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of the American spirit exhibits itself. It begins at the base and culminates above. The political powers in Europe were interested in having ignorant masses and a few learned men; for that reason the universities were older than elementary schools. These latter had great pains in getting started. The universities organized elementary and higher schools on their own system and perverse principles. But in America, people thought first of initiating a general popular instruction; they cared not so much for learned individuals as for a cultured people." Much of his time and labor was spent on public institutions. He was one of the surgeons of the Brooklyn City Hospital, the German Dispensary, later of the German Hospital; of the Mount Sinai Hospital, the New York Hospital, and in 1874 and 1875 in Bellevue. Here he resigned on account of what he considered and publicly proclaimed as the faithlessness of the board of governors, who after having solemnly bound themselves to organize the great institution on the lines proposed by the medical board, broke their promises at the first opportunity.

While he studied and recognized man as a link of all creation, he revered medical science as comprehensively connected with all scientific facts, no matter where found and whence collected. Thus, while he was eminently a humane and a practical man, in order to be so he was erudite, in the full meaning of the word. It was the erudition of his which proved one of the principal charms in his medical career. He was conversant with medical science in almost all its branches. Thus every word of his, when he participated in a discussion, was fraught with solid contents. He was one of our best pathologists. His counsel was sought in medical cases as in surgical; in practical politics of the city and state as in practical medicine.

In his views he was universal. He was just as removed from looking on medicine as a business as on a tissue of conjectures or possibilities, or a merely sentimental vocation. He was as well acquainted with the history of medicine as with the anatomic and physiologic points of a diagnosis, for the embryology of medical science was

of as much importance to him as that of the human being. He thought just as little of men who did not care for the fathers of medicine as he would have thought of an American who did not know the fathers of his country. For George Washington and Jefferson are of no vaster importance, politically, in the history of the world, than Harvey or Bell in that of medicine.

When he died, and after his death, I have often wondered which six men in the profession could or would fill the place he left vacant. H. B. Sands was as good a surgeon; W. H. Draper was as eloquent, as classic, as erudite; Alonzo Clark was as elegant and as full of knowledge such as Anglo-Saxons had furnished to the medical profession; Austin Flint was as painstaking and industrious, --but who was there with as wide a horizon, with absolute impartiality, who to equal his eagerness, to give his time and means, and strength, to the service of the profession, the community and mankind, his harmony of brain and heart, and his wonderful unselfishness. He was, and was called, a specialist with all that. Go, and do likewise.

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MONISM IN MEDICINE

Now that I have partaken of your dinner and enjoyed my neighbors and, I beg to apologize for becoming personal, the atmosphere of my surroundings, I begin to doubt whether I am in my proper sphere at all. Still I mean to have and to hold the floor, but not long enough to make you wonder why I do so. After all, however, you will have to be satisfied with fragments, since I have found that for lack of time an ample exposition of what I mean by monism in medicine and in the profession should not perhaps have been undertaken at this occasion. Still, as there should be nulla dies sine linea, so there should be no meeting of scientific men without some serious purpose, for life is short and opportunities are fleeting.

You understand me when I say that you and I as men and as medical men are ten thousand years old-we are twins, brothers, equals, call it what you please. The prehistory and the history of the world, unpleasant as it has been sometimes, and the reverse of ideal, has been from century to century an evolution in the direction of civilization and culture-which it may be said, many, after all, look upon as still barbarism. As medical men we stand on the shoulders of our ancestors; and we, from immemorial time on, belong to a family whose younger members enjoyed the results of previous experience or labors, and then again left to their successors untold problems. see monism, or at least a monistic tendency, in all that has gone before in the history of the world of medicine; I see unification, union working to a common end, monism as the underlying, unconscious power.

There is, however, no such thing as an unbroken progress. Progress is interrupted by relapses. Even great revolu

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tions never reach the end aimed at. Look at the great French Revolution, beginning in 1789, the German Revolution of 1848, and our own abolition of slavery. After each there was a period of reaction which threatened to do away with all the results of each of the great convulsions. To its full extent, that is fortunately impossible. No Bourbonism in politics and science was ever entirely successful. You might as well try to undo the results of a volcanic eruption. But every progress, whether obtained gradually or eruptively, leaves an improvement upon former conditions. Even stealthy peonage and anti-regro barbarities are better than legalized slavery, for during the latter everybody -the whole body politic-was criminal; the former are upheld by a minority only.

As an example of a gradual, though ever so slow evolution in the direction of union and monism, medicine stands foremost among the composite sciences. In antiquity we meet simply empiricism, soon combined with and preempted, as it were, by priesthood. Even Machaon, in Homer, was a priest; the Egyptian physicians, numerous specialists for every part of the body included, were laymen. The old Jewish healers were priests; the main healing places of the Greeks and Romans were neither dispensaries nor hospitals, but the temples of the gods. That is why now and them a patient of yours will tell you,even in the twentieth century-that after God he has confidence in you, as being able to give him calomel or cut his carbuncle. The priesthood, according to their privilege or business, introduced into medicine mysticism, superstition, and miracles. In that respect the priesthoods of all ages are alike. Unfortunately, the crystal-like clearness and directness of Hippocratic thinking and teaching were counterbalanced by the dualistic philosophy of Plato and Aristotle; these two influenced the medicine of medieval periods in spite of the teaching of the Arabs who had inherited from the school of Kos and Knidos. Plato and Aristotle controlled medicine for nearly 2000 years. Their dualistic philosophy, continued by Descartes, was the exact thing to suit both church and state, which relished nothing more keenly than the breaking up of the human organism

into body and soul, into the pestilent carcass and heavenborn spirit, and the absolutistic ruling of the material world through the plea of taking care of the future of the soul. It is not forty years since the Superintendent of a Foundling Asylum to whom I spoke of its 100 per cent. mortality, told me: "You know, Doctor, we care more for the souls than for the bodies." Another little example of modern times, teaching the calamitous influence of positive religions upon medicine is the following: When the great surgeon, Dupuytren, had an empyema, he was told to have it opened, and he replied that he preferred to fall into the hands of God rather than that of man. So he did fall into the hands of God in the year 1835, only 57 years old. Mind, that was in the nineteenth century, when the hands of Lænnec's successors, Andral, Piorry, Louis, could have been had for the asking.

The medicine of every period of history is sure to filter slowly into what euphemistically is called the brains of the lay community. The medicine of past centuries reappears in the popular medical creed of the people of the present time. That is why you have to meet amongst your patients the beliefs we have outgrown in the healing powers of human urine, or of the water of amber, made by Paracelsus out of cow dung, or the infinitesimal dilutions, or -what is not much better-in the ubiquitousness of diseases attributed to worms and dentition. It is not long since what is called Christian Science, witchcraft, and the evil eye, have disappeared from the etiology of both doctors and some laymen.

Things began to change in earnest when biological methods were introduced into the study of medicine, mainly by Virchow in Germany, when France had to give up its superiority established since Bichat. It was still the time, however, when they, or rather we, spoke of national, Anglo-Saxon, French, German medicine. Without going into particulars, I simply direct your attention to the Homeric laughter that would burst upon you if someone would speak of German or French physics, or chemistry, or Anglo-Saxon astronomy, or geology. If at present we should speak of national medicine we should merely admit

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