people. At threescore and ten the freedom of cities is pleasant, and laurel still becomes the ancient brow.

That was Howe's last happily successful endeavor. He returned with added honors to America, and promptly was called to further public work. The federal congress was bestirring itself in the early throes of imperialistic ambition, and folk talked seriously of annexing the islands of the sea. Santo Domingo was their first object, and thither went Howe with other forlorn commissioners, by direction of President Grant. It was a situation of curious paradox, the Apostle of Freedom, the Hero of Greece, and the Champion of Slaves, sailing away on a mission to annex the partycolored rabble of a farcical Carib republic. The object was a failure, as we know.

Howe came home, but went back later to the island, seeking health and forwarding a commercial enterprise. This expedition was a double failure, and our philosopher returned to Boston a broken man. His end was near. Much buffeting and novel strivings do not conduce to a peaceful old age. He died with little more ado, in his 75th year, on the 9th of January, 1876.

We have seen that here was a man of singular abilities, of noble aims, of quaint simplicity, of perfect courage. Among the great physicians of America his career is one of the most romantic and varied, and his accomplishments lasting. It is a name to be guarded in our annals, for he wrought and suffered much. In his native town they paid him public honors, and great ones of the earth told what he had done.

Here are the final charming words of Howe's old

friend, the poet-statesman Hoar: "His is one of the great figures in American history; I do not think of another who combines the character of a great reformer, of a great moral champion, of a great administrator of great enterprises, requiring business sagacity and wisdom as well as courage, always in the van, with the character also of a knight-errant who crossed the sea, like the Red Cross knight of old, to champion the cause of liberty in a distant nation. There was never on the soil of America, fertile as that soil has been of patriots and heroes and lovers, a more patriotic hero, a more loving knight."

STUDIES IN ANEURISM

HISTORICAL AND CRITICAL1

2

SAYS the learned Adams: "It appears to me that at certain periods of ancient times, the standard of professional excellence was such as would not easily be attained at the present day. . . . The Father of Medicine held that, to become an eminent physician, it was necessary, not only to be well acquainted with the structure of the human frame, but also to be skilled in logic, astronomy, and other sciences. His devoted admirer and follower Galen was evidently the very beau ideal of an accomplished physician; skilled in all the sciences of the day, in logic, mathematics, rhetoric, and the first philosophy; to all these ornamental branches of knowledge he added a minute acquaintance with anatomy and physiology; a practical experience with the phenomena of diseases; a singular perseverance in collecting facts; and an extraordinary ability for generalizing them."

Since the best of our forebears in medicine were such as Adams describes them, it is worth our while occasionally to glance back at what they did, that knowing their struggles and experiences we may more lucidly

1 Address before the Cleveland Medical Library Association, December 16, 1907.

2 Francis Adams: Editor of the "Seven Books of Paulus Ægineta"; Sydenham Collection, 1844.

and intelligently approach problems of our own day. The men as well as their problems go to make up a fascinating subject of study. Many of us have groaned perhaps over these matters, because the light of heaven has been obscured by pompous interpreters, by dull pedants, by dreary translators. But truly we must believe that those ancients were real men those worth knowing; and that they attacked their problems often in fine, spirited, sane, and knightly fashion.

We in these days, with our somewhat feeble, formal, and spiritless manner of reviving studies in the history of medicine, are wont to dwell overmuch on the lives of men, and to make a perfunctory rehearsing of their detailed endeavors. But may not the history of an endeavor interest us? - a great endeavor which has engaged our ablest minds through twenty centuries, a great endeavor which has been made a luminous accomplishment, at last, by men of our own time? Throughout history the mystery of the circulating blood, its nature, its course, the character of its components, the artful concealment of its source and forces, - has fascinated and baffled philosophers and scientists. To the old writers the heart and blood vessels seemed the noblest parts of man;-making up a mechanism and a system, constant, perpetual, wondrous, inexplicable, vital. We have been told that hidden, divine forces control this system; almost down to our own time the liquor sanguinis itself was held to contain intangible elements, which writers, groping blindly, were content to describe as "spirits"; and the ebb and flow of the life stream were for thousands

of years the theme of speculation, discussion, and marvel. If the nature of the blood and its vehicles was obscure to the physiologist, we must understand that to the physician and the surgeon the diseases of the blood and blood vessels were still more difficult of comprehension, so that we find no one department of the complex problem more troublesome or hotly debated than the subject of aneurism.

Galen is the first writer to describe it, and this is his definition: "When an artery is opened, the disease that occurs is called aneurism. It happens in consequence of the skin in the neighborhood of a wounded artery cicatrizing, whilst an ulcer remains in the vessel," and again, “An aneurism is a dilation or relaxation of a venous vessel, or a dispersion of the spirituous matter under the flesh, where it diffuses and distributes itself by jerks." 1

1

Contrast Galen's writing of the second century with that of Roswell Park, published this year of 1907: "An aneurism is a tumor communicating with an artery, and containing circulating or coagulated blood, or both." In 1825 Astley Cooper wrote: "An aneurism is a pulsating tumor communicating with the interior of the heart, or of an artery, and containing blood." Galen's statement is interesting and the man was a remarkable man. By the average reader of surgical literature his name is coupled with that of Hippocrates, and the two are pigeon-holed as admirable personages doubtless, but of no immediate interest to us.

Now Galen lived five hundred years after Hippoc'John E. Erichsen, Translator.