ADDRESS 
DR. w. F. PECK, President, 
< , ,i . . 
OK THE 
Jjiwa §|tate |||Ieiial flfcietg; 
AT ITS ANNUAL MEETING, 
Held at Des Moines, January 26, 1876. 
DAVENPORT, IOWA: 
GAZETTE COMPANY, STEAM PRINTERS. 
1876. ADDRESS. 
Custom renders it incumbent upon me as the presiding officer of 
your Society, to present annually an address, in which it is expected 
allusions will be made to the condition and advancement which the 
profession of medicine exhibits in a comparative relation to the 
other recognized professions. The present occasion is evidently one 
which possesses a peculiar and extraordinary interest when we con- 
sider that one hundred years ago the present year, fifty-five persons, 
representing nearly four millions of people, declared an independence 
which from that time has been perpetuated under the meaning name 
of an American Republic. 
It appears from the preserved archives, that the medical men of 
1770 contributed not a little to the determined spirit which secured 
for us disenthralment from English oppression. While the colonies 
were struggling to assist in maintaining a government which was 
regardlessly exacting in its administrative operation, we find that the 
medical men were actively at work with others in forming and exe- 
cuting plans for guaranteeing to posterity a toleration of thought and 
speech, the untrammelled exercise of which are necessary for a free 
government and a liberal profession like that of medicine. The 
medical profession furnished five of the signers of the Declaration of 
Independence. Their names are Josiah Bartlett of New Hampshire, 
Matthew Thornton of New Hampshire, Benjamin Rush of Pennsyl- 
vania, Oliver Wolcott of Connecticut, and Lyman Hall of Georgia. 
The opinions and views of liberty to which they subscribed, received 
the full endorsement of their medical constituents, as is fully shown 
by the efficient and active part which they performed in the revolu- 
tionary struggle which immediately followed. While there were iso- 
lated instances of suffering on the part of the Continental soldiers for 
want of medical supplies, not a single experience, so far as I have 
been able to ascertain, occurred where a medical man did not relin- 
quish all that was precious to him, when necessary, in order to render 
relief to those who became incapacitated by reason of wounds or 
disease contracted in attempting to establish the principles which 
have been from that date emblematically represented by our National 
ensign. The number of physicians practising in the Colonies, at the 
outbreak of the revolution, was three thousand five hundred, and out 
of that number about four hundred are presumed to have been gradu- 
ates. Four hundred surgeons were employed in the Revolutionary 
service, and out of that number four were killed and about six died 
from disease. It would seem that the privations to which the soldiers 2 
were subjected should have caused a rate of mortality much greater 
than that which occurred during the War of the Rebellion; but a 
careful comparative analysis shows that the forced hardships rather 
prompted a condition of health not equaled by our modern civilized 
advantages. 
Our national age as a profession furnishes an opportunity for us to 
compare somewhat the educational status of to-day with that which 
existed in the early history of the present century. And in making an 
examination of the facilities which were offered for the acquirement 
of an education, I find that only two medical colleges existed in 1776. 
One was located in New York and one in Philadelphia. The one in 
New York was organized in 1768, although lectures on anatomy had 
been given in it as early as 1764. The two colleges named had issued, 
when the Revolution commenced, about two hundred and fifty degrees, 
and it is supposed that not less than twelve hundred students had 
matriculated for one course of lectures. It was undoubtedly true that 
a large number of non-graduates, including all who pretended more 
or less knowledge of the healing art, practised medicine then than 
now. It was much more difficult to obtain the wherewith to procure 
an education; and furthermore, the student’s position then was un- 
like the comparatively encouraging one which he is permitted to enjoy 
to-day. Then his time of servitude was from three to seven years, 
during which he was, by the condition of his articles of indenture, 
compelled to perform such labor as his preceptor or master directed. 
It was the fortune of a few to have the support of sufficient means to 
visit England and Scotland, and there receive the benefits resulting 
from attendance upon hospital instruction, which was furnished by 
teachers justly celebrated for their education and thoroughness. 
Many of those whose names are connected with the progress of med- 
icine in the early part of tfie present century, enjoyed the advantages 
derived from anatomical study in foreign seats of learning. The mind 
of the American student and physician soon showed by its activity 
that the material of the United States could be utilized for the benefit 
of the profession. Other colleges were organized, and very soon the 
graduates in medicine increased in their relative proportion to those 
who were not properly qualified to practise. 
At the time of the signing of the Declaration of Independence there 
were but two medical societies—one was located in New Jersey, as the 
State Medical Society, and the other was the Delaware State Medical 
Society, which was organized in 1776. It is not possible to determine 
what constituted eligibility to membership. It is certain, however, 
that the punishments inflicted upon those who claimed to perform 
mysterious cures could not have served otherwise than to stimulate 
the student as well as the practitioner in the direction of examining 
into natural causes, conditions and results; and with this disposition 
to have definite results follow known causes, it certainly could have 
had no other tendency than to be pathological and rational in ferreting 
out disease and supplying means for its removal. The spirit of med- ical progress is well shown, when an exhibit is made of the number of 
medical colleges which exist in 187fi as compared with the number 
which were in operation in 177G.* There are now ninety-nine colleges 
-sixty-three are Rational, four are Plclectic, seven are Homoeopathic, 
eleven Dental, and fourteen .Pharmaceutical, thus aggregating the 
number mentioned. The course of study is very much improved; 
and in place of having one professor teach seven branches, as was 
done by Dr. Nathan Smith, (the founder of Dartmouth College,) for 
twelve years, one branch is assigned to one professor, and in 
some instances one branch is sub-divided so that from three to five 
teachers are employed in giving instruction in it. Anatomy is now 
practically studied under the protection of the State. Formerly great 
injustice was done the physician by requiring him to possess perfect 
knowledge of the human structures, and while the decisions of the 
courts were exacting in this particular, the statute books made it a 
criminal offense in case the searcher after truth was detected perform- 
ing practical dissections. No better evidence is needed, to prove that 
the medical profession is steadily at work removing bigotry and pre- 
judice, than the wise changes which the people, through the Legisla- 
ture, endorse in doing away with the unparalleled inconsistencies which 
have heretofore been considered law or justice! It is but a short time 
since our State showed this undoubted indication of liberal thought 
which found expression in the transactions of this Society. Slight 
changes are still necessary in order to make the present law perfectly 
satisfactory. No doubt the intelligence of the State, represented in 
the present Assembly, will do that which is needed to give the benefits 
Which were originally contemplated. 
In 177G there were but two medical societies. To-day there are 
not less than thirteen hundred in full operation in the United States. 
When the Revolutionary War commenced there were thirty-five hun- 
dred medical men in partial or full practice. There are at this writ- 
ing seventy thousand physicians who practice the rational system of 
medicine. In addition there are about ten thousand who pretend to 
represent systems of medicine of equivocal utility. 
It may be interesting to compare the rates of charges in 1781 with 
those allowed by fee bills at the present time. The following is fur- 
nished by Dr. James Thacher: 
The fee for a visit was one shilling and six pence, afterwards in- 
creased to two shillings. 
Midwifery and capital operations were at a guinea, with charges 
for after visits. 
The first fees established by the medical club of Boston were fifty 
cents for a visit; if in consultation, one dollar. Rising and visitintr 
in the night after eleven o’clock and before sunrise, double fee. Ob- 
stetrical case, eight dollars; capital operation in surgery, five pounds. 
Reducing a dislocation, or setting a fractured bone, one guinea. 
♦Dr. Jno. M. Toner’s letter. 4 
Bleeding, opening abscess, extracting tooth, fifty cents, and the usual 
fee for visit was added. 
The proportion of medical men to the population in 1776 was about 
one to every one thousand inhabitants. (If we could estimate all 
who gave medicine the ratio would undoubtedly be decreased.) Now 
with a population of full forty millions, the proportion is one physi- 
cian (including all who claim the distinction) to every live hundred 
inhabitants. From year to year, as the facilities for acquiring a med- 
ical education have been improved, do we find that the disposition 
for investigation and research is correspondingly increased. 
It is interesting to compare the exalted position of the profession 
to-day with that which it occupied at the beginning of the present 
century. At this historic time, other professions, societies and organ- 
izations will be examining their centennial record, having in view the 
laudable object of showing how much they have contributed to the 
progress of the citizen and State. In the early part of the present 
century pathology was less emphatic in directing medication. And 
inasmuch as the patient was surrounded by influences which tended 
to limit the use of his reasoning faculties, he was thereby impelled 
to confide almost implicitly in the dogmatic assertions of the age. 
Medicine was given in bulk, and as a consequence the extractive 
principles were not brought in immediate contact with the unhealth- 
ful agencies. One of the chief improvements which we assign to the 
nineteenth century is the utilizing of chemistry in abstracting from 
the crude drug the efficient agent which, when administered, acts 
more speedily in combating the deteriorating influence. There is 
also recognized the same improvement in the comparative tasteless- 
ness and concealment of the other objectionable qualities of the drug. 
The discovery which has contributed most to the alleviation of the 
suffering condition, is that of anaesthetics. And so long as the earth 
shall contain a civilized people, so long will the profession of this 
century be remembered. In 1848 Morton handed to the surgeon 
sulphuric ether, the use of which has done much toward removing 
one of the most objectionable conditions of human life. No product 
of any invention or discovery can be successfully compared with 
it. The sole benefit is not that it only relieves pain, but that it also 
renders possible operations for disease and deformity which without it 
would continue the existence of causes for the injury and disfigure- 
ment of the race. Those who are best qualified to attest its value are 
those who have been relieved of suffering by its administration. 
Electricity, in its application to tissues suffering from a want of 
nervous force, also its utilization to discuss and remove morbid 
growths, is one of the improvements in the use of which both the phy- 
sician and surgeon have reason for indulging in feelings of mutual 
pride. Mainly to Dr. Morse is the world indebted for the employment 
of the electrical current in transmitting thought, the product of the 
association of organic matter through or along unorganized particles. 
Among the many operations in surgery performed during the century now being celebrated by the Centennial year, the following are 
deserving of and should occupy a conspicuous place in the annals of 
American progress : 
In 1807* I)r. Samuel White removed, by cutting through the ab- 
dominal wall into the intestine, a teaspoon which had been accident- 
ally carried there. The patient recovered. In 1809 Dr. E. McDowell 
originated the operation of ovariotomy, which is now almost daily 
performed in different parts of the civilized world. It is well known 
that before his time all patients who suffered from ovarian tumors 
died. A little reflection will easily estimate that many thousands 
must have surrendered their lives prematurely for want of surgical 
interference. The very difficult operation of extirpating the parotid 
gland, was first performed by Dr. John Warren, of Boston, in 1798. In 
1818 Dr. Valentine Mott tied the innominata, his patient surviving 
the operation twenty-six weeks. Dr. Rhea Barton in 1826 resected 
the head of the femur. The patient recovered and walked with a 
useful joint. Dr. Paul Eve successfully extirpated the uterus. It was 
Dr. J. Marion Sims who first employed metallic sutures in utero- 
vaginal and vesico-vaginal surgery, thereby not only rendering the 
operation for vesico-vaginal fistula possible but commendable. lie 
also introduced the operation for dividing the cervix, in cases of un- 
due flexion, for sterility. Dr. Nathan Smith preceded Dr. Read in 
reducing dislocations by manipulatory means alone. Dr. Buck, by 
means of adhesive plaster, weight and pulley, demonstrated conclu- 
sively that less shortening, in fractures of the femur, will occur than 
when any other method of treatment is employed. Drs. Sayre, Davis 
and others, have done incalculable service to patients who suffer from 
hip-joint disease, in applying the principles of extension and counter- 
extension by means of the hip-joint instrument, thereby permitting 
free exercise, where before restraint more or less complete, was the 
received treatment. Dr. George McClellan removed the arm, clavicle 
and scapula of the same side. Dr. Austin Flint, jr., by experimental 
research demonstrated that the liver, in addition to its other func- 
tions, eliminated cholesterine, which makes its appearance in the 
bowels in the form of stercorine. The American ambidance has 
never been surpassed in its adaptability to the needs of contending 
army forces. 
It is with mingled regret and pride that we refer to the wonderful 
results which were contemplated by the medical administrative de- 
partment of the Federal army in the late war of the rebellion, in 
organizing and perfecting such a complete system of hospital and sup- 
ply management, which furnished without limit the varied wants 
created on account of wounds or disease. During that time no effort 
was spared to assuage pain and relieve suffering. The necessary 
pathology resulting from battle and other causes was concentrated in 
the Army Medical Museum, originally planned by Dr. Wm. A. Ham- 
*Dr. Smith’s Surgery. monel, which should be considered the professional shrine at which 
every American medical man ought to pay the tribute of his respect 
and admiration, by making an occasional visit thereto. Few stop to 
reflect upon the source and character of that representation. No 
Nation can exhibit such a fine collection of pathological specimens 
produced by circumstances and conditions so peculiar. 
There were employed in the *War of the Rebellion, in all, nearly 
three thousand surgeons, of whom nineteen were killed in battle; 
thirteen were killed by partizan hoops or guerillas while in the dis- 
charge of duty; eight died of wounds received in action, and nine 
died through accidents occurring in the line of duty. Seventy-three 
were wounded in action. The number of surgical cases treated was 
408,072, with a mortality of 37,531; died of disease, 180,210. There 
were 302 suicides, 103 homicides, 121 executions; killed in battle, 
44,238. Died of unknown causes, 24,184. The total number of deaths 
from the commencement to the close of the Rebellion were 303,504. 
The annual death rate of the colored troops was 148 per 1,000 of aver- 
age aggregate mean strength. In the case of the white troops the 
annual death rate was 88 per 1,000 average aggregate mean strength. 
The average strength of the army for four years two and a half 
months was 704,436. The entire number of enlistments was 2,252,007 
men. 
The important services which the surgeon of the army gave in 
rendering over two millions of troops useful in assisting to perpetuate 
the liberties of our nation, are not sufficiently appreciated by either 
the Government or people where the details of the cause of the bless- 
ings which we now mutually share are discussed. The statesman 
may comprehend the problems of government and also recommend 
plans for the adjustment of international difficulties, but the plans 
thus grasped and advocated could never innure to the country's good, 
when a resort to arms is had, unless the soldier is preserved in the 
possession of his health, and when disabled the cause of his disability 
removed by medical or surgical skill. A reward for the practical ex- 
ercise of that knowledge which assists in preserving life and health is 
almost never voluntarily extended. And too striking is the fact in the 
enactments of the nation’s authority which should be first to place 
honor and compensation where it is justly due. While we are all often 
reminded that our services have not been adequately appreciated, we 
should never allow the fact to permit us to cease or lessen the effort 
which enlightened skill may invite us to exert in behalf of our nation’s 
interest. It is to be hoped that when the historic writer for the second 
Centennial reviews the results of the united labor of the medical 
profession, he will, comparatively speaking, have ampler cause for 
merited congratulation. 
Some local thoughts and suggestions with reference to Iowa’s 
future may not be inappropriate, and wishing to see the physical vigor 
and Surgical History of the War of the Rebellion, of our State relatively increase, and with it the longevity of her citi- 
zens accord more with the intentions of nature’s laws, I feel like urg- 
ing the Society to take some action which will induce our legislative 
authority to duly examine into the propriety of creating a State Board 
of Health. The observing physician rarely visits a patient without 
enquiring, guardedly perhaps, concerning the possible existence of 
some near generating cause, for the disturbed functions which may 
resist his skill and endanger life. Few people are prepared to com- 
prehend the vastness of this fertile source of disease ; and inasmuch 
as the tendency of the age seems to be in the direction of searching 
for the cause of believed or claimed results, advantage should be taken 
of this rational correlation, and the fact utilized for the physical bene- 
fit of the people and the State. The proper committee appointed at 
the last session will bring the subject before you fully discussed, when 
I hope some settled plan or system for operation will be agreed upon. 
There seems manifested on the part of the present law makers of 
the State a disposition to establish a Board of State Charities. The 
Society should define in an appropriate manner their views upon this 
important improvement in the management of our State institutions. 
Unless the law is full of power, and unless the powers of such a board 
are very great, no good can be expected from it except, perhaps, the 
furnishing of lucrative offices to some well meaning but powerless 
aspirant. A former occupant of this office forcibly urged tiie pro- 
priety of asking the Legislature to provide for the large number of 
imbecile and demented persons in the State. At present the only 
refuge which this unfortunate class has is the hospital for the insane 
or the county alms house. The asylums are already too densely 
crowded; and certainly no more inappropriate place for their main- 
tainance could be selected than the houses located on the poor farms 
in the different counties of the State. In this enlightened country, 
about which so much has been said, greater effort should be exerted 
in the way of improving and making better by education this unfortu- 
nate class of feeble minded of our commonwealth, who, in their pres- 
ent condition, only serve to take from our wealth that amount of food 
and care which manual labor must produce for their unremunerative 
existence. This class must, at an early day, receive more than a 
sympathetic notice at the hands of those who should take pleasure in 
knowing that their labor has directly done good by relieving a de- 
praved condition which by some education may be made to under- 
stand, at least some of nature’s teachings. 
Wherever medical societies nourish there you may expect to find 
the spirit of medical progress more or less actively at work. It is 
with pleasure, therefore, that I allude to the successful working of 
our Society. Since the qualification for membership made it obliga- 
tory on the applicant to come representing a local organization, 
societies have been and are forming in most parts of the State. Where 
a single county does not contain a sulficient number of medical men 
to form a society, the practice is wisely carried out of aggregating 8 
medical men from different counties, forming thereby what is termed 
district societies; and while this fraternal disposition is rife in the 
profession, it should be so encouraged that it may render the object 
profitable, by causing the delegates to have the opportunity to take 
with them on their return to their respective organizations, evidence 
that it is both honorable and beneficial to have participated in our 
proceedings. In passing, permit me to suggest that each local society 
should require a member, before taking a medical student, to cause 
the applicant to pass an examination which should be satisfactory to 
the Society, before he is permitted to register for studentship. I am 
aware that this requirement is exacted by a few societies. But would 
it not be well to make the educational standard higher by universally 
demanding this prerequisite ? 
It is frequently stated by those who stand in the light of authority 
to the believing masses that the American race is degenerating; that 
the physical perfection which characterized the development of the 
inhabitants a century ago does not exist now, and that the medical 
profession, in many instances is responsible for this retrogression. 
In answer to such premature remarks and conclusions, the demurrer 
will state that it is not true that the race is degenerating physically, 
from the fact that with each succeeding year statistical proof accum- 
ulates showing that the days of man are becoming increased, which 
could not be the case progressively unless the physical organism 
showed greater ability to entrench against the beseiging forces which 
are continually at work trying to render defective the human constitu- 
tion. The immense financial accumulations of insurance corporations 
clearly prove that the tables of Carlisle do not favorably apply to the 
longevity of this people and age. Too much money is being paid to 
insurance companies on the hypothesis that we are short lived. The 
experience of companies annually demonstrates the incorrectness of 
their formulated assertions. They should either largely reduce their 
rates or compute life upon a more correct basis. The American ex- 
perience tables are somewhat better than the tables of Carlisle, but 
they do not fully recognize the improved physical condition and the 
increased longevity of the American citizen. 
The great value of the meterological observations now being 
made by the general government and the volunteer corps of our State, 
should find an appreciative expression in the proceedings of this 
organization. 
It has occurred to me that some special effort should be made to 
encourage original research, and to the end that such disposition may 
be stimulated I will offer one hundred dollars annually, as a standing 
prize, which shall be awarded by a committee appointed by the society, 
to the one who shall produce either an essay, an invention, or the re- 
sults of original research, which shall be deemed sufficiently meritori- 
ous. The acceptance of this proposition can be recognized by special 
action of the society.