AN ADDRESS \ DELIVERED AT THE ANNUAL COMMENCEMENT OF THE HfMcal ^f|ool of giarbarir Initeifjj, Wednesday, March 6, 1861. By GEORGE C SHATTUCK, M.D. HERSKV PROFESSOR OF THE THEORY AND PRACTICE OF PHYSIC. BOSTON: DAVID CLAPP, PRINTER.........184 WASHINGTON STREET. MEDICAL AND SURGICAL JOURNAL OFFICE. 1861. Boston, March 6, 1861. Db. SHATTUCK: Dear Sir,— In behalf of the Qraduating Class, we request a copy of your Address for publication. FRANCIS H. BROWN, EDWARD A. WHISTON, GEORGE J. ARNOLD. Boston, March 7, 1861. Gentlemen,— It gives me pleasure to accede to your request for a copy of the Address delivered yesterday, as I find therein an evidence of that mutual good will and understanding which should subsist between us. Very truly yours, GEO C. SHATTUCK. ADDRESS. YotTR EXCELLENCY AND Mr. PrESIDEN'T i In the year that has elapsed, since you last came to this College for the purpose of conferring degrees, much has been said and something has been done in this matter of medical education, some of the results of which are now' before us. 1 will ask your permis- sion, then, to make a few remarks upon those sayings and doings; to call attention briefly to the work done here, and the mode of doing it, before addressing myself to the task especially assigned to me at this time, that of giving exhortation and counsel to those who have just received from you their diplomas, and are going forth with the sanction of this ancient University. It is probably known to all here present, that the American Medi- cal Association, a body composed of delegates from the medical societies and colleges scattered throughout what has been, and, as we trust, will still be, known as the United States of America, has for a leading object the improvement of medical education. In the first volume of their Transactions, We have two long reports, one of a committee on preliminary education, the other of one on medical education, sixteen resolutions being appended to these two reports. Seven other reports are to be found in the subsequent volumes. The teachers of medicine were invited to meet in convention, and several schools- sent delegates to Louisville in 1859, and to New Haven in 1860. A committee of conference with these conventions made a report at the last meeting of the American Medical Asso- ciation, in which eight resolutions Were proposed to that body, seven of which, with some modifications, were adopted. Now we should infer from this, that the medical profession is not quite satisfied with the present state of medical education, nor with 4 the results as shown in the graduates of the schools. We must admit that they have an interest in this matter, and that opinions expressed by them should be treated with all respect. The Medi- cal Faculty of Harvard College think that they have not failed in attending to and considering the deliberations and resolutions of the representative bodies of the profession, and when they have not been able to act on their suggestions, they have properly communi- cated their views and assigned their reasons. A'few months ago, a retired member of the profession from our own immediate neighborhood, wishing to appropriate liberally from the proceeds of his professional labors to the cause of medical edu- cation, asked advice of the Massachusetts Medical Society, and a committee of that body was appointed, who conferred with that gentleman, and suggested some changes in the administration and regulations which might be adopted by the authorities of this school of medicine, in view of a liberal endowment appended to them. The Faculty, when requested, gave their opinion of the probable effect of the proposed new regulations, and offered their resigna- tions to the authorities of the University, in order that they, per- sonally, might not stand in the way of so important a benefaction. The proposed changes and modifications were duly considered by the Corporation, but it was not thought for the interest of the Uni- versity to adopt them. One of them in particular, and an impor- tant one, could only have been proposed, as it seems to me, from overlooking the construction and arrangement of our school, in details brought before us to-day, and to these I would invite the attention of those before me. But, first, we should do justice to the wisdom and generous spirit shown by the retired member of the profession in proposing to give so large a sum to the Corporation of Harvard College, for the en- dowment of its medical school. It is an example of the spirit of the oath of Hippocrates, which I would especially commend to you, gentlemen of the graduating class. I would remind you also, in this connection, of one whose name may not be familiar to you, of Dr. Caius, the President of the London College of Physicians, the Physician of King Edward VI., Queen Mary and Queen Elizabeth, who retired from court and from a lucrative practice, and founded the College at Cambridge, in England, the most celebrated in that University, at the present time, for its medical learning, spending 5 the latter days of his life in this academic retreat, to which he gave the proceeds of his professional labors. The seventh resolution of the committee of conference with the teacher's convention, adopted last year by the American Medical Association, was " an approval of all proper efforts by which the attention of persons of means and liberal dispositions, as well as of legislative bodies, shall be called to the importance of the en- dowment of medical colleges and professorships." Our excellent President, in his inaugural address, called attention to the endow- ments of the University, their great value, and the indebtedness of students to them. At college commencements, the names of de- ceased benefactors have always been mentioned with honor. Our building, our museum, our library, and funds to keep them in good condition, are the results of the munificence of the State as well as of private individuals. A medical education is the most expensive of all professional educations, whilst medical students are, as a class, possessed of less means than others; are less able to provide them- selves with what is needed for their education. With few excep- tions, all in our country who devote time to teaching, could spend it with more pecuniary profit in the practice of their profession. He, then, who offers to supply means for better medical education, has well-founded claims on the gratitude of the community, and his views and suggestions are entitled to a respectful consideration, and we believe that such was accorded to them in the case just refer- red to. The provision contemplated in the report of the committee of the Massachusetts Medical Society, on which I would now say a few words, was one for the establishment of a board of supervision, to be composed of prominent gentlemen from the community, whose official rank was a guarantee of the estimation in which they were held, with whom should be joined medical men of repute and experi- ence. Those, however, who established this school of medicine, had not been unmindful of such a representation of the parties interested in the results of medical education. The Corporation of Harvard Col- lege is a small but a carefully selected body of gentlemen, whose accomplishments and qualifications have been proved in various posts of duty and responsibility. One of them is a Judge of the Su- preme Court of Judicature of this Commonwealth; and another has but lately ceased to preside over the same court as its Chief 6 Justice, after discharging the duties of that office with distin- guished ability for a long time. Our Board of Overseers has amongst its members the Governor, Lieutenant Governor, Pre- sident of the Senate, Speaker of the House of Representatives, the Secretary of the Board of Education. The medical profes- sion is ably represented in both these boards. A large commit- tee composed of medical men, appointed by the Overseers, visits the Medical College every year, receives reports and suggestions in writing from each professor, holds personal conference with them, and makes a full report to that board, which is printed, and distributed amongst those interested in medical education. There was a conclusion arrived at by a hard-working member of the medical profession, under peculiar circumstances, it is true, but which I will refer to here; for certainly the founders of our medical school had not otherwise read the book of human nature, as evinced in the provisions established by them. A patient, in great pain and distress, from unnatural distension of one of the hollow viscera of the abdomen, sent for a medical man from a distance of many miles, on a very stormy night in winter. On horseback, through sleet and through snow, with utmost diligence, the doctor got to the patient, and administered prompt and thorough relief. The question of compensation came up, as the medical man was preparing to go back. The patient knew well what he had suffered, and what his physi- cian had done and endured to get to him, and the latter impulsively said in reply, give me what you think the service done for you is worth. From funds put into the sick man's hands for this purpose, the coin then known as a pistareen was selected and handed to the physician, who, turning it over and looking at it thoughtfully, ex- pressed aloud the conclusion, " What a poor creature is man when left to himself!" Now, Mr. President, the Medical Faculty of this University, charged with weighty cares and responsibilities, and realizing what the infirmities of human nature are, may congratulate themselves that the whole burden of medical education does not rest on them but that direction, counsel and support have been aniplv provided for them. In this matter of conferring degrees, for which we are now come together, they have taught, and they have examined according to prescribed ways and usages. The Corporation and the Overseers confer the degrees. There are those who would take away one of these duties, that of examining for degrees, from those who teach, urging that they cannot be safely trusted with it. It is said that, for the sake of increasing the number of their students and their incomes, they are too careless and too easy in the dis- charge of this duty. And yet, it must be admitted, that those who do so are short-sighted, even in the matter of their own interest. A medi- cal school is dependent for success on the good will of the profession and the community where it is established; and such negligence and faithlessness would lead to the loss of its reputation. It is not to be denied that medical students do not covet unnecessary labor, but at the same time they do prefer a diploma from a school which has a reputation in its graduates, and which is known to be careful in recommending candidates for degrees. The complaints and criti- cisms, to which I refer, are not so common here as elsewhere. These same questions have been discussed among us, as to whether there be not a better way of ascertaining the fitness of those who would enter the profession. Public examinations, such as are held in France and Germany, the presence of delegates from State medi- cal societies, as is the practice in New Hampshire and Connecticut, have been proposed by some. My own observation warrants me in believing that there is much less desire of change, however, in this community than in others, where medical schools are not con- stituted as is ours. There are independent schools in our land, where the professors establish their own systems of instruction, fill their own vacancies, manage their own affairs, and have no respon- sibility to any other body. For one, Sir, I am very thankful that I am not connected with such a school, and rejoice that there are those set over me with the wisdom and experience to make rules and regulations, and with the good sense and courtesy to appreci- ciate all well-meant efforts to discharge duties, the bounds and di- rections of which have been wisely and carefully and plainly marked out. I am satisfied, from extensive observation in other commu- nities, that the Medical Faculty of Harvard University have as large a share of the confidence, respect and good will of their medi- cal brethren, as is possessed by any faculty in this land, and I attri, bute so desirable a result in some degree, at least, to the regu- lations just alluded to, by which the parties interested in medical education have a share in the administration of affairs, as well as an opportunity to know what is being done, and how these affairs 8 are managed. I do not think, Sir, that the complaints made of medical schools, of their insufficient teaching, of their careless exami- nation for degrees, would have been so likely to have been made, had the legislatures in other States provided as wisely and amply in boards of supervision, as has been done in our own case. If medical education is defective, are those legislatures without re- sponsibility for such a result, who give charters indiscriminately to all applicants, and provide no means of subsequent supervision and control ? In the last Report made to the American Medical Association, much is said of the superiority of the medical schools of Europe, of requirements for a good preliminary education more thorough and better enforced, of a curriculum of study extending through four, five or six years, and occupying ten months of each year, of a much larger corps of professors presiding over many more branches, of more frequent and longer examinations for degrees. But, who established all this, who provides for it, and who pays for it? The Government. And when there are many State legislatures in our land doing nothing for medical education, with the exception of giving acts of incorporation to any associating themselves avowedly for this purpose, and allowing them to compete for students with an equal legislative sanction, arc medical teachers to be exclusively blamed because ignorant, ungentlemanly and unprincipled men are admitted within the ranks of the medical profession? When the law of the land makes no distinction between the various prac- titioners of the art of healing, but allows to each the same facili- ties for the collection of pecuniary compensation, makes no effort to repress quackery or to restrain the sale of nostrums, are medi- cal teachers alone responsible for deficiencies in mental and moral qualities, or in the preliminary education of those received as mem- bers of their schools ? If, in our own State, we might wish that the legislature did less to encourage female and eclectic colleges, we cannot reproach it with not providing ample means of supervising the medical school of Harvard College; and whilst the Medical Faculty may con- gratulate itself on harmonious and friendly relations with the super- visory bodies already provided, resulting in intelligent cooperation, tiey may be allowed to express such a degree of satisfaction with the present arrangements, that they do not see the need of making 9 any important changes. It is our belief, that those who have man- aged the affairs of this medical school, have never been insensible to the importance of keeping its standard of education on a level with that of the best schools in the country. You will find, for instance, among the resolutions adopted by the American Medical Association, one that insists on requisites for preliminary education, others on a course of study continued during three years, on attendance upon two courses of lectures, with a proper interval between each, on taking pains to ascertain that these requisitions have been complied with by those seeking degrees; and, in all these respects, we believe that the letter and the spirit of these regulations have always been and are conformed to in this school, whilst we know, and our students know, that there are schools in which all these provisions are dis- regarded. Our winter lecture terms are not so long as those of the schools in the great cities of New York and Philadelphia; but we have a summer term extending through a period of six months, in which there are daily examinations, recitations, clinical teachings. The admirable lectures of the University in other departments, on Comparative Anatomy, Zoology, Botany, Acoustics, and Optics, are free to our students, who are encouraged to attend them. We be- lieve it to be a great advantage to the medical school to be a part of a University, and that our students are the better for the means of culture thus placed within their reach. While the advantages pe- culiar to a city, in hospitals and dispensaries, are made available; students are offered facilities for a practical knowledge of chemis- try by working themselves in the laboratory, under the supervision of the professor of chemistry. And in our teaching at that season, we have the advantage of the assistance of those connected with hospitals and dispensaries, as well as of the younger and active members of the profession, who are willing to devote their leisure to such study as is emphatically necessary to teachers. In these and in other ways, may it please your Excellency, and you, Mr. President, we have endeavored to instruct our students, and our knowledge of those presented to you for degrees is not wholly derived from the comparatively short time spent with them in the formal examination. We are free to confess, that whilst we believe them to be furnished according to the prescribed standard in our land, we would gladly see that standard raised, and we willingly cooperate in all proper and feasible means of raising it. And you, gentlemen, who have just received your 2 10 degrees, although, hitherto, you may have been quite satisfied with what ha? been required of you, will soon be convinced that, if the medical profession is to be true to the interests confided to it, the culture bestowed on those entering its ranks cannot be too careful, the preparation too thorough. You are now graduates of this University, but you are not thus admitted to a monopoly. You will be obliged to contend with active, zealous and unscrupulous pre- tenders, who will condescend to arts and avail themselves of means of getting public favor and sympathy which you can never employ. You are coming forward at a time when charlatans and nostrum- venders are much in favor and in vogue, and how shall you compete with them? You have an advantage in thus being admitted to membership in a University, in being associated with the scientific and the learned. Sources of knowledge, and ways to them, have been shown to you as under-graduates. You must still be students, you must continue to walk in the paths in which your feet have been planted. One who did much for education in his own day, who founded and endowed a school and a college, from each of which have issued yearly for four centuries, a band of well-educated young men, many of them winning their way to high posts of dignity and usefulness, gave as a motto to his school: " Manners mak- eth man." Scientific and literary culture is not all that you need. It is, indeed, very important that you train your intellectual facul- ties, that you store well your minds with knowledge; but if you would exercise those faculties, if you would use that knowledge in active professional life, you must see to it, that in your intercourse with your fellow men you be gentle and courieous, kindly and well disposed. You are to be in close communion, not only with the good, the wise and the strong, but with the weak, the nervous, the fretful, the angry and impatient, and you must be able to deal with all these; you must know how to make yourselves all things to all men. The poor and the ignorant need your services, and are en- titled to them; you must exercise patience and forbearance, if you would benefit them. You must be largely conversant with the sins and infirmities of your fellow men, but you must not be contami- nated by them yourselves. You must be well read in the book of human nature, if you would make your abstract science of true service to your patient. The graduates of the European schools, who have been trained by the State during their four, five, or six years, and then go forth 11 into the community with a seal and stamp of due preparation, com- manding the confidence of those needing their services, and who are in a manner obliged to avail themselves of them, may presume on what has been done for them, and be negligent of improving duly all opportunities of self-discipline and self-improvement; but you cannot afford to rest thus on your oars. Hard work, self-denial, will be forced upon you by the stimulus of a fierce competition. Leisure, repose, retirement, are but too little accorded in our day to those who win the confidence of the community in the practice of their profession. And in view of what has been said of a low gene- ral standard of preparation, and as an offset to it, I would cite from the report of the committee of conference of the American Medi- cal Association, the concluding sentence: " Premising, that while it must be admitted that the number of imperfectly educated practi- tioners is large, it must not, by any means, be forgotten that our medical colleges are every year sending out graduates who are proving their own diligence and fidelity, and showing, by the success- ful practice of their profession, that they have availed themselves of the greatly increased facilities and advantages afforded them, and that their number was never greater than at present." A suggestion has been made, whether, in this country, we are not losing sight of one of the objects, and an important one, set forth in the establishment of oolleges. Men were collected to live to- gether, to sleep under the same roof, to eat at the same table, to pur- sue the same objects together, and thus to learn to adapt them- selves to each other, and each to repress those inclinations and habits which are likely to interfere with the comfort and well-being of others. One object of a college is to beat down selfishness, to cultivate amenity and courtesy, to teach how to submit, obey and conform. Now, no one can be successful in professional life, who cannot forego his own inclinations, and adapt his ways and lan- guage to those whom he would serve. The member of a large fami- ly, who has been a good son and brother, has had a training which fits him to discharge his duties as a professional man; a member of a college, who has been trained to live and work harmoniously with those of different tastes and natural inclinations, has a great ad- vantage when he "first comes in contact with clients or patients. Mutual understanding, cooperation, are much easier for such a one, and the idols of the den of which Lord Bacon speaks, his own fan- cies, notions, are much less likely to get a sway over him. The 12 Colleges of Oxford and Cambridge, in our mother country, Lincoln's Inn, Gray's Inn, and the Temple, in London, have been collecting men together for hundreds of years, giving them facilities for study, but also disciplining, training them in a daily intercourse as fellow mem- bers of a one body. At St. Bartholomew's Hospital, in London, there is such a college, and you, gentlemen of the graduating class, who have been living in the hospital, know something of the advan- tages of such an intercourse with each other and with patients as you have there enjoyed. For those of you who have spent only a winter with us, we cannot do as much in this way of personal inter- course as we gladly would. The clinical conference, however, which has been held once a week, has had one amongst other objects, that of making closer your relations with each other and with your in- structors. Our summer system of instruction, in which recitations occupy so large a space, does something in the same direction. Still we must admit a great deficiency in professional training in these respects. You all will have much to learn when you come into communication with your patients and with your profes- sional brethren, as to the establishment and maintenance of proper relations. The diploma you have just received introduces you; you must be able to prove to your brethren and to your patients, that you are worthy of their esteem and their confidence. To become members of a University like Harvard, is a most important step in your career. It opens the way for the successful exercise of your faculties, for the proper display of your knowledge. If you have formed habits of study, if you have made progress in self-know- ledge, self-discipline, and self-control, you will find great use for all such accomplishments, and you will be able to acquire more. You come forward at a time when, politically, conciliation and amenity are much wanted, and public men are sadly deficient in them. The recognition of lawful authority, the clear understanding of each other's rights and duties, do not prevail in this our day and genera- tion. And, though our calling leads to private life, though the hos- pital and the sick chamber are the scene of our labors, the spirit of conciliation and compromise are wanted there. Covetousness, pride, self-love and self-will are enemies against which we physicians must carry on a warfare within ourselves. Van Helmont, who has left such full accounts of his struggles and labors on his road to pro- fessional eminence, tells us that he lived not without daily self-exami- nation. 13 " 0 wad some power the glftle gle us To see oursel's as ithers see us !" was the prayer of one who had experienced the humiliation of defeat and subjection to his own appetites. Yes, gentlemen, we may be thankful in this troubled time, that our duties do not call us away from scenes of retirement, from opportunities of self- improvement. Let us all use our advantages rightly. Let us try to recognize the true battle-ground, and devote our energies to the warfare to which we are summoned. We are associat- ed together in a profession which exists in all civilized countries, which has survived revolutions that have destroyed wide-spread empires. Yet, if we would do our duties as members of that pro- fession, we must see to it, each of us as an individual, that we are making a conquest of ourselves, that we are bringing into subjection all sinful passions, appetites, desires, and inclinations. You, as in- dividuals, gentlemen, have differences of character, of intellect, of position, of attainment. How shall each employ his talents in the cause to which he is pledged ? How shall each guard against his own besetting sin or infirmity ? I have called your attention, with as much detail as was possible, to the history of our profession, to the lives and fortunes of its distinguished members. These all are full of interest to us, who are called upon to contend with difficulties which they strug- gled against. Amongst them all, no one was more successful than he whose monument was built by the city in which he had lived and labored, and whereon was inscribed the sentence, " Salutifero Boerha- vii Genio Sacrum." I have already said enough of his vast erudition, his persuasive eloquence, of his success as a physician, an author and a teacher. He was unwearied in his labors, full of business, and occupation, but we are told of him that he always reserved to himself the first hour of his morning, to be spent in the study of heavenly things. He who would conduct a successful voyage over the seas and oceans of our physical world, studies diligently his charts and keeps a bright look-out for shoals and rocks and quick- sands ; but he does not forget his observation of the heavenly bodies, nor feel safe until he has thus found out his position and his bearings. And we cannot expect to conduct successfully our voy- age of life, however diligent we may be in our studies of earthly things, if we do not look above and out of ourselves from time to time, and bring our thoughts and our actions to the test of a Divine Rule. As medical men we must be thoroughly conversant 14 with the weaknesses and infirmities of human nature. We must realize what the Scripture tells us, that " The human heart is de- ceitful above all things and desperately wicked." We must know well the truth of that other saying, that " He who trusts in his own heart is a fool." Should we not, then, strive to lay hold on some- thing stronger, higher, holier than ourselves ? In the step which you have just taken, Divine assistance and blessing have been invoked by the preacher of the University. As, in college daily life, there are prayers and devotions prescribed by their founders, to promote the daily well-doing of the members, degrees have their religious elements and bearings. They confer privileges to be used for the benefit of others; but there has always been a tendency to over- look the duties and obligations. Selfishness is a besetting sin of our nature, against which, at all times and under all circumstances, we must be on our guard. The University would remind us that our own true welfare is best promoted by a regard to our duties to God and our duties to our neighbor; that the fear of the Lord is the beginning of wisdom. We begin life with high aspirations for all that is pure, lovely and of good report; but these visions of the morning vanish as childish things are put away, and we assume the duties and responsibilities of the full-grown man. There are many of you, gentlemen, who are no novices in life, though you are but now entering into the medi- cal profession, and who know full well, by sad experience, the mean- ing of the apostle as he tells of a law in his members warring against the law of his mind. I would wish you all, gentlemen, to recognize what a noble profession is yours, what scope it gives for the deve- lopment of your intellectual powers, how it can satisfy the most burning thirst for knowledge. I would have you realize what an art you are called upon to practise, how it calls out your sympa- thies, your affections, how it gives play to all true instincts of kindli- ness and good feeling. I would not conceal from you the trials and disappointments, the difficulties and uncertainties, which will beset your path. I have spoken to you of two schools in our profession, akin to two modes of viewing truth in theology. There are those who tell you that nature in disease is a steady tendency towards death, which the physician must counteract and beat back by ac- tive and powerful treatment. There are those who say that in disease nature is healing, that its struggle is for life, for restoration, with which we must be especially careful never to interfere. I have 15 tried to make you see the truth in the views of both these parties, the danger of obeying exclusively the precepts of either. And in these dealings with ourselves, we may not deny that there are instincts and impulses towards the good which are to be cherished, and yet also to be trained and brought into subjection. The experience of St. Paul, " the good that I would I do not, but the evil which I would not that I do," has been that of all sincere laborers in this field of self-improvement from his time to our own. The great prizes of life—wealth, fame, influence, friends—are strong incentives to dili- gence, but they certainly will not fall to the lot of all of you, they may not be attained by any of you. The medical man often toils on in poverty and obscurity, known only to his immediate neighbors. But wherever your path may lie, however narrow your field of labor, however great your infirmities, the plaudit and reward of the faith- ful servant may be yours. Sir Walter Raleigh, in his history of the world, surveying the baneful effect of the inordinate desires and passions of our race, apostrophizes Death as eloquent, just and mighty, who can persuade those whom none could advise, as alone able to make a man know himself, proving the sick man a naked beggar, with interest in nothing but the gravel that fills his mouth, holding the glass before the eyes of the most beautiful that they see and acknowledge their own deformity and rottenness." From watching so often the approach, from looking so often at the work of this grim monarch, are we not in danger of neglecting such teachings ? And now, gentlemen, in taking leave of you, and wishing you God speed as you enter on a new field of labor, can I set before you any higher incentive to diligence and fidelity than is contained in the old motto of our University — Christo et Ecclesiee. Here is a watch-word which has animated many a good scholar of the cross in a life-long struggle with sin and infirmity, who now rests from his labors while his works do follow him. These works of conquest over ourselves, of charity to our noighbors, of piety towards God, we, each one of us, may be doing from day to day. Of each one of us, as in our turn we yield to that stern monitor who takes us from this our scene of probation, naked as we came into it, it may be said, " Lord of himself though not of lands, And having nothing, yet hath all." MEMBERS OF THE GRADUATING CLASS. Graduates. George Jerome Arnold, John George Blake, Francis Henry Brown, Sidney Howard Carney, Charles Monro Carlton, John Edward Cobb, Benjamin Tower Crooker, Joseph Whitney Cushing, Edgar Everett Dean, Henry Claudius Dean, Frank Eli Dow, Theodore Willis Fisher, William Caldwell Flowers, Theodore Scott Floyd, William Edward Hayden, Isaac Hills Hazelton, Jr., William Henry Weed Hinds, John Davis Jones, Jr., Henry Allen Lamb, Jarvis King Mason, Alexander McDonald, Francis Le Baron Monroe, Ephraim Bell Muttart, Abial Ward Nelson, John Pond Ordway, Ara Marshall Paine, Norbert Provencher, William Edmond Rice, George Thompson Shipley, Joseph Crandall Skinner, John Fletcher Stevenson, Charles Carroll Street, James Francis Sullivan, Augustus Valentine Tourtelot, Warren Webster, Edward Andem Whiston, Sullivan Whitney, John Warren Willis, Theoron Woolverton, Residence. Londonderry, Vt. Boston, Boston, Boston, Boston, Taunton, Bridgewater, Boston, Easton, Boston, Danville, Vt. Medway, Halifax, N. S. Keene, N. H. Louisville, Ky. Boston, Tewksbury, Providence, R. I. Portland, Me. Enfield, Conn. Charlestown, Medway, C. Traverse, P.E.I. Lakeville, Boston, Blackstone, Worcester, Boston, Boston, St. Johns, N. B. St. Andrews, N.B. Springfield, Chelsea, Boston, Gilmanton, N. H. Framingham, Newton, Milford, Grimsby, C. W. Theses. Ventilation. Fractures. Hospitals. Death. Treatment of Acute Pneumonia. Yellow Fever. Post-Mortem Examinations. Strictures and Perinatal Section. Etiology. Scarlatina. Phthisis Pulmonalis. C Acute Rheumatism and its Complica- te tions. Scarlatina. Surgical Inflammation. Therapeutics of the Mind. C Against the Theory of the Produc- I tion of Phthisis by Masturbation. Pleurisy. C Climatology of Providence, and the \ Modes of Life on Disease. Enteric Fever. C Physiological and Pathological Ac- \ tion of the Mind. Idiocy. Insanity. Cholera Infantum. Chronic Laryngitis. Phthisis Pulmonalis. Phthisis Pulmonalis. C L'Homme, consider* sous le rapport \ du Physique et du Moral. Aruemia and Chlorosis. Mental Surgery. Medical Man in Emergency. Biliary Calculi. Signs and Symptoms of Pregnancy. The Blood. Bilious Remittent Fever. Dislocations and Fractures. Anesthetics. Functional Diseases of the Stomach. Sequences of Gonorrhoea. Transfusion of Blood.