 
 have been crowned with success, and we might to-day rejoice in a 
 membership of two or three thousand. 
 
18 
 
 A COMMITTEE ON INCREASE OF FELLOWSHIP NEEDED. 
 
 The experience of the past should guide our future conduct. I 
 suggest, therefore, that a committee of three Fellows who are widely 
 and favorably known, energetic and willing to give hard work to 
 the cause, be appointed, with instructions to procure the address of 
 each physician in the United States who is eligible to fellowship 
 under our rules ; to ascertain his standing ; to furnish him, if 
 worthy, with a historical sketch of the Academy, a list of its Fel- 
 lows, a brief statement of its purposes and principles, and an invi- 
 tation to enter it. The Fellow from whom favorable information is 
 obtained will stand as the candidate’s sponsor. I feel a good deal 
 of confidence that our numbers could be trebled, perhaps quad- 
 rupled, by this system in one year. I recommend the appropriation 
 of $200 to defray the expenses of this committee. 
 
 Not only does the Academy need a large increase in numbers, 
 but means should be taken to arouse the flagging enthusiasm of the 
 Fellows. Many who do not know much about our society would 
 be gratified and awakened by full information concerning it. To 
 this end I make several suggestions: — 
 
 A CATALOGUE OF THE FELLOWS DEMANDED. 
 
 A need which has been often felt is a catalogue of our Fellows. 
 Once, at least, it was thought to have been provided for ; but noth- 
 ing came of the attempt. I advise, therefore, the appointment of a 
 committee of three Fellows, instructed to prepare and publish a 
 catalogue of the Academy, containing the following data concern- 
 ing each living Fellow or Honorary Member ; his name in full ; 
 post-office address; collegiate degrees received, with date of each, 
 and name of institution conferring them ; official positions of im- 
 portance held by him, such as professorships, physiciancies or sur- 
 geoncies to hospitals, membership in state boards of health, princi- 
 pal offices in important societies ; high political appointments ; the 
 titles of three volumes, and of three pamphlets or articles of which 
 he is the author. The catalogue should also contain the name of 
 each deceased Fellow and Honorary Member, and of his last place 
 of residence, the date and place of his death, his age and the data 
 concerning his degrees, positions and writings which would be pre- 
 sented if he were still living. A copy of this catalogue should be 
 sent to each Fellow, to every respectable medical journal, and to 
 
19 
 
 every public medical library iu the country. One hundred copies 
 more than are needed for these purposes should be printed, and 
 sold to parties wishing to purchase them. A sum not exceeding 
 two hundred and fifty dollars should be appropriated for the ex- 
 penses of this committee. 
 
 THE TRANSACTIONS SHOULD BE PUBLISHED. 
 
 The by-laws provide that the council of the Academy shall 
 “ decide upon and superintend all its publications,” and that the 
 secretary “ shall edit the transactions in the manner and style agreed 
 upon by the council.” Hitherto the president’s address has usually 
 been published in pamphlet form, and distributed to the Fellows, 
 and a very few other papers have been thus honored ; but “ the 
 transactions ” referred to in the by-laws have not been issued. It 
 would seem that the time has come for action in the premises. The 
 whole business is in the control of the council ; but that committee 
 will unquestionably receive with pleasure an expression of the 
 wishes of the Academy. It would be wise for the council to select 
 for publication such of this year’s essays as seem worthy of this 
 distinction, ascertain the cost of printing and binding five hundred 
 copies, and the number of these which would be purchased at cost 
 by the Fellows. If the demand should warrant the attempt, the 
 business could be undertaken with no chance of burdening our 
 treasury, and with a most beneficial effect upon the reputation of 
 our society. 
 
 THE PRICE OF THE PARCHMENT DIPLOMA. 
 
 A few years after the founding of the Academy, a Latin cer- 
 tificate of membership was prepared and engraved. The price of 
 this certificate, printed on parchment, is fixed by the constitution at 
 ten dollars, a sum so large as to be almost prohibitory. Only fifty- 
 one copies have been sold. The plate was paid for long ago, and 
 there appears to be no good reason for continuing a policy which 
 practically deprives most of our members of an official certificate of 
 fellowship, worthy of the dignity of the organization. I, therefore, 
 propose a change in the constitution, reducing the sum to be paid 
 for these diplomas to cost, which, at present rates, would not exceed 
 two dollars each. Very soon after the passage of this amendment, 
 there will be a brisk demand for these parchments, and our society 
 
20 
 
 will be brought prominently to the attention of thousands who have 
 never heard of it before. Let us hope that the time is not far dis- 
 tant when the Academy shall be so prosperous that the admission 
 fee can safely be raised to a price which shall enable it to issue a 
 diploma to every Fellow on admission, without additional charge. 
 
 A COMMITTEE TO PROCURE ESSAYS REQUIRED. 
 
 It is not a small task to procure essayists for our meetings. Our 
 Fellows are busy men, most being actively engaged in practice, and 
 very many being teachers in colleges, physicians and surgeons in 
 hospitals, editors, authors, and frequent contributors to medical 
 societies; and very few voluntarily offer papers to the Academy. 
 To illustrate the labor of providing acceptable entertainment for a 
 meeting, it may be remarked that the present programme is the 
 result of nearly fifty urgent invitations by the president, and a large 
 number by the secretary. I suggest that a special committee be 
 charged with this duty for the ensuing year. 
 
 The initial meeting of the Congress of American Physicians and 
 Surgeons was held in the city of Washington this year, and the 
 success of the venture was sufficient to make it probable that a 
 similar gathering will take place hereafter triennially. It is advis- 
 able for the Academy to consider the expediency of associating 
 itself with the other societies composing the Congress, and thus 
 bringing itself into more prominent notice than it has hitherto 
 enjoyed. 
 
 PROPOSED AMENDMENTS TO THE CONSTITUTION DISCUSSED. 
 
 At our last meeting in this city, seven amendments to the consti- 
 tution were proposed by six different Fellows. These were laid 
 over without decisive action at Pittsburgh, and again at Washington, 
 and now they present themselves anew for your consideration. 
 They naturally are arranged in two distinct groups, six being in one, 
 and one in the other. Those of the first set relate to membership. 
 It is pertinent for me to mention them, and offer my comments, 
 which I do with sincere appreciation of the loyalty of the proposers, 
 and most hearty regret at being constrained to differ with them on 
 points which they have much at heart, and firmly believe to be 
 importaut for the welfare of the Academy. 
 
 Dr. Sibbet wishes to have a provision for “corresponding mem- 
 
21 
 
 bers,” who shall be distinguished medical men in foreign lands. I 
 would prefer to delay this movement until we shall be able to com- 
 municate to such gentlemen as shall be interested to correspond 
 with us tidings concerning medical education in America of a kind 
 more creditable to our own land. 
 
 B. S. OR PH. B. EQUIVALENT TO A. B. 
 
 Dr. Sibbet also proposes that “ candidates having other literai’y 
 degrees than Bachelor of Arts or Master of Arts may be elected as 
 Fellows, provided they shall not exceed five percentum of the whole 
 number; and provided, also, that they shall have contributed to 
 the literature of the profession.” For instance, a gentleman who is 
 not a college alumnus, but has received an honorary degree of Doctor 
 of Philosophy, might be admitted under this rule; whereas, an 
 equally well-educated physician, who has no literary degree except 
 an honorary A M., cannot enter. This may not be what is intended, 
 but the rule would be easily capable of the construction which I 
 have put upon it. 
 
 It is clear to my mind that we are not acting with entire consist- 
 ency in excluding those, who, instead of the degree of Bachelor of 
 Arts, have taken that of Bachelor of Science or Bachelor of Phi- 
 losophy. One would expect us to put the two on the same footing, 
 judging from the words of our constitution, which says: 
 
 “The objects of the Academy shall be (1) to bring those who are 
 Alumni of Classical, Scientific and Medical schools into closer rela- 
 tions with each other; (2) to encourage young men to pursue regu- 
 lar courses of study in Classical and Scientific institutions before 
 entering upon the study of medicine.” In mauy colleges the stu- 
 dents in the same class, while pursuing identical lines in most 
 respects, follow diverging lines in others. The drill is equally 
 severe, the mental discipline probably as great in one as in the 
 other ; but, because one group has chosen to pay particular attention 
 to the humanities, and the other has selected a curriculum in which 
 the natural sciences have had a more prominent place, the degree 
 in arts is conferred on the one, and that in science on the other. 
 The A. B. and the B. S. are intended to balance in the academic 
 scales. On what ground do we decide the one to be evidence of a 
 good education, and ignore the four years of studious application 
 which is represented by the others? Suppose that a young man has 
 
22 
 
 looked forward to our fellowship as a coveted honor, and decides on 
 the strength of our counsel in Article II of the constitution to take 
 a regular preparatory course. His tastes lead him toward the 
 physical sciences rather than to the classics, and without noticing 
 the restrictions in Article III, he follows the plan which ends in the 
 B. S. degree. He is as able, as well furnished mentally, as upright 
 as his brother, who is A. B. But, after the two have become doc- 
 tors of medicine, the latter can enjoy our association, and the former 
 is excluded. Would he not feel an excusable bitterness at our 
 treatment of him ? 
 
 I hold in my hand an application from a physician who has been 
 engaged in practice eleven years, is a Bachelor of Science and a 
 Doctor of Philosophy. His sponsor, knowing him to be college-bred, 
 thought that he was a Bachelor of Arts ; but learning the fact, 
 writes, “ If any discretion is allowed, I would strongly recommend 
 his admission.” It seems to me that the interests of the Academy 
 would not suffer by recognizing B. S. and Ph. B. as the equals of 
 A. B., provided that they have been obtained after a regular four 
 years’ course. But an amendment must be differently worded from 
 that under discussion in order to effect this result. 
 
 Dr. Gihon would admit “ graduates in medicine, who, having no 
 degree in letters received in course, have distinguished themselves 
 in medicine and collateral sciences.” Literally interpreted, this 
 rule would open the door to no dangerously large number ; for, 
 while many who have no literary degree distinguish themselves in 
 medicine, very few become noted for their learning in collateral 
 sciences also. But, substituting “ or ” for “ and,” will it not be 
 better to leave this matter as it is, until we have gathered in all the 
 good men possible under our existing rule? 
 
 Dr. Bush would give the council power to nominate for fellow- 
 ship any honorable physician, who has distinguished himself by the 
 production of any valuable publication. On this proposition the 
 same criticism is offered as on the preceding. 
 
 Dr. Edward Jackson would have for each candidate thi'ee spon- 
 sors, who should write out a statement of his fitness. After a year’s 
 deliberation the council may report on the case, and the society 
 may elect. At a time like the present, when the chief need of the 
 Academy seems to be a large increase of members, it would hardly 
 be politic to make admission more difficult than it is now. The 
 
23 
 
 Academy probably has enough confidence in the discretion of its 
 Fellows, to take the approval of any one of them as abundant testi- 
 mony to the fitness of a candidate. 
 
 Dr. Mclntire would have the election of an applicant delayed a 
 year after the approving report of the council is made. This would 
 be a safeguard against the introduction of undesirable persons; 
 but the year of waiting would be unnecessarily annoying to -the can- 
 didate, because the same advantage would be gained by the simple 
 device of having each Fellow supplied with a list of applicants a 
 short time before the annual meeting. Then, if any Fellow wished 
 to object to the admission of any one whose name was thus pre- 
 sented, he could readily do so by letter or in person. This method 
 works admirably in the Maine Medical Association, in which it has 
 long been in operation. 
 
 DOES THE ACADEMY NEED A CODE OF ETHICS? 
 
 The sole proposal of the second set relates to an utterly different 
 subject. Dr. Sutton, one of our charter members, and but recently 
 our president, advocates a change in Article VIII, Section I. At 
 present the paragraph runs thus: “The Fellows of the Academy, 
 
 in their relations with each other and with their fellow-men, agree 
 to be governed by the principles embodied in the present code of 
 ethics of the American Medical Association, and by the constitution 
 and by-laws of the Academy.” Dr. Sutton desires to have this 
 amended to read as follows : “ The Fellows of the Academy will 
 
 be governed by those principles which actuate educated, cultured 
 and honorable men in every profession, and by the Constitution 
 and By-laws of the Academy.” 
 
 To this proposition I trust that the society will give its most 
 serious and judicial meditation. For my own part, I have no objec- 
 tion to the principles embodied in the Code of the American Medi- 
 cal Association. The expression of them seems to me to be not 
 altogether felicitous; but, if I understand them, they are worthy 
 of approval. During the uuhappy controversy over the Code in 
 this State several years ago, my sympathies were with the old code 
 men. It would be only harmful now to revive in detail the memo- 
 ries of that extremely unfortunate episode. Nobody on either side 
 would wish to renew the discussion, with its attendant circumstances 
 of ill-feeling and hostile exhibitions. But though I entertain no 
 
24 
 
 desire to have my State Medical Association abolish its Code, which 
 is that of the national society, I believe that the Academy will act 
 wisely if it adopts the alteration under consideration. If we had 
 no Code, it would not occur to us that one was needed. We are 
 here not as therapeutists, but as reformers. If we discard all allu- 
 sions to codes, we shall be in no peril of an invasion of wicked or 
 crazy irregulars ; for no candidate’s application can be considered 
 without the approving signature of a Fellow in good standing. We 
 need have no suspicion that the proposer of the alteration is plot- 
 ting to obtain our sanction in advance to orgies of unholy consulta- 
 tions. But more important than these thoughts is the fact, encoun- 
 tered by more than one of us in his search for applicants, that the 
 presence in our Constitution of the paragraph under discussion is an 
 obstacle of the gravest nature in the way of an increase in our 
 numbers. The objection does not come from the weak and whimsi- 
 cal, but from strong, high-minded thinkers. Many have been 
 offended by what they consider the unjust and tyrannical conduct 
 of the American Medical Association, and shun membership in any 
 society which even seems to be a satellite of it. After three years 
 in which to ponder on the subject, I have fully decided that the 
 adoption of this amendment is consistent with the strict, orthodox 
 principles of medical ethics in which I was reared, and is for the 
 best interests of the Academy. 
 
 THE ADMISSION OF WOMEN. 
 
 Never before has it been appropriate to address the Academy as 
 “ Ladies and Gentlemen but to-day it is my privilege to use this 
 significant expression. You have accepted as Fellows a number of 
 women, and henceforth we who have labored in this society for the 
 advancement of medical education are to have the cooperation of 
 the sex, long excluded from medical associations, but now admitted 
 on an equal footing with men in some of the foremost of our pro- 
 fessional organizations. It is indicative of a marked change of 
 sentiment and opinion that bodies as conservative as the Massachu- 
 setts Medical Society and the Philadelphia County Medical Society 
 have opened their doors to all, without reference to sex, who have 
 the requisite ability and training. It is not creditable to our coun- 
 try, or in keeping with the liberality which theoretically character- 
 izes our institutions, that a discrimination should so long have been 
 
25 
 
 made against women in scientific associations. But considerations 
 of justice have at last prevailed so generally that, at the present 
 time, the opposition to educated physicians on- account of sex is 
 feeble, compared to the violent antagonism which formerly existed. 
 The stock arguments that women have not the physical strength to 
 sustain them in the trials of practice, that they lack the intellectual 
 capacity and the moral force which we deem essential, have ceased 
 to have weight. Facts, easily observed, prove the contrary. There 
 are too many women practicing medicine scientifically, skillfully, suc- 
 cessfully, and without injury to their health, to permit such objections 
 to influence any one who is well informed. Having been the medical 
 teacher of many women, and having watched the careers of a con- 
 siderable number with peculiar interest and satisfaction, I feel fully 
 justified in the prediction that the Academy will be strengthened by 
 the admission of the gentlewomen who have entered to-day, and 
 will never regret this departure from its former usages. 
 
 It is noteworthy that some of the staunchest upholders of a strict 
 preliminary examination, as ascertained by the detective work of 
 our committee on the subject last year, were the schools managed 
 by women. They had advanced their standard because they saw 
 the necessity for reform, and they adhered honestly to their pub- 
 lished rules, as so many of the schools for men did not. The pro- 
 portion of those which stood by their colors was much greater 
 among the women than among the men. 
 
 It is simply justice to the Academy to state that it has never ob- 
 jected to the admission of women. This year is the first in which 
 women have applied for fellowship. 
 
 EMINENT DECEASED FELLOWS. 
 
 Since our last meeting the grave has closed over several of our 
 associates. Of these the most distinguished was Cornelius Rea 
 Agnew, whose sudden death shocked the community and left a void 
 so great that it will not cease to be felt as long as any survive who 
 knew him. His splendid natural endowments, his admirable devel- 
 opment, his great achievements, his moral elevation, have all been 
 the subjects of eloquent eulogies so recently, that further mention 
 of them is superfluous here. 
 
 It would be unjust to my feelings, were this occasion to be allowed 
 to pass without my paying a tribute to the memory of one of 
 
26 
 
 our lost companions whom I knew most intimately, Edward Swift 
 Dunster. He was still a young man when I first became acquainted 
 with him, but he had already made an enviable reputation as a 
 writer and lecturer. We were associated for two years in the faculty 
 of a large medical school, and, from sympathy of tastes and commu- 
 nity of interests, we were much together. He honored me with 
 his friendship, and the memory of it remaius with me like a pre- 
 cious benediction. His varied and accurate learning, his scholarly 
 instincts, his choice and elegant diction, and ready wit combined to 
 make him a most entertaining companion and a teacher of unusual 
 brilliancy and power. But though he won my admiration for these 
 attractive attributes, I chiefly delight to think of him as a bold and 
 tireless advocate of the principles for which the Academy contends. 
 Early and late he struggled with the prejudices, the indifference, the 
 stolid and unteachable conservatism, which those who should have 
 aided him threw continually in his way ; and just when the path began 
 to be clearer, and hope was strengthening into expectation, the fatal 
 summons came, and the task which he had set himself was left 
 unfinished. His death is a distinct and irreparable loss to the cause 
 of sound medical education. His vacant place should be a continual 
 reminder of the work which still remains to be done, and should 
 stimulate us to renewed exertions. 
 
 IN CONCLUSION. 
 
 In obedience to our rules, I have written this address. I have not 
 attempted an oration, for my conception of my duty compelled the 
 belief that the required paper should be of a business character. 
 Consequently, avoiding rhetorical horticulture, I have given an 
 account of my stewardship, and have expressed my views of the 
 functions of the Academy, and of the best methods to pursue in 
 order to compass the desired results. 
 
 A year ago, when you paid me the compliment of elevation to 
 the presidency, my surprise at the altogether unsought and un- 
 anticipated election prevented an adequate and seemly acknowledg- 
 ment of your partiality. I could merely stammer my thanks 
 and a promise to do my best to promote the interests of the 
 Academy. My term of service closes at this meetiug ; and, as I 
 look back upon it, I find that the hopes, which seemed at first to 
 be easy of realization, have been but imperfectly fulfilled. But I 
 
27 
 
 have no broken promise to regret, for I have really done what I 
 could for the Academy. 
 
 I am fully persuaded that less harm per year would ensue from 
 the absolute cessation of all progress in medical discovery and 
 invention, than now results from the low standard of preliminary 
 and technical education. I believe, too, that our cause needs coura- 
 geous, persistent and aggressive action. Holding these opinions, the 
 labor which I have done has been the practical expression of a con- 
 viction of duty. And my only grief in contemplation of the result 
 is that my best has been so poor. 
 

 
 
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