relieve suffering. I hope the time will never come, members of this Society, when the test tube and the microscope with a' their immense value will be permitted to displace the fundamental humane and human instincts which make the great physician. Given that, we have armed him with the most astounding array of scientific knowledge.

I mentioned Pasteur. I suppose, by and large-one speaks of these things cautiously, having in mind different fields of effort and different standards of judgment-I suppose that he is the greatest single benefactor the human race has ever known. Why? Because in the patient research of the laboratory he pursued the enemies of human health into the places of their origin; he studied their habits; he learned to know their enemies; and he laid before the world the results of his profound knowledge with all his marvelous power of exposition and interpretation. Pasteur and men like Lister-less famous but wonderfully serviceable to mankind-these men have done more for the happiness, the satisfaction and the working power of the human race than any other group of men in any field of activity who have ever come into it, from ancient Greece to our own day. And, Mr. President, that has happened, not only within the life of this Society, but in the latter half, almost the latter third, of that life; and no one dare foretell what increasing knowledge may add to the resources of the human race in dealing with the sufferings and the unhappiness of mankind. In consequence, this profession has come to have a very peculiar place in the mind of youth. I see that in my own experience. I do not refer now to its place in the public mind, or to its place in the public service. I speak of its place in the mind of youth. I have watched changes take place in the interests of the undergraduate during forty years. Forty years ago in this country the highest type of undergraduate was almost certain to select the profession of teaching-scholarship. Twenty-five years ago he was almost equally certain to select law. For the last five to ten years he has been quite likely to select medicine. This is a very interesting change. I do not attempt wholly to account for it. I think it is partly due to the feeling that medicine gives an opportunity to respond with the fullness and ardency of the young nature to the call for service;

partly to the fact that the youth knows now that he can make that response to the call to service in effective terms because of the instruments with which he is armed. At all events, that seems to me to be the fact; a very promising fact for our public health and for our public service. As a result of this, the preparation for the practice of medicine has become an enormously expensive undertaking. We must not shut our eyes to that fact. I sometimes wonder whether public opinion will indefinitely sustain that expense. You cannot prepare men, following Judge Stapleton's very profound remarks in this regard, for this great service hastily; you cannot prepare them in mobs. You must prepare them in small groups and as individuals.

The day has gone by when you can take 100 or 200 men into a clinic with any advantage whatever. One hundred and fifty trained surgeons may sit and watch a difficult or delicate operation and know all about it, but one hundred and fifty students of surgery cannot do it. You must multiply the number of your teachers; you must multiply the number of your clinics; you must multiply the number of your laboratories; you must lengthen the period of study. You must insist upon practical contact with the realities of medicine at every point, and you must be sure that all this is adequately housed and staffed and provided with illustrative and museum material.

All this has become a very expensive undertaking. There was a time when sound preparation for engineering was the most costly of all university undertakings, but engineering education, even of the highest type, has now been far surpassed in cost by medicine. The community, the universities, the medical societies, are confronted with that fact, and they must be prepared to deal with it.

We are sometimes told (and this is another point suggested to me by the very admirable and eloquent speech of Judge Stapleton) that it is undemocratic to insist upon high standards of professional training, and for admission to the practice of the profession. I deny it in toto. A democracy is under no obligation to be served by ignoramuses. It is entitled to the best possible service, and it is only by the best possible service that it can take steps to protect its interests and its health.

That argument is really beneath contempt, and I ought perhaps not to have mentioned it in this presence, because it is so unworthy.

I ought not to close what I am saying in this presence without a word concerning the state of public opinion in various parts of the United States on the subject of medicine.

There are a great many curious currents running in America. Some of them ought to be in a museum, and some of them, and very earnest and very forcible currents, are profoundly antagonistic to scientific medicine. They find expression in legislative acts, in interpretations of the word Medicine, which are oddly askew from the standpoint of the scientific student of medicine; but, nevertheless, they exist.

Those statistics which Dr. Copeland gave about smallpox could not be given for some communities in this country, should an epidemic break out, where vaccination is forbidden in any compulsory form. There would have to be a thousand or two thousand or three thousand deaths-a horrible sacrifice-before those communities would open their eyes to the fact. You should remember that people, from time to time, by gift or by will, actually establish permanent funds to prevent medicine from advancing, so great is their opposition to scientific medicine. There is such a fund in one of the western states, the name of which I shall not mention, and members of the legislature in that state tell me that the first bill introduced every second year when the legislature meets, relates to that topic, because the representatives of that fund depend for their stipend upon actively operating under the terms of the trust.

We have in this state a somewhat similar fund, and every winter the medical faculties of our universities must be represented at Albany to stop legislation to prevent them from doing their work. Money has been left for that purpose, and vigorous and astute ladies and gentlemen who are connected with the material product of that fund, give great attention to the subject.

These are some of the side issues of medicine, but they are very real and very important. If you permit one of these waves of ignorant sentimentality to sweep over a community and make its way to the statute book, it may well cost this state

and this country tens of thousands of human lives before you get it off. It is not rational, it is not scientific, it is not common sense to run those great risks.

The leaders in the education of public opinion must, of course, be the members of the medical profession. They are busy men, oppressed with cares, carrying away from the bedside or the hospital a dozen problems which at times seem almost insoluble, but on which so much depends, even life itself. It is difficult to ask them to do anything more, but in your corporate capacity in this and other organizations is the opportunity in season and out of season, not only from 1822, but from 1922 and from 2022 to keep before the minds of the American people the essential facts as to the scientific and humane basis of medicine, as to what preventive medicine means, as to what public health involves, and how the whole fabric, the economic, intellectual and social fabric, rests on health. Imagine a community of one hundred millions of human beings diseased; try to visualize their civilization; imagine their art, their literature, their political and their social occupations, their public debates. It is impossible. It staggers the imagination.

On the other hand, as physical health-with that inducement, to say the least, to mental health and moral health which accompanies it—as physical health extends and multiplies, as the physician substitutes prevention for the therapeutics and gains a larger knowledge of the cure of disease so that therapeutics is safer and more accurate, so you multiply year by year the satisfaction and comfort of the community that you serve. I can say no more, Mr. President and gentlemen, than to wish for this Society through another century a succession of such noble men and noble personalities and so steady an advance in public service and scientific knowledge, as have marked the century whose close we gladly celebrate to-night.

HENRY C. CALDWELL

A BLEND OF CAVALIER AND PURITAN

Speech of Judge Henry C. Caldwell (born 1832, died 1913) at the dinner of the New England Society of St. Louis, December 21, 1895. The president, Elmer B. Adams, occupied the chair, and said in introducing Judge Caldwell: "About one week ago, I called upon a distinguished jurist, a member of the Federal court, and requested him to be present this evening as the guest of this Society and help us out. He declined peremptorily. He said he could not speak. He did not know how to speak on such occasions; he had not anything to say; it was useless for him to try and that he must decline. I urged him to make the attempt and suggested this fact to him: that he had been presiding in court for a great many years, and had been calling down one after another of the lawyers that had appeared before him in a way very unpleasant to them; and I suggested that towards the close of the evening, it would very likely be found that many of those present had been telling strange stories about the Yankees, turning the meeting into a sort of mutual admiration society: and that I thought he might, in perfect consistency with the general tenor of his life, call us down. The gentleman I allude to is the distinguished jurist, Judge Caldwell, of the Circuit Court of Appeals of the United States."

MR. PRESIDENT, LADIES AND GENTLEMEN:-An after-dinner speech is a kind of intellectual skirt-dancing that I know nothing about. To prevent misapprehension, I will take the precaution to add that I don't know anything about any kind of skirt-dancing.

You are a curious people up here. You are never satisfied to eat your dinner in peace and give it a chance to digest. With the fact fully established by medical science that dull, leaden after-dinner speeches stop the process of digestion in those compelled to listen and are the source of most of the dyspepsia, apoplexy and paralysis that affect the country, you still go right