St. Joseph County, Indiana - Chapter 6: Northken Indiana Medical Society. - St. .toseph County Medical, 1880

St. Joseph Valley Northern Indiana Medical Society

The first organized eftort made by the physicians of St. Joseph valley was in 1839. In May of that year a number of the medical fraternity met at the American Hotel in South Bend, and adopted a constitution taking the name of the Medical Society of Northern Indiana. Asa Egbert was elected President; George Rex, Vice President: Daniel Daj'ton, Recording Secretary; F. W. Hunt, Corresponding Secretary; A. B. Merritt, Treasurer; L. B. Rush. Grifiin Smith, Lyman Griffin, J. Chapman and R. L. Groton, Censors. The society adopted as its seal a serpent winding in a spiral form around a knotty club, the whole being surrounded with the words, '"Medical Society of Nortliern Indiana." The committee reporting the seal gave the following explanation of it: ''The serpent represents ^Esculapius, the god of physic, as depicted by the ancients and worshiped at Epidaurus, his native place. The spiral form in which he is winding around the knotty club denotes that protection from disease which the world receives from the medical profession. The club represents the art of medicine, which is used in beating back those diseases wliich otherwise would destroy life. The knots on the club show the perplexing difficulties and knotty questions whicii arise in the study of medicine. yEsculapius was the son of Apollo, and was educated in the art of curing diseases by Chiron, the Centaur, who by living in the woods had discovered the medical virtues of so many plants that he became the founder of a new art. yEsculapius soon excelled his preceptor, and learn so much that he restored those whose situations were considered desperate, and it was even thought he had power of recalling the dead to life. His divinity being established, and his power over disease unprecedented, he was sent for to Rome to deliver the city from a pestilence. When the Romans came to Epidaurus to transport the god to R<)me, a great serpent came into their ship which they b3lievei to b-3 the god in the form of a serpent, and returned with him to Rome. Others say that when the Romans arrived at Epidaurus they were kindly received by tiie citizens, and when they came to the temple of ^Esculapius, the serpent, in whose form the god was worshiped, went voluntarilv into the (389) ship of the Romans, was carried to Rome, and after delivering the city from the pestilence, was worshiped in the form of a great serpent in a temple erected for him on an isle in the Tiber. yEsculapius having restored so many to life that the infernal regions were in danger of becoming depopulated, Pluto complained that his revenues and the number of the dead were very much diminished, and persuaded Jupiter to em])loy the thunder in destroying the inventor and god of the healing art. Thus was fullilled the pro])hecy uttered at his birth.

Pursuant to a notice in the St. Jo.feph Valley Reglder, a number of the physicians of St. Joseph county met at the Odd Fellows hall, in South Bend, June 11, 1855, for the purpose of forming a County Medical Society. Dr. R. Pierce was called to the chair, and D. B. Van Tuyl appointed Secretary.

The object of the meeting having been stated, a committee, consisting of Drs. Humphreys, liardman and Buchtel, was appointed to draft a constitution and by-laws and report to the meeting, which they accordingly did, tlieir report being received and constitution and l)y-laws adopted.

On the 2d day of July following another meeting was held and the constitution was signed by the following named physicians: Daniel Dayton, L. Humphreys, Jacob Hardman, David B. Van Tuyl, J. B. Buchtel, John H. Rerick, A. II. Johnson and J. R. Brown. The officers were then elected, as follows: L. Humphreys, President; R. Pierce, Vice-President; J. H. Rerick, Secretary; Jacob Hardman, Treasurer; J. B. Buchtel, D. B. Van Tuyl, J. R. Brown, Committee on Admission.

At the October meeting, in 1856, considerable discussion ensued in relation to consulting with irregulars, and the practice was generally condemned. Dr. Van Tuyl introduced a resolution allowing members to judge for themselves as to the propriety of such consultation, without throwing any responsibility on the societ3'. The resolution was not acted on at this meeting, and at a subsequent meeting held in January, 1857, it was withdrawn.

Resolved, That it is expedient to organize a County Medical Society, believing that the popular standard of the medical profession is now too low, and, as a consequence, that many are to be found in its ranks who are not qualified for its high and responsible duties, and that such an organization as is now proposed to be made by this convention, when duly perfected, may be made to embody in its transactions the united views and purposes of the medical profession of this county, hereby rendering more efficient and available the means of promoting true medical science, and enlightening a distorted public sentiment in reference to the healing art. And, further, that it is necessary for emulation and concert of action in the profession, and for securing brotherly and friendly intercourse between all who are the commissioned agents of its responsibilities. Therefore, belt

Constitution And By-Laws

Sec. 4. A candidate to be eligible to membership must be of good moral character, and be a graduate of a regular medical school, or a practicing physician eligible to graduate In such school by attending one course of lectures. In which case, if recommended by the Committee on Admissions, and voted for by two thirds of the members present, he may become a member by signing the constitution and by-laws, and paying an initiation fee of one dollar.

Sec. 5. Reputable physicians and surgeons, possessed of the necessary qualifications as set forth in the preceding section, who are present at the adoinion of this constitution and by-laws of this societj'- by signing the same and paying the initiation fee, shall be considered members.

Sec. 6. Honorary members shall only be admitted by a vote of two-thirds of the members present at any regular meeting, having first been recommended by the Committee on Admissions.

Sec- 7. A vote of two-thirds of the members present shall be requisite to the expulsion of a member; which vote shall be had in consequence of a report of the Committee on Ethics, and at the next regular meeting subsequent to such report.

Sec. 8. The officers of this society shall be a President, Vice President, Secretary, Treasurer, and a Committee on Admissions consisting of three, all of whom shall be elected annually by ballot, on the first Monday in January.

Sec. 9. The President shall preside at all meetings, preserve order, promote the progress of business, appoint committees not otherwise provided for, give the casting vote, perform such other duties as pertain to his office by usage or custom, and deliver a -nTitten essay before the society at the close of his term.

Sec 11. The Secretary shall keep i fair record of the proceedings of each meeting, and perform all other duties usually connected with his office.

Sec 12. The Treasurer shall hold the funds of the society subject to its order, and shall annually e.xhibit in writing the state of the treasury.

Sec 14. The following standing committees shall be annually appointed by the President: A committee on medical ethics, a committee of five members who shall make annually a report to this society upon the endemic and epidemic diseases which have prevailed during the j'ear in the county, giving In full their pathology and treatment.

Sec 15. The President may call a meeting at any time when in his judgment the good of the society may require it, or upon petition of a quorum.

Sec. 17. The regular stated meetings of this society shall be held on the first Monday in January, April, July and October, commencing at one o'clock p. m.

Sec. 20. The Committee on Ethics shall hear all complaints of breach of etiquette or violation of medical ethics, and sliall decide all questions of ethics submitted to it, taking the American Code for their guide. If any member shall be charged in writing with any violation of the provisions of the constitution, or unprofessional conduct, a copy of such charge shall be lurnislied to him, himself and accuser cited to appear, when the committee shall proceed to hear the case, reserving its decision to be reported to the society, when its action may be afllrmed by a majority of the members present.

Sec. 21. No member of thissociety shall engage in making or using any secret nostrum in his practice, or circulate publicly or privately any hand-bills or cards, claiming to treat general or specific diseases by a method unknown to the profession at large, thereby inducing public patronage on the assumption that he is in possession of a secret or specific remedy, or a secret mode of treating general or specific di>easrs; and it shall be deemed by this society as uni)rofcssional in any of its members to solicit public patronage by proposing to receive no compensation when no cure follows the treatment in any case of disease.

Sec. 22. It shall l)e the duly of every member of this society, in attendance at any regular meeting, to report at least one case that has occurred in his practice during the year, embracing its history, treatment and pathology.

Sec. 24. This society shall, as early as practicable, adopt measures for keeping a meteorological register, noting the temperature and density of the atmosphere, fogs, dews, dew point, rain, hail, hoar-frost, clouds, winds, electrical phenomena, and other conditions that may be supposed to shed light upon the etiology of our diseases.

Sec. 25. This constitution may be amended at any regular meeting of the society, by a vote of two-thirds of the members present, provided the amendment has been proposed in writing at a previous meeting.

Meetings were held with more or less regularity until 1859, when tliey ceased altogetliei'. No successl'ul etfort was made to revive them for several years. On the 12th day of May, 1S65, a number of the physicians" of the county assembled at South Bend, re-organized and adopted a new constitution. For about two years the meetings of the society were continued, and again it suspended.

In response to a call issued by Dr. AV.W. Butterworth, the members of the society assembled at the office of Drs. llamond McAllister March 16, 1875, and again re-organized, adopting for their guidance the following :

Constitution

Article 1. The name and title of this society shall be " The St. Joseph County Medical Society," and shall be auxiliary to and under the control of the Indiana State Medical Society.

Art. 2. The objects of this society shall be the advancement of medical knowledge, the elevation of professional character, the protection of the interests of its members, the extension of the bounds of medical science, the promotion of all measures adapted to the relief of the suffering, and to improve the health and protect the lives of the community.

Art. 3. - Sec. 1. Any graduate in medicine of a respectable medical school or licentiate of any regularly organized medical society, who is in good moral and

Sec. 2. In the absence of the credentials mentioned in the first .section of this article, the candidate for membership, by presenting a certificate of qualification - to practice medicine and surgerj-, from the Board of Censors, may, upon signing the constitution and paying five dollars (|5.00) to the Treasurer, be admitted to full membership by a vote of the society.

Akt. 5. - Sec. 1. The President shall preside over the meetings, preserve order, and perform such other duties as custom and parliamentary usage may require. He may call meetings whenever in his judgment the interests of the society may demand them, or upon the written request of three members of the society. He shall sign certificates of membership and those of discharge; also, the written warrants authorized to be drawn upon the Treasurer, and all the official instruments and proceedings of the society. He shall deliver an address before the - society at the close of his official term.

Sec. 3. The Secretary shall keep a fair, legible and correct record of the proceedings of the society, and when approved, transcribe them in a book kept for that purpose. He sha'll record a list of the members' names with specifications of such as fail to pay their dues, taxes or fines. He shall have charge of all papers belonging to the society, excepting such as may properly belong to the Treasurer. He shall give notice of the meetings of the society. He shall collect the dues of the members to the State Society and forward them with such papers and documents as may be directed to the Secretary of the State Society, on or before the first day ot each annual meeting of said State Society.

Sec. "4, The Treasurer shall collect all dues payable to this society and pay, upon presentation, the orders regularly drawn upon him by the Secretary and signed bv the President. He shall keep a full account of all moneys received and disbursed, and make satisfactory reports thereof at least annually, and oftener. If required by the society. Upon the expiration of his term ot office, he shall ex- hibit to the parties appointed to receive them, an account current of the receipts and disbursements of his term, accompanied with vouchers, and hand over to his successor in office all moneys, books, papers, or other property held and received by virtue of his office.

Sec. 5. It shall be the duty of the Censors to examine candidates for membership who have not the credentials prescribed by section first of article third, and the applicant gives satisfactory evidence of qualifications in the various branches of medical science, give him a certificate of the fact, if in the interim of the meetings, or during a s^ession, report the same directly to the society.

Sec. 2. Five members shall constitute a quorum to do any business, except as provided in section first of this article, or levy fines, make assessments, or appropriate moneys belonging to the society.

Art. 7. - Sec. 1. The society shall have full power to adopt such measures as may be deemed most efficient for mutual improvement, for exciting a spirit of emulation, for dissemination of useful knowledge, for promoting friendly_ professional intercourse among its members, and for the advancement of medical science.

Sec. 2. It shall have power to censure or expel any who, after due notice of charges preferred, may be convicted of violating its provisions, or of conduct derogatory to the honor of the medical profession, and enforce the observance by its members of the Code of Ethics adopted by the society.

Sec. 3. It shall have the power to compel the attendance of its members upon its meetings and their service upon committees by the imposition of fines, which shall not in any case exceed three dollars: Provided, however, that when satisfactory excuse is rendered for delinquency, the society may refuse to assess any fine.

Sec 4. It shall have power to raise money of its members for the purpose of securing its objects, by a tax which shall not exceed five dollars annually on each member, and the dues annually assessed by the State Society.

Akt. 8. - Sec. 1. Any member who shall remove from the location he may occupy at the time of his admission into the society, so as to change his postofflce address, shall be considered without the bounds of the society, and shall thereby forfeit his right of membership until he shall have notified the Secretary of the postoffice to which his notice of the meetings may properly be directed.

Sec. 3. Such forfeiture of membership shall not exonerate the member from payment of any dues to the society which may at the time be standing against him.

AuT. 9. Any member upon signifying his intention or wish to \yithdraw from the society, aucf producing a certificate from the Secretary that he is not in arrears to the Treasurer, may be permitted to make such withdrawal : Provided, there are no charges against liim of violating the provisions of the society, or of conduct derogatory to the honor of the medical profession, in which case the member shall be required to answer to such charge before permitted to withdraw.

Art. 10. Any member who may be expelled shall be debarred from the right of consultation or any of the privileges of professional intercourse with any member of the society, and shall forfeit all interest in its funds and property, but shall be held to the payment of all dues he may owe the society at the time of his expulsion.

Art. 11. This society may admit honorary members, upon compliance of the applicant with the same" forms as prescribed for the admission of b(jna fide members, except that no initiatory fee shall be required. They shall not be permitted to vote, nor shall they participate in any of the proceedings, except by the express permission of the society.

Art. 12. The funds of this society shall be devoted exclusively to the promotion of its objects as set forth in article second of this constitution.

Art. 14. Every proposal to alter or amend this constitution shall be in wi-iting, and if such proposed alteration or amendment receive the unanimous vote of the meeting - if there be a competent quorum present - it shall be adopted, but if objection be made, it shall lie over until the next regular meeting, when if it receive two-thirds of a quorum competent to amend the constitution, it shall be adopted.

Art. 16. This society adopts as its seal a circular disc, upon the face of which are the words, " St. Joseph County Medical Society, Indiana, Physiolotjien ifedicina Cautionw et Curae Morhorinn Vera Scientia est," with the figures "1855," giving date of its organization.

Art. 17. In order more effectually to secure the objects of this society, we hereunto subscribe our names, do agree with, and to each other, that we will faithfully observe all the requirements of the constitution, Code of Ethics, and all other regulations adopted for the government of the society, and all requirements of the State Medical Society of Indiana, to which this is auxiliary; and that we will in no case whatever, knowingly consult with, or extend the courtesies of the profession to any one who is not a graduate of some respectable medical college, licentiate of this or some other regularly organized medical society, or in any other way countenance or encourage quackery in any of its forms or pretensions ; for the faithful performance of which we do hereby individually pledge our truth, our honor and professional standing.

This Constitution was signed by the following named physicians: Levi J. Ham, South Bend (expelled); Louis Humphreys, South Bend; John Cassidy, South Bend; James B. Green, Misha-

This society was organized July 10, 1874, at South Bend, and is composed of physicians of St. Joseph, Elkhart and La Porte counties, Indiana, and Cass and Berrien counties, Michigan. Louis Humphreys, of South Bend, was elected President, and E. W. McAllister, Secretary. Thirty-eight physicians from the counties named signed the constitution adopted at the meeting. Semi-annual meetings of the society were decided upon.

The third meeting was held at La Porte, June 8, 1875, at which time R. J. Hagert}^, of Elkhart county, was elected President, and C. S. Pixley, of the same county. Secretary.

Niles, Michigan, was the next place of meeting, which was held June 13, 1876. Landon C. Rose, of La Porte county, was elected President, and C. S. Pixley of Elkhart, Secretary.

The third annual meeting was held at the same place, June 12, 1877. At this meeting L. t). Rose, of La Porte, was elected President and G. V. Voorhees, of South Bend, Secretary.

At the semi-annual meeting L. H. Dunning was elected Secretary to fill the vacancy occasioned by the resignation of G. V. Voorliees. This meeting was held on the 17tli of January, 1879.

On the 10th of June, 1879, the fifth annual meeting was held at South Bend. Dr. W. W. Butterworth, of Mishawaka, was elected President, and L. H. Dunning, of South Bend, Secretary.

The sixth annual meeting of the St. Joseph Valley District Medical Society was held at the Grand Central Hotel, South Bend, June 10, 1880, and was the most animated and enthusiastic in the history of the societJ^ Among those present were Drs. Butterworth, of Mishawaka; Dodge, of Bristol; Reeves, of Niles; Frink, of Elkhart; Greener, of Middlebury; Put, of Millersburg; Montgomery, of Wakarusa; Harrington and Neal, of Elkhart; Morse, of Dowagiac; Thompkins, of Cassopolis; Hani, of Middlebury; O'Conner, of Mishawaka; Work, of Elkhart; Dunning, Kilmer and Stockwell,

The society then proceeded to the election of officers for the ensuing year with the following result: Dr. Thompkins, President; Drs. Hani, Morse, O'Conner, ilose and Belknap, Vice-Presidents; Dr. Dunning, Secretary; Dr. Frink, Treasurer.

A resolution was offered by Dr. Frink and adopted," that, in the opinion of this society any physician becoming a member obligates himself morally to comply with its requirements, and that failing to comply with them or giving a reasonable excuse for not doing so renders himself liable to a vote of censure."

The annual banquet was served in the dining room of the Grand Central Hotel, and was a collation worthy of the house and the occasion, for doctors, like other mortals, enjoy the good things of life. The tables, two in number, were arranged to seat thirty, and were well tilled. The bill of fare included a long list of substantials, supplemented by all the delicacies of the season served in the most approved style.

At the conclusion of the banquet Dr. L. H. Dunning, the toastmaster, arose, and after a few introductory remarks in an exceedingly happy vein, proceeded to read the toasts and introduce the respondents, as follows: worthy of special mention, however, that Dr. Ham paid a glowing tribute to the memory of the lamented Dr. Louis Humphreys, ft was a grand eiFort, and heartily indorsed by all who listened to it. Subjects of papers for the next meeting were assigned and the society adjourned.

On the first settlement of the St. Josepli valley and its surroundings, no part of the West rivaled it in beauty and loveliness. Previous to 183.5 it possessed an almost fabulous reputation throughout the Eastern and Middle States for its exemption from disease of every kind. The early inhabitants of the valley, when writing to " the friends they left behind them," grew enthusiastic over the attractions of their new homes, possessed of a climate, mild and genial (except in winter), a soil of unrivaled fertility, equaling in productions the far-famed valley of the Nile, in Egypts ])almiest days - landscapes of pleasing variety, in prairies, streams and lakes, while the openings excelled the parks of the nobles of the old world. To crown all, the inhabitants were in a land where they could say, "We know no sickness," and it seemed the long-sought-for ideal, earthly paradise of some of the early explorers of the Western world had been realized.

At the period of which we are speaking, the country was thinly populated; and but here and there the deep, rich mold of the prairies had been disturbed. About the year 1835 large accessions to the population were received, attracted by the fame of the country for fertility and beauty, and the speculative epidemic in wild lands that pervaded the West. The hosts of emigration moved into our lovely valley, like pilgrim devotees to some modern Mecca. Columns of smoke from the domiciles of the new settlers were soon to be counted by hundreds upon the plains and prairies. In every direction the eye was greeted by lines of zigzag fences, peculiar to new countries; and thousands of long, dark furrows met the vision of the beholder, attesting that the broad, green bosom of the earth had been torn by the plow of the hardy pioneer.

The effects of that mysterious agent, to which medical writers have given various names, but generally known by that of malarm, began to manifest its presence here and there, and victims to its barbaric disregard of the feelings of those who had left their "dear native lands" to brave the perils of frontier life were occasionally seen in the pale and sallow countenances of those upon whom the hand of this subtile enemy to humanity had been laid. The victims of chills and intermittents received at the hands of their well neighbors but little commiseration or anxious care, for their sickness was regarded as " only the ague" and of slight consequence, only from loss of time and inability to work. As a general thing, those having attacks of ague resorted to but little medication, most of them "wearing out their relation to the disease," many of whom were left with sadly impaired constitutions, and a few sank from organic diseases resulting from repeated attacks. There were but few physicians in the country at that time, and remedial agents were scarce and difficult to obtain. The county continued to prosper, increasing in population and wealth, with perhaps no increase of sickness above the ratio of increase in inhabitants, up to the year 1S3S. This is a memorable year in the annals of the entire West. No portion of the Mississippi valley, north of the Ohio river, could, with justice, set up any claims of salubrity of climate, or healthfulness of locality over another, and the AVestern citizens of that year lind but few pleasing associations connected with it.

Before any attempt is made at a delineation of the sickness of 1838, it will be proper to refer briefly to the combination of causes that existed to produce such deplorable results. The months of March, April, May, June and the first ten or twelve days of July, of that year, were remarkable for the quantities of rain that fell during that period. During the previous winter the water in the lakes, ponds and marshes had been unprecedentedly low. Add to continuity of rain of these months, as yet, the unaccounted-for periodic "rises" of all western Waters, and we find sufficient cause for an e.xtensive and unusual submergence of the low lands of the country. The air was necessarily loaded with moisture; for humidity it could only be paralleled, perhaps, in the low countries of Holland. So marked was this state of the atmosphere that articles of furniture, books and wearing apparel were frequently found to be mildewed in the houses of the inhabitants. Many of the dwellings of the settlers were illy calculated to resist the eflfects of the existing dampness of the climate. A large majority of the residences were of wood, having foundations and cellars walled with the same material, subject to rapid decay underground, furnishing an abundant source for unhealthy emanations. Many of the inhabitants used, for drinking and culinary purposes, surface water, while nearly all the wells constructed at that day were curbed or lined with wood, which, from its rapid decomposition, impregnated the water with a deposit disagreeable to the taste, and presumed to be anything but healthy in its character.

Large numbers of the settlers, from necessity, were compelled to expose their persons to the exceedingly damp air of morning and evening. Their mental and physical capacities were often, also, taxed beyond a health}' point by over- work. Add to this a diet of the plainest kind, which was devoured with voracious appetites, by which derangement of the stomach and biliary organs were almost necessarily induced; nearly all were deprived of the articles of diet requisite to the preservation of good health, especially, the various kinds of fruits; in addition to all this, the turning over by the plow of thousands of acres of turf, and we find a combination of circumstances, with the peculiarities of the summer and fall seasons of that memorable year, which in the absence of a more scientific explanation of causes, seem to be well calculated to produce the results that followed.

The spring season and early part of the suiiiiner of 183S were noted for the rapid and luxurious growth of all kinds of vegetation and the development of organic germs of cryptogamous growth. About tlie 12th of July the rains ceased, and, with Ihe exception of two or three light showers, remained suspended until about tiie IStli of tiie ensuing October. The cessation of rain was followed by an unusually (for this latitude) high temperature. The thousands of acres ot laud covered by superficial ponds were rapidly uncovered by evaporation, leaving a deposit of decayed vegetable matter exposed to the action of the intense heat of tiie suu, generating as is generally believed, although not susceptible of scientific demonstration, a malarial influence by the evolution of miasma. So rapidly was the superficial water exhaled from the surface of the ground that fissures of several inches in depth and an indefinite width and length, were not unfrequently seen. There is no record of observation upon the dew point at that time. During the montlis of August and September no moisture from dew was visible for weeks in succession. The sky each morning presented a lurid, brassy appearance, and the strata of atmosphere upon the earth's surface presented the tremulous, vibratory phenomenon, before the rising of the sun, caused by radiation of heat from the surface of the ground. Tlie ground at the same time was covered by the debris of dead vegetation.

During the latter part of the month of July a few cases of bilious remittent and intermittent fever manifested themselves, and, soon after, a general and wide-spread epidemic of those types of disease prevailed from which but few escaped. Persons of robust constitution, and whose habits of life were nearly in accordance with the laws of health, constituted no exception. Unhappily, but few were situated so as to be able to observe the rules requisite to the preservation of health. A very large majority of tlie residents of the entire valley of St. Joseph were sick at one time from the prevailing epidemic. Not unfrequently whole families were prostrated on sick beds, no one of their numbers possessing the ability to procure even cold water sufiicient to allay the thirst of their suft'ering associates. An incalculable amount of suffering, and in some instances death, resulted from want of proper care and nursing. Perhaps no one attendant circumstance of the great epidemic of that memorable year served to dishearten and paralyze the energies of the new settlers, while they lay languishing on their beds, haunted by fitful, feverish imaginings of the profusion of comforts they had left in their native lands, as the deprivation of the services of kind and sympathizing friends.

There were occasional instances of almost entire exemption from the prevailing disease. Those persons escaping were mostly women who, true to their natural promptings, were almost nightly and daily at the bedsides of the sick and suffering. The number of medical men at that time was very inadequate to the wants of the people, and many of them mere pretenders in the profession. There were some (notvwithstanding uncharitable strictures upon them, that Ave sometimes hear from our self-sufficient brethren of the present day) who were then, as they would be now, if living, ornaments, doing honor to the profession and the age in which they lived. Not a few of the physicians in the St. Joseph valley fell victims that year to the prevailing epidemic; but like true sentinels at their post, emphatically, they died with the professional harness on. A very large portion of the corps of medical men were sick and disabled from excessive fatigue and exposure, and the fatality of a large number of cases was, no doubt, attributable to a want of proper and timely medical aid. Perhaps a majority of the cases were simply agues, of the "everyday or every-other-day " type, attended with regular rigors during the cold stage, succeeded by the hot and sweating stages. This form of the disease was attended by no immediate danger, but the sequel was often ruinous beyond reparation in producing obstructions and disorganization of the lungs and other vital organs. The type of disease in many others was that of bilious remittent or intermittent fever proper, attended with more danger to the lives of those thus attacked, but which seldom or never ran into projier typhoid form. This latter form of fever was but rarely seen in the valley ])rior to the year 1847. As was stated in the earlier history of the diseases of this valley so was it in 1838. The remedial agents most needed in the treatment of that year could not be obtained, owing to the scarcity of the supply, and the want of facilities to bring them here (there were no railroads in those days, and but few steamers upon the upper lakes). That most reliable of all the preparations of Peruvian bark as a tonic and anti-periodic agent, quinine, was not to be had. The various substitutes sought out and devised by physicians and people were sadly deficient in meeting the indications. It would be safe to state that a very large portion of the fatal cases (the percentage of which was exceedingly small in proportion to the number of sick)iiroved fatal for want of that agent; against which, it is to be regretted, even at the present day, there exists much popular prejudice, caused mainly by unprincipled mountebanks, who crowd the profession, altogether unjustifiable in its nature. It is but just to say that the effects of Peruvian bark and its preparations were not then understood by the profession as at present, and the discoveries in its uses within the last ten or twelve years are invaluable and constitute one of the proudest monuments in the progress of our profession. The principal treatment of the epidemic by intelligent physicians consisted in the use of cathartics, alteratives, anodynes, and such febrifuge agents as could be procured at the time. The lancet then, as now, was seldom resorted to.

occurring late in the fall, exhibited an approximation to typhoid features, but none were snflBciently marked to entitle them to the name of ryphoid proper. As has been stated, there were comparatively few cases to the number sick, which terminated in death, and many of the fatal cases occurred from the causes already' set fortli. The inhabitants of the St. Joseph valley in the fall of 1S3S were emphatically resembling more nearly a community of stalking ghosts than living, active specimens of humanity. Many bereft of all energy or inclination to mental or physical efforts became impersonations of despair, while not a few, as soon as they were sufficiently restored to health, set out for their native hills and valleys, thoroughly disgusted with the West.

Since that memorable 3'ear of suffering, time has worn on, but the country has never been visited, and there is no probability' that it ever will be again, by so widely diffused and general an epidemic, tor there never can exist again such a combination of causes, as did then, to produce disease. Although nearly twenty" years have elapsed since that year of suffering, yet the " West" has scarcely recovered from the reputation it acquired at that time, in the Eastern and Middle States, for its supposed unhealthy climate; whUe the facts are, in relation to health and general prosperity, the citizens of the valley of St. Joseph may safely challenge a comparison with any portion of the American continent, possessing a soil of equal fertility.* From thelirst settlement of the St. Joseph valley and the West, generally, to the present day, the intermittent and remittent types have constituted a distinguishing feature in nearly all prevalent diseases. Prior to the last ten years they generally "pure and simple," or without complications, when the practice of the merest tyro in the profession would be attended with some degree of success. Subsequent to the period mentioned, complications with almost every form of acute disease became prevalent, almost always disguised or masked behind functional derangement of some vital organ or organs. Indeed, this feature of the disease of our country, at the present day, may be said to be protean in form.

The intermittent and remittent complications of the most frequent occurrence are neuralgia, pneumonia (popularly termed lung fever), rheumatism, dysentery, diarrhoea and erysipelas, besides numerous other phases, all requiring in a greater or less degree the anti-periodic and supporting plan of treatment, demanding the exercise of a sound judgment and careful discrimination on the part of the practitioner, to determine when to exhibit and when to withhold that class of remedies, with(jut which the greatest errors will assuredly be committed. In addition to the everchanging forms of intermittent and remittent diseases we have had, for the last ten years, more or less typhoid fever. Since the appearance of this fever there has been less of the former t^'pes in simple forms.

The annual period of sickness, since the appearance of typhoid, has in a great measure changed from the summer and early fall seasons to the late fall and winter seasons. Physicians in active practice for the last ten or twelve years often encounter difficulty with the typhoid patients and their friends (who resided in the West previous to that time), in making them understand the radical difference between that form of fever and the intermittent and remittent forms in point of duration. Especially has this been the case since the latter types of fever have become so amenable to an improved method of medication, by which most cases are cut short in a few days from inception. In typhoid fever the attending physician is often importuned by non-professional persons for reasons "why the fever is not broken up," they failing to see essential differences in types of disease. The marked disturbance of the brain and nervous system, and especially the characteristic local disease of the lining membrane and small glands of the intestinal canal, bearing a striking analogy to skin diseases, such as sraall-pox, scarlet fever, and other diseases of the skin and underlying tissues, the depraved condition of the blood and humors of the system generally can only be understood by the close observing professional man. It is therefore not strange that they escape the observation of persons outside of the profession, and hence the difficulties physicians encounter in explaining why they can no more liope to cure or shorten the duration of typhoid fever, as a general thing, than they can hope to arrest small-pox or other eruptive fevers. There are many cases, however, in which the duration is materially shortened by appropriate treatment, but they constitute the exception to the general rule. The physician's duty consists in sustaining the enfeebled powers of the system, and meeting, by timely remedial aid, if possible, the unfavorable symptoms as thej' arise in these cases. Typhoid, as are other types of fever, is often complicated in a variety of ways. The more serious the complication, of course, the greater will be the danger. This form of fever, though serious, is not often fatal. It is, however, one of those ailments which put on very different degrees of violence under different circumstances. On some occasions it is exceedingly fatal- -more so in hospitals than in private practice. There are few diseases that exhibit more happily the good results of judicious medical treatment than this. It is true that the disease cannot be suddenly interrupted, as has been intimated, but often materially shortened, and still more frequently conducted to a favorable issue, when, if left to nature and without treatment, it would inevitably end in death. It is generally admitted not to occur twice in the same person; it very often prevails epidemically. Not unfrequently the most health}' localities in this country are visited by it in this form. This disease is often supposed to be contagious. Typhoid patients sometimes suffer for want of proper care and nursing through fear of contracting the disease on the part of those who, under other circumstances, would respond promptly to the calls of suffering humanity. Nothing can be more erroneous, and it is the duty of every pliysician to disabuse the public mind upon this subject. There is almost always an epidemic influence abroad when typhoid fever prevails. At such times persons predisposed to disease, if sick at all, will be very likely to have a typlioid type of sickness. Fatigue, exposure to vicissitudes of weather, and mental disturbances sometimes act as e.xciting causes of the disease in those already' predisposed; hence it is not unfrequently the case that persons engaged in nursing typhoid patients days and nights and weeks, continuously deprived of their accustomed sleep, and suffering from mental anxiety at the same time, take the disease. Farther than tills I am constrained to believe there is no inherent principle of contagion about typhoid fever, although many eminent men and scientific observers have arrived at different conclusions.

Au'jongst the various diseases in which the people of the valley of St. Joseph, as elsewhere, are deeply interested, none enlists more solicitude than that of pulmonary consumption. This disease, aside from collateral causes, may be said to be produced only in those predisposed to it, or hereditarih', or about whom a combination of causes has been operating a sufficient length of time to develop Acoyisumptive diathesis. From the remarkably damp and cold character of the spring seasons in this latitude a superficial observer would be led to suppose that consumption was quite a common disease in this country, although nearly all cases which do occur of this disease are developed by the variable weather of our "o]ien winter" and spring seasons in those predisposed, or who wantonly or indifferently expose themselves. Yet it is not in the West, as a general thing, the great scourge of the human race, as in the Atlantic States, where it is estimated that one- seventh of all the deaths north of the tropics occur from consumption. I believe it is the i-eceived opinion of physicians that there are fewer cases of consumption at this time in the St. Joseph valley, in proportion to the number of inhabitants, than there were a few years ago, when congestive forms of chills were more frequent, inducing disease of the lungs by some sanguineous engorgement, which takes place more or less extensively- during the cold stage of that formidable type of interraittents. Some persons have come into this climate with marked symptons of pulmonary consumption, and after a few years residence have appeared comparatively restored to health. Many solutions of this problem in physiology have been oflTered, but none as yet have appeared sufficiently demonstrative to be incorporated with the truths of science. Among other suggestions, we may ask if it may not be accounted for on the principle that the shock sustained by the nervous system during intermittent attacks diverts diseased action from the lungs, and by revulsion diff'iises it through the system at large, from the eff'ect of which its recuperative energies rescues it from that which would destroy life if concentrated upon a given organ or set of organs. As before stated, the variable effect of ooen winters and damp, cold spring seasons are productive of most cases of this disease, tlie evil effects of which can be guarded against by proper precautionary measures, sucli as the use of warm clothing and careful protection of tiie feet and lower extremities from the effects of humidity and cold.

While on this part of my subject I would make an appeal to parents and guardians in behalf of little girls and misses. Almost one-half of this part of our population are suffering from enlarged tonsils (better known as quinsy), the result of which in most cases is cough from irritation of the throat, imperfect respiration, difficulty in swallowing, an impaired voice, and almost entire destruction of the vocal powers, as exhibited in that most useful and charming of all acquirements in young ladies, - the ability to sing well and effectively. The disease is but rarely seen in men and boys, compared with the number suffering of the opposite sex. The cause can be no other than loio-necked, short-sleeved dresses and thin shoes. Tiie preventives are within the reach of all.

There is, perhaps, no class of diseases like those of the lungs that affords so wide a field for the operation of charlatans and mountebanks in the profession of medicine. It is too often the case that ' some traveling lecturer and vender of specifics for consumption, after heralding his advent into our towns and villages by flaming posters, equaled only by circus and Ethiopian minstrel annuuncements, promising to work miracles upon diseased humanity, and from his itinerant character, perfectly irresponsible, reaps a golden harvest from those who are not able to be "fleeced " by exorbitant charges, such as would utterly destroy the reputation and business of any permanently located physician. And it is often the case, those who are thus deceived and cajoled by hopes raised only to be blasted, return to their family physician, soliciting aid and comfort, in a worse condition than before they turned their backs upon professional friends who have a permanent abiding place and a character to sustain, to run after professional new lights.

Nine times out of ten remedies taken by inhalation are a positive injury to the consumptive, from irritation produced by direct contact with the delicate and sensitive linings of the air passages of the lungs, though some agents, properly and judiciously used in this manner, may be beneficial.

Much of the scrofulous and consumptive diathesis in our native population is the result of our habits in diet, dress, want of hygienic cleanliness, and the construction of our houses, in relation to the laws of respiration. There is, perhaps, no article of diet so universal in use that contributes so much to produce and develop scrofulous diseases in its protean forms as pork. So common is it found constituting one of the staples of the American table, among all classes, that purk-eating may be said to constitute a national trait of character. That swine are afflicted with scrofula and tubercles has been demonstrated time and time again, and much of the scrofula witnessed by physicians is attributable to this universal pork-eating. The indigestibility of swine flesh is a well established fact, and the hog should be raised in a great measure for the f;it and oil furnished by hiin. Beef, mutton and ])Oultry of a good quality are much superiorto pork as articles of diet, and if more generally used would add greatl\' to ihe health of the masses. It is unquestionably the dutj' of every physician to discourage so general a use of pork among those to whom he sustains the relation of medical adviser. Our native German and English citizens are striking illustrations of the truth of this position, with reference to the effects of large indulgence in swine's flesli. They use but little pork diet compared with the quantity used by Americans. Consumption is rarel}' seen in either of the two classes named, and this is no doubt attributable to their comparative abstinence from pork. This, conjoined to the national trait of character in the German, giving vigorous exercise to the lungs and auxiliary organs in vocal music, in which the English indulge to a certain extent; also, add to this the universal habit of the two classes mentioned of warm and substantial clothing, especially for the feet and lower extremities, and we are again more than fortified in our position.

A large majority of cases of pulmonary consumption are first developed by indigestion (dyspepsia), induced by repeated violation of the physiological laws of digestion. The use of large quantities of stimulating food of any kind will produce derangement of the functions of digestion. Perhaps no one popular custom contributes so much to produce indigestion and its sequel, disease of the lungs, as that of meeting together socially, in crowded apartments, and at very late hours of the night, indulging freely in eating nearly every kind of indigestible food, most generally accompanied by large draughts of strong hot coft'ee and tea, and, immediately after, dispersing to their homes to spend the remainder of the night in fruitless eflforts to sleep, and to leave their beds the ensuing morning with aching heads, flushed countenances, nausea of the stomach, and almost entire loathing of nutritious food. This absurd practice should receive the unqualified condemnation of every right-thinking man and woman.

The pleasures of the appetite are legitimate pleasures, but our Creator did not implant the sense of taste in mankind to ruin the beautiful structure of the body, or impair the noble faculties of the soul. Like all other appetites, that for food may be abused. If its proper condition be violated, loss of power, premature decay and untimely death are inevitable. The life of the oflTender is deprived of its own enjoyment and of its power of being useful to others.

Another habit of our people which contributes largely to develop disease of the lungs, is the small and almost air-tight sleeping apartments so generally used, the temperature of which, during hours of sleep, in cold weather, is often raised to summer heat by means of air-tight stoves. The deleterious effect of all this upon the lungs and general system must be obvious to every thinking mind. A full supply of oxygen from the air we breathe is necessary to sustain life, which after being inhaled by the lungs, is converted into carbonic acid, one of the most destructive agents to animal life. To effect this change tlie oxygen must unite with certain portions of the blood, thus producing a species of combustion. The blood contains two combustible materials, carbon and hydrogen. By the union of these with oxygen a great amount of heat will be evolved, while the product of this combustion will be carbonic acid and water, the same that results from the combustion of wood in your grate, or a candle on j-our table. Life is really a process ot combustion, and the smoke evolved, or in other words, the carbonic acid and water, are continualh' passing off through the lungs and skin. Thus, we see that the human machine is furnished with facilities for preserving a comfortable temperature, in a great measure, independent of artificial heat; but, in order to do this, it must have an abundant supply of oxygen, the agent of combustion. In small, tight sleeping apartments, how is it possible the requisite supply of oxygen can be obtained, when there is not sufficient to keep up a healthy action of the lungs of the sleeping inmates for a few hours, much less a whole night? Disease of the lungs must be induced, to a greater or less extent, when there is nothing for their sustentation but an atmosphere almost deprived of the lifegiving principle ot oxygen, and loaded with poisonous carbonic acid and unhealthy exhalations from the bodies of the sleeping occupants.

Every sleeping apartment should be large, or at least well ventilated and supplied with fresh air, and no artificial heat, especially by means of stoves, as the body, for reasons already set forth, will generate its own warmth if supplied with a sufficiency of material for combustion to the lungs, through a healthy animation and a free supply of the agent essential to the process. Another duty that should be enjoined by physicians upon those who are accustomed to look to them for advice respecting health, especially the preservation of a healthy condition of the lungs, is the use of coldwater bathing not the "plunge" bath, the "sitz" bath, the " shower " bath, or the " wet-sheet " pack, but the simple application of water to the entire surface of the bodj' by means of a sponge or towel, followed by brisk friction for the purpose of cleaning and preserving a healthy action of the skin. Every person should know the close alliance that exists between the functions of the skin and air passages of the lungs, that a healthy performance of one aids materially the healthy performance of the other. Bathing should be resorted to in the manner indicated two or three times a week in cold weather, [and much oftener in warm or temperate weather. The best time to bathe is in the morning. Under no circumstances should the water be applied so freely, or so cold, as to produce a disagreeable shock to the system, by which the equilibrium of the circulation may be disturbed, and thereby induce diseased action, but always at such a temperature as to he followed by pleasurable sensations ot warmth. Bathing should never be resorted to until sufficient vital heat is supplied by fire or exercise to resist and overcome the slight shock resulting from the application of water. AVe should begin the sponge bath in a guarded manner. Persons of delicate constitutions should use water of the temperature of the body only, and in a warm apartment. Let there be sufficient exercise before and after the bath to maintain the general glow. In this way bathing may be enjoyed, not as a physiological duty, but as a refreshing luxury. By pursuing this course we can gradually lower the temperature of the water to any degree desired. When we have thus far succeeded, we have overcome our morbid sensibility, increased our vital forces, and given sucli a tone to the constitution as will protect us from colds and other agencies so prolific of lung diseases. The bath, thus used, I believe entitled to much consideration, not as a curative agent, but as a preventive of disease, especially diseases of the lungs.

To conclude, the valley of the St. Joseph, as also the West generally, from the observations of medical men and others, is, be3'ond doubt becoming from year to year more health}'. The exemption of our entire population from diseases of all kinds the past two or three years has been most remarkable. The universal good health which prevailed during the year 1S56 is mainly attributable to the uniform dryness of the seasons of that year. The health enjoyed through the year 1857 being fully equal to the preceding year, is the result of the opposite, - uniformity in the periods of rain. Whether the position that an excited state of the public mind (politically or from other causes) conduces to health, as has been stated, is correct or not, can only be determined by statistics of the past and careful observations of the future. The year 1857 being almost entirely free from any general public excitement, and the year 1832, the great cholera year, and noted in the annals of our country for the tempest of political excitement that swept over the whole Union, would seem to controvert the truth of that position.

Whenever our State Legislature can be induced to pass such registration laws and other enactments necessary, by which a fair and just comparison can be instituted between the West and the Atlantic States in respect to health, the preponderance will be found to be largely in favor of the former as the most healthy locality, especially that portion embraced within our beautiful valley and its surroundings.