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lectures, cheap newspapers, and periodicals, and books are educating the people continually. The scepticism of the age is not afraid of the new and startling. Tendencies are prove all things, and hold fast to that which is certain. Prophets are not without honor, even in their own country. The cry.of Sir Thomas Bodley to Bacon, “ A fresh creating new principles of sciences would be, to be dispossessed of the learning we have,” is not heeded. Withal, there is no recklessness or immaturity in statement of theory or discovery. It has been said that genius is patience; certainly patience has characterized these later investigators. Whatever the subject, all forces and all knowledge are summoned to their aid. The testimonies of the rocks, the sky, the sea, the buried city, the exhumed remains of animals, are brought to prove their propositions. We are told that Darwin waited thirty years from the time of his first conception of the thought of natural selection before he published the matured “Descent of Man.” Buckle spent a whole life-time of toil and unwearying labor to accumulate material for a hypothesis, which is but shadowed in an introduction. The thousand uses to which steam and electricity and water are being put every day, are the results of countless experiments and untiring perseverance.

The utter devotion which Science demands of her followers has been rendered, and, in return, their voices have been listened to: disciples have gathered around them; rewards have been given in istinted measure. All theories have not been accepted unchallenged, but controversy has been enlightened and tolerant.

In this life-time of a generation of men, which has also been the life-time of this Association, what has been accomplished under its influence, amid all this restlessness and activity and earnestness? The purposes of the organization as expressed at the preliminary convention were to cultivate and advance medical knowledge; to elevate the standard of medical education, and to promote the usefulness, honor, and interests of the medical profession. It is a source of congratulation that a spirit of harmony and friendship has characterized its annual assemblings, and cordiality and good feeling existed among its members.

The interests of medical science have been uppermost in your minds, and a feeling of common brotherhood has bound you in a bond of sympathy. This is peculiarly an institution of the profession, by the profession, and for the profession. It is truly democratic in its workings; its doors stand wide open to the worthy, and by its laws every reputable physician in the land can be heard, either in person or by representative, upon all questions within the objects for which it was founded.

Have the hopes indulged in at its inauguration been fulfilled? If we listen to some carpers, who speak disparagingly of our efforts and progress, or to the murmured disappointment of others who expected too much at once, our reply would be despondent. But, I rejoice to say, such is not the feeling nor the voice of the profession generally. It may be granted that everything aimed at has not been accomplished; but certain it is, the Association has been an active and powerful agent in disseminating useful medical knowledge, and no similar institution has ever been more successful in carrying out its chief object—the promotion of science. It was appreciated at the time, that the work undertaken was difficult, and would require time, labor, sacrifices, and united effort to accomplish. There was no organization, but few medical societies were in existence, and their influence was slightly felt. Each society or community of physicians was a law unto itself; there was no medical code acknowledged as binding and to which all could appeal. The medical literature of the country was in its infancy; there were comparatively few professional works, and, of these, scarcely any were by home authors. The medical mind was conservative, inert, slothful. This Association arose, and a new order of things obtained. An eager desire for promised improvement and reform was awakened. State, and county, and city societies were formed in every State in the Union. The annual meetings of this body have increased in importance and usefulness, until the American Medical Association occupies an advanced position, not only among philosophical associations, but also among the deliberative assemblies of the world. The subject which has engaged most of your time and attention has been that of medical education and reforms in medical teachings,-one well worthy of all the talent, and thought, and energy devoted to it by some of the ablest and most erudite scholars of the age. No language is too strong to express its importance to the profession, and the well-being of society; no iteration too frequent to spur on endeavor in this cause. The reports of committees, as published in our annual proceedings, must convince every one of the great consequence of effort in this matter. Much has been accomplished. Medical schools have been founded and the curriculum of studies been extended; the standard for admission to the profession raised. Finally, to put into effect the many devised and conflicting views offered year after year without any practical result, the idea of the Medical College Association was adopted, and its subsequent organization effected, as the best supposed means of carrying into operation the wishes and objects of this Association. It may be that association has not done everything anticipated by its most sanguine advocates; but it cannot be denied that through this instrumentality many and important changes calculated to advance and elevate medical education have been made. Experience and experiment will give increasing assurance of its value. Its certain success is only a question of time. But going beyond this vexed question of education, much has been done for science. The thirty-two ponderous volumes of your porceedings speak for themselves; containing contributions from many of your thousands of members, representing the medical faculty of every State and Territory, which have attracted attention and stimulated thought both in this country and abroad.

I am satisfied that a brief enumeration of the valuable additions to our literature during the last ten years, as culled from these books, would astonish even those who have been regular attendants at our meetings. Want of time, and the limited scope of this address, will preclude me from more particularly directing your attention to the many original essays, monographs, and reports that can be read with interest and profit by the profession. All through these luminous pages are the evidences that our members have been imbued with the spirit of curious inquisitiveness which characterizes our times, and have made signal additions to the great mass of facts and knowledge which every day is enabling us to dispel some shadow or lay bare some mystery. You have made certain your standing in that great army, whose mission is to combat and conquer disease, and improve the condition of man, and whose power is increasing every day. And, in my opinion, no body of scientists in the world has done more in this direction and in the worth of their contributions to medical legisla

It is also reasonable to believe that these assemblies,

with their interchanges of thought and imposition of duties through sections and committees have been powerful stimulants to the production of original works.

The establishment of a medical journal, in lieu of the present annual volume of Transactions has been brought to your attention so frequently, and the subject was so ably presented by your honored President* at the meeting held in New York, that it seems a work of supererogation to mention it so soon again, especially as the report of the committee read at our last meeting was so convincing that further argument in its favor seems wholly superfluous. I sincerely hope the able committee, which now has the matter in charge, will see their was clear to an earnest, unanimous, and persuading recommendation for adoption at this meeting.

To this Association belongs the honor of introducing to the attention of the people of the different States the importance of sanitary laws. That your efforts have been in a great measure successful, is evidenced by the popular appreciation of sanitary organizations. Legislatures are now directing their attention to the framing of laws bearing upon questions of hygiene and state medicine as to one of their legitimate and necessary subjects for regulation, and boards of health for States, cities, and hamlets, are increasing on every hand. The establishment of a National Board of Health was a natural result from the repeated and persistent recommendations and the urgent demands of this body, speaking, as was seemly, with the voice of authority. Whilst referring to this matter of sanitation, there is one important subject deserving your most serious attention. That terrible scourge, the small-pox, has recently been declared by the National Board of Health an epidemic in this country. The deaths from this malady are comparatively enormous, and there should be no occasion for this great mortality. Vaccination and re-vaccination, duly performed and under proper conditions, are considered nearly a certain prophylactic. The people, as well as the profession, have been neglectful in this matter. Many who admit the advisability are criminally careless, and others from ignorance and superstition refuse to take advantage of this preventive. Some way should be arrived at whereby the lives of the masses of the people may be protected from the deluded or

* L. A. Sayre.

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obstinate individuals who neglect this great boon for saving human life. If possible, provision should be made by law for universal vaccination. It may be argued that compulsory vaccination would be an infringement of human rights. But this position is untenable. Governments are established and laws enacted for the protection and happiness of the greatest number of the people. The liberty and free action of the individual should be interfered with as little as possible. But something of natural right must be given up to the State; some restrictions must be placed upon all. Some trades can be carried on only in certain places and in certain manners. Property rights have to be violated for the common weal. Houses are blown up to save disastrous conflagrations. Trade is impeded and commerce delayed by quarantine laws. The yellow flag of pestilence and the cross-mark of danger are exhibited in infected neighborhoods, and the inhabitants confined to those quarters. The compulsory education, to a certain standard is conceded to be proper in the freest, most liberalized, and most enlightened countries. The principle seems firmly established that it is the duty of the State, in its effort towards the highest civilization, to pass laws whose object is to stay disease, to prolong human life, to prevent the recurrence of those plagues and pestilences which have their seat and growth among barbarous nations, and to cultivate within reasonable limits the mental nature of the subject.

At various times the attention of physicians has been called to the propriety of efforts for the relief of their medical brethren, disabled and helpless, and especially for assistance to the widows and children of those of them who, after lives of sacrifice, and exposure, and danger, die, leaving no legacy to their families but the sweet-smelling record of their unselfish lives. We see the contrast around us in the establishment of aid societies by other professions and in the numerous benevolent societies, notices of which daily crowd our newspapers. Without amplifying the subject, it seems to me that a deliverance upon it, setting forth its advantages and devising a common scheme for operation, miglit be the means of accomplishing much good and removing an ever-present anxiety from the life of many a struggling brother.

We have a code of medical ethics, the best ever given for the government of medical men, of acknowledged force and

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