THE Jf'f// ///€ o/ //e s/td/oi. MUTUAL RELATIONS O F THE MEDICAL PROFESSION, ITS PRESS, AND THE COMMUNITY. BY DR. STORER, Jr. (Horatio), OF BOSTON, FORMERLY PROFES80R OF OBSTETRICS AND THE DISEASE8 OF WOMEN IN TIIE BERKSHIRE MEDICAL COLLEGE, AND ASSISTANT IN THE SAME IN HARVARD UNIVERSITY; MEMBER OF THE GYNAECOLOGICAL SOCIETY OF BOSTON, AND OF THE OBSTETRIC AND MEDICO-CHIKUROICAL SOCIETIES OF EDINBURGH; CORRESPONDING MEMBER OF TIIE NEW YORK MEDICO-LEGAL 80C1ETY, AND OF THE OBSTETRICAL SOCIETY OF BERLIN; HONORARY MEMBER OF TIIE CANADIAN MEDICAL A88OCIATION, THE NEW BRUNSWICK MEDICAL SOCIETY, THE LOUI8VILLE OBSTETRICAL SOCIETY, ETC., ETC. ETC. I * /. REPRINTED FROM THE JOURNAL OF THE GYNAECOLOGICAL SOCIETY OF BOSTON. BOSTON: JAMES CAMPBELL, Publisher, 18 TREMONT STREET, MUSEUM BUILDING. 1872. JS O W READY. Volumes I, II, III, IV, V. THE f ourital of iltc |)gniecol(igicaI J>ocidg of | osioir. A special Medical Journal, devoted to the diseases of Women. PRICE, $2.50 EACH. EACH VOLUME SOLD SEPARATELY. Sent anywhere in the United States, postage prepaid, on receipt of the price. THE MUTUAL RELATIONS O F THE MEDICAL PROFESSION, ITS PRESS, AMD THE COMMUNITY. BY DR. STORER, Jr. (Horatio), OF BOSTON, FORMEEI-Y PROFESSOR OF OBSTETRICS AND THE DISEASES OF WOMEN IN THE BERKSHIRE MEDICAL COLLEGE, AND ASSISTANT IN THE SAME IN HARVARD UNIVERSITY; MEMBER OF THE GYNAECOLOGICAL SOCIETY OF BOSTON, AND OF THE OBSTETRIC AND MEDICO-CIIIRERGICAL SOCIETIES OF EDINBURGH; CORRESPONDING MEMBER OF THE NEW YORK MEDICO-LEGAL SOCIETY, AND OF THE OBSTETRICAL SOCIETY OF BERLIN; HONORARY MEMBER OF THE CANADIAN MEDICAL ASSOCIATION, THE NEW BRUNSWICK MEDICAL SOCIETY, THE LOUISVILLE OBSTETRICAL SOCIETY, ETC., ETC. ETC. REPRINTED FROM TEE JOURNAL OF TEE GYNECOLOGICAL SOCIETY OF BOSTON. BOSTON: JAMES CAMPBELL, Publisher, 18 TREMONT STREET, MUSEUM BUILDING. 1872. THE ADDRESS DELIVERED AT THE ANNUAL MEETING OF THE ASSO- CIATION OF MEDICAL EDITORS, ON MAY 1, 1871, AT SAN FRANCISCO, BY HORATIO ROBINSON STORER, M.D., EDITOR OF THE JOURNAL OF THE GYNAECO- LOGICAL SOCIETY OF BOSTON, AND PRESIDENT OF THE ASSOCIATION. GENTLEMEN OF THE ASSOCIATION OF AMERICAN MEDICAL EDITORS : Coming together from the opposite portions of the Continent, we have met to-night, not merely “ to cultivate professional courtesies and to facilitate the conduct and general management of our jour- nals,” but, still further to quote the language of our constitution, “ to promote their usefulness, and jnake them a still greater power for pro- fessional and popular good,” and thereby, most especially, “ to ad- vance the interests of Medicine.” Such being the purpose and intent of our organization, there can be no topic more appropriate for me to present to you, none more fitting to the time, the place, and all the circumstances of the occasion, than THE MUTUAL RELATIONS OF THE MEDICAL PROFESSION, ITS PRESS, AND THE COMMUNITY. These relations are manifold. To consider them all would be im- possible in the brief space of an half hour’s address. I shall, there- fore, endeavor to speak only of the most important of them, and, avoiding all attempt at fine writing, to make my remarks terse, very plain, and thereby, I trust, effective. I. The Medical Profession in this country consists of what ? To this question a multiplicity of answers present themselves; all of them true to a certain extent, and yet all of them, save one, very degrading to the term’s highest idea. Were every physician what he should be, — a thoroughly honest, straightforward man, anxious only for his patients’ welfare, laboring for the development of his science, and not alone for gain, liberalized by education, humanized in the highest sense by a constant entering into the sufferings he is compelled to meet, and, above and beyond all else, spiritualized by the recognition that his every success is but a vouchsafement of God’s great mercy, and he 2 but its humble instrument, r- what a different art were medicine, what a different place the world! Of the seventy thousand or more persons, in the United States, li- censed under the Revenue laws to practise medicine, how large a pro- portion, is it supposed, can be claimed to possess the qualifications just adverted to? Even if we eliminate all who, in default of professional graduation, have no valid title to the name, and all professed empirics, of whatever stripe or hue, — Caucasian, aboriginal, or Chinese; tackers, whether of “ path ” or “ ist” to their names, — there still re- mains a mighty host, swelled again almost to its original dimensions, if the title is permitted, as in many sections of the country, to dis- pensing druggists, and still again to that doubtful sex wearing the habiliments of womanhood, but assuming the work and the preroga- tives, wdiile it seeks to escape the legal responsibilities, of man. Ad- visers and conservators of their race, physicians should possess wisdom of the highest character. Too often they but ape the philosopher’s bearing, and become, however paradoxical the term, but grave buf- foons. Such clownishness is a disgrace to our calling; yet who does not recognize it within the circle of his own personal acquaintance ? Not simple pharmacists should we be, mere potterers in the crudest technicalities of chemistry, ever besalving, drenching, or otherwise torturing the poor creatures whose sorest needs are our best harvest; but counsellors, guardians, directors, — whose every aim it is to ward off disease, to keep death at bay, and to prolong to its utmost the brief span we all so dread the ending of. Even were time to permit, I have no inclination here to speak the truisms that are so stale, as to the pre-eminence of the medical pro- fession, in its scientific interest, the elevation of its work, its opportu- nities for good ; nor would you have the patience to hear me. Our brother Dunster of New York * has well discussed the merits and needs of the three grand callings, of which two preserve and govern men’s bodies, while the third saves, if but willing, their souls. They stand side by side; hand in hand it should also be, for their every depart- ment overlaps each other, and thus they should be joined indissolubly and forever. As a graduate in law as well as in medicine, from the twin schools of that dear old University whose foundation goeth back to the time when jurisprudence and the art of healing, those best transplantations of civilization, first were landed on the Atlantic coast, I yet yield for them the palm to that nobler vocation, by whose teachings and minis- * Editor of tho “New York Medical Journal,” and Professor of the Diseases of “Women, at Brooklyn. 3 trations, through God’s grace, our yokes here are lightened, and here- after our best hopes ensured. “ Christo et Ecclesise.” To these did John Harvard dedicate his worthy gift, whose ever-recurring power manifests itself in the skill, the intelligence, and the professional repu- tation of so large a proportion of American medical practitioners. Do I say that the lawyer and the physician should yield precedence to the priest ? Can any one of us who has personally looked within the vail, losing wife or child, or himself sick nigh unto death, do otherwise? By such recognition of the true sacerdotal functions, confessing our dependence upon that One Supreme, to whose immediate presence with us we owe every so-called cure, we but increase, with our own hap- piness and self-respect, our esteem by others ; for what sceptic even is there who would not sooner trust his life to a devout physician than to an unbeliever? Or what man or woman who can alford in their direst strait to spurn the gentle, loving touch of the All-Healing hand ? “ Cant! ” do I hear you say? Lips may thus articulate, but not one heart’s silent utterance ; for, underlying the hardest of natures, there exists, however stubbornly it may keep itself down from sight or even from self-consciousness, a conviction of the utter weakness of the strongest and wisest of us as against His Almighty power, our ignorance as compared with His All-Pervading knowledge, from which alone our little wit, our puny abilities are born, — and, may I not also say, our innate tendencies towards sin, conquered only through His saving mercy? The physician is to render to his patient of the tenderness and sym- pathy, care and assistance he has himself received. Let every man see to it that the Fountain is not forgotten, nor impute thereto his own defilement of the precious stream. Am I saying too much ? Rather, my words are too feeble, I trust that you will judge. Then let me reproduce to you, from the nobler language of our Vice-President,* the ring of whose every word is that of coin true to the mint-master’s hand. “ One thing more,” says Dr. Parvin, “you will pardon me— But what am I saying? No, your pardon need not be asked, for declaring that if the physician be truly a religious man, it will add to, not detract from, other qualifications. Religion is not a matter of particular creeds, and forms, and ceremo- nies, not a shibboleth to be shouted in men’s ears, nor a sanctimoni- ous face to be worn for men’s eyes ; but, as the etymology of the word * Dr. Theophilus Parvin, one of the editors of the “ American Practitioner,” and Professor of tho Diseases of WoraeD, at Louisville. 4 tells, a religation, a re-binding of the soul to its father, God, from whom it has wandered. Only here do destiny and duty blend in a common path ; only here does true light shine upon the vexed ques- tion, the unwearing riddle of human life, presented to all thoughtful minds, ever recurring from age to age.” * That the ideal I have presented to you is constantly fallen far short of, is no argument against its appropriateness or its possibil- ity. Allowances are to be made for the infirmities of man’s nature. after there has occurred that newness of heart, so essential to truly holy living, through which a man turns from the world’s allure- ments to a nobler walk and conversation, he will sometimes cast a lingering look behind, such is instinct and the power of former habits of life. It must not be forgotten, however, that there is nearly as much danger of underrating actual goodness and purity, as of extolling imperfection. Eyes as of a microscope are upon us all, ever quick to detect the slightest flaw. Malfeasance in morality is an easier charge to make against a physician than malpractice in art. For every uttered breath of scandal, ten thousand suspicions exist unspoken, — for mortals are prone to judge each other from what they themselves might do in similar opportunity, and they catch exultingly the faint- est Avhispers of the wind. What gynaecologist is there, for instance, who does not daily pass between walls of fire, liable as he constantly is to be misundertood, misrepresented, by the distempered imagina- tions his sad duty it is to seek to heal ? That there are uncertainties in medicine, equally as concerns diag- nosis, prognosis, and therapeutics, in nowise weakens what I have said of its claim to reverence. These uncertainties, from the very nature of things, must ever exist. Their number, however, and their range are constantly lessening. As the point of vision is raised and the horizon extended, a greater number of lines of shadow appear ; but the old ones are constantly growing smaller and less and less distinct. That the education of physicians is frequently so limited goes far, there can be no doubt, to prevent that general bestoAval of confidence which othenvise Avould be conferred. For this, however, the com- munity partlj’, as in part ourselves, are to blame. If a second-rate article is all that is sought by the purchaser, he should not complain if it be receiA’ed. If the medical colleges are content to underbid each other, and year after year to pursue the suicidal warfare, they * Woman and her Physioian. Introductory Leoture at the University of Louisville. 1870. 5 should not grieve that their students, become practitioners, so often are starvelings and so frequently do them discredit. This address will have accomplished much if it strengthen the counter-current that has at last been established in the profession against the faulty and false education that so long has held its pernicious own. To elevate the standard of collegiate instruction, to insist on a higher prelimi- nary qualification, to convince students, and the public which is to employ them, that the best education is none too good for those who are ever to stand bewixt life and death, — this is a duty which demands your every effort. From it not one of you should shrink, selfish or afraid. Professional “ intuition ” in the treatment of disease is seldom to be found. It is a very different thing from the vocation of which I have already spoken, — without a sense of which none should ever assume so sacred a trust. A knowledge of human nature is useful to us, as a matter of course. It no more, however, constitutes a complete preparation for practice than would a knowledge of mechanics, or of inorganic analysis. It is as with houses built upon a rock and upon the sand, — unless early educatioij be well laid and solid, a broad and good foundation, the most elaborate after-structure will prove easily shaken and unsafe. It matters not what, or how many, the apparent ex- ceptions to this rule, for these brilliant self-made men would have shofle with far more lustre had they but received the early training of whose lack none are more painfully conscious than themselves. However great is the credit their due, there’s always a blur to the gem, and some- times the very contrast with what might have been, makes this seem the greater. President Eliot, of Harvard University, told but the truth in that now famous paper of his, upon “ The New Education.” “ The term, ‘ learned profession,’ ” he said, “ is getting to have a sar- castic flavor. Only a very small proportion of lawyers, doctors, and ministers, the country over, are Bachelors of Arts. The degrees of LL. B. and M. D. stand, on the average, for decidedly less culture than the degree of A. B., and it is found quite possible to prepare young men of scanty education to be successful pulpit exhorters in a year or eighteen months. A really learned minister is almost as rare as a logical sermon.”* And as for the yearly graduates from our medi- cal schools, “ Poor humanity,” continues President Eliot, “ shudders at the spectacle of so large a crop of such doctors.” >Vho of you will not admit that a really learned physician, in the highest sense, is as rare as, by differentiation, the only possible method, a perfectly * “ Atlantio Monthly,” February, 1869, p. 215. 6 correct abdominal diagnosis, — which, I am sometimes inclined to say, has never yet been made. II. Such being the truth, what of ourselves, — to a certain extent representative members of the profession, — and of the power which we wield, its press? As individuals, we maybe very far from the standard our responsibilities demand, — many of us undoubtedly are, — but, in the aggregate, there’s a mightiness in this editorial function, that makes of one’s chair well-nigh the throne of Jove. "VVoe to the evil-doers upon whom its bolts chance to descend! The opportunities and the influence of the Medical Press, its history in this country, and the causes which, thus far, have in- terfered with its full measure of usefulness, — were all so intelligently discussed by my predecessor,* that I will not weary you by their recapitulation. A few words, however, may be necessary, in this connection, to render more evident the bearing of what will follow. As there are many classes of so-called physicians, with but one real and honest distinctive type, — so this expression “ Medical Press ” may mislead, unless now more strictly defined. Many of you are authors of no mean repute ; you have published, out of the stores of your own experience, manuals or text-books in the several depart- ments of medicine, or have laid your contributions, in the form of original memoirs or monographs, upon the lap of our science. Others, of whom the number was formerly far greater, have de- scended to a lower plane, and, as translators or copyists, have re- vamped the work of foreigners into our English tongue, — doing it too often, I grieve to say, as veritable pirates, without the slightest concert with the authors themselves, — thus bringing the whole editorial profession into grave disrepute. With neither of these classes have I now to do. Nor, gentlemen, are we here as the repre- sentatives of merely an ephemeral literature, fluttering between earth and sky for a brief moment, and then forever dead, nor as the harvest- ers of an idler’s crop, where thistle-down and the seed of tares is far in excess of golden grain; but as the purveyors to the profession of the best fruits of the medical mind ; the preservers from oblivion of its choicest discoveries; the directors, and the creators, in all essen- tial matters, of public opinion; the tribunal, indeed, before which • Dr. N. S. Davis, of Chioago. See “ Chicago Medioal Examiner,” July, 1870, p. 413. 7 professional reputations are made or fall. I do not hesitate to repeat this statement, plain though it may seem, for I am firmly convinced of its truth. In our calling, as in all others, there are strong and positive tendencies, — on the one hand, upwards; on the other, towards de- terioration. In the union that we now commemorate, just as there is strength for us all, so will it be found that the purer tendencies to which I have alluded will be intensified, the less worthy ones diminish or be destroyed. License, for instance, you will not tolerate, even while ensuring a truer freedom. Every leaning towards irregularity in practice, or towards its excuse or encouragement, as one man you will rebuke. Praise of self will find itself merged in an utter forgetfulness of self- contemplation, through the very working for others’ good. A common interest, secured by a common bond, ever exerts the best policery ; and true as this will be found of our relations to each other, it equally knits us to the best interests of the profession at large, upon whom we depend, so far, for our daily bread. "VVe cannot, however, look for perfectness of unanimity regarding minor details, whether of general polity or of individual action ; nor would it be desirable, even could such identity be attained. Localized as are our centres of labor and of influence, in such diverse and widely separated fields, there must necessarily be somewhat of a sectional tinge distinguishing us. So be it we are not provincial, that worst of faults, the quality to which I refer is an advantage; for it makes us the better ac- quainted, through reciprocal interchange, with a wider range of practice, of observation, and of thought. Different ideals we all have, and yet in reality the same standard. For different ends we are each working, and yet for a common one. Ourselves we are to forget for the sake of the whole; our private aims we are to make subservient to the general improvement. A want of concert in the efforts that we are all making for certain well-recognized and ac- knowledged results has hitherto been painfully apparent. Hence- forth let us be more closely identified with each other. Our constitu- tion and the articles of our association show us what is needed, and the easy way towards its attainment. Shall M*e not, then, as we advance, press more closely together, each of us feeling the respon- sive touch of a brother’s hand ? In a more trusting and profitable exchange of thought, a more cordial support of each other’s endeavors, a heartier co-operation in the enforcement of professional reforms; and the correcting of public and private abuses, we shall find our 8 reward, and in a more appreciative and grateful material response from our myriad patrons. In this connection I would say one word concerning the relations that we hold to these patrons, our brethren of the profession itself. We have our work to do for them, and we all of us endeavor to do it well. They encourage us by their contributions to our pages, by kind messages in the letters they write to us, and, to an ever-increasing extent, by the money enclosures therein contained. And yet, though personally I have had every reason to be grateful upon each of the scores I have named, I am sure that you will agree with me when I say, that the medical profession as yet falls far short of its duty towards its Press. Of the great number of practising physicians in the United States, there is good reason to believe that but a compar- atively small number subscribe for more than a single medical journal, and that a very, veiy great many take none at all. This is far from being as it should be. There is no other such means of keeping the busy practitioner afloat with the ever-swelling tide of discovery and improvement in practice, as that which you, the periodical Press, afford. There is no other such solace for his weariness, rest for his busy brain. There are honorable exceptions, it is true, to the remark that I have made. The magazine under my own direction has a sub- scriber who wrote that the “ Gynaecological Journal ” was the thirteenth medical periodical that regularly came to his table ; and this was a hard-working, over-driven physician, in a sparsely settled country district, with no leisure for study, it would seem, than that afforded while in the saddle upon his daily beat; and yet I will venture to say that this gentleman, by this means, kept himself better informed, more completely at a level with the prominent men of the day, than thousands of practitioners, with greater wealth, more leisure, infinitely more pretensions, and far less liberality towards the mem- bers of this association. There is not a physician in this country, I dare affirm, who would not each year obtain his money back again, at compound interest, were he to subscribe for, and read with the most ordinary appreciation, a copy of each of the journals that we represent. One half of the sum that most men throw away at auction sales for stale and musty editions of authors now far behind the age, expended in subscriptions for the medical journals of the day, would not only do much for the continued education of our friends in prac- tice, and keep their minds alive to the improvements in methods of study and treatment, constantly being made; but it would tend, infinitely, towards a greater appreciation of, and respect for, our own native medical writers, who, through the channels of communication 9 you offer them, are becoming recognized, as never before, by the pro- fession of foreign lands. III. Let us turn now to the relations of our profession and its Press to the community. There are many persons who look upon their physician as simply their servant, to be paid his wages, and not always when due ; at their beck by day and by night; and to be discharged when the whim takes them, as summarily as their horses’ groom. There are prac- titioners, on the other hand, — would that there were more of them ! — who, while they look to the public for the means of support, yet believe that the skilled laborer, in such a calling, is in every way worthy of his hire ; and, so far from considering themselves as favored by those who call them to set a limb or ward off a convulsion, hold that it is they themselves who confer the boon; and that the arduous and often repulsive labors thus undergone, for others’ sake, are not to be balanced by gold. These views conflict, the one with the other. Both are to a certain extent wrong ; but I should dishonor my calling did I not hold, as I do most devoutly, irrespective of any esprit de corps, that our own view of the question is by far the more correct one. That it is not universally accepted by the community is not owing so much to a lack of grateful sensibility upon its part, as to a cheap- ening by physicians of each other, and of themselves. The moment a medical man descends to underbidding or decrying his neighbor, that moment he becomes, to the commonest intelligence, a mere mar- ket man, to be haggled with, browbeaten, or taken advantage of himself. Were the provisions of the Code of Ethics of the American Medical Association generally, accepted as they are by members of the profession, even though not as yet connected ■with that national body, but known and appreciated by the community, our present relations would be very materially changed. It would then be under- stood, that so far from being merely a system of checks and counter- checks for self-protection, and to preserve the privileges of a guild, the code exists for the safety of the public, to prevent quackery and its reckless tampering with the lives of men; to keep for the sacred art, so far as possible, its character of self-sacrifice; and to ensure, through the physician’s own effort, his retaining the intrinsic nature of a gentleman, — refined, and so, fit to deal with exquisite mental and physical derangement, — honorable, and so, to be trusted as the friend in the sorest need. We are not permitted to 10 dispense secret medicines, though to do so were a royal road to for- tune, neither may we patent a medical invention or discovery, how- ever meritorious in itself it may be. This negation is not for the pur- pose of defending ourselves from each other, but to protect the com- munity from the chance of our yielding to those ordinary temptations that surround all classes of men, and to ensure to it the full measure of every stream of beneficence of whose source we may perchance obtain the key. Were these facts but better appreciated, there would be less dis- trust of physicians, and of their measures for the relief of suffering, and less complaint by them of the ingratitude of their patients. If it be true, as I have said, that there exists this exalted though mutual dependence between the practitioner and the community in which he lives, with equal justice I may assert for you, as repre- sentative men, just as between yourselves and the profession, mutual duties and claims between you and the public. In proof of this fact, let me point to the extent with which many of your journals are purchased, in some instances indeed regularly subscribed for, by non-professional persons ; the frequency with which they are now placed upon the open consulting lists at public libraries ; and the readiness with which they are received, in exchange, by the editors and publishers of the literary and business papers and magazines of all large communities. As illustrative of the interest to which I refer, let me instance the discussions obtaining at the East, in the daily papers, flanked by quotations from the medical journals, concerning the safety of chloral, and the influence upon health of the sewing machine. Holding, as you do, the control of such*high destinies, able to show by your own examples to the extremest ends of the land the dif- ference between ignorant empiricism and a sound education, it be- hooves you to exercise a wise discrimination as to the work to which you turn your hands. Too many of our journals, it seems to me, are but tame copyists of each other; each depending too much upon gatherings from some other’s dust-heap, or upon the petty gossip of a neighborhood, instead of aiming at being a new focus of light and heat, itself to intensify all the rest. Our conjoined bouquet, to be all that it should be, needs greater variety ; even were all roses, there should be diversity of hue. At the best, there must be a same- ness about us all, when last year’s volume is bound and placed away upon the shelf; but every journal can be fresh and sparkling and new when it is first issued, and so win the interest and approval of an ever-extending circle of readers. 11 We all of us know by experience how much easier it is to criticise than to escape criticism; and yet we all of us, I hope, prize the en- dorsement of earnest, fearless, downright men, far beyond the weak approbation of timid and time-serving enemies to progress. I hold, with every one of you, that we are to work for the mass of the pro- fession, and not for ourselves or the interest of any little clique or faction; that the broader the subjects we treat, and our views upon them, the more satisfaction we shall give and the greater the good we shall do; that we should abstain from personalities and everything like aggression, unless we are pricking a public wrong or abuse, and some knave or dolt comes out of his way to impalement upon our needle. We should take the lead in every matter of social science, and, by stimulating, thus educate the community to a wiser self-pro- tection. We should, however difficult the task, combine towards compelling those with whom the duty may lie, towards a higher standard of medical education, and thus avert somewhat of the cloud of charlatanry that now overshadows the land. We should be quick to seize upon, and to turn to good, here at home, the suggestions that, mail after mail, are brought to us from foreign co-laborers with ourselves. But, I may be asked, is it possible for us to withstand, to any appreciable extent, the flood of empiricism that is now everywhere threatening to beat down and cover all the old landmarks? Unless we have faith that it is possible, wc are unworthy to be here in Cali- fornia at the present moment, surrounded, as we are upon every side, by monuments to success under what seemed insurmountable difficulties ; to courage that saw, in things begun, the same already accomplished. That there exist in all communities representatives of every form of irregularity in practice, what our Canadian neighbors call medical “ sects ; ” that the present extreme tendency to popularize, upon the part of our more prominent professional writers, may bring dignity and permanence of standing into jeopardy; that the running riot of men’s and women’s minds in their discussions of questions of social science, whether within or without special associations provided therefor, goes far to confuse anew many a matter already none too plain, — these are certainly discouragements. But what of that ? Were everything plain sailing, were there no dangers to avert, and no obstacles to overcome, of what possible purpose would be our As- sociation? Of what use indeed, our journals at all? We object, very properly, to certain definite and distinct violations of the Ethical Code ; to “ irregularities ” so-called, and every looking 12 thereto ; but we yet permit an extremely wide range of action. We would not advise that every man should be his own physician; he, himself, is often the first to recognize that error ; precisely as when, his own lawyer, he attempts to manage a case in court. And yet how much preferable it would be, did technical skill and what is known as common sense, oftener make each other’s acquaintance ! We be- lieve in erudition; and yet, is not he the best general practitioner, who is, after all, the best nurse? Was there ever a coroner’s inquest, where it would not have been for the public interests had the jury understood a little better the scientific evidence underlying the case ? Was there ever a trial for malpractice, where justice did not feel the lack of a clearer insight into medical measures or surgical methods, and the still more mysterious processes of nature ? To work, and to work together, to raise, in all these matters, the level of mankind, should be your aim. Only take good care that its elevation be not attended by a corresponding lowering of yourselves. The temptations to courses that are unprofessional are many and strong; resistance to them is seldom, if ever, easily made; when done, the effort and the sacrifice are not always appreciated. In our union, as in all others, there lies the chief secret of strength. There may be instances, within our circle, of men of pre-eminent en- ergy, and of such magnetic force or power of persuasion, that every frost of indifference and brazen wall of opposition melts down before them. Such, however, are few. Accept them if you choose, and they are otherwise worthy the trust, as leaders; but still do not neglect that closing in of the ranks, and that hand-touch together, without which you become an easy prey to every foe, and can never reach to any really great accomplishment for the general good. If what I have now said be true of the relations which you bear, on the one side to the profession, and on the other to the community, it must be evident that there should be constant concert of action between yourselves and the great representative body of American practitioners who assemble here to-morrow, and to whose meeting our own is as it were but the prelude. Far more than the college pro- fessors, influential though these have been and stronger though they mean to become, through their own private organization not effected the present year, we constitute the power behind the throne, and the measures which we initiate will give its tone and pith to the action of the National Association, upon any topic to which we may earnestly devote ourselves. Let a measure be proposed by a member for per- sonal or improper ends, and how quickly he is scathed through our pages. Let even so august a person as its presiding officer under 13 take to force upon the profession any Utopian views of his own,— whether they regard the acknowledgment of female physicians, for instance, or any other pet heresy, and it were better he had never accepted the chair, whose attainment constitutes the most laudable ambition of every physician in the country. It requires a steady hand, a calm pulse, and a cool brain, so to fulfil the duties of the presidency of the American Medical Association as to give satisfaction to, and receive efficient support from, the little group of ability- gaugers, who compose this Editorial Association. To-morrow we are to meet our subscribers and contributors from all parts of the country. They have given us aid and encouragement; we, in return, can stay their hands in their every effort for the increased influence and honor of the great national medical body. Many and varied will be the measures that are to be, or may be, proposed. There is the fundamental and ever-recurring question of Medical Education. Shall it still remain in the custody of the college teach- ers, who have found it difficult to be perfectly disinterested in this matter, — there are many of them among ourselves, but as editors they have risen to a higher level, and I can therefore speak thus freely, ,— or is it to be settled by the outside profession, which has already wisely decided that it has the power? In the letters which I have received from every one of your number, you have urged me, almost without exception, to declare as the decided voice of the Editorial Association, that the standard of medical education in this country must be raised. Let it be once understood by the colleges that you are in earnest, and what you have determined upon will soon b« accomplished. I hope, I may say I believe, that Massachusetts, long so laggard, will now be found to be foremost in this matter, and that the representative man who, in the fire of youth, brings a greater wis- dom than that of age, will prove, in his practical test of The New Education to which I have alluded, that he has obtained the wbip- hand of the medical, as of the other departments of the University, whose destinies he has been called to direct. Will it, again, be an advantage or not for the Association to recom- mend the formation of a National Medical School, liable as such would be, through political changes and favoritism, to pass into the hands of the common enemy? The establishing of a National Medical Journal, which, over- shadowing that of our learned brother Cox,* should, like the organ of •The “National Medical Journal,” Washington, D. C., edited by Prof. C. C. Cox, of Georgetown College. 14 the British Medical Association, serve as the especial mouth-piece of the great annual professional conclave ; The formation of a Board of General Scrutineers, whose gauntlet would prove far more fatal than those of the present Annual Com- mittee of Arrangements and the Committee upon Ethics combined, to many presenting themselves as delegates ; The founding of a National Board of Censors, with branches in every State, whose examination should stamp, as worthy or not, the standing of every physician already holding a college diploma; Whether or no there should be a National System of Quarantine ; The upholding the Code of Ethics, as binding upon societies of medical men as well as upon individuals, and branding with infamy attempts, like that recently made by the Councillors of the Massachu- setts Medical Society, to set it at naught; These are all of them topics of the highest professional moment. In their settlement you have an interest, now by your votes, and hereafter in the fertile fields for discussion they are to afford your pens. I have no question that your influence, then and now, will be cast as an unit upon the side of the right. We legislate not for our- selves, but for the future. I have exhorted you to be kindly affectioned one to another, and towards all mankind. But at the same time I warn you, would you preserve your influence, that of this Association, and your own self- respect, never to palliate wrong, never to afford shelter to the evil- doer. To do ,so seems often the easiest course, — it indeed may be for the time, — while to act uprightly may involve temporary miscon- ception, remonstrance, or blame. As an instance' in point, and as having had some personal experi- ence myself of the chance of being misunderstood, to which I have just alluded, let me again refer to one of the topics that I have men- tioned as not unlikely to come before the general Association at its session during the present week. It is the extraordinary conflict of jurisdiction that has arisen in the State to which I belong, and the question whether or no the American Medical Association and its Code are in reality to be the controlling power. The discussion of these topics by the Journal of the Gynecological Society has been the means of bringing to its editors’ table an ocean of communica- tions, in commendation, of inquiry, and in fierce denunciation, from physicians in every part of the country. It has also been the means, I doubt not, through your kind favor, of placing one of those editors, at the present moment, in this honorable chair. 15 You will pardon me, if, in view of their importance, I briefly state to you the facts in the case. They are these : — 1. Harvard College and the Massachusetts Medical Society had, for many years, an arrangement, by which all practitioners in the State being compelled to enter the Society or be treated as irregular, the graduates of the college were admitted to fellowship without any examination, upon mere presentation of their diploma, while those of all other schools were subjected to an examination, that, to use the language of the Censors to an applicant from St. Louis, who had been more than twenty-five years in practice, was “ such as is demanded of a student going up for his degree.” We tried for two years to right this at home ; but in vain. It was accomplished last year, but only through the American Medical Association. 2. Some sixty homoeopaths — most of them admitted on the free pass of the Harvard diploma — were a year ago in full fellowship with the Massachusetts Medical Society. Repeated efforts had been made to right this at home, but in vain. It was done at last, or at least was attempted to be done, by the society at large, in consequence of last 3>ear’s order of the American Medical Association. 3. The State Society has a so-called Board of Councillors, a sort of House of Lords, through whom the iniquitous arrangement had been made with the College, several of the professors being upon the Board. This body claims that the American Medical Association has not the right, or if so, not the power, to discipline it for its violations of the Code. It openly sets the Association at defiance, and has ordered the fellows of the Society to appoint no delegates the present year. At the same time, it has voted to send a protest to San Fran- cisco against the last year’s action of the Association. 4. Certain of the District Societies, of which the State Society is but an agglomeration, have nevertheless decided to stand by the Code of Ethics, and have elected their delegates. The Councillors have just sent a circular to the officers of those District Societies, ordering them to recall the credentials they had issued for San Fran- cisco ; this being, and intended as, a renewed insult to the National Association. 5. The action of the Association at Washington was obtained by a formal memorial from the Gynaecological Society of Boston, whose members are also Fellows of the State Society, setting forth the abuses referred to, which could not be righted at home, and were, besides, of a national interest. 6. That the Councillors of the State Society voted censure upon the 16 representatives of the Gynaecological Society, of whom the speaker was one, as individuals, for their action at Washington, though it was of a purely delegated character, — these gentlemen do not com- plain. They were endorsed by a very large vote of the State Society at its annual meeting upon their return, and the Gynaecological Society, assuming for itself all the responsibilities of the matter, has in vain demanded a trial, as provided by the by-laws of the State Society. 7. As matters now stand, the Association is at present openly defied by these “ Councillors,” who claim to represent, but do not represent, the State Society of Massachusetts. They have practically made their own laws ; elect the annual officers of the State Society, without the members at large having even an endorsing vote ; and do other things at variance with justice and propriety. There is a very strong feel- ing now awakening for an abolishment of the Board, and a formal re-acceptance by the Society of the Code of Ethics. The Councillors assert that the army of irregulars, although declared expelled by the Society at large, shall still continue in fellowship. Those of the Society, who remain true to the union, desire that the Association shall not permit Massachusetts to secede.* These are questions for the Association to decide ; you, of the Press, assist in the formation of all such decisions. My own action, and that of the Journal which I conduct, in the matter of which I have spoken, I confidently leave with you for judgment. Among all the matters which may engross the attention of the National Association the present year, one will probably be pre- sented, for which I would bespeak in advance your heartiest sympathy. I refer to the invitation which has been extended to the physicians of America, from Scotland, to assist in founding worthy memorials of one, who, during his life, both as a contributor and a subject himself for discussion, did more for the interest of medical journals than any other person of his time,— the late Sir James Y. Simpson. His hand was always extended to this country in peculiar recognition of its advances in medical and surgical science ; his home was the central gathering place in Great Britain, of American practi- tioners. As the first tidings of his death were received at Washington, before last year’s'delegates had left for their homes, their mass meeting in his memory at the Army Medical Museum being held before he was even yet laid in his coffin, so, on the present occasion, may such resolutions be passed as shall show that heart still beats to heart in regretful sympathy, though a continent and an ocean lie wide between. * “ Pacific Medical and Surgical Journal,” May, 1871, p. 550. 17 There are two points, of great interest to us as journalists, to which I would here call your attention. Together they comprise a means of reaching the profession collectively, and of placing the labors of our fraternity within its reach to an extent never before possible. For them both we are indebted to the unselfish and tireless industry of Dr. J. M. Toner, of Washington, for many years a prominent mem- ber of the American Medical Association. Dr. Toner has prepared and corrected to the present moment a list of 50,000 of the physicians now practising in the United States. This he places at your disposal, for consultation or other use. He is also engaged in preparing a com- plete index of the contents of all the medical journals hitherto pub- lished in the country. The value of this work, when completed, will be incalculable. One of the objects contemplated in your Constitution was the establishing “ a community of effort and means in a system of receiving foreign exchanges, and of sending our own journals abroad.” I am happy to state that, through the courtesy of Prof. Joseph Henry, of Washington, the Secretary of the Smithsonian Institution, I have secured to each of your number every facility for the most extended interchange; the only condition being that your parcels are delivered in Washington free of expense to the Institu- tion, and that you observe certain rules in regard to fastening and directing them, the particulars of which will be furnished you, upon application, by Prof. Henry. Upon the very great importance of such foreign interchange I need not dwell. Through it our Ameri- can writers may become introduced to the outside medical world, of whose work, in turn, we ourselves are none too well informed. In conclusion, I have to report that while at the time of our last year’s meeting but thirteen of the forty-two medical journals then in the country had become members of this Association, there now belong to it thirty-eight, or all but three of the whole number at present existing, both in the United States and in Canada. Though our constitution speaks of the Association as confined to our own ter- ritory, its title is that of “ American ” ; in accordance with which, and in the belief — in view of the cordial reception extended to my- self the past year at Ottawa, as delegate from the American to the Canadian Medical Association, and the conviction then renewedly impressed upon me that science knows no imaginary dividing line, — I ventured in your behalf to extend an invitation to our colleagues across the border to join the Association. As the result, Dr. John Fulton, of Toronto, Editor of the “ Canada Lancet,” and Drs. George E. Fenwick and Francis W. Campbell, of Montreal, 18 Editors of the “ Canada Medical Journal,” these being the only two professional periodicals in British America, have joined our body, formally signing its articles. I congratulate you, both in view of the present and the future, upon this important accession to your ranks; and I have no doubt that you will always look upon our Canadian associates as alike friends and brethren. But three American journals, as I have said, have not entered our organization, and of these but two have declined to do so. Dr. Butler, of the “ Philadelphia Medical and Surgical Reporter,” has failed to respond to the letters of invitation that have been sant to him ; possi- bly from absence, perhaps through illness or inadvertence. Dr. Hays, of the “ Philadelphia Quarterly,” while speaking in the kindest way of the Association and its objects, regrets that he feels that he ought not to assume conjoined responsibilities for which he considers himself unfitted, from being unable to attend your meetings. But a single journal in the whole country — I say it with pride—-has flatly refused to associate itself with its contemporaries; and this, as a Boston man I say it with shame, the “ Medical and Surgical Journal ” of my own city, the plea of its editor, Dr. Francis H. Brown, being that “ he does .not think it advisable, at present, at least, to bind himself by the rules which such an organization might see fit to im- pose upon him ”! The following is the register of the Association. At the time I assumed its Presidency, there were, as I have said, thirteen journals enrolled; of which one, the “ St. Louis Medical and Surgical Re- porter,” has since ceased to exist. There remained, therefore, the following twelve: — Chicago Medical Examiner. Baltimore Medical Journal. Richmond and Louisville Medical Journal. Nashville Journal of Medicine. Galveston Medical Journal. New Orleans Journal of Medicine. Detroit Review of Medicine and Pharmacy. American Practitioner. (Louisville.) Cincinnati Lancet and Observer. Oregon Medical and Surgical Journal. American Journal of Obstetrics and Diseases of Women and Chil- dren. (New York.) Journal of the Gynaecological Society of Boston. 19 In addition to the above, there have joined us during the past year no less than twenty-six journals more ; to wit: — New York Medical Journal. New York Medical Gazette. New York Medical Record. 4 Journal of Psychological Medicine. (N. Y.) National Medical Journal. (Washington, D. C.) American Journal of Insanity. Buffalo Medical and Surgical Journal. Medical Times. (Philadelphia.) Chicago Medical Journal. Indiana Journal of Medicine. (Indianapolis.) Michigan University Medical Journal. (Ann Arbor.) St. Louis Medical Archives. St. Louis Medical and Surgical Journal. Cincinnati Medical Repertory. Leavenworth Medical Herald. North-western Medical and Surgical Journal. (St. Paul, Minn.) Pacific Medical and Surgical Journal. (San Francisco.) Boston Journal of Chemistry. Physician and Pharmaceutist. (N. Y.) Photographic Review of Medicine and Surgery. (Phila.) Georgia Medical Companion. (Atlanta, Ga.) Medical and Surgical Repertory. (Griffin, Ga.) Kansas City Medical Journal. Clinico-Pathological Reporter. (Jefferson, Texas.) Canada Medical Journal. (Montreal.) Canada Lancet. (Toronto.) Making a total of thirty-eight journals now belonging to the Association, out of the forty-one that are so-called regular, at present exisiting in the country. It is a souroe of great pleasure to me that I can transmit to my successor a list that is practically complete. The two or three little gaps in your line are so slight, in comparison Avith the perfection of its extent, that they are almost lost sight of. Gentlemen : you had my hearty thanks for the honor you conferred, far beyond my every poor merit, when electing me to this most honor- able post. I now repeat them, for the courtesy extended to me upon the present occasion. In your behalf, also, I would express the grati- tude of the Association to our California brethren for their kind welcome and most liberal hospitality. 20 May we return to our homes from this land of enterprise, rapid growth, and largeness of heart, educated, even by so short a sojourn, to a greater breadth of view, a more self-sacrificing zeal, and higher purposes, than a single one of us has ever known before. Our union will then have been cemented strongly enough to resist any and every force of demoralization, whether from without or within ; and the profession, recognizing at last the power of our fraternity, will frankly confess, as has so long been done by the community at large, that the Press, well organized and wisely conducted, in reality rules the world. The following Editorial, from the August number of the Journal of the Gynae- cological Society of Boston, chronicling an advance in the Medical Education of this country made since the foregoing address was delivered, may be of interest in connection with a remark that was made upon page 14 : — A very long road it is that knows no turning, and it were the bas- est ingratitude that did not recognize and publicly acknowledge the full accomplishment of one’s heart’s chief desire. A great, fundamental, and complete change has been made in the Medical School of Harvard University. Not merely have the means been now afforded of obtaining a more thorough professional educa- tion than ever before, but the very ground plan of the school itself has been altered throughout to suit the wants of the age, and Har- vard is again, by a bold stroke of administrative genius, at the head of our American medical colleges. We prophesied, months and months ago, that this change would come, and very shortly too, just as we had taken occasion to show, previously, that it must come ; and the action of the American Medi- cal Association at San Francisco, with reference to which such bitter comments were made at the late annual meeting of the Massachusetts Medical Society, wras as surely predicted, certain as we wrere that the time was close at hand when, the old cobwebs that sloth and selfish- ness had woven about the school all swept away by the resistless influence of “ The New Education,” w'e could call upon the profession everywhere to rally to the support of dear old Harvard. Our own position has, for some time, been that of opposition. We have been contending, however, with principles, and not with men, save as these may have been the embodiment of what has seemed short-sighted or wrong. The ends for which we have striven, with such earnestness and persistency, have all been accomplished ; and it is with pleasure that we now cast down the sword. The changes that 21 this Journal lias so often suggested, have been accepted, President Eliot has stated, “by the unanimous consent of the College Faculty.” This being the case, we bury the past, and shall endeavor, as best we may, to strengthen the hands of those who, willingly or unwillingly, have at last taken a stand worthy the name they bear. To this subject we shall, and perhaps repeatedly, allude. Mean- while, writing still from the shore of the Pacific, we commend to all friends of true reform in Medical Education the appended remarks by the President of the University to the Fellows of the Massachusetts Medical Society, wherein the same regenerative influences are ac- tively at work that have saved the College.* “ I thank you, Mr. Chairman, in the name of the University, for your cordial words, and you, gentlemen, for this hearty salutation. Your warm greeting means more, and is more welcome than usual at this moment; for, as your chairman has said, the University has lately taken a great step as regards medical education, and stands in special need of the approbation and support of the medical profes- sion. The University counts securely on that support, knowing that the true physician stands always ready to grasp any new weapon wherewith to fight old evils or new. Precedent does not hold the place in medicine which it holds in law. Physicians are necessarily innovators by temperament and practice. As Lord Bacon says: ‘ Every medicine is an innovation.’ Again, the very existence of this ancient society is a pledge of the support of the profession in every wise attempt to raise the standard of medical education. “The society exists mainly to guard the profession on the one hand, and the community on the other, against ignorance and im- posture. The medical profession is to be congratulated that it has enjoyed these many years the best and most lasting guaranty which has been devised in this country for the protection of a liberal pro- fession. The bar has tried to defend itself against incompetency and dishonor by legislative enactments and rules of courts concerning admission. These means have failed in conspicuous cases, and are yearty becoming less and less efficacious. The bar is consequently just beginning to protect itself by the very means which the medical profession has used so long, namely, by private incorporated associa- tions. Now the basis of all such associations is education; from their very nature and purpose they will always hail with gladness every effort to make professional training more thorough, and to •Vide Dr. Carpenter’s Address upon Quackery in the Regular Profession. — Boston Medical and Surgical Journal, May 11, 1871, p. 313. 22 plant deeper* in the minds of aspirants to a liberal profession the principles of honor, catholicity and humanity. “ You will indulge me, therefore, gentlemen, if I steal a few mo- ments from these festive hours, to set before you the grave change which has taken place in the Medical School of the University. “ In the first place, the instruction will hereafter be given by lec- tures, recitations, clinical teaching, and practical exercises, uniformly distributed throughout the academic year. This year begins on the Thursday following the last Wednesday in September, and ends on the last Wednesday in June. Secondly, the course of instruction will fill three years, beginning with the fundamental subjects of anat- omy, physiology, and chemistry in the first year, and carrying the student progressively and systematically from one subject to another, until, at the end of his third year, and not till then, he will have studied all the recognized subjects of a good medical education. Thirdly, in the important subject of anatomy, physiology, chemistry, and pathological anatomy, laboratory work will be substituted for, or added to, the usual didactic. “ Every student will have his place and time in the anatomical, physiological, and chemical laboratories, and in the microscope room ; and he will be made to feel that such work is even more necessary for him than attendance at lectures and recitations, and is quite as much required of him as such attendance. In this connection, I am rejoiced to tell you that the corporation has just received a most timely gift of $5,000 from the estate of the late Dr. George Wood- bury Swett, himself an ardent student of physiology, for the purpose of providing a suitable laborator3r of pli3rsiology at the Medical Col- lege. Acute, searching observation is the first faculty for a physi- cian. There is more training of the powers of observation in a month’s work in the laboratory or the hospital than in years of hear- ing lectures or attending recitations. Lastly, every candidate for the Degree of Doctor of Medicine must hereafter pass a satisfactory ex- amination in every one of the main subjects of medical instruction, and these examinations are to be, in part at least, by questions and answers upon paper, so that the governing boards of the University, and the profession at large may hereafter know just what the stan- dard for the doctor’s degree really is. “These, gentlemen, are great changes in medical education. They amount, indeed, to a revolution. It is unnecessary for me to con- trast the new scheme with the old. You remember the winter’s sur- feit of lectures for the mass of students, the summer’s surfeit of recitations for the better third of the whole school, the lack of oppor- 23 tunities for laboratory work, the lack of due order and progression in the arrangement of studies, the brief attendance at hospitals, the hasty oral private examination for the degree. “ And now to whom does the University and the profession owe these important improvements? To the faculty of the Medical School as an organized body. The faculty adopted these changes, after full discussion, by unanimous consent, foreseeing all the diffi- culties of such a revolution, risking their scanty pay, enlarging and strengthening their body by the admission of 3Toung and enthusiastic teachers, while retaining the older and more experienced, and cutting loose from long-established connections with the other medical schools of the country. “ They have been encouraged to this act by the belief that in the long run t-he best course of instruction will command the most public favor; by the knowledge that the new scheme is not only better for those students who have money enough, but also more advantageous and less costly than the old for those whose means are slender; by the conviction that it presents no serious obstacle whatever to those who do not neglect their opportunities; and, lastly, by their confi- dence in the support of the profession which has longed for, and indeed loudly demanded, some change in the established system of medical education. “ Ultimately, therefore, gentlemen, the responsibility is with you. Professional education can never be much in advance of the general sentiment of the profession. Give the University the encouragement of your sympathy, the moral strength of your approbation, and the benefit of your advice to young men and their parents, and the ex- periment upon which the Medical School will enter next September will soon prove a conspicuous success. We hope to be found worthy to ennoble the whole family of medical schools in this country.” Still further changes have been made in the Harvard School than at first were indicated. Special branches of instruction that a year ago were laughed at by the old regime, have now been honored with full professorships. One or two, however, remain as yet thus unrecognized ; pre-eminently, as distinguished from Obstetrics proper or Midwifery, the diseases of women, a separate chair for which has now been established at fourteen of the other American Schools, and than which no other department commends itself more forcibly to the advanced medical student. The establishment of a “clinical lecture- ship” is a step in the right direction, but it is not all that the pro- fession requires. Hotel Pelham, Boston, 15 Dec., 1871. A SPECIAL MEDICAL JOURNAL THE JOURNAL OF THE GYNAECOLOGICAL SOCIETY OF BOSTON, A Monthly Journal, devoted to the Advancement of the Knowledge of the DISEASES OF WOMEN. Edited by WINSLOW LEWIS, M. D.; HORATIO R STORER, M.D., LL. B.; GEO. H. BIXBY, M.D. Terms, $5 a-year, in advance. Single numbers, 50 cents. Half-yearly Volume, $2 50. The Journal will be under the editorial management of the officers of the Society, and no pains will be spared to render it creditable to the source from whence it emanates, and to the profession to which it looks for support. While devoted to the awakening of a greater interest in the knowledge of the Diseases of Women, the Journal will yet not wholly ignore matters of general medical and surgical bearing, inasmuch as it is upon general principles that all success- ful specialties and especialties must rest. It is impossible, however, now that'general practitioners are so universally beginning to appreciate the importance, comfort, and pecuniary advantage ot a thorough knowledge of the diseases of women, for these to occupy any longer, in general or special journals, a subordinate place. IN COMMENCING THE ISSUE OF A SECOND YEAR OF THE GYNAECOLOGICAL JOURNAL, the Publisher would call attention to its peculiar recommendations to practitioners of Medicine and Surgery. 1st It is the only journal ever yet published exclusively devoted to the Diseases of Women 2d. It presents, every month, an extended report of discussions upon these diseases, by gentlemen skilled in their treatment; and, as is well knowm, there is more to be learned from the perusal of such discussions, affording as they do diverse experiences concerning a given topic, than from a formal treatise by the most learned physicians in the profession. 3d. It is not a mere re-cast of articles taken from the current medical journals, which arc already supposed to be upon the table of every active physician. 4th. Its editorials are always fresh, pointed, terse, and effective; of that character, indeed, which made the London Lancet for so many years, while under the charge of the elder Wakley, the leading medical journal of the world. 5th The Journal of a Scientific Society is the more likely to view the medical events of the day from a high and dignified stand-point—without, howrever, forgetting that to effectually clear anew path, and to remove obstacles in the way of progress, blows are frequently neces- sary. and that they must be heavy, vigorous, and conclusive. 6th. The unexpectedly large circulation in every part of the country that it has already' attained may be considered an indorsement of its excellence. Each Number will contain the transactions of the Society at its regular meetings (two each month), Original Articles, Editorial Notes, Book Reviews, &c., &c. Each number will consist of not less than SIXTY-FOUR PAGES, OCTAVO, (PRUSTTUID IN HLAARGEE TYPE, ON PINE PAPER, and it will be the aim of the publisher to make it fully equal in appearance to anything of the kind in the country. NOW READY. Volumes I, II and III, neatly bound in Clotb. Price, $2 50 each. ‘ It is edited by active, thinking, and liberal men, and published in a style that will command the approbation of all critics. The half-year forms a volume replete with instruction, and one that is worth much more than the money it costs to every physician.’’—Philadelphia Medical and Surgical Reporter, March 5, 1870. JAMES CAMPBELL, Publisher, Boston, Afass.