[ Compliments of the. Author.] 
4. 
MICHIGAN 
STATE MEDICAL SOCIETY. 
ADDRESS OF THE PRESIDENT, 
Dk. WM. I’.RODIE OF DETROIT, 
Delivered at Ana Arbor, May 10, 1876. 
(A Reprint prom the Society's Transactions.) MICHIGAN 
STATE MEDICAL SOCIETY. 
ADDRESS OF TRTPRESIDENT, 
Dr. \VM. BRODIE OF DETROIT, 
Delivered at Ann Arbor, May 10, 1876. 
(A Reprint prom the Society's Transactions.) ADDRESS 
OF THE PRESIDENT, Wm. BRODIE, M. D., OF DETROIT. 
Doctors, Members of the State Medical Society: 
The Tenth Annual Meeting of this Society is now in session, 
and it gives me great pleasure to congratulate you upon its re- 
turn,—its growth and success, and the evidence of increasing 
interest. 
For the first time in its history it has met in the city of Ann 
Arbor, the seat of the University of Michigan,—an Institution 
in which we have great State pride,—and from whose halls 
many of you now present have received your diplomas to prac- 
tice the art of medicine and surgery. 
When the Legislature of Michigan, in the session of 1852, 
repealed all laws relative to the practice of medicine and the 
organization of State and county medical societies, it removed 
all restrictions and obligations save a suit at law for malprac- 
tice. It opened the field, in the broadest sense, to any and 
every person, whether educated or ignorant, qualified or un- 
qualified, to practice the healing art, so that the State was at 
once overrun with all varieties and all grades of medical im- 
postors. 
There was no legal nucleus around which the educated phy- 
sicians could gather; but the necessities of social intercourse, 
and the desire to sustain the then infant Department of Med- 
icine and Surgery in the University, brought many of the 
physicians of the State together in this city, when the first voluntary State Medical Society was formed, and held its first 
meeting in the hall of the Medical Department at the annual 
commencement of 1853. 
For five years the Society met here when the medical com- 
mencements were held, and many were the valuable papers 
presented and discussed at the meetings. At the session held 
in 1857, it was decided to make the Society peripatetic, and 
the next session was held in Detroit, the second in Lansing, 
from which place it adjourned to meet in the then village of 
Coldwater, January 18, 1860. But three members out of Cold- 
water were present. An adjournment was had to Ann Arbor 
on commencement day, but so few were present that it was the 
last meeting held. 
On the 5th of January, 1866, a convention of physicians was 
held in the city of Detroit, when the present Society was organ- 
ized. Constituted as we are, upon a different basis from any 
other State Medical Society within my knowledge, we come 
together from all parts of our great and growing State to this 
annual gathering to renew our local relations, to invigorate our 
mental faculties, and take council together upon any and all 
matters that necessarily arise in the practice of such a profes- 
sion as ours. 
Man, with rare exceptions, is a social being, and enjoys the 
coming together of those who are in special sympathy with him. 
Indeed it is a necessity, and to medical men exemplifies itself 
in the formation of local, State and national associations 
whereby opportunity is given to discuss individual opinions, the 
merits of which may be of the greatest value, and the whole 
Avorld benefited thereby. 
The social renewal of old acquaintance, the laying aside for 
the time of the daily toil of both body and mind that inures to- 
the doctorate are only a few of the fruits of our annual gath- 
ering. 
But the greater object of thus associating is addressed to the mind, and the meeting is successful or unsuccessful according 
to the amount of intellectual pabulum furnished. 
The essay, the reports of committees, voluntary communica- 
tions, expressing more particularly individual views on either a 
specific disease in its general or local character, or some special 
investigation into some one of the many specialties into 
which the practice of medicine and surgery is now divided, are 
simply the dishing up of the repast, the enjoyment resting in 
the discussion and amplification of the matter presented and 
the opinions expressed. 
Among the many objects that have attracted the attention 
of this Society, the chief has been that of medical education, 
and scarcely a session has passed without some action on that 
subject. 
It was not, however, until the meeting held in Saginaw City, 
that definite proceedings were taken, when a representative 
committee of the Society was appointed “to confer with the 
Board of Regents and the Medical Faculty in respect to the 
relation of the Medical Department of the University to the 
medical profession of the State, and in respect to the future 
conduct of the said Department under any contingencies ne- 
cessitating a change in its organization.” 
On the 24th of June following the committee met in this 
city and held a conference with the Regents and Medical Fac- 
ulty, and presented their views in writing. The paper was 
referred by the Board to the Medical Committee, and was pub- 
lished as an appendix in the transactions of the Society for 
1873. 
At the succeeding meeting of the Society the committee 
made a report of their labors, which was unanimously adopted. 
At the meeting held in Detroit last year the following reso- 
lution was adopted; “That the Regents of the University are 
hereby requested by the State Medical Society to make, as soon 
as practicable, a full three years’ graded course of study and lectures obligatory upon all students graduating in the Med- 
ical Department, and that the requirements for admission be 
made equal to those for admission into the Scientific Depart- 
ment. 
The past action of the Society in reference to the Medical 
Department of the University is proof conclusive of its deep 
and abiding interest in its welfare and success, and also of its 
deep solicitude that its pupils should be highly educated and 
its graduates without their superiors in the land. 
It gives me great pleasure to inform you that your labors and 
desires have not been without results. The first part of the 
resolution has been the subject of consideration by the medical 
committee of the Board of Regents, and also by the medical 
faculty, and so soon as the necessary pecuniary and other ar- 
rangements can be completed, practical effect will be given to 
your request. 
The second part of the resolution has also received prompt 
attention, and at the opening of the past course of lectures 
examinations were held and fourteen applicants were denied 
admission for lack of satisfactory preliminary education. 
This is only a beginning of the good work, and to make it per- 
manent and more thorough, the faculty should and ought to 
have your full and free support. 
It is not within my knowledge that any other medical school 
(save Harvard or the Chicago Medical College), whether free 
or private, can show a better record and an example every med- 
ical school should follow. 
Public opinion should be so educated as to compel all medi- 
cal schools to sift their applicants closely, and allow none to 
enter their portals save such as are mentally, morally, and 
physically qualified. 
It has been the cry of the schools: Give us a higher grade of 
students and we will return you a higher grade of graduates, 
thus throwing all the responsibility on the profession. That day, however, lias passed away, and the responsibility cannot 
be shirked by the schools any longer. They, and they alone 
must bear the onus of the character of the education their 
graduates possess. The general practitioner has no time to 
enter into the minutiae of educating the neophyte, and his name 
to a certificate can only be of value as a note of reference for 
his moral character and position in the community from which 
he hails. 
The medical colleges have the entire power of educating in 
their own hands; they can receive and they can refuse; and 
when the intelligence of the graduate is made the standard of 
excellence, instead of numbers and large cash assets, then will 
that institution merit the rewards and benefits of both the 
public and the profession. 
The time was, in the medical history of our country, that 
physicians were needed faster than they could be collegiately 
educated. The written learning of the profession was com- 
prised in a few books, and a short time only was needed to 
read them; the preceptor showed the student how to prepare 
his medicines and how to apply them, and the head that held 
the best brains proved the most successful. 
Now the status is entirely changed. The learning of the 
profession has become so extensive, even in its elementary 
character, that the short term of three years is not sufficient 
for its consideration. Many of the specialties alone require 
from one to two years of time to be thoroughly mastered, and 
the general practitioner should be as well educated in the 
specialty as the specialist; for often when the latter fails in the 
cure, it is to the former the patient returns for the recovery 
of his health. 
The day is not far distant, and every effort should be made 
by the profession to bring it early about, when medical education 
will be conducted on the same principle for a degree as the 
literary. A four years’ course, with a preliminary standard,— regular daily recitations and a final course of clinical instruc- 
tion, the authority to practice to he determined by a distinct 
and independent board. 
The efforts of this Society with the late Legislature “to es- 
tablish a State board to secure the registration of physicians, 
and require of them certain general qualifications,” nearly 
proved successful, and I would respectfully recommend that 
the Committee on Medical Legislation be continued, and action 
on the subject be again urged upon the next Legislature and 
indorsed by the Society. 
The subject of insanity lies in the province of the physician, 
and is one in which we as a profession are deeply interested. 
Modern researches and observation are daily informing us that 
the term insane is very broad and significant, especially so in 
criminal jurisprudence, and it behooves us, who ought to be 
the arbiters between the people and the criminal, to be thor- 
oughly informed on the subject. Not only that the plea of 
insanity may be justly proven, and the person charged at the 
bar be intelligently protected if insane, but also that the people, 
his accusers, may be protected against any false plea made by 
the criminal. For if the crime committed be done by reason 
of absence of the normal condition of the mind, the physician 
should be the proper person to prove it to the satisfaction of 
the court and jury so that justice may have its true course. 
Not only is this plea very frequently made, in matters crim- 
inal, but in the disposal of property by will dissatisfied heirs, in 
order to benefit themselves against the true intention of the 
testator, often seek the intervention of courts at law, their 
main reliance being the opinions of their medical friend. 
There is no one subject upon which the profession is called 
publicly to express their opinions that requires more knowledge 
and skill (and really has less) than this question of insanity. 
How much, and to what extent, the brain in mature life is gov- 
erned and influenced by the many conditions from conception to maturity! The product of an inebriated father or mother, 
or botli; syphilis in either parent or both; convulsions ante- 
partum ; convulsions in childhood; inflammation or concussion 
of the brain, either in infancy, youth, or adult age; each and 
every one of these conditions must certainly affect the mental 
faculties more or less. 
At the present time, in our schools of medical learning, a 
few lectures are given by the professor of medical jurisprudence 
on this subject, when it is dismissed as no particular part of 
the curriculum of study for the degree of doctor of medicine. 
Indeed, some schools have not even a professor, and medical 
jurisprudence is not taught at all. How, under such circumstan- 
ces, can the young physician be expected to advise either a 
court or jury, or give an intelligent opinion whether a person 
is insane or not? “In Ireland,” according to the 1ST. Y. 
Medical Record, “the increase of insanity is so rapid that the 
Commissioners of Lunacy, in view of the facts, strongly rec- 
ommended the systematic study of insanity in the regular 
schools of medicine.” 
It is an appalling fact that insanity is on the increase, grow- 
ing with the wealth and intelligence of the people, and there- 
fore demanding not only the skill of the physician, but the 
wisdom of the law-giver to meet its necessities. 
Our own State has entered upon the erection of another asy- 
lum, and statistics inform us that when completed and filled 
the poor-houses will still be surfeited by a class not receivable 
in the asylums, as being non-curablo or chronic. 
It is a hard thing to confess the fallibility of science in the 
cure of a diseased mind. Yet, the fact nevertheless remains, 
and it belongs to the State to provide that these persons should 
be well and properly cared for. How? is the problem ; and the 
necessity is imperative, whether by farm labor and cottage re- 
ceptacles, or the more elaborate asylum or hospital. You, gen- 
tlemen, can have a large voice in forming the public opinion. Dr. Jno. B.Chapinof Brigham Hall, Canandaigua, New York, 
in a report on provision for the chronic insane to the American 
Medical Association, says: “ Every plan for the relief and care 
of the insane should be comprehensive and include all condi- 
tions of insanity, more especially the chronic insane poor, usually 
sent directly or indirectly to the poor-houses.” “ An organiza- 
tion supplementing the asylum or hospital should comprise 
arrangements for the custodial care of the quiet, harmless, and 
manageable insane, mostly of the chronic class. Two-thirds 
of all the insane are of this class. This organization should he 
in the form of a colony made up of detached buildings for both 
sexes, having a relation of contiguity to the hospital. 
It -would supplement the hospital by affording more extensive 
facilities for classification. While the hospital building would 
furnish the extreme of restraint, the colony organization would 
reduce it to the simplest form of surveillance. The colony 
should be composed of several buildings, which might be 
located with reference to the various employments incident to 
a large establishment, as the cultivation of fruit, and the gar- 
den, the farm, the care of stock, and certain mechanical oper- 
ations. Among the chronic insane are to be found a large 
number who possess, notwithstanding the mental impairment, 
physical strength unimpaired. 
They are capable, under the direction of judicious influences, 
of performing the usual manual labors of a farm. The physi- 
cal strength remains, but the force of will to direct is impaired. 
A certain proportion are feeble, mentally and physically, but 
susceptible to the impressions of surrounding circumstances. 
Of the different forms of occupation, not any contributes so 
much in its variety as farm labor. 
Under the influence of regular employment the monotony 
and idleness which render the life of the insane so intolera- 
ble, and so often find expression in fitful outbursts of violence, 
-will disappear. As a remedial measure out-of-door occupation is invaluable, and in this way we can explain the reported re- 
coveries of patients in the poor-houses, after they have been 
discharged as incurable from an asylum. As the connection 
of a large farm with well organized departments of labor would 
afford employment for males, so the various domestic indoor 
avocations which females could follow would be encouraged.” 
These are the views of a gentleman experienced in the manage- 
ment and treatment of the insane; and the crowded condition 
of our poor-houses with chronic insane is a sufficient excuse to 
bespeak for them our sympathy and earnest endeavor for their 
amelioration. 
The State has already taken the acute insane as her own 
wards, and yet another class of our fellow citizens, male and 
female, need her fostering care. I refer to those persons who- 
have become so habituated to the use of intoxicating drinks as 
to be beyond the government of their own wills, the influence 
of personal friends, or the rebuke of the public in its cessation. 
For the reception and cure of such persons inebriate asylums 
have been erected by some of the States, but from some fault 
in their organization or management thus far they have been 
of little benefit. It does seem as though such an institution 
with the legal guards of our insane asylums thrown around it 
would be of incalculable benefit. 
The inebriate in a certain sense is an insane person. He 
cannot control his passions any more than his appetite while un- 
der the influence of strong drinks. His body and mind both 
become enfeebled, and he commits acts for which he cannot be 
really accountable. 
Prom the medical profession of the State the ball should be 
set in motion for such an institution, and the report of a com- 
mittee from this society at its next annual meeting, with full 
statistics setting the matter in a clear light before the people, 
would soon result in the proper legislative action. The subject of medical advertising, so-called, is exciting con- 
siderable interest in the profession, and is worthy of your at- 
tention. Code of Ethics, American Medical Association, Sec- 
tion 3 of Article I., of the duties of physicians to each other 
and the profession at large, is the only published law on the 
subject, and many are the diversified constructions put upon it. 
The faculties of medical colleges and associations under the 
name of Medical Dispensaries publicly offer advice under the 
guise of a clinic to the poor gratis (and were the poor the only 
recipients the object would not be so objectionable), and claim 
in so doing they do not evade cither the letter or spirit of the 
section, while the individual practitioner must be held rigidly 
not only to the spirit but the letter. The former can indulge 
in the use of the public prints directly or through the aid of 
the reporter, while the latter doing the same acts must be 
styled an empiric and dealt with acccordingly. The editor of 
the “Medical Record” has taken the subject in hand, and in 
a series of editorials is throwing much light on the subject, and 
we also learn “ that the subject of medical advertising is at- 
tracting the attention of our British cousins. On the whole 
they take very strenuous grounds. Not only do they object to 
the advertising of medical colleges in the daily papers, but to 
the announcement of medical works and their review in the 
secular prints.” Surely some remedy should be adopted so as 
to place all on the same plane. 
The subject of Hygiene is one of important interest, not 
only to the physician, but to the citizen. The laws of health 
cannot well bo disregarded without entailing their conse- 
quences. Heretofore this subject has occupied the attention 
of the different medical societies, State and local, but since 
the advent of the State Board of Health this interest has in a 
measure abated, owing to the fact that the Board of Health 
has taken it under its own special protection. It is evident from an examination of the reports of the Board that the pro- 
fession outside thereof take but little interest in its labors and 
furnish but a small modicum of their proceedings. 
This can be accounted for on two grounds at least, which 
are fundamental to its success: 1st. The board is composite, 
haying professional and non-professional elements in its forma- 
tion, when it should be entirely medical. 2d. Although the 
law of its organization says nothing about its political complex- 
ion, yet all the members have been of the same political creed 
as the Governor,—by implication men of medical and scientific 
attainments, with equal, if not of more experience, but holding 
contrary political opinions, have not been thought worthy of 
appointment. Science should know no political belief, but 
when it so prominently thrusts forward, as in the organization 
of the State Medical Board, it presents sufficient reasons for the 
lack of interest on the part of many of the profession. Yet 
another reason may be added. By the law, instead of each 
township, village, or city having a well-informed physician prop- 
erly compensated, and as such properly recognized by law, to. 
examine into the hygienic conditions of the locality under his 
jurisdiction and report to the Board, the -whole subject is left to 
be examined and reported upon by the clerk of such township, 
village, or city board of health, whose education might be so 
limited on the subject as not to know whether excessive moist- 
ure or excessive dryness is most productive of malaria. Not- 
withstanding all this and the consequent inaccuracies of statis- 
tics collated under such circumstances, the Board have pre- 
sented a large amount of practical information, and which has 
been distributed to the public through their annual reports 
prepared by their efficient Secretary, a member of this society, 
—Henry B. Baker, M. D., Lansing. In view of the advan- 
tages to be derived in a sanitary point of view, I would sug- 
gest that a committee of one from each organized county in 14 
the State, he appointed to report upon its hygienic condition 
at the next annual meeting. 
Within the last twenty-five years a great change has taken 
place in the practice of medicine and surgery. With the excep- 
tion of special attention to the eye and ear, such a practitioner 
as a specialist a quarter of a century ago was unknown. To- 
day the case is different, as is exhaustively exemplified in the 
experience of Dr. Robert Barns, who says in the London 
Lancet: “I have recently been honored by a visit from a 
lady of typical modern intelligence, who consulted me about 
a fibroid tumor of the uterus; and lest I should stray be- 
yond my business, she was careful to tell me that Dr. Brown 
Sequard had charge of her nervous system, that Dr. Wil- 
liams attended to her lungs, that her abdominal organs 
were entrusted to Sir William Gull, that M. Spencer 
Wells looked after her rectum, and that Dr. Walsh had her 
heart. If some adventurous doctor should determine to start 
a new specialty and open an institution for diseases of the um- 
bilicus,—the only region which, as my colleague Mr. Simon 
says, is unappropriated,—I think I can promise him more than 
one patient.” 
Dr. George Jackson Fisher, the late President of the New 
York State Medical Society, in his Annual Address delivered 
in Albany, New York, February 3d, 1875, says, and I quote his 
language as expressing my own views: “ We see numerous soci- 
eties and journals devoted exclusively to a single tissue, organ, 
class of diseases or special mode of treatment. High and 
mighty sounding titles, indeed, are the journals of “ Neurology 
and Electrology,” of “Otology and Ophthalmology/’ of “Der- 
matology and Syphilography,” “Gynecology,” &c., and ex- 
ceedingly convenient and taking are the skin and bone, brain 
and nerve, throat and lung, heart and kidney, rupture and 
tumor dispensaries which abound in every city. I am aware of the fact that most of the distinguished 
specialists of our great cities were general practitioners and 
thoroughly posted in every department of medicine and sur- 
gery before they devoted themselves to a specialty; and that it 
was not original choice but peculiar circumstances that guided 
them in the particular line wherein they subsequently became 
more or less eminent and celebrated. This is true of the great 
ovariotomists, lithotomists, and many oculists, and a few other 
specialists. What I am anxious to check is the present ten- 
dency to increase the number of this already too numerous 
class of practitioners, and protest against the encouragement 
of young men to study with reference to practice in a field 
limited to one organ or a single class of diseases. 
I do not wish to be understood that special studies and re- 
searches should be discouraged. On the contrary let every man 
select a subject and make a hobby of it as far as it is possible 
for him to do so, for by this means the greatest contributions 
have been made to medical science; but never forget that the 
human body is a harmonious unit, that exclusive practice 
prejudices the mind and narrows the Judgment of the physi- 
cian, that the tendency is to belittle the general practitioner in 
the public mind, and that the extravagant fees demanded by 
specialists for treatment or counsel, though a minor, is yet an 
important consideration to all except the opulent.” 
At the last session of the Legislature and previous to the late 
meeting of this society an act was passed and approved April 
27th, 1875, authorizing the Board of Regents to establish a 
Homeopathic Medical College as a branch or department of 
the University to be located at Ann Arbor, and the Treasurer 
of the State was directed to pay over to the Board of Regents 
the sum of 16,000 annually, to be used exclusively for the ben- 
efit of said department. 
In conformity to this law the Board of Regents have organ- 
ized a Homeopathic Medical Department of the University in this city and one course of instruction has been given. The 
calendar informs ns that only twenty-four students were matric- 
ulated in that department, while in the school of regular med- 
icine 313 were in attendance. Unless the future develops a 
larger annual matriculation a repeal of the law will be impera- 
tively demanded as being a too costly luxury for even its own 
friends. 
Brethren, we are convened in the great centennial year of our 
national independence, but neither time nor space will permit 
me even to touch upon the extended march our profession has 
made during the hundred years now passed. Other minds and 
other pens will write it, and the proceedings of the Centennial 
Medical Congress, to be held in the city of Philadelphia on the 
4th day of September, may be looked to with interest for that 
purpose. 
Let us as a society take on a fresh impetus, let us keep up 
with the people in the grand march of improvement. As I 
have endeavored to show, there is much yet to be done in order 
to keep our profession in the vanguard of society and science. 
We should be a unit, each member striving to add his mite to 
the general fund. Above all be not diverted by outside issues 
from the straight way that leads to unity, harmony, and 
strength in all and every matter pertaining to the great and 
noble profession of legitimate medicine.