July 5, 1889.] 



SCIENCE. 



13 



more inspiring than the labors of brave, self-sacrificing, and intel- 

 ligent women in the hospitals. Who that has read " What we did 

 at Gettysburg," or " Hospital Days," has forgotten their lessons ? 

 As a direct result of the war, nurses' schools have grown up in 

 every part of this land. Our hospital has such a department soon 

 to be opened, where nurses will be trained, not only for their 

 merciful offices within these walls, but for household engagements, 

 and for visiting among the poor. 



A good hospital may readily become the rallying-place of the 

 medical profession who are resident in the city. 



" Through mutual intercourse and mutual aid 

 Great deeds are done, and great discoveries made ; 

 The wise new wisdom on the wise bestow, 

 Whilst the lone thinker's thoughts come slight and slow." 



One purpose of this central building is to afford opportunities 

 for professional intercourse. Here are rooms set apart for the 

 library that will presently be collected ; here the medical journals 

 will be taken in ; here are the best appliances and instruments for 

 the treatment of patients ; here are rooms for private consultations 

 and for public conferences ; here are laboratories for physiological 

 and pathological determinations ; and it will not surprise me to 

 hear that within a very short time medical associations are here 

 brought together " for mutual intercourse and mutual aid " at the 

 invitation of Dr. Osier, the physician-inchief, who this day assumes 

 his great responsibility with the hearty welcome of Baltimoreans, 

 and with the well-earned confidence of the profession throughout 

 the entire land. 



Reference must also be made to. the lessons that this hospital 

 has already given to the world, before a single patient has been re- 

 ceived. The vast amount of thought bestowed upon these build- 

 ings, not only in their general arrangements, but in thousands of 

 details which promote their efficiency, has not failed to attract the 

 attention of observers from every part of the globe. The letters 

 which have been received during the last few days from the most 

 distinguished surgeons and physicians abroad, and the presence of 

 this large body of medical men from the distant cities of the 

 United States, are indications of this interest. 



Finally, if this hospital becomes the seat of knowledge in all that 

 pertains to the nature of disease, its treatment, its prevention, and 

 its cure, it will of necessity be a constant guide to the people of the 

 city and the State in which it is placed ; it will promote the general 

 health of the inhabitants. There is an altar in one of the churches 

 of Messina which bears an inscription to /Esculapius and Hygeia, 

 the god of medicine and the goddess of health ; and their statues 

 are found together on the fagade of Guy's Hospital. May they al- 

 ways be associated in Baltimore ! 



Is all this outlay wise ? I might answer an inquirer in the words 

 which Wordsworth employed in speaking of King's Chapel, one of 

 the most costly structures in the Uaiversity of Cambridge : — 



" High Heaven rejects the lore 

 Of nicely calculated less or more. 

 Tax not the royal saint with vain expense ; 

 With ill-matched aims, the Architect who planned 

 This glorious work of fine intelligence." 



For in this hospital, as in that church, are 



" Thoughts whose very sweetness yieldeth proof 

 That they were born for immortality." 



But I prefer to give a more specific and appropriate r^ply to 

 those (if any such there be) who say, " I believe in every thing that 

 is practical, in whatever leads to the relief of suffering ; but I am 

 afraid of this talk about science. !• would rather see a thousand 

 beds for patients than any provision for medical education," Such 

 reflections are to be heard with respect, for they are natural to 

 minds unacquainted with the intimate relations which subsist be- 

 tween the progress of medical knowledge and the progress of medi- 

 cal art. Nevertheless it is true that those who have most carefully 

 studied the conditions by which human life is perpetuated, human 

 sufferings lessened, and human vigor increased, are well aware that 

 every step forward in science leads to many forward steps in prac- 

 tice. May I endeavor to be a mediator between these two diver- 

 gent views, and bring a few illustrations from the doctor's shop to 

 the attention of those who are practically interested in hospitals, 



but who have paid no attention to the steps, so slow, so difficult, 

 so uncertain at first but so sure at last, by which the healing art 

 makes progress. 



The late Dr. Austin Flint of New York, in an address prepared 

 near the close of his life, has pointed out with the wisdom of ex- 

 perience the probable future of medicine. It would be presumptu- 

 ous for me to attempt to do again what he has done so recently 

 and so well. But on this day of promise, in view of all this ex- 

 penditure, it is fitting that we should bring to mind some inspiring 

 thoughts. 



Let us first consider the benefits which have come to mankind 

 from the opportunities which hospitals have afforded for the ob- 

 servation of disease. There is no one among us more competent 

 to speak upon this subject than the pathologist of this hospital. Dr. 

 William H. Welch, who, years in advance of its opening, has been 

 engaged as a professor of the university, in the study of the nature 

 and origin of disease. He has called my attention to these note- 

 worthy points : — 



" Those who have contributed the most to the advancement of 

 practical medicine and surgery have accumulated their experience 

 largely in hospital service. By the constant attendance of skilful 

 physicians and of well-trained nurses in hospitals, precise observa- 

 tions can be made, and the phenomena of disease and the influence 

 of treatment determined, under the most favorable conditions. 



" Our present knowledge of the natural history of disease, of its 

 diagnosis, prognosis, and treatment, are based to a very large ex- 

 tent upon experience derived from hospitals. Text-books, mono- 

 graphs, and medical journals incorporate this experience, and 

 bring it to the knowledge of the medical profession. This is why 

 intelligent physicians are always eager to secure the advantages of 

 a hospital service." 



The benefits which medicine has received from purely scientific 

 investigations may be shown by so many examples, that it is diffi- 

 cult to make a selection among them. Dr. Welch mentions 

 these : — 



" Upon the foundation laid by Helmholtz's researches in physio- 

 logical optics, and his discovery of the ophthalmoscope, the art and 

 science of ophthalmology have developed into the most accurate 

 department of clinical medicine. 



" The investigations which received their impulse from Du-Bois 

 Reymond in the difficult subject of animal electricity have ren- 

 dered electricity available for diagnosis and treatinent, and have 

 advanced thereby our knowledge of nervous diseases. 



" Of the many ways in which the work of the chemist has aided 

 medicine, may be cited, as one of its most recent contributions, the 

 introduction into modern therapeutics of many useful remedies 

 which are the products of synthetic chemistry. Doubtless this is a 

 field which will be cultivated still further, and it would be rash to 

 attempt to foretell what agents for the cure of disease and relief of 

 suffering are still hidden in the chemist's laboratory. 



" By the discovery of the specific gertns causing various infec- 

 tious diseases, surgical practice has been revolutionized. It has be- 

 come possible to prevent the infection of wounds from the ex- 

 terior, and thus to guard against a host of traumatic infections 

 which rendered dangerous and futile so many surgical operations. 

 Preventive medicine has taken its place among the exact sciences. 



'• Accurate knowledge of the c:iuses of disease now forms a sure 

 basis for intelligent therapeutics, and there is every reason to ex- 

 pect that the future will bring to light means to overcome the in- 

 jurious agents which are now, for the first time, known." 



But there is another illustration so marvellous that it may almost 

 be called miraculous. The relations of advancing knowledge to 

 advancing charity are brilliantly displayed by the history of methods 

 for the relief of pain. 



To put a stop to suffering is an instinct of human nature, distin- 

 guishing man from animals. The most scientific men, and the 

 most practical, are agreed upon this, and have been so agreed for 

 centuries. But Anaesthesia, most welcome of all the angels of 

 mercy, came down from heaven. When the older surgeons in this 

 assembly were students, opium and alcohol were the imperfect 

 ansesthetics most usually employed. Their use was restricted and 

 unsatisfactory, if not dangerous. No one can tell what was suf- 

 fered in places where gentle sleep now quiets apprehension, and 



