its personnel & large number of notable personages, and is rapidly extending its membership throughout the country. Full details regarding the Service and its great work may be obtained by addressing Director General Pilcher at Carlisle, Pa. The Lakeside Hospital Medical Society met on Wednesday, May 27, 1908. The following patients were shown: A Case of Large Luetic Perforation of the Nasal Septum and a Case Showing the Result of Radical Operation for Frontal Sinus Disease, W. B. Chamberlin; A Case of Rheumatism with Marked Formation of Subcutaneous Fibroid Nodules, B. C. Barnard; A Case of Epithelioma of Penis in a Man aged 28, and a Case of Traumatic Rupture of the Urethra, I. A. Fuhs; A Case of Obscure Arthritis in a Girl aged 13, B. C. Barnard; A Case of Coxa Vera with General Marked Bony Deformity, E. F. Cushing; A Series of Cases of Pericarditis, with presentation of a patient, C. L. Cummer; A Case of Gangrene of the Leg from Thrombosis, Complicating Typhoid Fever, J. R. Beiter. The following paper was presented: Some Further Experimental Work in Severing the Pelvic Vessels in Bitches and its Bearing on Ruptured Ectopic Pregnancy, Hunter Robb and F. C. Ainley. Presentation of Pathologic Specimens, J. H. Hewitt. The June meeting was held on Wednesday, June 24. The following patients were shown: A Case of Adduction Paralysis in a Tabetic, W. B. Chamberlin; A Case of Pott's Disease of the Upper Dorsal Region; A Case of Bowlegs with both Anterior and Lateral Curvature, and a Case of Osteomyelitis with Extensive Removal of the Tibia, H. O. Feiss; A Case of Brain Tumor without Localizing Symptoms, C. W. Stone; A Case of Sarcoma of the Antrum Showing the Result of Operative Treatment, I. A. Fuhs. Report of a Case of Nasal Diphtheria, W. B. Chamberlin. The Use of Sulphosalicylic Acid as a Testing Reagent for Albumen, E. Lowthian. Report of an Interesting Case of Spinal Lues, C. W. Stone. Exhibition of Pathologic Specimens (1) Purpura Occurring in Lymphatic Leukemia. (2) Tuberculosis of Endometrium in a Case of Tuberculous Meningitis. (3) Ball-Valve Thrombus in Mitral Obstruction, J. H. Hewitt. The Alumni Association of the Medical Department of Western Reserve University held its annual meeting in connection with the sixtyfifth annual commencement of the Medical College, Wednesday, June 10, at the College Building. Following the meeting a banquet was given. It was decided to hold an alumni meeting and have a table hereafter at the banquet during the National meeting of the American Medical Association. The following officers were elected: President, J. G. Spenzer; Vice-Presidents, B. E. Garver and P. King; Corresponding Secretary, E. H. Season; Recording Secretary, J. B. Austin; Treasurer, A. H. Bill. Reunions of the members of several classes were held. The oldest graduate in attendance was a member of the class of 1859, although there are members of classes back to 1844 still living. The total attendance at the Alumni meeting was large and was one of the most successful meetings in recent years. The sixty-fifth Commencement of the Medical Department of Western Reserve University was held in connection with the Commencement of the other departments of the University on Thursday, June 11. The graduating class consisted of 31 men, being the largest class to graduate for the past five years. The following are the members of the class: Charles J. Albl, Siegfried Baumoel, Oliver P. Bigelow, A. B., Robert H. Bishop, A. B., Courtland L. Booth, A. B., Jacob G. Brody, Ernest R. Brooks, A. B., Robert S. Campbell, A. B., Samuel C. Hotchkiss, A. B., Archibald N. Dawson, A. B., Perley H. Kilbourne, A. B., John Dorsey Knox, A. B., Elvin L. Lowthian, A. B., William C. Martin, A. B., Brown S. McClintic, A. B., Arnold Minnig, A. B., Rudolph J. Ochsner, B. S., Geo. B. Parisen, B. S., Lawrence A. Pomerov, A. B., Harley J. Powell, Ph. B., Homer P. Prowitt, B. S., Claude E. Price, A. M., Homer G. Scranton, Henry H. Skinner, A. B., Orvall Smiley, Aron M. Swados, Arthur M. Tweedie, B. L., Charles W. Wendelken, B. S., Cecil O. Witter, B. S., Chauncey W. Wyckoff, A. B., Noah Zehr, A. B. The majority of these men have received hospital appointments for the coming year. On Monday evening, May 13, 1908, at the monthly meeting of the Charity Hospital Medical Society, the death of Rt. Rev. Ignatius F. Horstman, D. D., was announced. A special meeting of the Society was called to order, directly after the close of the regular meeting, and the following resolutions were passed. Whereas: The Rt. Rev. Ignatius F. Horstman, D. D., Bishop of Cleveland, always manifested a deep interest in the welfare of the medical profession, and especially in the various hospitals with which he was affiliated, and gave his personal as well as financial support not only for the relief of suffering humanity but also for the advancement of medical knowledge; and Whereas: The death of Bishop Horstman is a great loss to the medical profession and to the various hospitals, especially St. Vincent's De Paul Charity Hospital of Cleveland, now be it Resolved: By the Charity Hospital Medical Society that we do hereby express our appreciation of the services of Bishop Horstman to our Society and Hospital and extend our sincere sympathy and sorrow to those immediately associated with him, and to the Diocese of which he was Bishop; and be it further Resolved: That these resolutions be inscribed on the minutes of this Association, and a copy of these resolutions be sent to the Administrator of the Diocese of Cleveland. Deaths Harry Blackford, of Middletown, died June 8, aged 41. The Cleveland Medical Journal VOL VII AUGUST, 1908 Medical Ethics By FREDERICK C. SHATTUCK, No 8 Jackson Professor of Clinical Medicine in Harvard Medical School, Boston, The subject of my remarks this evening is not of my choice. It was assigned me by the higher powers for reasons I do not presume fully to understand. I cannot believe that you are peculiarly in need of instruction in medical ethics, and I know that I am not specially qualified to give it; but having from my youth been brought up in habits of obedience I cannot break away from early and long training, and-you must take the conse quences. Of several definitions of ethics in the Century Dictionary, I have selected the following as perhaps best meeting our requirements of the evening as I conceive of them. "Ethics is the doctrine of man's duty in respect of himself and of the rights of others." Ethics thus formulates right conduct and aids us to see the light; but we must constantly strive to be led by it. Intellect and character are very different qualities, too rarely coexistent in their higher degrees in the same person. One or the other may be highly developed, or less or more atrophied, congenitally, from disuse, or both. He whose unclouded vision sees things just as they are, including the right and wrong of almost any and every question may, allowing himself to be dominated by love, ambition, avarice or some other passion, with open eyes choose a low Per contra, he whose intellect, which may be acute though narrow, fails to grasp the true relation of things, may, course. An address to the students of Western Reserve University Medical College and the Academy of Medicine of Cleveland, April 25, 1968 subduing all passion and apparent self-interest, act nobly, even if, with a mind more logical than clear, false premises lead to false conclusions. History affords examples of either extreme, as well as a few of that harmonious balance of intellect and character, which, in General Washington, has so impressed the world, and as long as man works upward must remain a living force. Standards of ethical conduct-that is, conduct which not only tends to the development of individual character but also to that of the well-being of the race-have undergone considerable evolution, the most potent single influence which has been brought to bear upon them being Christianity. “An eye for an eye and a tooth for a tooth" of the Judaic, is supplanted by the offering of the other cheek to the smiter, of the Christian dispensation. Taking the world as a whole, even today, external standards vary enormously with the degree and kind of civilization-and its lack-with the religion and organization of society, the physical peculiarities of a country, the density of population, means of communication and a thousand other things. With us a state of relative fixity has been reached. A homely illustration of the state of flux which obtains elsewhere is afforded by the war-like people of Portugese East Africa, the Masai, dwindling in numbers and in power. When the white man first came into contact with them a few years ago their mode of friendly greeting was to spit in the face of the person greeted. This custom— and every custom has its ethical side-has now given way to the handshake of the European, so Patterson tells us. I have tried to find out the origin of handshaking; but nothing certain appears. There is plenty of theory, but the custom is evidently one of great antiquity and of unknown origin. The more complex society becomes, the closer knit by applied science, the more organized gains on individual action, the more numerous are the restrictions which must be placed on the individual for the benefit of society as a whole. That which may be perfectly right and proper for the savage, or even for the civilized man in the wilderness, may be highly reprehensible under other conditions. All this may be trite-I shall not complain if you say too trite. We are all agreed that as men we should so live as to cultivate our intellects, to enlighten our consciences, to strengthen and elevate our characters, and, in as far as in us lies, to promote the well-being of mankind. This is practical ethics. What, then, is medical ethics? Has an adjective any place in ethics? If so, why? Cannot all practical ethics be summed up in the Golden Rule? Yes and no. It can be so summed up, but rules based on analysis are useful as short-cuts, promoting the rapidity of decision as to right conduct in concrete cases which may seem, or really be, complex. Every calling involves some peculiarities of relation to other persons, which adds to or modifies the restrictions imposed by general ethics. I have heard a stock-broker say that brokers, as a class, are the most honest men in the world, a simple word or nod being absolutely binding. But is not this due to the necessities of the business rather than to a sudden accession of spiritual grace which resides in and emanates from the seat in the brokers' board to each successive owner thereof? Were contracts thus apparently loosely made not inviolable, the business as at present conducted could not be transacted. The peculiarly intimate relations, especially with female patients, involved in the practice of medicine necessitate a very strict standard, lapses from which are less pardonable to the doctor than to men of any other calling save the priesthood. This has been recognized from very early times as we shall see later. The French law, it would seem very properly, pronounces void a legacy from a patient devised during the illness to the physician in charge of him during the same. Neither in this country, England or Germany is there any such legal provision, and it seems to me to speak well for the integrity of our profession that physicians with us are so seldom legatees of their patients. History tells us that everywhere in early times the priest and the physician were one, and so it is today among many primitive peoples. In the absence of knowledge superstition rules, and as long as illness is regarded as a demoniac possession the priest is naturally the medicine man and lays down the rules for his conduct. When the mind gets to the point of coldly collecting and collating facts and of recognizing that they are the masters, not the servants, in all matters open to observation and experiment, the care of the soul and of the body cannot remain in the same hands. The Babylonian Code of King Hammurabi, 2287-2232 B. C., contains 282 sections. Nine of these apply to medicine, four to veterinary medicine. This is, however, a legal code, and the medical sections deal only with fees and penalties. The whole code reveals a remarkable state of civilization at the time, but |