peerage. It is clearly understood that another and a lower dignity is the stamp of honor which the State accords to the very highest eminence in medicine and surgery-as if to show in the clearest light how inferior in its eyes are the professions which do most to mitigate the great sum of human agony to the professions which talk and quarrel and kill."* And yet Jenner almost saved England from extinction, and Simpson and Lister have done far more to mitigate the terrors of surgery and the pangs of maternity, to save life, and to bring health and happiness to the human race than Marlborough and Wellington and Nelson have done to destroy life and to bring sorrow and pain, rapine and misery.

It is pleasant to record that with the opening of this year, England has atoned for such long-continued neglect. In making Sir Joseph Lister the first medical peer she has conferred less honor upon Lord Lister than upon herself.

The statue of Marion Sims, not long since erected in New York, and this of Samuel D. Gross, let us hope, are the beginning of a similar recognition of beneficent genius in our own land. Go through the broad streets of this beautiful city, and in its circles and parks and squares you will find, with singular exceptions, only the statues of statesmen and warriors-men who deserve, we all agree, their well-won honors and immortality. But, truly, "Peace hath her victories no less renowned than those of war." Though its heroes are not, it may be, portrayed in marble or bronze, they are enshrined in the grateful hearts of mankind, immortal in literature, even the humblest of such toilers as the Gideon Grays and the Weellum Maclures that cheer and brighten the world.

And were the soldiers, whose statues one may see everywhere around us, the sole possessors of bravery? In 1832, that most dreaded of all scourges, Asiatic cholera, for the first time broke out all over this country with the greatest

* Democracy and Liberty, i, 429.

virulence. Easton was only eighty miles from New York and the citizens, in terror lest the dread disease would reach their own town, appointed a young, intrepid surgeon to visit New York and learn what he could for their benefit. When others were fleeing in frightened thousands from the pestilence Gross bravely went directly into the very midst of it, reaching New York when the epidemic was at its very height. In that then small and half-depopulated town 385 persons died on the very day of his arrival-and he stayed there a week in a hot July, visiting only its hospitals and its charnelhouses. What call you that but the highest type of bravery? -a bravery which Norfolk and Mobile and Memphis have since seen repeated by scores of courageous physicians ready to sacrifice their lives for their fellow-men with no blare of trumpets, no roar of cannon, no cheer of troops, no plaudits of the press! No battlefield ever saw greater heroes; no country braver men!

Yonder statue of Joseph Henry has stood alone for too many years. We have to-day unveiled its worthy companion. Both of them are memorials of men great in science, whose lives were devoted to the good of their fellow-creatures, to saving life, adding to human comfort, lessening pain, promoting knowledge, cheering the sick, and assuaging even the very pangs of the dying. We do well thus to honor in imperishable bronze the men who have won these victories of peace! To no one can the words of the blessed Master apply with greater force than to the kind surgeon whose time and thought and talents are given to humanity, and, above all to the poor, with no payment but the grateful look of returning health and rescued life and that inward satisfaction. which far surpasses all the wealth of the Orient. "Inasmuch as ye have done it unto one of the least of these my brethren ye have done it unto Me."

SEMICENTENNIAL ADDRESS IN SURGERY.*

MR. PRESIDENT AND GENTLEMEN OF THE AMERICAN MEDICAL ASSOCIATION:

It is proper to acknowlege and distinguished a body

T is always proper to acknowledge an honor, but when it

of men, representative of the entire profession in the United States, and on an exceptional occasion, I feel it a double honor to have been chosen to deliver the Semicentennial Address in Surgery. I beg to return you my very hearty thanks for your extreme kindness.

As we celebrate on this occasion the Semicentennial of the organization of the American Medical Association, in this city, in 1847, it is very natural and proper that the Address in Surgery should be a review of the work done in the last fifty years, and, by contrasting the state of surgery and of surgical teaching in 1847 with that which exists in 1897, to see what progress has been made. To recount what has been achieved in these "fifty years of science" far better than a "cycle of Cathay" is not only a pleasure, but it is an immense incentive, since by the progress made in the last fifty years we can in some measure anticipate the enormous, and probably even still greater progress, that will be made in the next half-century.

The time, also, is opportune. Last year was celebrated the centennial of vaccination and the semicentennial of the first public administration of ether. Sydney Smith's bitter

* Delivered at the Semicentennial Meeting of the American Medical Association at Philadelphia, Pa., June 3, 1897. Reprinted from the Journal of the American Medical Association, June 12, 1897.

query in 1820, "In the four quarters of the globe, who reads an American book, . what does the world yet owe to American physicians or surgeons?" was answered a quarter of a century later and made all these "four quarters of the globe" our grateful and everlasting debtors for the gift of anæsthesia. It was the discovery of an American dentist, was first used by an American surgeon, was christened by an American physician and littérateur, and the recent celebration awakened throughout the world the interest not only of the profession, but also of the entire public. The strains of our still living poet, novelist, physiologist, and, as we all best love to remember him, neurologist, Dr. S. Weir Mitchell,―nihil tetigit quod non ornavit, -as he sung of the "Birth and Death of Pain," have scarce died away before we begin anew our round of celebrations in the anniversary of this now almost venerable association.

A most important factor in the improvement not only in surgery, but also in all departments of medicine, has been the immense advance made in Medical Teaching. The educational plane of the profession has been steadily elevated. If the teachers of fifty years ago were to revisit the scenes of their early labors they would scarcely recognize the medical colleges in which, in their day and generation and with the meagre appliances then at their command, they did what we must still recognize as yeoman's work in education. Apparently, at that time, the entire instruction consisted in lectures, no text-books even being advised. In reply to a letter addressed to the deans of the Jefferson Medical College and of the Medical Departments of the University of Pennsylvania, Harvard University, and Columbia University, I am told that no lists of text-books whatever appear on the catalogues of fifty years ago. In the "catalogue" of the Jefferson for 1857-a mere catalogue of names of the faculty and students, instead of the present elaborate "Announcement" for the first time appears a list of "Books of Refer

ence,' ," and the Dean of Harvard states that there "the first mention whatever made of text-books appears in the announcement of the summer session, beginning March 12, 1866," four years after I graduated! At first the text-books generally recommended on surgery were Drewitt and Erichsen; Malgaigne and Pancoast* on "Operative Surgery," and, for collateral reading, Brodie and Holmes.

The course of didactic lectures then began on the second Monday of October and ended soon after the middle of February, and if we take out the holidays, and remember that not a few made up for coming late by leaving early, it was quite a possibility for a man to receive his authorization to practice, a diploma which alleged him to be "Virum probum in arte medica, æque ac chirurgica dignum amplis

simis honoribus academicis," after practically only two sessions of little more than three months each! The examination was a farce and the diploma a falsehood. Even so late as 1860, when I began the study of medicine, there were no laboratories, except that of anatomy-the dissecting-room. I doubt whether of the two hundred and odd men who graduated with me in 1862, 10 per cent. had ever looked through a microscope or handled a test-tube, palpated a tumor, or auscultated a chest. There were no recitations; neither were there ward classes nor other means for actual contact of the student with disease. We can but wonder that any of us who graduated in the first twenty years of the halfcentury we are celebrating ever learned enough to prevent some from being rivals to Saul, who had slain his thousands, and the more nimble from rivalling David, who slew his ten thousands. That we have become respectable practitioners, or possibly more than respectable, is due not so

*The names of American surgeons are printed in italics, to point out more distinctly some of those Americans who have aided in the development of surgery. The limits of the address only allowed me to name a few, and I must apologize for all the necessary omissions.