ANNUAL ADDRESS BEFORE THE SAN FRANCISCO MEDICAL SOCIETY, DELIVERED PURSUANT TO APPOINTMENT November 9, 1869. By H.EXRY (HBBONS, M. 1) PUBLISHED BY DIRECTION OF THE SOCIETY. CLAKk Sax FRANCISCO: SHOOK AND JOB PKINTEK. [ /// Clay Street. ' 1 8 fi 9. ANNUAL ADDRESS BEFORE THE SAN FRANCISCO MEDICAL SOCIETY. DELIVERED PURSUANT TO APPOINTMENT rr November 9, 1869. 1IBB0 By HENRY GIBBONS, M. D PUBLISHED BY DIRECTION OF THE SOCIETY. rL%> SAN FRANCISCO. CLARKE, BOOK AND JOB PRINTER, 411 Clay Street. 1869. ADDRESS. San Francisco ought to be a healthy city. With straw- berries at Christmas and overcoats in July, we have no summer, and our winters are never wintry. The sea-breeze may make us shiver and cough, but it purifies the atmos- phere. It precludes that frightful infantile mortality from enteric diseases which always comes with the heat of sum- mer in tlie^Atlantic cities. The flat south of Market Street is deemed malarious. Along the water front, hydrogen sulphide from the dock-mud blackens the paint on the signs, but does not engender disease. Perhaps it kills the ague- plants of Professor Salisbury. Practitioners in this city can not have failed to notice the very large number of deaths among children which they are required to verify without being responsible for them. The early stages of disease are allowed to pass unheeded, sometimes through sheer neglect, sometimes through want of faith in doctors. Many people appear to think that the study of the Healing Art disqualifies for the practice of it; they prefer any ignoramus, male or female, to a regularly educated practitioner. Parents afflicted with this perver- sion of common sense, are reluctant to employ a physician for their sick child. They give liap-hazard doses by advice of the old lady next door; or they macerate the patient in water; or they dispense inoffensive sugar from their own medicine chesfc, so called—for all this costs nothing. So they let the curable stage of disease go by, and then send for the doctor, that the patient may die in his name. 4 Sometimes they throAv aAvay the last anchor by taking counsel of their want of faith, and failing to enforce the treatment thoroughly. Thus lack of confidence in the doc- tor deters them from giving him a chance to save life. Some very intelligent people are in this crowd—intelligent in regard to cabbages, poultry, phrenology, psychology, and all that. There are tAvo noteworthy facts in this relation, not easily reconciled Avith each other. One is, that many children in San Francisco and no doubt in other parts of California, are permitted to die, or which is equivalent, to pass beyond the point of cure, for fear of a doctor's bill. The other is that the bill in such cases, notwithstanding the laclnymation excited by it, is not apt to be paid. The services of the doctor are deemed Avortliless to the patient, find the doctor finds them worthless to himself. In all neA\dy settled places and border countries, where a miscellaneous population are tliroAvn together, many of hem homeless, reckless, and intemperate in every respect, human life is cheap, and a substantial per centage of mor- tality is due to causes not operative in older settlements. It is especially so with children. They come faster than they are Avanted. They are often superfluities, and not only that, but in the Avay—nuisances. This may look like a libel on some of my neighbors, and even on human na- ture. But it is true, nevertheless. There can be no doubt that many children are allowed to die every year because they are in the way. The interests and the affections of the parents run in other channels. It is not easy to cor- rect this evil. Let us hope that it Avill correct itself by and by. Nor do children alone suffer from this Avant of confidence. Confidence is a valuable medicine. Its remedial opera- tions are poAverful and diverse. It is an efficient stimulant. It stands at the head of nervous sedatives. It has active antispasmodic and anodyne qualities. It is sometimes better than iodine as an alterative. "Without it, our art is often impotent. Confidence means hope, and want of it L> means despair. The Physician of Nazareth could perform no mighty works among a certain people because of their unbelief—their want of faith—of confidence. When a patient is impressed with a presentiment of death, it is regarded as a bad symptom. And why? What is there portentous of evil in the anticipation of death, Avhen it is contemplated ^vitli indifference or com- posure ? The ansAver is obvious. The stimulus of Hope is wanting, even though Despair, AA-ith its positive depres- sion be absent. It is not suprising that so many people lack confidence m regular medicine. Our profession lias all the sins of tAvo thousand years to carry. Of this, every new sect takes advantage, and depends for its existence and growth on the subversion of the old—like parasitic vermin, ungratefully tormenting the animals they feed on. All forms of empir- icism combine with all forms of irregular practice in fo- menting prejudice against the regular system. Certain '' drugs " are singled out for abuse, and serve the purpose of the Negro and Chinaman in politics. Calomel and antimony and all mineral remedies are gibbeted as poisons, by schis- matics who employ vegetables much more potent. Quinine has terrors for multitudes who SAvallow it under another name. Careful mothers who have a dread of opium and morphia, dose their infants with "soothing syrup !" In the form of secret and patent medicines, people swallow lovingly the poisons Avhich tliey quake to look upon, under their proper names. I have known a man severely salivated by Holloway's " Vegetable " Pills. Whiskey too vile to be sold as such—and that is saying a good deal—is impreg- nated with wormwood and nux vomica, and converted into " Bitters " of a hundred kinds, all of which cure everything. And how shall the lineage of Esculapius survive this horrid onslaught of organized foes and of bushAvhackers ? The followers of Hahnemann, who follow or not, as the Avind blows, exult in their victories. The Eclectics who choose the crumbs and reject the loaf, are also jubilant. Then come aquatics, and spiritists, and mesmerists, he and 6 she, and other tribes and clans and camp-followers, motley and multitudinous as the army of Xerxes, surging against the ancient temple of physic with clangor of trumpets and shouts of triumph. But what does it all amount to ? Now and again a timid brother thinks it worth while to lift the defensive sword. But the professional masses are undis- turbed and imperturbable. They heed the attack no more than they would the gongs and stink-pots of Chinese warfare. In our own ranks there are men who assist in exciting- prejudice against the regular profession, and impairing confidence in it; who speak with contempt of their associ- ates and of their predecessors. Noav and then some dis- tinguished individual wakes up to the errors and follies of the past and reviles the memory of his forefathers: not con- sidering that by proving his ancestors to have been fools, the world is entitled to judge him a fool by inheritance. I would recommend to such the old proverb concerning birds which are careless of their oavh nests. It is worthy of remark that in spite of prejudice and hostility, in spite of thousands of sects and impostures boasting of their success, the regular schools of medicine have the confidence of nine-tenths of the civilized world. And perhaps nine-tenths of the remaining tenth, Avhen danger and death stare them in the face, fly to us for suc- cor, like truant children running home for protection. But let us return to the subject of the health of San Francisco. Intelligent and humane people outside the pro- fession, Avill scarcely credit the statement that many chil- dren in this city would be allowed to die without a solitary visit from a physician, were it not that a certificate from a medical man, setting forth the cause of death, is- required by law for the purpose of interment. And yet we all know this to be a fact. There are very few cities in the civilized world, if any, as large as ours, destitute of a dispensary system, to supply professional service and medicine to the poor. Doubtless such a system would somewhat reduce the mortality among children—not so much among the poor, however, as the 7 mean and miserly, such as I have described, and who would be the first to take advantage of a public bounty. The philanthropy of our profession is always large enough to cover the sick who are really poor. But few of the dis- ciples of Esculapius will turn a deaf ear to the poor man's appeal for relief. To speak of the noxious effects of living in basements and cellars and ill ventilated apartments is commonplace and useless. In this respect the laws of trade control—not the laAA'S of health. When men build houses to let, what care they if the tenements be dungeons and slaughter- houses, if the rent come ! Look east of Market Street, where the spacious squares, laid out originally to provide plenty of yard room, are cut into narrow strips by narrow streets, so that the houses back against each other and crowd the filthy privies almost into the kitchens. Hun- dreds of people in that section of the city eat and sleep and live—if it can be called living—so jammed up that a chain six feet long, fastening their feet to the threshold of the door, would scarcely contract the range within which they perform all the functions of their physical being. That children breathe so much nastiness and live, proves the miraculous power of the human organism to resist poisons. The street is their only play-ground; and the good they derive from it is cheaply purchased by the sacrifice now and then of a little innocent Avho has its brains dashed out by the rushing vehicle. When such a thing transpires, the public, that is, the newspapers, are terribly excited for an hour or two. AH this is unphilosophical; for it is a law of human society that, in every large and boisterous city, about a given pro- portion of persons are killed annually by being run down in the streets. In London the number is counted by hun- dreds. Were it not for the terror excited by these occa- sional fatalities in San Francisco, mothers would suffer their babes to crawl aboutt he streets like pismires; and there would be twenty deaths in the streets where there is one now. 8 There are few evils in life without some compensatory good. A large infant mortality growing out of neglect, rids the flock of the most feeble and sickly individuals, and leaves a higher standard of health to the rising generation. On the other hand, if the utmost care were exercised to rear up to adult life all infants with feeble or depraved constitutions, it is evident that their admixture with the common stock as parents would lower the average health of the next generation. This is a well established law. The husbandman observes it Avlien he kills the feeble and dwarfish, and spares the strong and vigorous of his herd. It applies as strictly to the human household as to the farm-yard. Thus a scrupulous observance of hygienic laws in the rearing of infants, with the exercise of the highest degree of medical skill, tends to preserve the seeds of disease and death and transmit them to posterity by in- heritance. Thus the increase of the mean duration of life in one generation lays the foundation for shortening it in generations to come. But there is a remedy for this. Persons avIio bear in their constitutions the morbid inheritance must not marry. They must not transmit it to another generation. Let every sound man who seeks a partner—and no other than sound men must entertain the design—inspect the lady and investigate her pedigree, as the medical examiner does a candidate for life assurance, or a jockey does a horse; and if he find weak points, reject her; and so on. Every healthy woman too must exercise the same right and re- quire a bill of health, personal and ancestral, before saying yes. Not only the physical but the moral qualities must be analyzed and their adaptation cyphered out. Such is the tenor of books and essays many, which, in these latter days erratic philosophists and reformers do promulgate. Is it possible that the Author of our being ever intended the marriage relation to be subjected to such heartless and cold-blooded calculations? Marriage is the business of the heart rather than of the head, though it is well that the head also be consulted. But if either must have entire 9 control, it were a thousand fold better to give it to the heart. The doctrine that Avould exclude from the privileges and enjoyments of marital life all persons avIio may be regarded as predisposed by organization or inheritance to pulmonary disease, is essentially barbarous. Do Ave not know that the tubercular diathesis is apt to be associated Avith the divinest qualities of human nature ?—the highest ca- pacities for connubial fellowship and domestic happiness ? Does not the destroyer choose for his victims the fairest and loveliest of the flock ? And must those who are thus endoAved with superior sensibilities and affections be doomed to repress their emotions and to be virtually ban- ished from society ? And what if the wife of a few brief years go to her eter- nal rest, leaving desolate the earthly home of her partner! What if some of her offspring, inheriting her bodily Aveak- ness, join the "innumerable caravan!" Of such is the Kingdom of Heaven. Death has his uses. Were he al- ways to withhold liis touch till age should enfeeble both mind and body—until our fathers and mothers should be- come senile and helpless and idiotic, the Avorld Avould lapse into savageism, and aged cripples Avould be buried alive as among the Malays. In his indiscriminate visitations death is a minister of civilization and religion. When he takes our infant, our parent, our partner, oh Iioav lie softens the ob- duratelieart! How he opens the sacredfountains of grief! How he points our ATision to the "undiscovered country!" How he proclaims to us immortality and eternal life! Were it possible always to prolong life into useless and cumbersome old age, and were it the sole office of death to rid society of its Avorn out and effete members, the tender- est sympathies of our nature Avould never be developed, and man would fall like Lucifer from Heaven. Together with the cares and anxieties of the chamber of sickness, affection and love Avould also take their departure, and the halloAAred associations Avkicli, like a rainbow, encircle the grave, would vanish forever. 10 It appears therefore to belong to the dispensations of Providence that death should lie in wait perpetually, Avatch- ing and counting every pulsation of the heart, even before the enjoyment of independent existence. And is not death a minister to life ? Behold how he dissolves organic forms and prepares the dust for the nourishment of neAv crea- tions ! Hoav he converts the soil into a mother's bosom from which flow the fountains of nourishment for all ani- mated nature! '' The very earth we tread upon Has lived and felt and suffered.'' Life and death work hand in hand. If death lies at the door, it is always to proclaim the gospel of resurrection. Through the discovery of Aaccination, the improved methods of treating certain diseases, and improved modes of living, the medium duration of human life in civilized countries lias been considerably lengthened. But it follows from the circumstances before stated that there is a natural limit beyond Avliich it cannot be prolonged. In the health- iest parts of Europe and America, there is one death in every 45 of the population. To have reached this point is deemed a great triumph. It remains to be seen whether when reached, it can be sustained. Already it is surmised that the mean duration of human life in England is dimin- ishing after culmination. Meanwhile, let results be what they may, it is the allotted mission of our profession to allay human suffering and to prolong individual life. There is no casuistry in our calling. The same humanity which requires us to knock a crippled horse in the head or to terminate the sufferings of a favorite dog with strychnia, shrinks with horror from the idea of cutting off a short hour from the possible exist- ence of a human being, even in the tortures of hydro- phobia. The duty of the physician does not end when all hope of saving his patient expires. Still he may smooth the dying pillow. Still he may alleviate the final pang. But this is not all. He has duties to perform to those who stand 11 around the dying couch with bleeding hearts. To him they look for sympathy and consolation. On no one without the family circle have they such claims. Perchance the infant Avhose eyes are closing forever, drew its first breath in his hands. As he stands by the departing mother, perhaps the group of orphans at his side identify him Avith their birth. Let him have a heart as Avell as a head. Let him be capable of rejoicing with those avIio rejoice, and mourn- ing with those who weep. So shall he exalt his calling. It has pleased the Heavenly Father, in establishing the laws of animal existence, to make the love of offspring par- amount to every other attribute. He has decreed, for both man and beast, that a mother shall sacrifice, for her pro- geny, every other instinct, emotion or faculty, and even her own life. The love of a father is acquired. It grows and is developed with the groAvtli of his child. But a mother's love is born before her offspring. It is a holy instinct, without which a woman is a monster. Monstrosities in this regard do, however, exist. In viewing the dark side of Chinese morality, Ave are struck Avith horror at the prev- alence of infanticide. So revolting is the aspect which this vice gives to the Chinese character, that one is scarcely willing to look beyond it for a possible good. It Avere well to reserve a portion of our indignation and abhorrence for the Avomen of our oavii country. AVliat better is the prevalent Feticide among American Avomen than the Infanticide of the semi-barbarian Mongols ? Does it not equally demonstrate the violation of a Divine law ?—the subversion of a Divine instinct?—the destruction of the Divine image in the female heart? Our young Republic, scarcely loosed from its swaddling clothes, boasting its civilization and refinement, and Avith no excuse of an over- croAvded population, is already so infected with this Satan- ic perversion of nature, that there are sections where the increase of the race depends on the substratum of society, draAvn mainly from foreign lands, and Avhere Avealth and fortune enlist all the enginery of crime, to frustrate the laAv of nature and of Clod. 12 We can appreciate the motives that lead to feticide in females avIio have slipped from the path of virtue—unjusti- fiable and criminal as the act still is. But that married women should folloAv in the path of the harlot admits not the shadow of a shade of excuse or palliation. And Avhat shall be said of physicians Avho hire themselves for this base purpose ? I need not say that such a one would noAvhere be recognized as a member of the frater- nity. Bumor occasionally Avliispers the infamy of some miserable starveling avIio has missed his calling and failed of success by legitimate practice. But the mere whisper taints his character, and cuts him off from intercourse Avith the profession. We Californians are not ashamed of our record in this respect. There is a Avholesome public sen- timent on this coast, amoiuj men at least, which renders it difficult for an abortionist to escape the fangs of laAAr, pro- Abided reasonable proof be adduced against him. I wish it Avere so elseAvhere. An Eastern medical journal states that a member of the Massachusetts Medical Society, living not far from Boston, is Avell knoAvn to be engaged in the practice. AVhat if this could be said of a member of the San Francisco Medical Society ? The very thought is pre- posterous. The butchery of unborn children is carried on mainly by a brood of impostors Avho assume the title of '' doctor," and who profess to cure "obstructions " and so forth. An advertisement of the cure of secret diseases is prima facie evidence of an abortionist. There is scarcely an exception. The newspaper which comes daily into our homes, into the hands of our wives and daughters, carries the intelligence— not in plain terms, but under cover of removing obstruc- tions, restoring the menses, and other expressions often in- decent and obscene. Let me repeat it as a truth that should be kept in mind by all decent people, that men who advertise to treat secret diseases are, in general, villainous abortionists. Their advertisements are mostly forgeries and falsehoods from beginning to end. In some instances women undertake their own cases, 13 without asking aid from any one. We all knoAv hoAV fre- quently they injure themselves seriously in this way. One of my medical friends has consulted me within a feAv days on account of a female who had nearly killed herself in the attempt to produce abortion. Not only are charlatans and impostors able to announce themselves perpetually to the public through the newspa- pers and thus attract multitudes into their toils, but they acquire a certain degree of respectability—an endorsement or sanction from the same source. Advertising is and al- ways has been the soul of quackery; and the length of the advertisement is apt to be proportionate to the ignorance or turpitude of the perpetrator. A few neAvspapers refuse to hire their columns for this purpose. But the pay, which is enormous, generally secures admission, often, let us hope, against the better judgment of the editors and con- ductors. There are some newspapers which could not be sustained at all, Avithout the compensation which they re- ceive from quack advertisements. It is honorable to our profession that a very small num- ber of advertising charlatans have sprung from its ranks. Though it is acknoAvledged that ignorant and incompetent individuals frequently obtain the medical degree, owing to the low standard of education permitted by many of our schools, yet scarcely any of them but appreciate their diploma too highly to disgrace it by such practices. SAvaim, the pioneer of the "Panacea" family, probably made the largest fortune ever accumulated in America by the sale of a patent medicine. He Avas a poor bookbinder in New York—sick with syphilis, and a patient of Dr. Quacken- boss, from AArhom lie procured the formula, adding oil of Avintergreen and some other articles to disguise it. Not on- ly Avas he ignorant of medicine, but so uneducated in other respects that lie had to learn to a\ rite, his name to affix it to his certificates. Jayne, of carminative celebrity, Avas a day laborer in NeAv Jersey. Being troubled with an ob- stinate diarrhea, lie Avas cured at last b}' the aid of some medicines obtained from a physician. FolloAving in the 14 footsteps of Swaim, Jayne went to Philadelphia, and succeed- ed in obtaining notoriety through his Carminative. Hiring the brains of a famished doctor to contrive new recipes and to indite fourth-proof puffs, he figured in connection with his "Vermifuge" and his " Expectorant;" and finally amassed a fortune from a slender capital of cunning and diarrhea. The history of California quacks Avould be a lively and fragrant production. We should find an upholsterer's journeyman among the pioneers, filling the land Avith his name and his fame, Avitliout pretending to prescribe for his patients; that function devolving upon some vagabond doctor hired for the purpose, and mistaken by the patients for the genuine original. And even iioav, when his body has long ago mingled with the dust, his name is still flaunt- ed in the eyes of our people as a better catch-trap than that of his living successor. We should find another Avho gained his entire medical education in the course of a year's industry as a newspaper carrier. Others again passed through their course of study in a single night, and graduated in the columns of the morning papers. One, who merits the special regard of your "orator," did good service with pick and spade in the mining region, until either through fatigue or ambition, he was led suddenly to change his coat and his name, and from plain John Fitz- gibbon, miner, Avas transformed into the "celebrated" Doc- tor J. F. Gibbon, extensive dealer in patent French safes and other nastiness. Allow me to remark, before leaving this subject, that the few individuals possessing a medical education and a med- ical degree, who issue filthy advertisements about secret diseases and female troubles, are commonly British or Eu- ropean adventurers. Our American schools may not always impart as much learning as the others, but they appear to infuse into their alumni a higher sense of honor in this re- spect, and a greater regard for the dignity of the profession. There is another phase of this advertising business Avhich deserves the attention of the newly-instituted Pharmaceuti- 15 cal Society of San Francisco. I allude to the use Avhich some respectable druggists allow to be made of their names for the promulgation of patent medicines. It is not to be expected that the publisher of a nostrum will confine his laudations to the truth. Every asserted remedy must be better than any other, and must cure nearly all diseases. Every trade has its usages and its license in such matters, and all puffing is done on the principle that a certain per centage, varying, say from fifty to a hundred, must be deduct- ed on account of poetry. But tradesmen have enough to bear generally on their own account; and it is to be hoped that respectable druggists will require the proprietors of patent medicines to do their lying in their own names and not over those of the druggists who vend the article. Noav let us come home and bring to judgment a sin in the family. Within the profession there is a species of quackery Avhich is advertised, not by the printing press, but by the uterine speculum. There prevails very exten- sively among our Avonien a singular disorder, of which the most prominent symptom is a passion for uterine explora- tions. To some extent medical practioners are responsible for the general prevalence of this malady. It is easy for sensitive females to persuade themselves that their afflic- tions, from the toothache doAvmvards, are due to falling of the womb, or ulcerations or tumors: and he is the sharp- est doctor who first detects the difficulty. Here comes in the charlatan, to exaggerate the disease, if there be any, and to beguile the patient with promises of cure. Henceforth the speculum becomes to the poor woman an essential part of the daily routine of life. Caustic, the knife, and various manipulations, look like Avork; and she is charmed Avith the industrious and energetic attentions of the professional mechanic. By and by the bubble bursts; and for all the good that has been done by subjecting the uterus to a course of torture, its proprietor might as well haATe adopted the treatment accredited to that miracle of scientific skill, Li-potai, namely: the application of a blister to the crown of the head to raise the fallen womb to its place. 16 It is to be hoped that the fashion of Avomen to mistrust and slander their Avombs and rejoice in having them ex- plored and tinkered, lias passed its culmination; and with it the professional mania for persecuting that organ. The highest authorities have taken the back course and con- demned their own uterine surgery in some respects. We may therefore indulge reasonable expectation that the uterus will shortly AvithdraAv from public exposure, and re- gard the decencies of private life. But let us return to the point from Avhich I have wander- ed—the great crime of American Avomen—Feticide. We have noted the powerful influence of the neAvspaper press in familiarizing the popular mind to the practice through the advertisements of abortionists; also the wanton per- version and destruction of maternal instinct, at the bidding of passion and pleasure and convenience, and sometimes, not so often, however, as might be imagined, under the pres- sure of poverty and want. But there is a deeper source than all this, in the tone and taste of society at large— respectable and virtuous society. The evil tendency be- gins just as soon as husbands and Avives begin to make calculations on the inexpediency of increasing their family. Generally speaking, the poor give themselves little trouble about such matters. They may think, but they do not care. They may neglect their children after birth—they may suffer them to die from carelessness; but they have no dread of offspring. They do not esteem it a curse to have children. On the other hand, not only in fashionable life, but in the great middle stratum of American society most favorable to moral culture, it is customary to make calculations as to the number of children that shall be born, just as ser- vants or horses are made subjects of calculation. Then come restraint and prevention. In their little coteries women vote it beastly to have a large family. A popular sentiment grows up in this way, Avhich becomes the law of the household. As the means of prevention often fail, thousands of children are conceived and born under pro- test, as it were. The natural instinct is blunted, and a long 17 step is taken unwarily in the direction of feticide—if, in- deed, feticide be not attempted by drugs or violent exercise. There are few married people who have dAvelt in large cities but will acknoAvledge the truth of this picture. I Avish to make it broad enough to take in many excellent persons who declaim against feticide Avith holy horror, and yet overlook the little beginnings: as men are Avont to de- nounce drunkenness AAdiilst they folloAv the practice of drink- ing a little, the only path by which drunkenness is reached. Let me cite an instance in Avhich even polite literature has been inveigled into this rebellion against humanity. One of the SAveetest of NeAA- England's poets, and one of the purest and best of men, who Avould shrink with horror from such an accusation, has unwittingly fostered the vi- cious sentiment in his much admired poem of Maud Muller: •' She wedded a man unlearned and poor, And many children played 'round her door." To enhance the impression, a large family of little ones is pictured in the illustration, as if emblematic of misfor- tune and disgrace. In truth, the moral of the entire poem is pernicious. Do not understand me to inculcate that it is not advisa- ble under any circumstances to endeavor to limit the size of a family. What I do maintain is that it Avere far better, as in the marriage selection, to throw off restraint and leave the result to impulse and accident, than to make calcula- tions and efforts which lower the maternal instinct and nurture the elements of feticide. In all times and in all nations, the mother of a large family has been crowned with honors. The names of ma- trons avIio have given to their country a numerous progeny have been written in letters of gold on the page of history. In many cases states have bestowed on them substantial favors. AVhat a precious example is presented by the Queen of England, as a rebuke to such American Avomen as are induced by fashion and pride and perverted taste to regard the parental relation as burdensome and odious ! 2 18 What if Ave propose to the Ecumenical Council to adopt the proper means to place Victoria among the saints ? An inquiry, curious and interesting to the physiological student, arises in this connexion: whether the child com- mencing its embryo existence under restraint and appre- hension is liable to be deficient in vigor, and whether, during the uterine development, the vitality of the fetus is lowered by the aversion and antipathy of the mother. It can scarcely be doubted that unsuccessful attempts at abortion may inflict serious injury on the offspring—pos- sibly to the production of cripples and idiots. If the ichneumon's egg be thus deposited in the embryo—if the children of dread and of sorrow thus avenge themselves in the womb on the anti-maternal liate of the mother, then is another curse on posterity added to those already inci- dent to the progress of civilization and luxurious refine- ment: and the rich and the proud, the noble and the mighty of the hour, must hand over the destinies of the race to the humble sons and daughters of toil. Among all nations there is more or less dread of a re- dundant population. Different means are adopted to pre- vent it. Infanticide is the Mongolian method—sharp, practical, decisive. The American system is feticide. Across the Atlantic, calculation, late marriages, and "prudential restraints" are in vogue. British and Euro- pean journals are vexed with the problem. Good people talk of the sin of bringing children into the world before the means of supporting them are secured. Therefore people who have means Avill not marry, and married people who have means will not bear children—if they can help it; and for the purpose of helping it they adopt "prudential restraints," nearly equivalent to the plan of a personage Avho lived in the land of Canaan many years ago, and whose name has been handed down to the present time Avithout honor. In some points of view, and under some circumstances, it seems desirable that there should be a small family. But the purpose is liable to involve serious penalties— 19 nothing less than prostitution, licentiousness and disease. Late marriages have the same effects. Take a lesson from France. At the commencement of the present century the average number of children in a family in Paris was four and in the rest of France fiwe. Noav there are but two in Paris and three in France. The official lists draAvn up for conscription sIioav that the number of young men between tAventy and twenty-one years of age does not increase: and the proportion of healthy and vigorous subjects who con- stitute the strength of the empire tends more and more to decline. We have it on good authority that the mean stature of the French nation has diminished. The medical journals and associations of France have, within a few years past, been much engrossed with two topics; one, the excessive infant mortality, the other, the increasing prevalence of venereal disease. It would not be surprising if cold calculations of matrimony, and "pru- dential restraints," and the loosening of maternal ties, should loAver the average A'itality of infants and stamp the nation Avith degeneracy. To increase and multiply appears to be the law of God in regard to peoples, as it is the laAv of nature. In spite of malthusian speculations, men estimate the prosperity of states and nations by the increase of population: and in- dividual poverty, unless it amount to indigence, is not in- compatible with national strength. Whenever our race lias multiplied abundantly, the elements of power and great- ness have been developed Avith their teeming numbers; and semi-barbarian though they may have been, they have wrested the sceptre from the empire of luxury. Let me put the proposition in another form. Rapid increase denotes constitutional health and physical vigor. If the race or original stock be good, a nation so increas- ing accumulates all the material and psychical capabilities Avithin the range of human nature. On the other hand, pau- city of births, whether from aversion and restraint, or from starving indigence, implies a degenerate and decaying 20 race. With aversion and restraint are associated pesti- lence and disease. Look at the Israelites. Never did there exist a race so eminently parental through so many generations of history. Dating from the tAvelve sons of Jacob, love of offspring has been characteristic of the JeAvish people. In the bondage of Egypt, in the starvation of the Avilderness, in doAvnfall and dispersion and persecution, the JeAvisli Avoman has ever been faithful to the maternal instinct. And uoav, after eighteen centuries of homelessness and exile, and in spite of evils essential to the restriction of marriage Avithin the race, the children of Israel are found in all parts of the civilized Avorld, enjoying Avealtli, poAver and influence, and reflecting honor on their patriarchal ancestry. Look at the Irish. Ground down for long centuries be- tween the upper and nether millstones of State and Church, and decimated again and again by pestilence and famine, the population of Ireland has groAvn Avithout restraint. It has furnished to Britain the right arm of her military and naval poAver, and supplied SAvarms of colonists to the western Avorld. That Irish mothers have no dread of off- spring, lias preserved the vigor and energy of the race, and enabled it to recruit, with bone and sinew at least, the ranks of American population, threatened Avith depletion by the great crime of American women. It was my design to make some remarks in extenso Avith especial relation to this Society. But I dare not trespass much longer on your patience. Our organization has been nearly tAvo years in existence and at work. At its founda- tion, the prophets of evil doomed it to speedy death. There was too much acid and alkali, too much villainous saltpetre in the profession in this city to escape destruc- tive effervescence and explosion. But we have belied all the bodings of Cassandra. Our course has been one of un- exampled harmony. Not a word of discord lias broken the even current of our progress. All of us who have been in the habit of attending the meetings know that we have 21 gathered from them instruction and benefit. We have given and Ave have received. We have performed a duty to ourselves and to our patients. I learn that some of our German physicians have lately organized a medical association of their own nationality. They will permit me to express the opinion that their action is of doubtful policy. It is their interest, practising in an American community, to identify themselves Avith American physicians. We Avant American physic in California—not German, or French, or British physic. We do not ask them to throw aAvay the rich stores of knowledge they have accumulated in the proud schools of Europe, but to add them to the common stock with ours, for the common benefit. I am sure Ave can learn from each other. If a number of American physicians should find themselves en- gaged in practice in one of the cities of Germany, the first thing they Avould do, instead of segregating themselves in a coterie for the cultivation of American and English med- ical science, Avould be to plunge into the current of German physic and adapt themselves as quickly as possible to their neAV field of practice. Our German physicians Avould lose nothing by casting away a little of their conservatism, and mounting the Yankee locomotive. In connection with the status of the profession in Cali- fornia, I refer Avith the highest gratification to the Medical Association of Sacramento, Avhich. Avas founded soon after ours, and which enjoys a healthy and vigorous life. The papers and discussions produced by it exemplify a degree of industry and scientific research AAhich Avould do credit to any medical association in the Avorld. We may hope to see its example, and ours, followed in other localities. Nor must I omit to extend a cordial welcome into the field of organized scientific labor, to our cousins the den- tists and apothecaries of San Francisco. Formerly Ave all belonged to the same family. I well remember my first lesson in pharmacy as a medical student. It Avas the manufacture of Dover's powder in a hand-mortar. Before the process Avas completed I had a remarkably clear and 22 impressive idea of the nature of an impalpable powder; and I never regretted the separation of pharmacy from practice. The old doctors who knew what it was to tug at a refractory grinder, will always feel grateful to the dentists for releasing them from such labors. The societies re- spectively which the pharmacists and dentists have formed, can not fail to elevate the members and the professions in their social and intellectual position. But I must conclude. Perhaps I owe an apology for not devoting my hour to the contemplation of loftier themes and a Avider range of thought. But I am not good at apol- ogies, and my humble essay must go for what it is worth.