[REPRINTED FROM THE NEW YORK JOURNAL OF GYNECOLOGY AND OBSTETRICS FOR MAY, 1893] Reminiscences of the Founders of The Woman’s Hospital Association' THOMAS ADDIS EMMET, M. D. NEW YORK Stuyvesant Press 154 AND 156 WEST TWENTY-SEVENTH STREET 1893 DR. MARION SIMS, 1857- REMINISCENCES OF THE FOUNDERS OF THE WOMAN'S HOSPITAL ASSOCIATION.1 Thomas Addis Emmet, M. D. In 1853 I lived in Fourth Avenue just above Twelfth Street, a locality then well up-town, since many of the wealthy people of the city still lived to the west of the City Hall and along Broadway. One afternoon in the Autumn, as I was walking with a companion on the outskirts of the city, we passed a solitary house standing on the east side of Madison Avenue between Twenty-Eighth and Twenty-Ninth Streets, and on the site of my present residence. The neighborhood was in that desolate transition-state between country and town, in which the picturesque domicile of the recent immigrant and the sportive goat are the most prominent features of the landscape. As I passed this house I read the sign of a physician then unknown to me. While commenting on such a situation for a physician the name attracted the attention of my companion who exclaimed : “ Why, it is Dr. Sims who lived in Montgomery, Alabama ! I do not know him very well but I have heard he was ill and would like to call.” After ringing the bell and while standing at the door I noticed several vessels passing on the North River, in which direction the view was unobstructed. No other dwelling house was to be seen in the vicinity nearer than the backs of a number on the north side of Twenty-Second Street and two old taverns on the Bloomingdale Road, on the present site of the Gilsey House and just beyond that of the Fifth Avenue Hotel. While in the parlor I recollect looking out of the back windows where quite a number of country-seats were to be seen towards the East River, with an unobstructed view of passing vessels and of the old Almshouse, which had recently been organized into the present Bellevue Hospital. I was introduced to Dr. Sims who was a remarkably young-looking man and evidently in very bad health. I parted from him after a few moments with no expectation of ever meeting him again. In May 1854, a public meeting of the profession was called at the Medical College of the University of New York, then situated on Broadway and, 1 believe, nearly opposite Bond Street. The object of the meeting was to introduce Dr. Sims, who was to present a new method of curing 'Read before the Alumni Association of the Woman’s Hospital, January 18, 1893, Thomas Addis Emmet, M. D. vesicovaginal fistula. The meeting was called chiefly through the influence of Dr. Valentine Mott, Professor of Surgery, Dr. John W. Francis, then a prominent practitioner of medicine, and greatly through the efforts of a much younger man, Professor Fordyce Barker, who was at that time president of the most influential medical body in the city, the New York County Medical Society. The plan for establishing a Woman’s Hospital had been freely can- vassed by the profession, in advance of the meeting. The most uncompromising opponent was a Dr. Meredeth Reese, a free lance in the profession and a man with a grievance. He had recently been removed from the position of Physician-in-Chief of the Almshouse, and he wielded a certain amount of influence as editor of a medical journal then published in the city. He maintained that the field was too small a one for a special hospital. For he thought any one could apply nitrate of silver to an ulceration with a cylindrical speculum, that an astringent injection was all that was needed to cure a leucorrhoea, and “there was no difficulty in introducing Physic’s globe-pessary for prolapsus.” He thus summed up what he believed constituted the whole range of the diseases of women which needed special attention, and even these, he considered, could be quite as well treated in a general hospital. But the meeting was held and, notwithstanding the opposition before it of a few persons, it proved a great success. It roused not only the profession to an endorsement of the necessity of a special hospital for women, but the public at large became quite interested in the movement. There seems to have been, however, no money forthcoming, and but for the persistent efforts of a few individuals the whole matter would soon have been forgotten. A new impulse was given by acting, on the advice of Dr. Barker, that a committee of ladies be selected to take charge of the organization. I learned from the Doctor himself, a short time before his death, that the selection was left to him and was made from among his own patients with the single exception of his wife, whom the ladies themselves elected as their first Secretary of the Board. A representative man had been chosen from each of the medical colleges in the city, to form a Con- sulting Board of Physicians. Dr. Mott and Dr. Alexander H. Stevens were the Consulting Surgeons, and Dr. Delafield, Dr. Francis, and Dr. Horace Green the Consulting Physicians. A dozen or more houses had been erected in the neighborhood referred to on Madison Avenue, shortly after my first visit to Dr. Sims. DR. MOTT, Reminiscences of Founders of The Woman's Hospital Association. 3 One of these, then known as 83 Madison Avenue, now 93, and on the pres- ent site of my private hospital, was taken on a short lease by the ladies of the Woman's Hospital Association. Their object was to obtain a place where Dr. Sims might demonstrate his operation for closing a vesico- vaginal fistula. For at first it seemed to many that there was more need of a special hospital for cases of fistula than for the special diseases of women, of which so little was then known. These facts I learned after I became connected with the organization. I was present at the meeting held in the Spring of 1854 but, though the subject interested me in a general way, the matter soon passed out of my mind, as something with which I had no further connection. I must now ask your indulgence for an apparent digression, while I cite a few points connected with my own immediate history, which will have its bearing later on. In 1850 I received the first permanent appointment made on the Resident Staff of the Emigrant Refuge Hospital, Ward’s Island, after its re-organization with a Visiting Board of twelve physicians and surgeons. It soon became one of the largest hospitals in the world and was, I believe, one of the best schools for obtaining a thorough and practical knowledge of every branch in medicine. The experience of over five years in that institution embodied more than a life-time, under ordinary circumstances, in general practice, and it fitted me to become a specialist in after years. My term of service was two years, and a few weeks before it expired I was appointed, much to my surprise and gratification, Visiting Physician by the Commissioners of Emigration. When placed in this responsible position and made the peer of some of the most distinguished members of the profession in New York, I was eighteen or twenty years the junior of the youngest man in the Board. As my duties at the hospital occupied but a portion of my time, I was now enabled to resume the practice of medicine among the tenement-houses, then chiefly situated on the east side between Eighth and Fourteenth Streets. I soon gained a competency sufficient, at twenty-five cents cash, or a dollar a visit if charged, with the addition of four dollars a day for visiting the hospital, to marry and settle down as a fixture. Some time in the Winter I think of 1854-5, a great political change occurred. The Commissioners of Emigration were removed and, notwithstanding the fact that none of us had taken part in politics, we all lost our places to make room for the “political doctor,who had to be rewarded for his services to the party. Thomas Addis Emmet, M. jD. 4 As part of my service in the hospital I had had over two thousand cases of “ship-fever” or typhus under my care. I set about tabulating the features in the history in each case, under some appro- priate head, with the purpose of arriving at the etiology of the disease. Late one night in March 1855, I was engaged in this work in my office, having no idea of the hour as a snow-storm had been raging all day and the general quiet was very conducive to continued mental effort. I was suddenly startled by a loud rap on my window, and on opening the door I admitted Dr. Sims, whom I did not recognize. He apologized for disturbing me but, knowing no one else in the neighborhood and seeing my light, he had come in to get warm. His car had gone off the track and he feared he might have to walk home. No man could make himself more genial, especially to young men, than he and, after asking me some questions about the work spread out on the table before me, he soon became interested in the subject and, I recollect, to a very flattering degree. Suddenly he turned to me and said: “ You are just the man lam looking for. I have spent all the evening with some gentlemen in organizing a hospital for the treatment of the diseases of women and, though according to the by-laws my assistant must be a woman, if you will come up to 83 Madison Avenue to-morrow morning at nine o’clock I will show you something you have never seen before.” I was punctual the following morning and then made my first acquaintance with old Mary Smith and with Margaret Brennan the nurse. The former was a patient sent by Dr. Mott and, I believe, the first and only one yet admitted. The atter, Marga ret Brennan, you all know. Mary Smith had but recently landed, an immigrant from the west coast of Ireland, and her condition was deplorable. I saw for the first time the application of Sims’ speculum and the knee-chest position used. But I was unable to say what I did see, beyond the fact that the patient’s body in the neighborhood of the vulva seemed greatly excoriated by the escaping urine and that she was a most offensive and loathsome object. A grayish mass projected into the vagina which seemed to me to be an immense stone. But as Dr. Sims investigated the case, he found that she had a vesico-vaginal fistula, which appeared to extend from one side of the pelvis to the other. The bladder was filled with a wooden float from a seine-net, which was about the size of a goose-egg. This had been introduced by the local medical attendant before she left home, to prevent hernia of the bladder, which otherwise would have become filled with intestines and DR. DELAFIELD, Reminiscences of Founders of The Woman's Hospital Association. 5 protruded through the fistula and out through the labia. The float had become encrusted with a thick deposit and was thoroughly saturated with phosphatic urine. After a remarkable display of patience and dexterity, Dr. Sims finally succeeded in removing it. It was done, however, amid her screams from intense suffering, for it was before the general use of anaesthetics. I saw the first administration of ether in Philadelphia, I think in 1847, and yet anaesthesia did not come into use,, at least in the Woman’s Hospital except for special cases such as ovariotomies, until about the close of our Civil War. The history of this case, the first admitted to the Hospital and of whom many of you have a personal recollection as a nurse, is not without interest. Of the many hundreds of like cases admitted after her and cured she alone, after some thirty-four operations, is now incurable. Dr. Sims operated upon her a great many times without apparently gaining anything, but at length, and shortly before he went abroad in 1861, he did succeed in bridging over the base of the bladder and in preventing the fundus from prolapsing into the vagina. He made, however, no attempt to form a urethra. After I became Surgeon- in-chief I made for her a new urethra and gained for her retentive power, so that she was enabled to discharge her duties as nurse for six or seven years. After that length of time she began to suffer from irritability of the bladder, due doubtless to cold from exposure and brought on by her constant imprudence. She did not consult me but saw Dr. Sims, who found a small stone in her bladder. He decided to dilate the urethra for its removal and did so against my protest, for I knew the character of the tissues which I had united would not bear the strain. He dilated, however, the stone was removed, and she has continued to this day without any retentive power. The operation was done shortly before Dr. Sims resigned from the Hospital, so that he had no opportunity afterwards, if he had contemplated it, to make an effort for her relief. For years past, as most of you know, she has been a common street beggar, and she would no doubt have been unwilling to lose part of her stock-in-trade, even if it had been possible at her age and in her condition to have attempted any further surgical procedure. For various reasons, but chiefly from the fact that I had no official position, I was unable to do much at the Woman’s Hospital until the Autumn, or early Winter, of 1855. I was then appointed Assistant Surgeon with full power to act in the absence of Dr. Sims. Being 6 Thomas Addis Emmet, M. D. thoroughly familiar with the details of hospital management, of which Dr. Sims knew little, I was able to render efficient service and he was glad to be relieved of all detail work. I began a systematic registry of the history of all cases, with descrip- tive drawings. I started a clinic and, after the first year, did quite as many, if not more, operations than Dr. Sims, whose private practice was already beginning to demand a great portion of his time. Of the first Board of Managers, beyond a social acquaintance, I have little recollection or of their special work, save that of Mrs. David Codwise, the first Directress, and of Mrs. T. C. Doremus. Mrs. Codwise was well advanced in years yet she took a very active part I have been told in forming the organization, in obtaining the act of incorporation from the Legislature, and in collecting funds from among her friends for the early wants of the association. But Mrs. Doremus is the one most closely associated in my mind with all the early struggles made from day to day to establish the Woman’s Hospital after it had ceased to be a novelty, and, owing to my position, I was thrown into closer relation with her than with any one else. The piety and faith of this good woman were remarkable. I cannot say more in praise of her than to compare her work with that of a Sister of Charity who, devoting her life to the service of others, is actuated alone in the discharge of her duty by the love of God and of her neighbor. I well recollect on more than one occasion, when we met in the morning, Mrs. Doremus has said: “ Doctor, we have not a dollar in the house and it will soon be time for me to go out to get something for dinner.” I would jokingly say: “Well, Mrs. Doremus, how is it possible to get something for nothing ?” “ The Lord will provide in time,” she would answer. The dinner was always forthcoming, for she would not go very far before she met some business-man who would give her five or ten dollars for her purpose. Mrs. Elisha Peck, who afterwards became Mrs. Abernethy, was a member of the first Board of Managers, and she has continued with great singleness of purpose to serve the hospital to the present day. With the exception of Mrs. Fordyce Barker, who resigned from the Board of Managers after two years service, Mrs. Abernethy and myself have outlived, I believe, every one else connected with the early history of the Woman’s Hospital Association, and I sincerely hope she may be spared many years longer for her good work. As I have stated, the Consulting Board was selected from the Faculty of each medical school in the city. Dr. Delafield was of the MRS. DOREMUS, MRS. ABERNETHY. Reminiscences of Founders of The Woman's Hospital Association. 7 College of Physicians and Surgeons but seemed to take little interest in the beginning of the hospital, nor do I recollect ever to have seen him at a consultation during Dr. Sims’ service. Soon after the hospital was opened I was present at the first con- sultation. The case was that of a young woman with what was thought to be a movable tumor in the abdomen. The mass may have been a floating kidney, a pedunculated fibroid, or nothing more than a phan- tom tumor, as Dr. Sims had not yet reached that proficiency in diagnosis for which he was so noted in later life. He held, however, that it was a fibrous growth connected by a slender attachment to the uterus, and he wished the sanction of the Consulting Board to open the abdomen and remove it. He made so plausible a plea that at one time it seemed as though he would carry the Board with him in favor of the operation. All had spoken favorably when Dr. Stevens rose. He expressed his great interest in the subject but said he knew nothing about a fibrous tumor; doubted, in fact, if he had ever heard of one before. He felt every confidence in Dr. Sims and had no doubt that he would be successful, if he undertook the operation. But he protested, in the name of humanity, against such a procedure, for. if Dr. Sims was successful in the removal, it would not be long before every young doctor in the land would be opening the belly of every young woman to see if she had a fibrous growth. Surely the Spirit of Prophecy must have hovered over the old man, as he thus had a glimpse into the future. Dr. Stevens was Surgeon to the New York Hospital then standing on Broadway opposite Pearl Street, in the midst of about four acres covered with forest trees. He had the reputation of being a skilful and successful operator, but he was withal a very eccentric man. In the Spring of 1850 I made an effort to obtain the nomination for the house-surgeon- ship of the New York Hospital. I did not then know Dr. Stevens personally, though he had been an old friend of my father. So I called upon him one morning at his residence on Fourth Street, near the Bowery, to ask for his influence. When I was shown into his back- parlor office, he was walking up and down the room with his hands behind his back and in deep thought. Upon my addressing him, he recovered himself but refused to hear anything I had to say. Placing a pen in my hand he pushed me into a chair alongside the table and told me to write. He had evidently being lying in wait for some victim and proceeded at once to dictate his eulogy on John C. Calhoun, who had been a fellow-student with him at Yale College. In spite of 8 Thomas Addis Emmet, M. D. my protests I was obliged to write until the task was completed, about two o’clock in the afternoon. I was then pushed out of the room and told to come back to breakfast the next morning, when he would hear what I had to say. I was punctual but did not get my breakfast. The old gentleman complained that my hand-writing was atrocious, and, receiving the information that he did not have the appointment for that year, I was shown the door. Dr. Stevens was very simple in his tastes and used few instru- ments. He always carried in his pocket an old, stained, and rusty- looking curved bistury, with which he seemed to be able to do almost anything in minor surgery. Some years later I had frequent occasion to call in his services in my tenement-house practice and I well recollect how he put at naught all our aseptic precautions of the present day. The old bistury would be brought out and hidden among the bed-clothes, until the opportunity arrived for using it. After it had rendered service, if a basin of water were not at hand, he would manage, with a little saliva and the aid of the patient’s blanket, to cleanse it sufficiently for use on the next occasion. The Doctor lived to an advanced age, but for several years before his death he was greatly incapacitated both in mind and body. A short time before his death, however, it became known among the friends of the family that a great change had taken place in his mental condition which seemed to have recovered its normal strength. He took the greatest interest in the illness of an inmate of his house, suffering with typhoid fever in which the diarrhoea was the most marked symptom. As Dr. Stevens had been so distinguished a physician in his day the family were well pleased at his interest in the case, and particularly so when he proceeded to prepare some medicine for the patient. The story current at the time, and never contradicted, was that after two doses had been administered the family discovered that the Doctor had prescribed about an ounce of Spaulding’s Liquid Glue, then just being introduced for household use. The old gentle- man was correct from his stand-point, that if he could glue up the bowels the diarrhoea would cease. He was not allowed to prescribe again, however, but as he died shortly thereafter, almost the last act of his mind was connected with the practice of his profession of which he had been so bright an ornament. Dr. John W. Francis was the most remarkable man in the Con- sulting Board. While prominent in his profession, he was more noted, with the world at large, for his literary attainments. He prided him- ft, , . I«■ PHI»U»>-XT OF TH r, * ATMS AX MKDKAt, ASiOCUTBX. ,■ , vr »»»n. I-. 143. .■ J Reminiscences of Founders of The Woman's Hospital Association. 9 self also upon his resemblance to Benjamin .Franklin.* His “Old New York"’ will always be a most valuable book of reference, as his recollec- tion of persons and events connected with the history of this city during the first half of the century was indeed marvellous. His home, No. i Bond Street, was the house generally first sought for by any distin- guished stranger. The Doctor was always selected as the man to be depended upon to preside at a public meeting or to take part in the advance of any new undertaking. Hence his connection with the Woman’s Hospital, to which he rendered good service and was a true friend to the hour of his death. I am free to say that I was never much impressed with his professional attainments, but he was always kindly, especially to young men, and after he had his noon-day toddy he was most genial. He belonged to the old school, of which in many respects Dr. Pangloss in the “ Heir at Law ” was not so much of a caricature. He affected a certain pomposity of manner with a gruff voice and was a firm believer in the efficacy of the heavy gold-headed cane as a supporter of professional dignity. Moreover, he was an equally firm believer in what I once heard a darkey term “ sarching medicines.” He had lived in New York at a time when the people, if not primative, were at least more simple in their tastes and habits and generally more robust as patients than at the present day. So he often bled heroically, and the administration of a good dose of calomel and jalap was his delight. He was wise enough to realize that no few of the trials of man have an origin in his digestive apparatus, so he never went unprepared. Mrs. Francis, who looked well after her husband’s interests, was generally at the front door to receive any seeker after his services. As the Doctor was getting ready to respond to any summons, Mrs. Francis would call to Mary Ann to “get the Doctor’s hat, his cane, and the box of triplex pills.” In those days many of the physicians still dispensed their own medicines, and, by the way, I would suggest that in the interest of the profession I believe it would be an advantage to return to the old custom. During one Summer when Dr. Sims was absent at Newport and I was left in full charge of the hospital, a woman happened to be brought in one day by a policeman, who had picked her up in the street, suffer- ing from diarrhoea. She was too ill and feeble to be transferred to a general hospital and, as she spoke neither English, French nor German, it was impossible to obtain any history of her case. I soon discovered that she had not an ordinary diarrhoea and realized that the less medi- IO Thomas Addis Emmet, M. D. cine she received the better. So I set about carefully feeding her and hoped, with good nursing and stimulants, to get her well. Mrs. Mason, one of the Managers, was on the Visiting Committee at that time and came to me protesting that I was too young a man to assume the responsibility of treating such a case; as Dr. Sims was absent I must have a consultation. I offered no objection and as Mrs. Mason recalled passing Dr. Francis in his gig, she set out to bring him from his home after his one o’clock dinner. On the Doctor’s arrival I undertook to give him as clear a statement as I could, but I soon saw that his mind was on some other subject and proposed that we should see the patient. Upon seeing her he turned and said : “ Doctor, have you bled her ! ” I replied: “ Certainly not, as she has needed stimulants and was almost pulseless at her admission.” “ Has she had any calomel, Doctor % ” was the next inquiry. My reply was that I had only given her a small dose of castor oil. That such an opportunity should have been lost was too much for him and, raising his eyes to heaven in pro- test and with his arms extended, he exclaimed : “ Then God be with her 1 ” and left the house. As I let him out the market-boy came in with a basket of ripe peaches and, as I had lost my lunch by waiting for Dr. Francis, I helped myself to some. While passing the bed of the sick woman, she seized the peach I was eating and devoured it. I have always been a great believer in the promptings of nature, so I determined to let this woman have something to her taste even if some risk was incurred. The boy was called and I picked out five or six of the ripest peaches and gave them to her. On my return an hour later the woman was sleeping quietly, and from that time her convalescence was rapid and uneventful. I learned, subsequently, that she was a Swede and had just landed after a voyage of several months across the Atlantic in a sailing vessel. As I discovered from the con- dition of her gums that she was scorbutic, the effect of the peaches in checking the diarrhoea was explained. A few days later I met Mrs. Mason, who expressed great satisfaction at the improvement in the Swedish woman’s condition and remarked : “ Now you see the impor- tance of having older counsel and that of an experienced man, for that woman has been improving every moment since Dr. Francis saw her.” 1 did not attempt to undeceive her, and to the day of her death she labored on all occasions, as a duty, to obtain for her friends the advan- tage of older counsel. I can recall but a single occasion on which Dr. Francis seemed to have lost his temper, and then it was sadly out of joint. He had DR. FRANCIS Reminiscences of Fou?iders of The Woman's Hospital Association. 11 missed his accustomed toddy at noon and had, in addition, just learned a disagreeable piece of news. This was to the effect that one of his best patients had been delivered, when he had not even suspected pregnancy, and, he being away from home when sent for, that some one in the neighborhood had gotten the case. He came into my office, as he often did when I was not at the hospital, and his first exclamation was: “Damn these hoop-skirts! Young man,” he said, “there was a time, when I went to church, that I could look around me and form some idea of what my income might be during the year, hut now, since the invention of these damned hoop-skirts, I can no longer judge of the condition of the women. I am away from home when wanted, and some young whipper-snapper is called in and gets the case.” The situation was a clear one to him of personal grievance. I used to think he was £ grand old fraud, for he would come up and say : “My boy, I have no time to read now; is there anything new in the medical line ? ” I was a close reader myself at that time and might tell him of something I had recently read in one of the journals. For a while, it would arouse my indignation to overhear the Doctor shortly thereafter detailing the information I had given him with a most learned air and almost in my own words, to some one of his own age who listened in wondering admiration. But withal I had a very warm spot in my heart for the old Doctor. Of Dr. Edward Delafield I knew nothing in connection with the hospital. He was a very popular man, had a large practice, and in later life devoted a great portion of his time to the treatment of the dis- eases of women. I know of but one feature of his practice, and that one was to make nearly all his female patients ride on horse-back. He seldom took part in discussions at medical meetings, and his experience was lost with his death, for I am not aware that he ever published any- thing of special value. For some cause unknown to me he was never a friend of Dr. Sims, and possibly for the same reason he seemed to take no interest in the Woman’s Hospital. Dr. Horace Green was a quiet and mild-mannered man, who had many friends in the profession. He enjoyed for a time quite a reputa- tion for the treatment of pulmonary diseases by direct application to the bronchial tubes. He certainly acquired great dexterity in introduc- ing a probang-sponge into either btonchus at will. His chief remedy was nitrate of silver in solution of different strengths. From the dam- age done my throat in early life by his hand I gained a valuable experience and an aversion to the constant use of nitrate of silver as I 2 Thomas Addis Emmet, M. D. an application to mucous membranes in any part of the body. Dr. Green had a gentleman under his care in this city who was well known in society. One day while passing the probang into the bronchial tubes rupture took place somewhere, allowing air to enter the connective tissue. Emphysema supervened, the man became enormously dis- tended about the head and neck and died a few days thereafter. It was a coroner’s case and the community was thrown into a great state of excitement in consequence. It became a question as to how far the cause of death might have been due to the man’s habits, which were not good. Dr. Green was fully exonerated, but his health seemed to have given way under the strain and within a short time his own death occurred. My earliest recollection of Dr. Valentine Mott was in connection with the removal of my tonsils, about 1837, at my uncle’s house in Broome Street, then’ a fashionable neighborhood but yet rather far up- town. The Doctor was always remarkably neat in the appearance of his linen and in later life was very particular about his dress. But when I first saw him he wore the Quaker costume, which made an impression upon my youthful mind. Dr. Mott had an European repu- tation as a surgeon, and he was certainly a very brilliant and dexterous operator. His office practice was always a large one, and when he moved up-town to Depau Row, in Bleecker Street, it was often impos- sible for a late comer to find standing space in his reception rooms. His office fee was, I believe, one dollar, and he kept together his office work until within a short time before his death. Dr. Mott is almost the only instance I know of in the profession, where any medical man occupying the social position which he did, has succeeded in leaving to his heirs a large competency acquired, as I believe his was, entirely from his professional work. As you advance in life you will find that the more successful you become, the greater become the demands upon your purse from all quarters, a tax you must pay for your prominence. I will now briefly refer to one whom you all knew and honored, Margaret Brennan the nurse. She was a most remarkable woman, and one who, I believe, contributed more in her way, by her tact and good sense, to the success of the hospital, than any other individual ever connected with it. She could neither read nor write, a want which very few people recognized in her, and yet in over thirty-four years of service she never was known to have made a mistake or to have forgotten an order. Much that now passed into our common stock of knowledge in the detailed care of patients, while under treat- ment and after plastic operations, particularly in the care of cases of DR. HORACE GREEN. Reminiscences of Founders of The Wo mads Hospital Association. 13 vesico-vaginal fistula, we owe to the observation and judgment of Margaret Brennan, who was the pioneer nurse in this specialty. Her great tact was shown in attending strictly to her own business and in seeming to know nothing of the business of others around her. She was always cheerful and exerted a most beneficent influence upon the patients, in keeping them encouraged and contented with what was being done for their relief. Without ever committing herself she im- pressed each patient with the conviction that the surgeon in charge of her especial case was the most skilful. She certainly had her favorites, but in her loyalty to the Institution she never let those who were not so see any indication of her preference. Her whole life was moulded by an earnest desire faithfully to discharge her duties, and she discharged them through the love of God. Few about her ever realized what the incentive was which actuated her to spend a life of unselfishness, which was devoted, almost to the last, in serving God through her care for others. She was strong in the belief that she had been sent into this world for a special purpose, and she was firmly convinced that her reward was to be in proportion to the manner in which she availed herself for good of the opportunities given her. No one knew her so well as I did, during so many years and often under the most trying circumstances, and I am sincere in my belief that her reward was great after death for so well-spent a life. After a continuous service of over thirty-seven years, I may justly claim that fate had decreed that my name must be associated with the progress of the Woman’s Hospital. In the past I have been most indifferent as to the credit due me, but as my services draw the nearer to a close, I am the more impressed with the importance of placing on record some statement of my work. Especially does this seem just to me, since even those who are to-day in charge of the management ot the hospital have but a slight appreciation of my efforts in the past for its success. If I know myself, I am the last person who would lessen in the slightest degree the credit due to Dr. Sims, and yet in all truth and in justice to myself I must state that he has received more than he would ever have been willing to have had claimed for him. In the past, there have been those who have credited Dr. Sims not only with the con- ception of the hospital but also for its full growth. I have been made to appear as though I had been only the shadow, and that I was, in addition, indebted to him for my knowledge in the specialty. Dr. Sims’ name must be for all time, and justly, identified with the founding of the Woman’s Hospital Association ; I am willing that he should Thomas Addis Emmet, M. E. 14 have full credit for everything done at the hospital while he was at the head of the institution, and even up to the Summer of 1862, though this includes over eight months during which he was absent abroad. I grant all this, notwithstanding the fact that it can easily be proved that I did, throughout our association, a large proportion, if not the greater part, of all the work, I being the younger man with more time to give to it. It is for the older members of the profession, and especially those who have served on the Consulting Board, to verify my statement that the Woman’s Hospital Association was not in a most prosperous condition when Dr. Sims left it and went abroad to live. And I will say further, that some of the most prominent men in the profession, of whom a number are now dead, such as Drs. Willard Parker, Buck, Post, Cheeseman, Van Buren, Delafield, Sabine, and others, were open in their hostility and were prejudiced against Dr. Sims, I have always felt unjustly so as far at least as I ever had any means of know- ing, and were opposed to the Hospital at that time in consequence. If Dr. Sims had remained in New York, his reputation in 1862 was not sufficient to have made the Hospital eventually a success, and it mattered not so much who had charge of it as that a change had to be made in order to overcome the existing opposition. Dr. Sims was widely known at the South, and it was from this source that he received the most profitable portion of his practice. At the breaking out of the war, partly because his business had become less profitable, he was obliged to go to Europe and it was while he was abroad that he made his world-known reputation. On his return to this country years after as a successful man, many seemed to have forgotten their former relation to him and became most friendly in recognition of his success, thus showing a very common trait in human nature. Between the Spring of 1855 and September 1862 my relations with him were as close as those between a father and his favorite son, and I shall ever keep green the memory of our intercourse at this time. I repeat that when I became first connected with the Hospital I had received a thorough hospital training. I had thus obtained a practical knowledge of my profession and had moreover held, for three years and more, the post of Visiting Physician to a large general hospital. The first intention in opening a Woman’s Hospital was to devote it to the cure of vesico-vaginal fistula by the use of an operation, of which Dr. Sims had then so far perfected the general principles that no improvement has been made upon his method to this day. The MARGARET BRENNAN, THE NURSE, HOLDING THE SIMS SPECULUM. 1857 Reminiscences of Founders of The Woman's Hospital Associaiioti. 15 treatment of the diseases of women, however, was an after-thought, as it were, and when we both entered upon this field I possessed undoubtedly as accurate a knowledge as did Dr. Sims of what little was then known. But he was a most skillful operator, and although beginning in an entirely new field, he never seemed to be at a loss; so great indeed was his ingenuity that he seldom did for the same indication any two operations alike. But from the beginning Dr. Sims drew his own deductions and I mine ; they were seldom the same or even made from the same stand-point. If I operated or treated a case for him I followed out his views, but otherwise I followed my own judgment. I doubtless profitted by witnessing his ingenious methods of operating and certainly gained more thereby than he did himself, for I kept accurate records of the cases with the object of studying the results of differing operations and had many of these patients under observation for years. I received no other advantage, however, beyond the opportunity for observation, for during my entire association with Dr. Sims, I never received from him the slightest explanation or reason for anything he did. He was not a teacher and operated naturally with such rapidity that very few, unless they were familiar with his methods, were able to receive much benefit from witnessing his operations. I was at times almost in despair, after I became Surgeon-in-Chief, on account of the unfriendly feeling of certain influential medical men towards the Hospital, but I began at once to write and to teach, gave two clinics a week, and demonstrated each step fully upon the black- board. During the ten years that I held the Surgeonship-in-chief, my climes were crowded by physicians from every part of the country. I claim thus to have popularized the Woman’s Hospital and the practice of gynaecology itself. Seldom has it happened, I believe, that the teaching of any one individual has become so widespread in its con- sequences. I labored to teach the general practitioner how to do the least harm and the most good, as I hoped, for the relief of suffering woman. But I may have erred in judgment and I may have overdone the teaching, since the criticism of Dr. John Scott of San Francisco, whom some of you knew, was to the effect that I “ would ruin the specialty by making every physician believe that he was a natural-born gynaecologist,” and when my last work was published, he reiterated his opinion that I had succeeded in my efforts. I certainly succeeded at length in gaining the good will, I believe, of nearly all those who were in opposition to this movement, and so much so that the greater por- i6 Thomas Addis Emmet, M. I). tion, at my request, became connected with the institution as members of the Consulting Board. The Hospital became so popular that Mr. Apollos-R. Wetmore, the Vice President of the Board of Governors or the then recently chartered corporation of the Woman’s Hospital in the State of New York, was able to raise within a very short period sufficient funds to build the pavillion now bearing his name. The Woman’s Hospital Association under a Board of Lady Managers then ceased to exist as a corporation, but its members became afterwards a part of the organization of the Woman's Hospital in the State ol New York. So the facts of the case are, as regards the establishment of the present Woman’s Hospital, that the money was collected by Mr. Wetmore, towards which a large number of my friends contributed, the building was erected under my supervision, the Hospital was then organized by myself and was in perfect running order for several years under my sole charge before Dr. Sims returned to this country, and consequently he had nothing whatever to do with it until it had become as fully established as it is to-day. At an interview shortly after his return 1 offered to resign in his favor or to divide the service with him, as a recognition on my part of our former association. He declined to accept either proposition, because he then felt compelled to devote his whole time to building up again a practice. But in the presence of others he paid me the com- pliment of saying that the Hospital had then reached, under my care, a degree of success which he had never deemed possible under any circumstances. At my special request the position was made for him and he was appointed Senior Consulting Surgeon and through my influence and that of my friends he was elected a member of the Board of Governors. Ido not care to enter into the merits of our estrangement afterwards. He lived long enough to have a return of his old kindly feeling for me and to realize the false position in which he had been placed by others. My feelings prompt me before closing to note the services of my old friend, Mr. James W. Beekman, who for so many years and with such devotion filled the position of President of the Woman’s Hospital in the State of New York, and also to refer to other friends among the Governors and among the Board of Lady Supervisors, but I would be obliged at once to enter upon too extended a field. The history of the Woman’s Hospital must be written by another pen, and my task there- fore ends with the end of the Woman’s Hospital Association as an organization. THE WETMORE PAVILION OF THE WOMAN’S HOSPITAL ASSOCIATION.