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It frees him from accident, sickness, and suffering, to which his body has been liable all his life, and from which he has often suffered, sometimes intensely and for long periods of time.
It frees him from all sorrow. No one who has reached even adolescence escapes sorrow. To many, sorrows are multiplied manifold and bear down even the stoutest heart. The "weary" and the "heavy laden" make up the mass of mankind.
It opens the gates of heaven to him. While we know nothing accurately of the details of the heavenly life, we do know that there we shall live in eternal bliss; there we shall be in the presence of God himself; there we shall see and know intimately our Lord Jesus Christ; there we shall feel the influence of the Holy Spirit; there we shall meet the saints of all ages; there we shall be reunited to the dear ones who have happily preceded us; there shall come in due time the dear ones we have left on earth; there our minds will expand beyond our present comprehension; there all the unsolved problems of earth will be as clear as day; there we shall learn why perplexity, disappointment, and trouble were our lot on earth and were needful for the orderly and sufficient development of our own character, and of God's large plans not only for us, but for the race; there, in a world, all that is evil shall vanish away and all that is good shall be ours forever.
If death, then, is not a painful, unpleasant process, and if it does for us so much, it should be, not the last enemy, but our best friend; not dreaded as the messenger of evil, but welcomed as a companion who will lead us into paths of pleasantness and reveal to us the joys for which we have been longing all our lives. We shall not speak of the terrors of death, but should feel in our very hearts the cheerfulness of death.
THE NEED FOR INCREASED ENDOWMENTS FOR MEDICAL INSTRUCTION.*
URGE "The Need for Increased Endowments for
T Medical Instruction is entirely superfluous before this
audience. It consists of a large number of doctors who know only too well the need for endowment for their own and for every other medical school in this country. I can only repeat, therefore, in part what I have said elsewhere,† adding somewhat to it, perhaps, in the hope that you will repeat it to others, your patients and friends, whom you may persuade to give liberally. It is for the purpose, therefore, of concentrating your thoughts for a few moments upon the question of the urgent need of such endowments that I ask you to listen to me.
I base the need of endowment of medical schools by the general public upon three grounds:
First. The costliness of modern medical instruction.-If you look at any large medical school of the present day you will find a very different state of affairs from what we had when I began the study of medicine. Then we had two lecturerooms between which we swung like a pendulum, seven men who talked to us in one great mass for an hour at a time for two years on precisely the same subjects-and that was all. To-day you need a large medical building, you need a large hospital, you need a dozen laboratories each with a costly. equipment and with a large number of assistants. You need, as President Eliot has so well pointed out, individual in
* An address at the complimentary dinner tendered to Dr. D. B. St. John Roosa, in New York, March 1, 1904.
† Presidential Address before the American Medical Association, p. 295.
struction; not simply lectures to a large class without illustrations and without laboratory work; but small classes of ten, fifteen, or, at the most, of twenty, and individual instruction in the laboratory for every man. When I began the study of medicine in 1860 at the Jefferson Medical College there was no hospital, and from the faculty down to the janitor the number of those who took part in instruction. numbered less than a score. To-day in the Jefferson College and Hospital, and its dozen laboratories, we have over eleven score of instructors, an increase of over eleven hundred per cent., observe! And these men must be paid, and the men in the theoretical branches, who have not the means of making additional income by practice, must be paid large salaries so that they will be able to give their whole time to the medical school. Yet the fees paid by the students have been less than doubled, that is, increased less than one hundred per cent. against an increase of eleven hundred per cent. in the teaching force!
The medical fees are practically as large as we can make them. The expense, therefore, of modern medical education must be borne largely by endowment. Just exactly as in the academic department of our universities we need great endowments to eke out the insufficient incomes derived from the fees of students, so in our medical schools we need large endowments for the same purpose. Compare, for instance, the theological schools of this country with about 8000 students, in which the average endowment for each student is $2250, with the medical schools attended by 24,000 medical students with costly laboratories, hospitals, and appliances that theology does not require, and a paltry endowment of $83 per student!
The second reason for generous medical endowments from the public is the commercial value of the medical profession to the public. I am not speaking now of the value of health to everybody, or of our cherished desire for the health of those
who are dear to us at home. I am not speaking of the kind father that may be lost to a young dependent family, of the loving mother that cares for them, of the dear child whose place can never be filled in our hearts or homes-I am speaking, mind you, of the mere sordid commercial value of the profession to the community, that is, its value to the community in hard cash-dollars and cents. Let me refer to this somewhat in detail.
It is only a few years since quarantine was one of the most horrible things we could imagine. To-day, practically, quarantine has been almost abolished by reason of the researches and work of the medical profession. We no longer fear cholera, the plague, or yellow fever, or even typhoid fever, as we once did, because we have exterminated the rat, we can quarantine or kill the mosquito, we have corralled the fly, and we are filtering and boiling our drinking water. By the most patient scientific laboratory work all these things have been shown to be needful and efficient as the chief means for the prevention of disease.
But a few years ago a single case of cholera or yellow fever down yonder Bay would have meant the loss of millions of dollars to your merchants; but to-day, as has been shown in your hospitals, cases of cholera, or yellow fever, or even of plague, that might and do occur, scarcely create a ripple of excitement because the community knows that your able medical men have these diseases by the throat. Dr. Reed and his fellow-workers in Cuba have accomplished an epochmaking work. For the first time in one hundred and seventy years Cuba has been made free and kept free from yellow fever, and the merchants of New Orleans, of Mobile, of Norfolk, and of New York are reaping the benefit of this unselfish labor in hard dollars on the credit side of their accounts.
The horrible character of the plague we scarcely appreciate. In the fourteenth century twenty-five millions of human beings lost their lives in Europe alone, and even to-day
among the ignorant people of India over two hundred thousand human beings a year are offered upon the altar of the plague. But we are beginning to see a brighter time. Haffkine's inoculations have diminished the susceptibility of the people by seventy-five per cent. and have diminished the mortality in equal proportions; and I believe that the time is coming when the plague, like yellow fever and small-pox, will be practically wiped out.
Again, we do not appreciate what small-pox was in the past. In the eighteenth century sixty millions of people died from small-pox in Europe alone, and in addition to that almost all the living were left with the ravages of the disease marked upon their persons. Before that memorable day when Jenner inoculated young Phipps, it was as uncommon in the streets of London to see a person not pock-marked, as it is to-day to walk down Broadway and see one who is pockmarked. In Russia alone, in the year of Jenner's splendid accomplishment (1796), two millions of people died from small-pox.
I said a moment ago that I would consider only the sordid commercial value of the labors of the profession to the public. Consider, therefore, what all these millions of saved lives mean in revenue to the State, in revenue to the family, in the prevention of pauperism, in the comfort of human beings: then we begin to appreciate in some degree the value of the services practically of one man, the most magnificent benefactor of the human race that ever lived, Edward Jenner.
In 1890 there were 156,638 unnecessary deaths in our large cities because of defective sanitation. For the ten years from 1886 to 1895 the average death-rate in New York was 25.18. The sanitary reform which followed that year saved in 1895, 3758 lives; in 1896, 7736; and in 1897, 9920-a total of 21,414 in three years. As there are an average of twenty-eight cases of sickness for every death, sanitary