Boston City (part 19 of 67)

In the year 1800 he published a tract entitled A Prospect of Exterminat¬ ing the Small-pox ; being the history of the Variola Vaccina , or Kine-p ox, etc. ; and in it he describes the method he used, July 8, 1800, in vaccinating his son, Daniel Oliver Waterhouse, a lad five years of age, who had this dis¬ ease in a mild way. From the arm of this boy he vaccinated another son, three years old, who had the customary symptoms in a light form ; and subsequently he " inoculated a servant boy of about 12 years of age, with some of the infected thread from England." This expression furnishes the clew to the method adopted for obtaining the vaccine virus, which came

" by a short passage from Bristol," Eng¬ land; though, in the autumn of 1802, Dr. Waterhouse speaks of receiving quillpoints, or " tooth picks," charged with virus. Before he had finished the practice in his own family, he had vaccinated four of his children and three of his servants, with no serious symptoms or consequences. The faith he had in the efficacy of the oper¬ ation, prompting him to try it on one of his own children, was of that living kind which always commands attention. In this matter we are re¬ minded of Dr. Boylston's bold act in inoculating his son for small-pox.

In the year 1802 Dr. Waterhouse, published a work of one hundred and thirty-four pages, which formed Part II. of the previously mentioned tract ; and in it he gives a full account of the new inoculation in America. In all his efforts to introduce vaccination, Dr. Waterhouse was warmly seconded by Dr. William Aspinwall, of Brookline, who deserves no small meed of praise in this matter. Dr. Aspinwall had paid much attention to variolous inoculation ; and after the death of Dr. Boylston, the first American inoculator in point of time, he erected small-pox hospitals in Brookline, where he treated a large number of patients for the disease, which had been artificially induced. No man in America, probably, ever inoculated so many persons, or enjoyed so wide a reputation for his skill in so doing, as Dr. Aspinwall.

During the summer and autumn of 1802 some interesting experiments were conducted under the direction of the Boston Board of Health, whose unremitting exertions at that time to prevent contagious disease entitle them to the highest praise. The Board fitted up a hospital on Noddle's Island, now known as East Boston, and invited a number of physicians to co-operate with them in an undertaking to diffuse knowledge and dispel prejudice in regard to vaccination. It was here that the trials were made, which fortunately were highly successful. On Aug. 16, 1802, nineteen boys were vaccinated, and all passed through the regular stages of the cow-pox; and on November 9 twelve of these children, together with a son of Dr. Bartlett, who had previously had the cow-pox, were inoculated for the small-pox with matter taken from a patient in the most infectious state of the disease, and no trouble whatever followed. In order to show the true variolous character of the virus used in this experiment, two lads were inoculated at the same time with the same matter, and in due time a severe eiuptive fever followed, with a plenteous crop of variolous pustules. When these two cases were in the right stage, matter was taken from them and inserted, for a second time, in the arms of the twelve children who had been previously inoculated, - and, besides, in the arms of the other seven boys who were absent at the first inoculation. They had, moreover, been exposed to infection, most of them for twenty days, by being in the same room with the two lads who had the small-pox, and all nineteen escaped. These and other facts are given in a report which was made and signed by eleven physicians, - James Lloyd and Benjamin Waterhouse appearing at

1 [This portrait was painted by Stuart, and Dr. Lloyd was born at Oyster Bay, Long Island, now belongs to Miss Alida L. Borland, of Boston. March 14, 1728, and died March 14, 1810. - Ed.]

At the beginning of the present century Boston had no hospital for the treatment of general disease, though there were such institutions in New York and Philadelphia. During many years before this time there were various indications in the community that the want of such an establish¬ ment was beginning to be felt; and in the summer of 1810 strenuous efforts were made to supply the want, which proved successful. A circularletter, dated Aug. 20, 1810, was prepared by Dr. James Jackson and Dr. John Collins Warren, and addressed to some of the most influential citizens of Boston and its neighborhood, for the purpose of awakening in their minds an interest in the subject. It was the opinion of Mr. Bowditch, as recorded in his History of the Massachusetts General Hospital, that this circular-letter might be regarded as the corner-stone of the institution.

Dr. James Jackson, the first signer, is perhaps the most conspicuous character in the medical annals of Massachusetts. No physician in the State ever exerted so large and lasting an influence over his professional brethren or his patients. Born in Newburyport, Oct. 3, 1 777, graduated at Harvard College in the class of 1796, he studied his profession under the venerable Dr. Holyoke, of Salem. In the year 1812 he was appointed to the Hersey Professorship of the Theory and Practice of Medicine, which he continued to hold until 1836. At this time he gave up the active duties of the office, and was chosen Professor Emeritus. His writings are numer¬ ous, and all his publications show great wisdom as well as literary culture. During a period of more than half a century he was a frequent contributor to the pages of the New England Journal of Medicine and Surgery, and of the Boston Medical and Surgical Journal. His death took place on Aug. 27, 1867.1

A charter for a hospital was granted by the Legislature, Feb. 25, 1811, containing a liberal gift, made on the condition that $100,000 more should be subscribed by individuals. Besides giving the Province House, the official residence of the Provincial Governors, for this object, the State helped along the matter in various ways. By a special resolve it was pro¬ vided that the stone for the building should be hammered by the convicts in the State prison at Charlestown. The work thus done is estimated at more than $30, 000. 2 The institution was opened in the autumn of 1821 ; though the McLean Asylum for the treatment of the insane, under the same board of managers, was in operation several years before this time.

The greatest boon to the human race, since the invention of printing, has been unquestionably the discovery of the anaesthetic properties of ether; and this great fact was first demonstrated to the world at the Massa¬ chusetts General Hospital. It was on Oct. 16, 1846, that ether was here

1 [The Life of Dr. John C. Warren contains 2 [Views of the Massachusetts Genera] Hosportraits of Dr. Warren; his father, Dr. John pital are in the. Life of John C. Warren, p.208; Warren; and of Dr. James Jackson. See also the in the History of the hospital; and elsewhere. History of the Mass. General Hospital. - Ed.] * - Ed.]

administered, under the immediate supervision of Dr. William Thomas Green Morton, in the presence of the surgeons of the institution. A full account of the affair, together with a detailed statement of the controversy connected with it, is given in Mr. Bowditch's history of the hospital.

The City Hospital, supported entirely by the city, was opened in the year 1864. It is situated hr Harrison Avenue, and occupies a square con¬ taining nearly seven acres. It consists of a central building and several large pavilions for the treatment of medical or surgical cases. During the past year nearly five thousand patients were treated within the hospital, be¬ sides ten thousand six hundred and five out-patients.

The Massachusetts Homoeopathic Hospital, in the immediate neighbor¬ hood of the City Hospital, was opened in the spring of 1876, and is con¬ ducted by physicians of the Homoeopathic school.

The Carney Hospital, at South Boston, is a large and useful institution; as is also the New England Hospital for Women and Children, situated in Roxbury.

There are numerous other Hospitals and Homes in various parts of the city for the treatment of the sick ; notably among them is the Children's Hospital, first opened in the year 1869. A large and commodious building for the use of this institution is now erecting in Huntington Avenue, which will be finished during the coming year.

Additional Memoeanda

THE PROFESSION. - To write of " Medicine in Boston " is not unlike writ¬ ing of the tides in Boston Harbor. Boston is a fraction of the civilized world, as its harbor is a part of the ocean. In both we must expect to find general laws and phenomena, modified more or less in their aspects by lo¬ cal influences.

It is safe to say that our descendants who may read these pages will be very much the same kind of human beings that we are, as we are very much like those who have gone before us. Elderly people will talk about " oldfashioned snow-storms" as we do. They will speak of "good old-fashioned constitutions," and bewail the degeneracy of the times to which they have survived. It was so in the days of Nestor; it was so in the days of good Dr. Holyoke. Among the fragments left by that excellent and sensible, but not eminently poetical, old physician was one which embodies a feeling

There are many changes in the conditions of society, and even in the aspects of Nature, taking place from generation to generation, some for the better, some for the worse ; and it is not always easy to strike the balance between the helpful and the harmful ones. The clearing of the forests alters the whole face of the country, - to some extent modifying the climate. The damming of streams necessarily introduces new sources of disease. Look at our Boston as it was in 1630, and as we now see it ! Faith, aided by cer¬ tain material agencies, has said to one of the hills of the Trimountain trip¬ let, " Remove hence to yonder place ! " and it has removed, being literally " cast into the sea." The little neck which united Boston to the main land has expanded into a great territory, covered with costly edifices. The old "Mill Pond" has been so long a part of the solid territory that its former existence is only known to a few students of the past. A little brook of fresh water from the hills runs through every street, and waits at every man's door, ready to serve him at an instant's notice. These are changes which might well be expected to affect the health of the citizens, directly or in¬ directly.

There has always been a prejudice in the minds of some of the old in¬ habitants against the "made land" of Boston. The territory embracing what was once the Mill Pond is said to have been unfavorable to the health of its inhabitants. Some have felt apprehensive that the creation of the New Boston, as we might almost venture to call it, - the stately city lying west of the Common, - would call a malarious region into existence. So far as our present experience reaches, these apprehensions of timid citizens, - shared, if I remember right, by the late Dr. Buckingham, - have proved groundless. Dr. Edward H. Clarke said to me, some time before his death in 1877, that, up to that date, he had never had a case of typhoid fever in the newly-peopled quarter, where he found a large proportion of his patients. Dr. Charles F. Folsom, late Secretary of the State Board of Flealth, writes me (Oct. 18, 1881), in answer to my question on the matter, as follows : -

" As to the Back Bay land, there is no evidence of any conditions unfavorable to health which can amount to proof. If there is any injurious emanation through the gravel from the filth below that, it must be very difficult to prove the fact. There is so much space and sunshine that, on the whole, the mortality is the lowest in the city, - perhaps largely due to the character of the population."

" There seems to be pretty clear evidence that typhoid fever diminished in Boston after the introduction of Cochituate water, the evidence being chiefly from the state¬ ments of physicians. (See Second Report of the State Board of Health , pp. 125 etseql) I know of no way of ascertaining its effect on the general death-rate."

The question as to the former and recent origination of fever and ague in this section of the United States is of late years assuming a new interest. On this subject I can speak with some authority. In the year 1837 the Boylston Prize Committee proposed the following question: " To what ex¬ tent and in what places has intermittent fever been indigenous in New Eng¬ land? " This question I answered to the best of my ability, with the aid of letters from distinguished physicians all over New England in answer to my inquiries. My dissertation, published with other essays in 1838, is accom¬ panied by a map of New England, in which every locality where the disease could be shown to have originated is marked by an asterisk. Of the twentynine marked localities fifteen were in Massachusetts. Among these the town of Boston had its place, by the testimony of the earlier writers and on the strength of a single case given by me as related to me by Dr. James Jackson. The patient was a lady, under the care of the late Dr. Dixwell. She had lived in Essex Street for a year or two, and had not been travelling for some time previous, if for many years. "This is the only case," Dr. Jackson says, " I have ever known of intermittent fever in Boston, so far as I am acquainted with that vicinity ; nor have I heard on any good authority of a case of this disease in my day within these limits." Even this case he considered questionable. All my inquiries in 1837 failed to bring out evi¬ dence of any other indigenous cases. Neither have I been much more for¬ tunate, or unfortunate, in finding proof of the existence of the disease as native here in these later years. Dr. Folsom writes, in the letter abovementioned : - -

" I have never heard of any recent case of intermittent fever in the vicinity of Boston, except three cases near Fresh Pond, in Cambridge, this autumn. I think there were a few in Chelsea some years ago. Dr. Walcott [the successor of Dr. Fol¬ som] tells me that he has no further information. Doubtless you know that there has been a great prevalence of the fever in Western Massachusetts, Eastern New York, and Rhode Island for a few years."

I have recently made inquiries of several of our leading practitioners, but no one of them had seen, in the course of a long practice, a single case undisputedly originating in Boston. My record of more than forty years ago is confirmed by that of to-day. Boston has been, for several'generations at least, almost if not absolutely free from that form of malaria which produces fever and ague. That it was not so in the early periods of the settlement is rendered probable by the facts cited from old authorities by Dr. Green, as well as those collected by myself in the dissertation referred to. That it may not be so in the future is rendered, I do not like to say probable, but certainly not very unlikely, by the facts referred to, which have been observed within the last few years. The Medical Record for Oct. 8, 1 88 1, makes the following statement: -

" It is, we believe, about five years since it [ malaria , - meaning fever and ague, its effect] began to travel up the Connecticut and along the sea-coast. It has now reached some of the river towns in lower Vermont, and has been quite prevalent at several points in western Massachusetts, along the Connecticut River Valley. Cases also occurred at Providence, R. I., and in the vicinity of Boston. According to the Connecticut Board of Health, the malarial wave is gradually extending over that State. The only rule which seems to be observed is that it follows up the river valleys, spreading on either side. It also travels along the coast line, extending thence inland. Local causes do not apparently develop the disease, although marshy ground, newly-turned soil, etc., have in some cases increased the amount or modified its character."

The disease has appeared in the vicinity of New Haven, of Hartford, and of Springfield, at Greenfield, Lenox, and North Adams. The Boston Medical and Surgical Journal for Oct. 6, 1 88 1 , says: -

" We learn that eight or ten cases of intermittent fever, of unquestionable local origin, have been observed in Millbury in this State. Millbury, as our readers know, is a pleasant manufacturing town of about five thousand inhabitants, situated on the Blackstone River, not far from Worcester."

Whether the early experience of Boston and its neighborhood is to be repeated in coming years we can only conjecture; but there is reasonable ground for apprehension in the encroachments on New England territory which have occurred of late years.

Since writing the above paragraph, the Boston Medical and Surgical Journal for Oct. 27, 1881, contains a statement, borrowed from the Report of the city registrar of Providence, that there are more than a hundred cases of fever and ague in that city at this time. In the same number of the Journal it is stated that the malarial wave has extended up the Blackstone River as far as Lonsdale, where eight cases had been observed by the physician making this statement. Another physician reported thirty cases at Cranston during the present season. I must, therefore, confess that what I claimed for New England in verse so long ago as 1846 cannot be affirmed in truth-telling prose in 1881 : -

With the swarming in of a new population of poor foreigners, new sources of disease have naturally come into being. The month of June is commonly the least sickly one of the year in Boston. As the hot weather comes on, the better residences in the newer parts of the city are gradually left for the country, until the broad avenues of our Westminster and the adjacent streets are silent and lonely as Tadmor in the Desert. In July the ravages of the destroying endemic, cholera infantum, begin to be for¬ midable, and they continue until the cooler days and nights bring with them typhoid fevers and dysenteries. The large death-rate of Boston is in great measure due to the fearful mortality among children in the crowded streets and poorer dwellings of the city. The malaria of filth and overcrowding takes the place of the marsh miasms which afflict other parts of the country. Why our city should so long have enjoyed exemption from these also it is not easy to say. It has suffered from cholera, from diphtheria, from the ordinary eruptive fevers ; in the earlier part of the century from slight inroads of imported yellow fever : but while it has shared the diseases which belong to the whole country and the whole world, and felt the usual effects of crowding common to great cities, it has never known any destructive lo¬ cal pestilence like the plague of London, or the yellow fever of New Orleans or of Philadelphia. A source of anxiety at the present time is the condi¬ tion of the water supply, which, though abundant, is so far from being sat¬ isfactory in quality that spring water is as much an article of commerce as ale or wine ; and many families no more think of drinking the Cochituate in¬ fusion of organic matters than they would of drinking the salt water of the Charles.

The question as to a change of constitution in the American from the Old-W orld type and habit is under active discussion at the present time. Long before another century shall be completed, we may trust that a thorough investigation will have taken the place of vague impressions and partial statistics. The Rev. Samuel Stanhope Smith, sometime President of the College of New Jersey, maintained, as others have since his time, that the white man in America was becoming assimilated to the Indian in physical character. It has been generally believed that the American, as compared with the Englishman, is leaner, paler, more nervous; that his teeth are more liable to decay; that the young women, though singularly handsome in early life, fade much sooner than do their English sisters. All this was attributed to such causes as the climate, which is thought to be drying and stimulating; to the common food, which is accused of beingindigestible and badly cooked ; to the eager activity of the people in the pui suit of gain, with also a neglect of exercise and athletic amusements. On the other hand, I once heard it maintained by a well known writer that the American is "an Englishman reinforced." In a recent article, founded on long and careful observation in both countries, the characteristic Ameri¬ can and English types, as seen in ordinary representations, are said to be found as well marked in one country as in the other. There is at this time a rather common belief that the new generation in this city is breeding up to a higher standard than that of its ancestors. The prevalence of a

Two obvious causes tend to improve the development of the new gen¬ eration. The first is the prolonged residence in the country of all who can afford it during the hot season. Man, but more especially woman, is a hot¬ house fruit in our inclement climate. To make up for long confinement under glass, free exposure, so far as the seasons permit, is essential. The second obvious cause of physical improvement is found in the great atten¬ tion now given to out-of-door exercises. Base-ball and cricket, lawn-tennis and croquet, football, lacrosse, boating, running matches, fencing, sparring, - all these have become serious pursuits, under the name of amusements. Training for athletic contests has been better than sermons in enforcing the connection between perfect health and temperate habits. Wholesome food, abstinence from alcoholic stimulants and narcotic nerve-poisoners have proved their value, or rather their necessity, as conditions of success in the rowing match and foot-race.

We have seen families, long resident among us, run down and die out. We have seen others breed up, showing a physical constitution far superior to that of their progenitors. The question of acclimation cannot be con¬ sidered fully worked out as yet. But w7e do know that, under proper influ¬ ences, vital capital may be accumulated here as well as any other and less valuable property. Daniel Webster and Jeremiah Mason strode in upon us from the hungry hillsides of New Hampshire. Two of the most athletic young men I have known traced their lineage backward through four or more generations to invalids of our city and its immediate neighborhood. How many centuries it may take to mould the true American type, or whether there will be one or many gradually taking shape on the Western Continent, we must leave it to the future to decide. This at least we know, that the fancies of Buffon and the whims of such ethnologists as the late Dr. Knox, of Edinburgh, are already rendered ridiculous by the history of many successive generations, represented at this day by men and women not a few of whom are far above the average European in bodily and mental vigor; while the beauty of American young women is generally recognized as a national characteristic. The causes of improvement and deterioration in the race will vary with time and circumstances; but we have a right to anticipate a constantly growing adaptation of the settlers of the New World to their atmospheric and other natural environments, so that we can hardly guess what physical and mental standard our descend¬ ants may reach after a thousand years of ancestral acclimation.

The death-rate among the poorer classes in a crowded city must always, it may be feared, remain large. But there are many circumstances favor¬ able to health in well-built, and especially in well-paved, cities; and we have a right to hope that our city will, by replacing its unwholesome tenements by habitable dwellings, the improvement of its drainage and, we must add, of its water supply, diminish a ratio of mortality now larger than it should be in a town so situated. *

II. Medical Practice as it was and is. - Our forefathers appear to have given more thought, a great deal, to the salvation of their souls than to the care of their bodies. Disease itself, the offspring of sin and penalty of a poisoned nature, was for them a theological entity rather than a disturbed physiological process. The superstitions of the clergy were naturally, to some extent, reflected in the practice of the physicians. Plow far this was the case we have scanty means of knowing, for very little is recorded of the practitioners of medicine as compared with the abun¬ dant memoirs of the preachers. One curious fact hints at a difference of opinion and feeling in the two professions, which was probably more exten¬ sive and deeper than any record can show. In the endemic mania at Sa¬ lem the Swinnerton family are said to have been all along opposed to Mr. Parris, and to have kept remarkably clear from the witchcraft delusion. Dr. John Swinnerton, who died just before the reign of ghostly terror pre¬ vailed, was the chief medical practitioner of Salem ; and we can hardly doubt that his influence had much to do with the attitude taken by the family with reference to the all absorbing question. But notwithstanding the proverbial freedom of thought characterizing the medical profession, we could hardly expect the earlier physicians to have been much in ad¬ vance of their age; and we can conjecture what must have been the state of medical belief and treatment among the colonists, by recalling the con¬ temporary conditions of medical science and art in the Old World.

If one of the earliest settlers, or of the next generation, had gone to England with a scrofulous child, Richard Wiseman, the distinguished author of Chirurgicall Treatises , member of the Honorable Company of Barber Surgeons, would have commended him to the touch of his royal master, as being the divinely appointed cure of the "King's Evill." If the traveller had been fortunate enough to carry an introduction to the Hon. Robert Boyle, one of the most illustrious philosophers of his age, that distinguished gentleman might have handed him a little book which the great man him¬ self had put forth, in which he would find the ashes of the " Sole of an Old Shoe worn by some Man that walks much," or the powdered warts from the leg of a horse, recommended for different affections, - - the last for in¬ ternal use. Mr. Boyle would have very probably advised him to consult Mr. Valentine Greatrakes, the touch-doctor, or to procure some of the "Powder of Sympathy" of Sir Kenelm Digby, wherewith to anoint the weapon , not the patient, if one had been wounded. If the colonist had passed over to the Continent he might probably have sought the counsel of the world-renowned Van Helmont, the successor in some respects of Paracelsus, who would have explained to him the mysteries of the Archceus , the ruler of the living body, who was to be humored and coaxed or driven into good behavior; perhaps have commended him to his Irish friend, Butler, who would have tried the virtues of his famous pebble upon him. Not much could be expected of medical science in the New World if such was its condition in the Old. Physic was a lucrative calling, in which the desire of gain, joined to the benevolent purpose of relieving suffering, - aided also by the natural vanity which leads men to over¬ estimate their own powers and performances, - conspired to attribute a much larger share in the movements of disease to medication than really belonged to it. Mr. Ward, the Vicar of Stratford-on-Avon from 1648 to 1679, who might have told us so much, and has told us so little, about Shakespeare, quotes a lively description of the doctors quite as damaging to their patients as to them: "There are several sorts of physicians, said one; first, those that can talk but doe nothing; secondly, some that can doe but not talk; third, some that can both doe and talk; fourthly, some that can neither doe nor talk, - and these get viost monie."

1 had the privilege of examining and reporting to the Massachusetts Historical Society on a paper of medical directions placed in my hands by the Hon. Robert C. Winthrop, the president of the society. It is headed, " For my worthy friend, Mr. Wintrop," and signed " Ed. Stafford." Its date is 1643; and I was not able to decide whether it was intended for our Governor John Winthrop, or for his son, the Governor of Connecticut. The list of remedies is made up principally of simples, or vegetable substances. St. John's wort, black hellebore, great bryony root, the four great cold seeds, maiden-hair, fennel, parsley, witch-hazel, elder, clown's all-heal ( stachys palustris), saffron, foxglove, jalap, scammony, snakeroot, are among these, many of them inert, some dangerous, if not carefully handled. Caranna and tacamahacca, - two gums, of which it used to be said, "Whatever the tacamahacca has not cured the caranna will," - and Burgundy pitch are also enumerated. Of mineral substances, lime-water, salt, saltpetre, crocus metallorum (sulphuretted oxide of antimony) are mentioned. " A Wilde Catt's skin on y' place grieved " is recommended for pains in the heart or limbs. More formidable to the imagination than any of these is " My black powder against ye plague, small-pox, purples, all sorts of feavers, poyson, either by way of prevention or after infections." This is made by burning toads to charcoal, and reducing this to powder. ' It belongs to that list of abominations which disgraced the old pharmacopias, but which have disappeared from the armamentarium of regular practitioners. As late, however, as the year 1789, Cullen had to censure Vogel for allowing burnt toads and swallow chicks to remain on his list of remedies.

The Winthrops, - to one of whom Dr. or Mr. Stafford's directions were given, - assisted their fellow-citizens with medical counsel as well as in many other ways. The Governor of Connecticut, John Winthrop, treated a great number of medical cases in Hartford, and left a record of his practice extending from 1657 to 1669. This manuscript was also intrusted to me. I examined it very carefully, and reported upon it in the lecture before the Massachusetts Medical Society to which I have already referred. From it we may get an idea of what was likely to be the kind of treatment to which our Boston predecessors would be submitted. The excellent Gov¬ ernor seems to have been consulted by great numbers of persons, - to have had a wider circle of practice, it may be suspected, than many or any of those who called themselves doctors. The common diseases of all ages and both sexes appear to have come under his care. Measles and their consequences are at first most prominent, and fever and ague had often to be treated. He used the ordinary simples dear to mothers and nurses, elecampane, elder, wormwood, anise, and the rest; and besides these certain mineral remedies. Of these, nitre (saltpetre) was his favor¬ ite. Another favorite prescription was spermaceti, which, like Hotspur's fop, he seems to have considered " the sovereign'st thing on earth " for inward bruises, and often prescribes after falls and similar injuries. Other remedies were antimony, now and then a little iron or sulphur or calomel, rhubarb, jalap, horseradish (which I remember Cullen recommends for hoaiseness), guaiacum, and the old mithridate or farrago which, like so many foolish mixtures, owed all its real virtue to opium. He amused his patients with doses of coral and of amber, and sometimes gave them (let us hope without their knowing it) some of those unmentionable articles which insulted the senses and the stomachs of seventeenth and eighteenth century patients. One medicine which he very often prescribes he calls rubila. After long search I found that this consisted of four grains of dia¬ phoretic antimony, with twenty grains of nitre, and a little salt of tin. I do not remember that the Governor ever mentions bleeding or blistering. Whether busy practitioners found time to bleed their patients as readily as those who had little else to do might be questioned. One of my old friends told me that the Philadelphia doctors used to order blood-letting more frequently than the Boston ones, because there was in that city a set of professional bleeders.

Among my old books I found a small manuscript volume of Dr. James Oliver, a famous physician, who graduated at Harvard College in 1680, and died in 1703. It contains an account of the medicines he purchased and prescribed. The usual simples are mentioned, with certain warming elixirs and cordials; and also iron and mercury.

By the kindness of the late librarian of the American Antiquarian So¬ ciety I had placed in my hands a manuscript of Cotton Mather, entitled "The Angel of Bethesda: an Essay upon the Common Maladies of Man¬ kind, offering, first, the sentiments of Piety," etc., and " a Collection of plain but Potent and Approved REMEDIES for the Maladies." His start¬ ing point is, of course, theological. " Sickness is, in Fact, Flagellum Dei pro peccatis mundi. 1 he treatise is full of pedantry, superstition, decla¬ mation, and miscellaneous folly. Yet Cotton Mather's drag-net is always worth looking through. He prescribes euphrasia, eye-bright, in recogni¬ tion of the absurd old doctrine of signatures. For the scattering of wens " the efficacy of a Dead Hand has been out of measure wonderful." He apostrophizes the millipede, " Poor sowbug ! " and then proclaims its heal¬ ing virtues. We are to take " half a pound, putt 'em alive into a quart or two of wine," with saffron and other drugs, and of this tincture the patient

" Among the plants of our soyl Sir William Temple singles out Five [six] as being of the greatest virtue and most friendly to health ; and his favorite plants, Sage, Rue, Saffron, Alehoof, Garlick, and Elder.

" And yet for the cleansing of the small Blood Vessels, and making way for the free circulation of the Blood and Lymph, there is nothing like Mercurial Deob¬ struents."

In the year 1718 William Douglass, M. D., settled in Boston as a prac¬ tising physician. He was of Scotch birth, and educated partly in Paris, partly in Leyden. He is said to have been at one time the only practi¬ tioner in the town who had a regular degree. He was a man of learning and ability, eminently given to dispute, - a good instance of the peifervidjun ingenium Scotorum. He at first opposed Dr. Boylston and Cotton Mather in their efforts to introduce the practice of inoculation, but afterward pro¬ nounced himself in its favor.

I suspect that medicine in Boston owed the reform of its Materia Medica largely to William Douglass. He mentions four remedies as the most im¬ portant ones in the hands of the physicians of his time. This was in the dedication of his quarrelsome treatise on inoculation, in the year 1730. Nearly seventy years after this Dr. Holyoke, who had then been in prac¬ tice for half a century, took a student just beginning his medical education with him, - young James Jackson, - into the room where he kept his medi¬ cines. Pointing to the drawers and bottles ranged around the room, he said to the young man : " I seem to have here a great number and variety of medicines; but I may name four which are of more importance than all the rest put together; namely, Mercury, Antimony, Opium, and Peruvian Bark." Dr. Jackson gives these four remedies the same prominent place which his " old master" assigned them. Now these are the four remedies which Dr. William Douglass, practising a century before Dr. Jackson, con¬ sidered to be the most important articles of the Materia Medica. Dr. Danforth substituted ipecacuanha for antimony, retaining the other three articles with this as his chief reliance. We shall see presently what rank they hold in the practice of to-day. If Moliere had restated the prevalent method of practice in acute diseases, as it was within my own memory, it would be saignare, purgare, et blisterizare. The object of these measures, aided by rest and low diet, was to subdue inflammatory action, and thus avert its destructive consequences. But as a series of restorative processes involves a sustained effort on the part of the living powers, and as these are liable to fail if not properly supported, and the patient to die of exhaustion, the fear of debility comes in to balance the fear of over-excitement. Medical prac¬ tice, therefore, always tends to vibrate between depleting and sustaining measures. The doctors have most commonly been for bleeding and starv¬ ing, the old women for feeding and stimulating " to keep up the strength," in such diseases as fevers and inflammation of the lungs. Dr. Fuller, who came with the Pilgrims of the " Mayflower," says, in 1630, " I have been to Matapan [now Dorchester] and let some twenty of those people blood." Dr. Benjamin Rush bled his patients like so many calves. Forty years ago, or later, a physician carried a lancet-case in his pocket almost as a matter of course. Still there were those who never used that little instru¬ ment. Our Boston Dr. Danforth was opposed to venesection. Dr. William Tully, of Connecticut, said, " The lancet is a weapon which annually slays more than the sword."

The old women have got the upper hand. Patients are fed diligently through the whole course of acute diseases. Blood-letting, as one of my friends in active practice tells me, " is almost getting to be a lost art." " My assistant," he says, " in the last year of his studies had never seen venesection performed, and did not know how to do it." I remember being told by a former medical student, who had been long a resident in the Bellevue Hospital of New York, that he had never seen a patient bled. Still it is advocated by Dr. Barker and others in puerperal convulsions; and I have seen a recent discussion in which it was maintained by some of the disputants that it was useful in some cases of pneumonia. The essay of Louis on the effect of blood-letting in this disease did much to weaken the confidence long felt in its efficacy.

In order to know what drugs are most frequently prescribed at the present time, I applied to four physicians for a list of their favorite reme¬ dies, and to three apothecaries for the names of the medicines which they most frequently put up for regular practitioners. Opium and quinia were oftenest mentioned, being named by all of the seven gentlemen consulted. Next came bromide of potassium, mentioned by six of the whole number; iodine, etc., by five; ipecacuanha, mercury, bismuth, salicylic acid and salicylates, and iron, by four; pepsin, rhubarb, and chlorate of potass, by three; arsenic, guarana, and phosphates, by two. Among the other rem¬ edies in the list I find ergot, chloral, strychnine, belladonna, pilocarpine, glycerine, podophyllin, coca, and the familiar old medicines, castor oil, squills, and nitre.

The following list of the remedies most used at the Massachusetts General Hospital was kindly furnished to me by Dr. Whittemore, the Super¬ intendent of that Institution: Opium, iron, quinia, iodide and bromide of potassium, salicylic acid, subnitrate of bismuth, chloral hydrate, mercury (in specific disease). The cathartics most employed are sulphate of mag¬ nesia, castor oil, podophyllin, compound cathartic pill, aloes, compound colocynth pill, compound liquorice powder, various cathartic waters. " Listerism " is almost universally emplpyed in surgical cases. Subcutaneous injections of morphia are extensively used, also of ether and alcohol when stimulation is demanded : apomorphia is employed in the same way to pro¬ duce immediate vomiting. Venesection is rarely practised ; not a single case of it for medical disease during five years is remembered. Leeches are applied for contusions; cupping ordered once in a great while; blisters rather more frequently, but not very often.

Externally, I am told that ointments are much less used than formerly. Carbolic acid, as all know, is employed to a great extent. Liniments of opium,, aconite, and chloroform are employed ; also tincture of iodine. " Vaseline" and " cosmoline " are much used in place of the old ointments. It may be interesting by and by to note which of these various remedies passes out of general employment, and what others take their places. Leeching and blistering seem to share in some measure the disfavor of venesection. I have not spoken of the various anaesthetics, among which ether has from the first been preferred in Boston. Next to these in silenc¬ ing pain is the practice of subcutaneous injection of morphia, now com¬ monly employed and of great and speedy efficacy.

The founding of the Boston Dispensary (1796) and of the Massachusetts General Hospital (1811). The establishment of the City Hospital (1864) and that of the Eye and Ear Infirmary (1826), and other medical charities. The removal to Boston of the Medical School of Harvard University and the erection of the Massachusetts Medical College (1815), followed by that of the building in North Grove Street, and of the noble edifice now in course of construction at the corner of Boylston and Exeter streets. The formation of the Boston Medical Association (1806), of the Suffolk District Medical Society (1849), °f the Societies for Medical Improvement ( 1 839) , for Medical Observation (1835 and 1846), of Medical Sciences (1869), and others.

The most notable change in the conditions of the Profession is its sub¬ division into specialties. We have not only Oculists, Aurists, and Den¬ tists, but Gynaecologists, Dermatologists, Laryngologists, Orthopedists, practitioners devoted to nervous diseases, Alienists, and the guardians of public health, - Sanitarians.

Among the remarkable improvements of the present century, which have been taught and made practical here as elsewhere are the following: The introduction and perfection of instruments of research, - the stetho¬ scope, the medical thermometer, the sphygmometer, the ophthalmoscope, the laryngoscope ; all showing us the condition of parts beyond the reach of the earlier and unaided methods of observation.

Our knowledge of the intimate organic changes connected with disease has been acquired to. a great extent within the last half century by that signal improvement in the compound microscope which rendered it a trustworthy instrument. The almost entirely new science of Histology, or General Anatomy, - the broad idea of which is still to be found in the original work of Bichat, - owes its present condition entirely to the micro¬ scope, which is to the biologist what the telescope is to the astronomer. Out °t its teachings have grown not only a new anatomy, but a new physi¬ ology and a new pathology.

In the mean time chemistry has not merely aided in the analysis of the material elements of the organism, but it has succeeded in eliminating gieat numbers of powerful principles from the compounds in which they were disguised by nature. Quinia, morphia, strychnia, and aconitia are ex¬ amples of isolated organic elements which have the essential virtues of the plants from which they were derived. Nor are we to forget our obligations to the pharmaceutists who have divested medicine of its horrors to such an extent that we no longer shudder as we see the physician writing his pre¬ scriptions.

It is but a fractional power that the physician has over disease, and a comparatively small fraction over the issues of life and death. But he can avoid the errors of the past, which over drugged the sick in the belief that whatever was loathsome to the senses and perturbing to the functions was likely to be useful in disease. Nor is the healing art to rest contented with simple expectation. The discovery of the efficacy of the bromide of potas¬ sium in epilepsy and other nervous affections, of salicylic acid and its salts in rheumatism, show us what may be expected before another half century ' has passed into history.

Of the triumphs of modern surgery, - Listerism and the rest, - of advances in the treatment of deformities and of various local diseases, I have not spoken. After what we have seen accomplished in the removal of abdominal tumors, we hardly know what limits to put to the happy audacity of the skilful operator. We ought not to forget here the import¬ ant contributions made by one of our own townsmen, - Dr. Henry J.

the improvement of the operation of lithotrity. The greatest of all improve¬ ments since the first operator took a knife in his hand is unquestionably the discovery of the art of painless surgery at the Massachusetts General Hos¬ pital in Boston.

III. Medical Authorship. - Boston has not been so prolific of medi¬ cal publications as some other of our great cities, especially Philadelphia. A large part of our medical authorship has been in the form of contribu¬ tions to the publications of the Massachusetts Medical Society and to the two or three Medical Journals which have been published in Boston from the year 1812 to the present time. The principal writers of the first half of the present century were Dr. James Jackson, Dr. J. C. Warren, Dr. Bige¬ low, Dr. John Ware, Dr. Channing, Dr. Hayward, Dr. J. B. S. Jackson. The writers of the last thirty years have been very numerous, and are most of them still living and active. Of these I should make honorable mention if their names were ready for a place upon a public monument. Of those no longer living I will only name Dr. J. Mason Warren and Dr. Edward Ham¬ mond Clarke. An essay by Dr. Clarke, - Sex in Education , - was very widely read, and gave rise to a prolonged and animated discussion by vari¬ ous advocates and opponents of its doctrines.

I think it may be fairly claimed for the publications of Boston physicians that while they have not included many text-books and compilations, or been largely given to theoretical speculation, they have contributed in fair proportion to the practical knowledge of the profession ; and especially that the reports of cases, with the comments upon them which have been pub¬ lished in our local periodicals and in the catalogues of our museums, have a real and permanent value.

IV. Personal recollections of noted Physicians. - The artist who paints a group of portraits often leaves some figures in the back¬ ground in shadow, or half averted, or at any rate too indistinct for easy recognition. He sometimes takes the liberty in painting an historical picture of introducing one or more personages whose right to be there might be disputed.

I claim a privilege like that of the artist in introducing the first personage of those I shall mention. Once only did my eyes fall upon the figure of the most venerable Dr. Edward Augustus Holyoke, who passed the greater portion of his life in Salem, but belonged in part to us as President of the Massachusetts Medical Society, to the whole community by his talents and virtues, and more singularly as one of the few centenarians whose age was so much a matter of public record that it could not be questioned by the most sceptical. He survives only as a shadowy silhouette in my memory, like the well known figure which a paper-cutting has preserved of him. His portrait at the ages of forty-five and of one hundred may be found in the memoir of him by his townsman, the late Dr. A. L. Pearson. Stat nominis umbra in my pages ; but it pleases me to tell my reader that I remember the good and wise old patriarch who was born within the twelvemonth in which Cotton Mather died, and who must have met in his daily walks many old persons who as children had witnessed the hanging of the witches.

My personal recollections of Boston physicians go back to Dr. John Jeffries, who died in 1819. He came, probably, to administer the profes¬ sional coup dc grace to an agecf relative of my own, who had been given up by his attending physician, and only awaited the final word of a skilled and ancient expert to authorize his departing in peace. Dr. Jeffries was ac¬ companied by his son " the young doctor," whom I lived to know as " the old doctor," and who died in 1876. I have very little to say of the impres¬ sion which the father made upon me, a boy eight years old, to whom an old physician was an object of personal dread and antipathy. Dr. Jeffries, or "Jeffers" as the old ladies used to call him, was always remembered in con¬ nection with his famous balloon ascent. It is not so generally known that he had the signal distinction of being recognized as a medical theorist by one of the best known of modern professional writers, Broussais, who devotes some pages to him in his Examen des Doctrines Medicates. The late Dr. Jacob Bigelow, in his last years, entertained me with personal anecdotes of the old Doctor which showed that he had his whims and peculiarities as well as his virtues and talents. This recollection is hardly worth preserving; still it was something to have seen the man who first crossed the British Channel, not by water but by air; who walked among the dead of Bunker's hill battle and pointed out the body of Joseph Warren to those who were searching for it in the heaps of slain ; and who helped to deprovincialize the medical science of Boston.

I might well have seen Dr. Samuel Danforth, - "Danfurt" as the com¬ mon speech would have it, - who died ten years after the time when I looked upon Dr. Jeffries. I used often to hear him spoken of as being asked in " consultation," as the extreme unction of the healing art is called. If " old Dr. Danfurt" or "old Dr. Jeffers" was seen entering a sick man's door, it was very likely to mean nothing more or less than a nunc dimittis. Dr. Danforth's handsome features are well known to us in the fine portrait painted by Stuart and lithographed in Thacher's American Medical Biography . It is a pity that we do not know more about him. He was very positive, some¬ what passionate; swore like our army in Flanders, and did not care much for other people's beliefs. Of course he was an interesting personage ; but he has special claims to professional remembrance as having anticipated the practitioners of our own time in entirely giving up blood-letting. His materia medica was very limited, having as its leading articles the same four remedies which, as has been mentioned, were most relied upon by Dr. Holyoke and his pupil Dr. James Jackson. These he supplemented by rubbing, blistering, and the warm bath. He quarrelled with Dr. James Jackson, with whom it was very hard to quarrel, and must, a fortiori , have had difficulty with others of the profession, for he could not bear opposition. But he was a great favorite with his patients, and commanded their entire confidence.

Still in the background, and a little at one side, - for they were not Boston physicians, but lived on the other shore of the river at Cambridge, - are three figures belonging to three physicians, each of whom is a typical representative of a class; all distinct images in my memory.

Benjamin Waterhouse, whose name stands on his title-pages over an in¬ verted pyramid of titles of great dimensions, studied in London, Edinburgh, and Leyden, at the last of which places he took his medical degree in the year 1780, - the same in which died the learned Professor Gaubius, a pupil of the world-renowned Boerhaave. He was a relative of the excellent Dr. Fothergill of London, with whom he used, as he tells us, to drive upon his rounds of medical visits. He will be long and deservedly remembered as having introduced vaccination into the Western world. He was for some years Professor of Theory and Practice in Harvard University. He speaks of himself as Director of the Military Department comprehending the States of New Hampshire, Massachusetts, Rhode Island, and Connecticut. He may have voluntarily relinquished practice ; but whether this were so or not, I never remember hearing of any patient under his care. He had however vaccinated great numbers of persons, myself among the rest. He probably liked to write and lecture and talk about medicine better than to practise it. A brisk, dapper old gentleman, with hair tied in a ribbon behind and I think powdered, marching smartly about with his gold-headed cane, with a look of questioning sagacity, and an utterance of oracular gravity, - the good people of Cambridge listened to his learned talk when they were well, and sent for one of the other two doctors when they were sick. Two brief extracts from an essay of his will sufficiently show his way of thinking and prescribing : -

" As to planetary influence, mentioned by Boerhaave and Mead, - the various aspects of the sun and moon ; their accessions, recessions, perpendicular or oblique irradiations, conjunctions, and oppositions ; and their effects on us through the me¬ dium of our atmosphere, - we are not prepared to express a decided opinion. . . . Millipedes have been given with good effect in whooping cough. . . . Physicians in the last century thought they could not practise without millipedes ; while too many in this day believe them good for nothing."

While Dr. Benjamin Waterhouse was walking about with his gold-headed cane, like a London physician mums his chariot and his patients, Dr. William Gamage was riding round on a rhubarb-colored horse with his saddlebags behind him, and stopping at door after door. Grim, taciturn, rough in as¬ pect, his visits to the household were the nightmare of the nursery. He would look at the tongue, feel of the pulse, and shake from one of his phials a horrible mound of powdered ipecac, or a revolting heap of rhubarb, - good stirring remedies that meant business, but left a flavor behind them which embittered the recollections of childhood. This was the kind of practice many patients preferred in those days ; they liked to know they had taken something energetic and active, - of which fact they were soon satisfied after one of Dr. Damage's prescriptions.

While Dr. Waterhouse was airing his erudition on foot and Dr. Gamage was jogging round on horseback with his saddlebags, Dr. Timothy L. Jennison was driving about in an ancient chaise drawn by a venerable nag, chiefly, it may be suspected, to exercise the quadruped and get the benefit of the fresh air for himself, - for his practice could hardly have been con¬ siderable, though I do remember hearing that he was employed by one family. I believe he was the safest practitioner of the three, for he was accused of over fondness for old womens' harmless vegetable prescriptions, - which means that he gave Nature a fairer chance than she is apt to have in the hands of learned theorists and heroic routinists.

1 he young man whom Dr. Danforth found it hard to get along with was his successor in public esteem as a practitioner. Family connection gave me the opportunity of knowing him well. He was my revered friend as well as my instructor, and my longer and fuller acquaintance with him ena¬ bles me to confirm all that Dr. Green says in his praise.

Dr. J ames Jackson was one of three brothers who became eminent, each in his several pursuit. Charles, the eldest, as a lawyer; Patrick, the young¬ est, as a manufacturer and man of business; and James, as a physician. He was long recognized as the head of the profession in its medical depart¬ ment, - - as his friend and contemporary, Dr. John Collins Warren, was the first among Boston surgeons. Dr. Jackson studied with Dr. Holyoke in Sa¬ lem, and afterward attended the hospitals in London. The name of Mr. Cline, the distinguished surgeon, is the one I have oftenest heard him mention among those of the teachers he followed through the wards of their hospitals. He soon found that it was best to restrict himself to medical practice, leav¬ ing surgery to his friend and contemporary Dr. Warren. Side by side, in a city of moderate dimension, they labored during their long lives, without any jar or collision to disturb their friendly relations.

Dr. Jackson had the happy union of mental and moral qualities which was seen in his " old master," as he always called him, - the venerable and well remembered centenarian, Dr. Edward Augustus Holyoke. Of serenely cheerful aspect, pleasant, inspiriting manner, always neatly and plainly dressed, exact in all his habits, punctual as the morning sun, searching in his inquiries and examinations, precise to minuteness in his directions, full of the sober wisdom of experience, but always open to new conviction, incapable of any unworthy effort to obtain public favor, it came to him in virtue of his talents, his entire devotion to his profession, and the confi¬ dence inspired by a pure and noble character. It was not only the public which looked up to him as an honor to his calling, but he was reverenced by his professional brethren as a model as near perfection for sound mental and exalted moral qualities as human nature was like to furnish, - something in the way that Hermann Boerhaave was regarded in his day and generation, and has been since remembered. A sounder nature to the very heart of its being it would be hard to find in life or in books. What his relations with his fellow-practitioners were may be judged by the " Prefatory and Dedica¬ tory " Epistle to Dr. John C. Warren prefixed to his " Letters to a young Physician." Medical theories and medical practice may change, but the spirit which animates that dedication to his old rival and friend cannot lose its virtue with the lapse of years. It is not unworthy of taking a place on the next page to that which holds the Oath of Hippocrates. The medical profession in Boston has long felt and still feels the influence of a man above all jealousies, whose whole life was an illustration of what the physi¬ cian should be as a student of nature, as a helper by his art, as a fellowworker with others in his beneficent occupation.

Dr. John Collins Warren, the great Boston surgeon of his time, has just been referred to as the most prominent contemporary of Dr. Jackson. In the Dedication above cited Dr. Jackson says to him : -

" You and I began our active lives in this city nearly at the same time. . . . We were so circumstanced as to be peculiarly rivals. Our business led us across each other's paths every day for a long series of years. What one gained the other seemed to lose. . . . We do not resemble each other in temperament, and cannot see all things alike. From this cause, and not always looking at objects from the same point of view, we often differed in opinion. Bnt we havfe always agreed to differ. . . . And thus it is, that being now, as regards age, in the front rank in our profession, we have con¬ tinued to this day on terms of intimacy and friendship. This is something to rejoice in, and something for which we may properly thank God ; and I know you will join me in giving thanks reverently."

Dr. John Collins Warren was indeed very different in temperament from Dr. James Jackson. A spare man, with strongly marked features, of austere expression, authoritative manners, sometimes careless, occasionally" aiming at elegance in personal presentment, devout, but far from deficient in that wisdom which belongs to the children of this world in their generation, - he commanded allegiance and obedience where Dr. Jackson inspired love and confidence. As a surgeon he was supreme among his fellows, and deserv¬ edly so. He was one of the best educated medical men of his generation among us. He had a good intellect, a sure hand, an imperturbable spirit, a strenuous ambition, a persevering industry, and an entire surrender of all his faculties to his professional duties. He performed a great number of diffi¬ cult operations ; always deliberate, always cool, with a grim smile in sudden emergencies where weaker men would have looked perplexed and wiped their foreheads, - for he had the stuff in him which carried his uncle Joseph Warren to Bunker Hill and left him there, slain among the last in retreat. He was -for more than forty years a teacher of anatomy, physiology, and surgery in the medical department of Harvard University, to which he be- queathed his large collection of anatomical and pathological specimens, with a handsome provision for its preservation and increase. He left one valuable work as his record, A Treatise on Tumors , and many papers on practical and scientific subjects. He took part with Dr. James Jackson in the measures which led to the founding of the Massachusetts General Hospital. He will be long remembered in the annals of American sur¬ gery, as well as in our local medical history ; but he was one of those men who by the force of their personality exercise an influence on their own generation not whplly to be explained by what they leave after them for posterity.

Dr. Jacob Bigelow came into practice some ten years later than Drs. Warren and Jackson. A man of great natural endowments and varied ac¬ quisitions, he was prominent for more than half a century before our com¬ munity, and was recognized as the head of the profession in Boston after Dr. Jackson had ceased from his labors. Dr. Jackson once said to me: "If there is one grain of wheat in a bushel of chaff, nobody will find it so quick as Dr. Bigelow." Sagacity, - an instinct for the pith of a question like that of the ferret for the spinal cord of its victim, - this was one of Dr. Bigelow's remarkable characteristics, but one among many. He was more widely ac¬ complished than any member of the medical profession we have had in Boston, probably than any medical man we have had in this country. Grave of aspect, he was yet a man of infinite humor. A busy practitioner, he found time for a wide range of studies and important services to the community. He was one of the earliest of our native botanists, and published two valua¬ ble works on the subject, - the American Medical Botany and the Florida Bostonicnsis. He studied the useful and ornamental arts and lectured in Harvard University upon them, under the general name " Technology," which he first used, and applied to the work he published on these arts. He also published a brief, perspicuous, sensible work on Materia Medica. In 1835 he delivered a lecture on self-limited diseases, which has probably had more influence than any single medical essay ever published in New England, to say the least. He was an ardent lover of the classics and an excellent Latin scholar. He gave much time to the study of architecture, and made with his own hands beautiful models of some of the most famous edifices of antiquity. In his later years he entered with great interest into the question of the place which the classics ought to hold in education. His essays on this and various other subjects were published in two vol¬ umes. Besides these he published, anonymously, a volume of pleasant verse, in which some of his friends found themselves ingeniously parodied without being aggrieved by harsh handling. But of all his extra-profes¬ sional services the most important was the leading part which he took in the creation of rural cemeteries. Mount Auburn owes its inception as a cemetery more to him than to any other man ; and this was the first of numerous attractive suburban burial-places which have sprung up all over the land.

Dr. Bigelow was a man of very quiet and unassuming manners, grave in counsel, lively in conversation, patient in waiting until others had had their say, and then expressing his own opinion with judicial precision and sententiousness. Calm, cool, cheerful, always busy, yet never seeming hur¬ ried, his very long and useful life was also a singularly happy one. Nothing could subdue his equanimity. He became blind in his later years; but as the loss of sight gradually stole upon him, he seemed to take the pleasure of a child in teaching his hands to work without the aid of vision. At last, hardly able to distinguish light from darkness,. his hearing much im¬ paired, his limbs disabled so that he was confined to his bed, he still kept his pleasant smile and hearty welcome for his friends, delighted in telling of the noted persons and scenes he remembered, tasked his memory for passages from the classics and from English poetry, - oftenest perhaps from Byron, especially Childe Harold, - and after long lingering in painless but utterly helpless dependence upon the kind ministration of others, at the age of ninety-two, faded away from a life which had come to be but the name of living.

Dr. John Ware deserves to be named with the best of those I have men¬ tioned. His name was almost of itself a guarantee of excellence; but his personal merits would have commended him to the confidence of any com¬ munity where he might have appeared as a stranger. Very gentle, very amiable, very conscientious, his natural modesty kept him from challenging public attention as emphatically as his ability and knowledge might have entitled him to do. Two essays, however, the results of close observation and careful study, gave him a high reputation, - his papers on Croup and Delirium Tremens. He followed Dr. James Jackson in the chair of Theory and Practice in the medical school of Plarvard University, and proved himself a worthy successor of that admirable and revered teacher.

A few years only have elapsed since the death of Dr. John Barnard Swett Jackson, nephew of Dr. James Jackson, and in his own sphere not less entitled to honorable remembrance. He was never in large practice, and was comparatively little known to the general public ; but his labors in the field of pathological anatomy made an era in the medical history of Boston. Never before had the effects of disease upon the organs been so patiently and faithfully studied in this part of the country, at least, as after he began his labors in connection with the Society for Medical Improve¬ ment. He was the life of that society for a whole generation, laying before its members the results of the examinations which for many years he made for his professional brethren, almost to the exclusion of others who were thankful to commit a delicate and often repulsive task to his always willing hands. He it was chiefly who built up the select but most valuable patho¬ logical museum of that society. As Professor of Pathological Anatomy in the medical school of Harvard University, and Curator of the Warren Anatomical Museum, he classified and arranged the specimens in that collection, and greatly increased its value by his own constant additions.

His two catalogues, large octavo volumes, are of far more significance than the name catalogue would imply, being not merely a guide to the speci¬ mens, but containing a great amount of important practical information, - - brief histories of the essential symptoms of cases, often of rare diseases, with a lucid and entirely trustworthy account of the organic changes observed after death. Dr. John B. S. Jackson was too sensitive for eminent success as a practitioner. He followed the wise guidance of instinct in choosing the scientific rather than the immediately practical part of medicine. He served the profession, and through that the public. His professional broth¬ ers repaid him with their gratitude and respect. It was at the request of many among them that he sat for the portrait painted by Mr. William Hunt, which at the present time is deposited in the hall of the Boston Medical Library Association.

All these of whom I have spoken lived to be old men, and thus im¬ printed their personal qualities deeply on their fellow-townsmen. Many others of our deceased practitioners are held in well defined remembrance, and would receive their due tribute in a more extended memoir. Several family names have become associated with eminence and success in the practice of medicine ; and where the names have been lost, the blood has asserted its hereditary predilections for the medical profession. There has hardly been a year for more than a century in which " Dr. Warren " or " Dr. Jeffries" could not be called upon by his Boston fellow-citizens for his services as surgeon or physician. Dr. Jackson is represented by his grand¬ children and other blood relations; Dr. Bigelow, Dr. Hayward, Dr. Channing, Dr. Putnam, Dr. Shattuck, Dr. Homans, are names as familiar to the young people of to-day as they were to their parents and grandparents. The memories of the past yet survive in our two honored medical brethren, - the venerable Dr. Edward Reynolds, and the indefatigable Dr. David Humphreys Storer, who still attends to his professional duties as he did in the youthful period of the century.

The true value of a good physician is not to be measured by the fame he acquires or the name he bequeaths to posterity. Many men have become known all over the world, and received the honors of stately biographies, who have really done less good to mankind than the faithful practitioners who have lived unknown beyond their own narrow circle, and died unre¬ membered beyond their own generation. The most famous of American physicians is undoubtedly the excellent and versatile Dr. Benjamin Rush. A biographer says of him: "His name is a brilliant star in the galaxy of American worthies. His fame associates with the renown of How¬ ard, Sydenham, Cullen, Boyle, Davies, and Washington. His memory, like their memories, will endure until time shall be immersed in the ocean of eternity." After language like this, and much more like it, let the reader turn to the judgment passed upon one of his legacies to the profession by Dr. Elisha Bartlett : " Dr. Rush had also a special doctrine or theory of fever, to which he seems to have attached much importance, and which he seems to vol. iv. - 72.

have regarded as very sound, logical, and philosophical. It may be safely said, I think, that in the whole compass of medical literature there cannot be found an equal number of pages containing a greater amount and variety of utter nonsense and unqualified absurdity, a more heterogeneous and ill-ad¬ justed an assemblage, not merely of unsupported, but of unintelligible and preposterous assertions, than are embodied in his exposition of this theory." Compare this severe judgment with the same writer's estimate of Dr. Rush's brother physican, Dr. William Currie: " Dr. Currie was a contemporary of Dr. Rush, and a practitioner in the same city. His general descriptions of disease are quite as good, to say the least, as those of his distinguished fellow-citizen, and his medical philosophy infinitely sounder and more ra¬ tional." Yet in the same biographical dictionaries where we find the flam¬ ing praises of Dr. Rush, the name of Dr. William Currie is not even men¬ tioned. A medical theorist, with a gift of fluent expression, will go down to posterity in a triumphal chariot of eulogy, while a quiet, sensible practi¬ tioner, whose life has been spent in useful service, is hardly remembered at all by the generation which comes after him.

Many such men as this have lived and labored and died among us, - too many to be mentioned in this brief article. They did not seek for fame in the broad highway of ambition, but were content to follow the narrow path of duty. If there were a Day of all Saints for the departed worthies of the Medical Profession, for every name that I have spoken of there would be a score to claim a place upon the roll of memory. I have thought that. the few shadowy reminiscences I have given might gather interest by the lapse of years, when the personages to whom they relate shall be to our descendants but vague and indistinct images, as William Douglass and Zabdiel Boylston and William Aspinwall are to us of the present generation.

By John T. Morse, Jr

* ' the New England fathers, whose chief object in life was the cultiva¬ tion of virtue, sinned, quarrelled, and over-reached each other sufficiently to render tribunals of justice a necessity at a very early day. Indeed, they indulged in such a multiplicity of courts and magistrates as now appears quite confusing; and how so many judges, justices, and commissioners could find occupation in a small and poor community is a very perplexing question. One forum, however, they had which has since disappeared, and which might have been well worth preserving. This was the strangers' or merchants' court, established for the speedy determination of questions in which temporary sojourners in our seaports were interested, who could thus obtain justice without over costly delay. In 1651, also, another special court of seven Commissioners was found necessary for Boston, as was said, by reason of the concourse of people and the increase of crime in the Puri¬ tan town ; but some jealousy of this tribunal was manifested, and at the end of the year, for which it was first established, it was not continued.

Yet though there was thus early not only a Bench, but many Benches, and divers supplementary and inferior courts besides, it was long before there was any Bar.1 For many years there was no distinct class of attor¬ neys ; and when, in 1701, attorneys were recognized as officers of the court, and were required to take an oath before practising, still no term of study was required, and apparently no examination was had, so that the way was broad enough for any one to enter. Occasionally some one who had had a professional education in England found his way to the colony; but, as may be imagined, the sparse wanderers failed to have much influence upon the general customs and practice. As a rule every one was supposed, alike by himself and by others, to be abun¬ dantly able to plead his own cause ; and even so late as 1 746 it was ob¬ served that the people were especially "-addicted to quirks of the law, . . . " so that a very ordinary countryman in New England is almost qualified for a country attorney in England." Even when it naturally befell that some individuals,, gifted beyond their fellows in art or eloquence, were occasionally engaged to represent their less shrewd and eloquent neigh¬ bors, we find them for a long time to have had other regular callings in life. For example, one favorite attorney was by customary occupation a tailor; others were merchants. Bullivant, whose " knowledge of the laws fitted him for the office of attorney-general," which he filled apparently with credit to himself, was an apothecary and medical practitioner, and withal an active politician.1 It was rarely that even the judges had had the advantages of a legal education. Judge Lynde 2 took his seat on the Bench of the Superior Court in 1712, and was the first judge of that court who had been regularly trained to the profession. Afterward came also Chief-Justice Joseph Dudley,3 son of the first Governor Dudley, and himself the father of Paul Dudley, who was likewise Chief- Justice of Massachusetts from 1748 to 1751. But a very short list of incumbents really trained in the calling fills the rather uninteresting professional record of the eighteenth century.

IH'or a long time the governors were ex officio judges presiding in the Court of Assistants, the assistants being officers of the corporation chosen annually by the freemen at the meeting of the General Court in Easter Term. It might sometimes happen that there was not an educated lawyer among them ; though some of the governors were not ill-qualified for the judicial function. John Winthrop, for example, had been educated for the Bar in England ; so also had Governor Bellingham, who, however, it may be supposed, was more willing to enforce the observance of the laws by others than to abide by them at all times himself. A droll story is told of his courtship, a foil to the popular tale concerning Miles Standish and John Alden. A friend of his, who lodged at his house, was engaged to be mar¬ ried, and the wedding-day was at hand ; when the governor, upon a sud¬ den finding himself enamored of the lady, " treated with her, and obtained her for himself." The affair was speedily brought to a conclusion " by the governor's marrying himself, without first publishing the banns, as required by law." A Puritan grand jury, however, could not be expected to be a respecter of persons, and the governor was accordingly presented for his unlawful action. The secretary summoned him " to answer the prosecu¬ tion ; " but in his singular combination of characters, - governor, chiefjustice, and culprit, - he dodged justice with admirable skill. He declined to leave his place on the bench in order to take a position in the dock, and thus " escaped both trial and punishment." 1 The outsiders, however, who meddled most with the law's administration were clergymen ; nor was their interference always creditable to their sense of justice. Thus an action, ap¬ parently in the nature of slander, brought by a minister against a layman, was about to come on for trial, when the Rev. Mr. Barnard, sitting at dinner with the judges, stated to them that, when the cause should be tried, he would like to make a few remarks. Accordingly so soon as the plaintiff's counsel had opened the case, the reverend gentleman began interrogating the plaintiff. Not until he had concluded were the more regular proceed¬ ings continued. But at the close of the argument for the defendant, which was larded - rather ungratefully, as it appears - with "many fleers upon the ministry and our churches," the chief-justice gave the clergyman another chance; and he thereupon "paid his respects to the court and delivered his speech,' and begged the magistrates to dismiss the action, which they forth¬ with did, glad to " get rid of so dirty an affair."

This is only a specimen of the prevailing condition of practice. Thus we hear of an instance where one juror, who was standing out against the eleven others, Avas called out by the attorney-general and obligingly directed as to what he should do. But when the refractory wretch refused to yield his opinion under such civil entreatment, he was starved into compliance, while his felloAvs received meat and drink; it being properly enough remarked that it \A'as better that one man should be destroyed than eleven. Verdicts were sometimes rendered to the effect that there were strong grounds of suspicion, though falling short of proof ; whereupon the court would sen¬ tence the defendant for such crime as it appeared probable that he had committed, though it had not been alleged in the indictment, nor perhaps even found by the jury. For example, a defendant indicted for forgery, which could not be proved, was reported by the jury to be a "cheat," and had to stand upon the court-house steps for half an hour at midday, having pinned upon his breast the forged bond and the label " cheat " in large let¬ ters. It was a rough but substantial justice, and had its advantages over more technical and less efficient systems. Appropriate to such crude and rough-hewn notions were also the manners of the judges, Avhich are repre¬ sented as execrably bad. They bullied and browbeat the counsel after the old-time English fashion, and promoted their own views rather than impar¬ tial justice. But, on the other hand, they themselves were liable to be treated Avith singular disrespect by members of the Bar Avho felt able to ven¬ ture on such behavior. For example, one day when a miserable old Avoman came hobbling into court and could find no seat, the laAvyer who had sum¬ moned her told her to go up on the judges' bench, which the old crone at once innocently proceeded to do. The wrath of the court Avas aroused : "How came you to do this?" said the judge, angrily addressing the laAvyer.

impudent counsel; and the judges thought it wise to let the matter drop. A yet more serious feature was the multiplicity of grossly inconsistent offices, which were often held by one and the same person ; and at the pres¬ ent day we learn with surprise that Hutchinson was allowed to combine the positions of lieutenant-governor and of chief-justice, besides which he was also commander of the Castle, a member of the council, and judge of pro¬ bate. Yet many instances as bad, or worse, can be given of a custom productive of infinite and obvious mischief. But miserable as was this farrago of ignorance, of demoralizing customs, and of evil principles, amid it all there were forming the elements of a courageous, independent, and learned Bar; 1 and when in time the days of trial came, we shall see that men who were both able and willing to vindicate in the courts the cause of the people were found to have gained all the needful training.

Jeremiah - or, as it was the fashion of the time to call him, Jeremy - Gridley has often been called the " Father of the Boston Bar; " and un¬ questionably he well deserved the name, though little can now be learned about him.2 He was born "about 1705," says the Biographical Dic¬ tionary , which devotes four lines to his name ; while the Catalogue of Harvard College shows that he graduated there in [725. It is the pen of that true gossip, John Adams, which chiefly has rescued from oblivion the memory of this very estimable man. It was some little time before he found his real vocation in the world. He taught for a while in a grammar school in Boston, and occasionally also appeared in the pulpit. In 1732 he started a newspaper called The Rehearsal , which, how¬ ever, only lived for a year. In time he came to the Bar. Apparently it was his influence, aided, perhaps, by that of Edmund Trowbridge, which gave the first impetus in Massachusetts in the direction of profound legal learn¬ ing and a high professional spirit. " Pursue the study of the law," he said, " rather than the gain of it. Pursue the gain of it enough to keep out of the briers ; but give your main attention to the study of it." This was a kind of advice quite novel in those days. In 1765 - less than three years before his death - the industrious old man formed a project of a " law club or sodality" for the purpose of reading and discussing works upon the civil law, and upon oratory. He had to seek his associates in the younger gener¬ ation, where it was largely due to the effect of his own example that such a

1 [One of the earliest to give character to the in a lower court was necessary to become a bar- Bar was John Read (II. C. 1697), and the break- rister, and this term was extended in 1766. In ing up of the prejudice against lawyers was largely owing to his character. See his Life by George B. Reed, privately printed, 1879; see also Vol. II. p. 427. The title of "barrister" seems first to have been used in our courts by Thomas 1782 the Supreme Court was authorized to con- Newton, who came here in 1688 (see Vol. II., p. fer the degree of barrister-at-law; they never did 1 55) ; and was occasionally used by the elders of so, however, after 1784. N. E. Hist, and Geneal. the Bar without any rule till 1761, when the Supe- Reg., April, 1877 , p. 207. - Ed.] rior Court determined that three years' probation 2 [See Vol. II. p. 427. - Ed.]

The Bench And Bar In Boston

scheme could find favor. John Adams, one of this club, delighted to call Gridley his master, though he was not so in the strict sense of the phrase.

Adams's account in his Diary of his own early life at the Bar is the best sketch extant of the professional circle then living in Boston and the vicinity. Ble lode into town in 1758 with the intention of being admitted to practice; walked into the court-house, " and sat down by Mr. Paine at the lawyers' table. ' I felt shy, ' he says, " under awe and concern; for Mr. Gridley, Mr. Piat, Mr. Otis, Mr. Kent, and Mr. Phacher were all present and looked sour. I had no acquaintance with anybody but Paine and Quincy, and they took but little notice.' It would seem that business was not so abun¬ dant or so lucrative at that time as to permit those who divided it among themselves to welcome any increase of their numbers. Yet when Mr. Adams called on Mr. Gridley on the following day, he found himself kindly received. Gridley examined him as to his accomplishments, and gave him much good advice concerning his professional career, especially that he should not marry early, since an early marriage would " obstruct improve-? vuiit, besides involving him in expense. Gridley made light of the fact that Mi. Adams had not brought with him the customary formal certificate from the gentleman with whom he had been reading. But Benjamin Prat, whom also Mi. Adams visited, in compliance with a custom requiring appli¬ cants foi admission to the Bar to make the round of at least the more distinguished practising barristers and obtain their concurrence, thought the want of the certificate a more serious matter, justly suggesting that no one knew anything definite as to the young man's character and acquirements, to which some testimony should be adduced in the usual way. Thereupon Mr. Adams who even at this early age dealt out his esteem or dislike wholly with reference to the behavior of the special individual toward him¬ self delivers a eulogy upon Gridley, and assails Prat with a vehemence which the impartial reader must regard as undeserved. Somewhat later, indeed, as if to keep the scales even, Gridley, having appeared a trifle too arrogant and vain in the presence of Mr. Adams, comes in for his share of that sensitive and peppery gentleman's abuse. Mr. Adams continued upon his canvassing tour in propitiation of the great lawyers, till he further visited James Otis and Oxenbridge Thacher, and being well received by them, appears to have rested content. When the day for admission came, Gridley " rose up, and bowed to his right hand and said, ' Mr. Quincy,' when Quincy (Samuel) rose up ; then he bowed to me, ' Mr. Adams,' when I walked out. Then Mr. Gridley made a little speech in commendation of the accomplishments and character of the two youngmen; Mr. Prat fol¬ lowed with a few words ; the oath was administered ; the neophytes shook hands with the members of the Bar, " received their congratulations, and invited them over to Stone's to drink some punch, where the most of us res,orted and had a very cheerful chat."

Though we have seen John Adams come away " full of wrath " from his interview with Benjamin Prat, and hasten to stigmatize him in his Diary as at best an ill-natured man, yet there is no reason to doubt that Prat is en¬ titled to rank with the best lawyers of the , colony in his day and generation.

Adams's vanity. "He was," says Hutchinson, "of the first character in his profession." About the time of the argument concerning the Writs of Assistance he was appointed Chief-Justice of New York, and removed thither, where about two years afterward he died, at the early age of fiftytwo. While so many more interesting and important facts concerning him have been forgotten, it is carefully recorded that he was lame. Hong after the grave had closed over the poor gentleman, and the memory of him was lapsing into meagre tradition, we find Mr. Adams speak in somewhat lauda¬ tory language of Prat. In 1817, when sixty years had softened the asperi¬ ties which had found expression in the Diary of 1758, he wrote a few pages concerning the case of the Writs of Assistance. " In a corner of the room," he then said, " must be placed, as a spectator and an auditor, wit, sense, imagination, genius, pathos, reason, prudence, eloquence, learning, and immense reading, hanging by the shoulders on two crutches, covered with a great cloth coat, in the person of Mr. Prat, who had been solicited upon both sides, but would engage on neither, being, as Chief-Justice of New York, about to leave Boston forever."1 This was, so far as can now be judged, a fair picture.

When the Stamp Act set the colony a-flame it had at least one effect which frivolous scoffers at the legal fraternity might say went far to counter¬ act all its many other evil qualities. It put a stop to litigation. The people, finding they could have only stamped writs, would have none at all. With that exquisite lack of perspective which he never failed to manifest whenever his own figure entered into the picture, Mr. Adams abuses the " execrable project," which he believes to have been "set on foot for my ruin as well as that of America in general, and of Great Britain." But his fellow-citizens came to the rescue of Mr. Adams as well as to that of America in general ; and in order to be sure of doing this wisely and effectually, they voted unanimously in town-meeting that Jeremiah Gridley, James Otis, and John Adams, Esquires, be " applied to as counsel to appear before His Ex¬ cellency the Governor in council, in support of their memorial praying that the courts of law in this province may be opened." A few days later these three gentlemen were privately heard, but obtained nothing better than a tolerably civil dismissal. For some little time afterward they appear to have acted as advising counsel for their townsfolk in those troublous days, when rendering legal service to the patriots was a matter not only

1 [ John Adams's Works, x. 245; Washburn, in which he was held. This address was printed Judicial History of Massachusetts, p. 225, refers in the newspapers. Prat's office was on the west to an address from the Bar to Prat on his leaving side of the present Washington Street, just north for New York, as evidence of the high esteem of Court Street. - Ed.]

Too many of the gentlemen who really adorned the Bar at this time have left little save their names to posterity ; yet, as we peer into the dim ob¬ scurity of the past wherein their scarcely distinguishable shades flit through the streets of old Boston, they look to us very picturesque and interesting personages, and it is sad to find that they will not disclose themselves to us in more distinct outline. Besides those whom we have already mentioned, it is right, if we can do little more, at least to name Robert Auchmuty, a gentleman who seems to have stood much higher in the general estimation than in that of Mr. Adams, in whose pages it is. his misfortune now chiefly to live, for a time he was regarded by many persons as at the head of the Bar. He was appointed a judge of the Special Court of Admiralty, upon which Bench sat, among others, Governor Bernard and Lieutenant-Governor Hutchinson, to whom, if Adams may be trusted, Auchmuty behaved with an ignoble servility. Two years earlier Adams wrote of him : -

" Auchmuty is employed in sessions and everywhere ; the same heavy, dull, in¬ sipid way of arguing everywhere ; as many repetitions as a Presbyterian parson in his prayer. . . . Such nauseous eloquence always puts my patience to the torture. In what is this man conspicuous ? ... in confidence, in dogmatism, etc. His wit is flat, his humor is affected and dull. To have this man represented as the first at the Bar is a libel upon it, a reproach and disgrace to it."

Richard Dana, - -or Justice Dana, as he was commonly called, - a little older than Auchmuty, was the founder of the well-known Dana family. He it was who in the presence of a great assemblage of the angry townspeople, standing under the Liberty Tree, administered to Mr. Secretary Oliver the oath z that he had not distributed, and that he would take no measures for distributing, the odious stamps, nor for enforcing the hateful act of the British Parliament.

Benjamin Kent began life as a clergyman, - a calling so utterly out of keeping with his disposition that he soon left the pulpit for the bar. He