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partly unjust, during the Spanish-American War, the sick percentage was 3 instead of 20 per cent. and the mortality was 2 per cent. Even in distant-and as I suppose some would call it-barbarous Manila the mortality was but 10 of 1 per cent. But you may say these were soldiers and sailors wasting the country's substance and not adding to it; to which I reply that for every soldier or sailor who died an artisan or a farmer had to be taken from productive labor to fill his place; every soldier or sailor saved meant that another productive unit was saved to his family and to the State, and a family which threatened to become a charge upon the community was saved from expensive pauperism.
In fact, at the present day we have changed the aspect with which we look at medicine. Doctors thus far have been, and always will be to some extent, for the care of the sick; but to-day the medical profession is for the care of the well-to prevent sickness instead of curing it. I glory in it that ours is the only profession on the face of God's earth, I believe, that is trying to destroy itself.
As I am a surgeon, I have purposely preferred to take my examples from medicine, hygiene, and sanitation, rather than from surgery. But I cannot refrain in passing from calling to your minds also a few of the triumphs of surgery. The dreamless sleep of ether cannot be estimated in current coin of the realm, but what would you offer for its blessed relief were it just beyond your reach? But antiseptic surgery has a definite money value, when the mortality of compound fractures-one of the most frequent accidents, especially among our laboring population-which formerly swept into the grave sixty out of every one hundred of its victims and so often left their families destitute, is now shown to be less than five per cent.; when legs and arms formerly cut off to save life are now saved and their owners restored to the ranks of the breadwinners; when rupture which killed so
many and disabled so many more is now cured with almost no mortality; when diseased conditions wholly beyond the skill of our fathers are now remedied and their victims returned to active life. Translate these facts into figures and tell me then the money value of surgery alone to the American people! One Jenner, one Koch, one Lister, is worth a fabulous sum to the world.*
I should also refer to the commercial value of all the medical work done in animal diseases, such as trichina, which touches man as well as animals, hog cholera, chicken cholera, rinderpest, and all the other local diseases that affect our cattle. Our failure to control and eradicate hoof and mouth disease in cattle cost a single steamship line lately, in its trade to Great Britain alone, $5000 a day profit-and they say "money talks." The researches and improvements introduced by our profession have reduced the losses to the community by millions of dollars every year, because of the prevention of those diseases. But when a man does not lose his cattle, when the loss is only prevented, he is apt scarcely to appreciate what has been done for him negatively.
I think one of the most remarkable things we have observed in our day has been that experimental railway near Berlin, where on an electrical trolley line they have driven the cars up to a speed of 130 miles an hour. Dr. Pritchett has given a most interesting account of it in a recent article in "McClure's Magazine." It seems that the idea began in a Stu
*As though to reinforce what I have here stated, the newspapers on April 11th called attention to the fact that Dr. Daniel Lewis, the Health Commissioner of the State of New York, in his Annual Report to the Governor said:
"If the monetary value of a human life is assumed to be $5000, the deaths from only five of the preventable diseases during 1903 in this State represents a loss of $94,960,000. These figures seem appalling and yet millions upon millions can properly be added to this sum, in loss of wages, expense of the care of the sick, and many other expenses incidental to the management of these epidemic and infectious diseases."
denten-Gesellschaft, a company of students who proposed to study minutely and exactly all the obstacles in the way of rapid transit and the means by which each in turn could be overcome. That they have solved the problem where all the rest of the world have failed we know to-day, and Dr. Pritchett well says in that article: "The research habit once considered so far removed from utilitarian ends, is to-day the greatest financial asset of Germany."
Go around the world and you meet in Japan, in China, in India, in Egypt, everywhere, the familiar label, "Made in Germany." Why should it not hereafter be "Made in America?" When we have acquired the "research habit" and make it our best and most valuable "asset," I believe that this label will surely supplant the other. This "research habit" in medicine is of as distinct value as a financial "asset," as it is in engineering or in commerce.
The third reason that I suggest for increased endowment in medical schools is the genuine and lasting pleasure that it gives to the donors. I alluded but a moment ago to the enormous number of human lives saved to the community by surgery. Let me ask, can there be a greater pleasure to any of your rich patients than to know that he has had the comfort and the pleasure of taking a large part in such a wonderful achievement, a large part in such a superb gift to humanity, a gift far better than any warrior ever gave? Could there be a greater comfort while a man lives, or when he enters the valley of the shadow of death, than to know that his gift to a medical school has done and will always do such untold good?
Most of us work both in hospitals and in colleges. As I look over my own work in the Jefferson Hospital and the Jefferson Medical College, I see in the hospital scores of patients, even hundreds of them every year, who go out happy and in comfort, contented and restored to their families and to wage-earning power, and it is no end of pleasure
to me, as it is to you, my colleagues, to remember such cases. But when I look over the faces of the hundreds of young men that I have the pleasure of teaching, when I remember that I can instill into them high ideals, when I can bring to the birth in their lives this "research habit" and the desire to learn, and think that they will go all over the world and cure hundreds more than I can-thousands more than I can -which work is the greater? The curing of my scores of patients, or the teaching of hundreds of young men to go out to cure their scores of thousands and to bring the blessings of many an exultant wife and many a poor widow upon their heads for the work that they have learned to do through you and through me?
The joy of the teacher, gentlemen, as you know so well, is a joy that is never ending. It is one of those delights that come to us new every morning and fresh every evening, and yields a sense of satisfaction beyond anything else in this world. And if the rich men of this country will only endow our medical schools and so teach through us all of these hundreds of young men that go the world over as heralds of cheer and apostles of health, surely they will enjoy the greatest satisfaction that can be given to any man.
And when we lay us down for the last time upon our pillow, we can all thank God that we have been able to contribute, some by our work, others by their means, to this magnificent gift to humanity.
AGE AND YOUTH IN MEDICINE.*
KNOW nothing more inspiring than a scene like the
present. Before me is a company of young women and young men, recruits in the medical army, anxious to press forward to all the dangers, trials, failures, and successes of a medical life to final victory. My career will soon end while yours is just beginning. I look toward the western setting sun, you greet the eastern rising sun. Mine is the past with its splendid accomplishments, its dismal failures, its disheartening, unaccomplished tasks. Yours is the golden future, yours to renew the attack where we have failed and to win the battles that we have lost, yours to fulfill our unaccomplished tasks. Naturally, therefore, the occasion suggests a contrast between myself and yourselves. Accordingly, I have taken as my topic "Age and Youth in Medicine."
Let me recount briefly some of the wonderful things that I have seen accomplished in the more than three-score years covered by my own life and then glance at what may be in store for you.
First, the geographical and political changes I have seen have been almost kaleidoscopic in their variety and extent. The map of Europe has been re-made. Since 1859, the year that I graduated from the University, Italy has been recreated as a united kingdom. This new political life has been followed by a wonderful intellectual revival, so that Italian medical science and letters to-day have won an enviable place.
* Address at the Commencement of the Medical Department of Cornell University, June 8, 1904. Reprinted from the Medical Record, July 30, 1904.