Dr. JOSEPH H. WARREN, of Massachusetts, Chairman of Committee of Foreign Delegates, presented his report.

On motion, the reading of the report was deferred, and it was referred to the Committee of Publication.

Mr. President and Fellows of American Medical Association:

As one of the delegates to foreign countries for 1880-81, from this grand and noble Association, I have the honor to report that I was well received in Europe, that every attention was given me, and that I feel especially proud in being your honored servant.

I was treated both in public and in private in a most princely manner in Great Britain, France, and Germany. I found that gentlemen of the profession abroad not only take great interest in this highly respectable Association, but that they delight to hear the progress of scientific interest and improvement in the American profession generally. I found not a few of the members of our Association well known and appreciated as honored sons of a noble profession; and since all line of distinction by country or place of birth had been abolished, that they had been exalted to be fathers, and brightly shining lights in medicine and surgery, and were quoted and honored as great originators and leaders in medical science.

Did time allow, I might mention many of these names; but, by your permission, I will mention only a few. I found high in renown J. C. Warren, the father of New England surgery, the hero of etherization, and an early President of this Association; Henry J. Bigelow, the graceful surgeon and successful operator in litholapaxy; Nathan Smith and E. R. Peasley, highly honored sons of the "Old Granite State;" S. D. Gross, at the present, our father of American Surgery; Pancoast and Mitchell of the "City of Brotherly Love;" McDowell, the originator of ovariotomy, and thrice-honored son of Kentucky; J. Marion Sims and Robert Battey, sons of the fair South, and honored and original investigators and operators in the surgical diseases of women, to say nothing of others, as highly esteemed in the wide world of scientific attainments as those I have mentioned by name. What a rich feast it would be to recall all their wonderful developments in scientific medicine! How our mouth waters with the words of worthy praise we could bestow upon them, but also how the emotions of heaviness fill our souls, and choke our utterances as we recall, with tears of sadness, that many of them have ceased their labors, and have long been gathered to their fathers.

Of the duties I performed while in Europe the past summer, one of the most important and pleasing was my attendance upon the Forty-eighth Annual Meeting of the British Medical Asso

ciation held on August 10, 11, 12, and 13, in that fine old classic town and honorable seat of learning, Cambridge. The meeting was very fully attended by the most noted and renowned men in the English profession, and some from other countries, and was said to be one of the largest and best gatherings of the kind held since the foundation of the organization. The opening address by the President, George Murray Humphrey, was a most cordial welcome, replete with words of love and wisdom.

The Address in Medicine by John Buckley Bradbury, M.D., was a complete résumé and epitome of medicine in the nineteenth century. This distinguished gentleman also gave a dinner in the evening, at Caius College, to some forty or fifty of the most noted men in the profession. It was here my pleasure, while sitting opposite my host, to remark that it was very seldom that one man gave two such repasts in one day as he was giving us. It was delightful to see how well this was received by his worthy peers, who had listened with marked attention to his feast of "Modern Scientific Medicine," and who delighted to do him. honor.

The Address in Surgery by Timothy Holmes on "Fergusson and Conservative Surgery-Excision of the Knee and of the Hip," was most masterly, embracing all the surgical bearings of these operations, and recalling pleasant memories of that genius in science, Sir William Fergusson.

The Address in Physiology by Michael Foster, M.D., F.R.S., on "Relations of Physiology and Pathology-The Professional Aspects of Physiology," was remarkable, and might well be considered a multum in parvo, for it went so deeply and thoroughly into all the various branches of the subject, and gave so minutely the most recent anatomical and physiological experiments, as to weld and melt them into the life-work of every member who practises the art of medicine.

The next public Address was on "Elementary Pathology," by Sir James Paget, and was one of the very best papers read before the assembled Association. To hear this eminent pathologist as he discussed, in the most majestic and masterly manner, a subject in which few living men can possibly be considered his equal, was to be charmed. I wish that all here present could have enjoyed with me the privilege of listening to his liquid eloquence, flowing like a mighty river, and with a soft cadence of voice like a sweet-toned distant bell. You would, then, I know, all agree with me in calling him the silver-tongued orator, and the greatest in the profession in all the British Isles. As he charmed me, so he charmed others, many of them the solid and matured men of the profession, and I can readily see why his eloquence should attract the better students of England to listen to his teachings.

The various Sections were also all most fully attended. The

Chairmen were patterns for any Association to follow, as every paper was received in its order, and everything was managed in the most exemplary manner. I cannot dwell upon, or even so much as mention all of the many acceptable papers presented before the sections, but must content myself by mentioning some of the most worthy. For a more detailed account, I must refer you to the British Medical Journal, a weekly and influential journal published by the Association, and considered by far the best journal of its kind in the English language. As such, it is a journal worthy for us as an Association to pattern after, both in management, and much of its detail. The editor, Mr. Earnest Hart, by his great push and enterprise, has caused the journal to outrank any other journal published by any other Medical Association. But to him is due the credit, not only of developing this journal, but also of leading the British Medical Association into the highly successful and honored position it occupies before the profession throughout the world to-day. Previous to his editorship, it was hard to get the better men of the pro-" fession and of the Association in England to attend, much less take an active part in, the meetings. All were willing to play a passive and inert part, but few were eager to perform labor to develop the highest interests of the profession at large. At the present day this journal has succeeded in rallying the profession up to a sense of their true responsibility, and the proper performance of their duties as members of a National Association. I would, Mr. President and Fellows, that the American Medical Association had, in place of its ponderous annual publication, a weekly journal published under its own immediate auspices; and I would that at its head we had an editor with a vigor equal to that of Mr. Hart, that he might, with his editorial staff, stir all the dry and mouldering members into a new life, and that he might infuse into them an interest and activity equal to or even greater than that which the British Medical Association show to-day. I think I am not mistaken, nor overconfident, when I say that such an editor and such a journal would be the means of developing from an atrophied membership of to-day some real honest work, and of displaying the mighty power and the wonderful, but latent scientific matter that now lie dormant in the hands of our fellow-members.

In the Section of Public Medicine, the Address by Henry W. Ackland was very good and acceptable, as were also other interesting and important papers read before the Section, among which might be mentioned a discussion on "What Diseases are Communicable to Man through Food." In the Section in Surgery, the Address was by William S. Savory, "On Constitutional Disturbance." In the same Section was a highly interesting discussion on the dressing of wounds, in which the antiseptic and non-antiseptic methods of dressing were discussed by Lister,

Bastian, McLeod, Erichsen, J. Wood, and others. Mr. McLeod said he always gave quinine for several days before operating in strictures, and gave opiates at night, when the patients would bear them. Another practical and very instructive paper was read by Sir Henry Thompson, entitled "Remarks and Progress in Treatment of Stricture of the Urethra." The same surgeon also elaborated, in another paper, "The Removal of Stone by Lithotrity;" and showed many hundred stones of all sizes he had successfully removed, thus giving evidence of the most remarkable success of any living surgeon in this operation.

In this connection, it may be of interest for this Association to know that an American, Dr. J. H. Warren, of Boston, showed some twelve or fifteen newly-devised surgical instruments, and read a paper on "Operations for Cure of Hernia by Subcutaneous Injection," which seemed to be well received. There were also other valuable and instructive papers read before the Section, giving new and improved surgical operations, among which may be mentioned a pair of very ingeniously contrived hæmostatic scissors shown by Dr. Warlomont, of Brussels, for preventing the hemorrhage following section of vessels in surgical operations.

The Section in Psychology devoted almost the whole of its time and labors to the consideration of "The Influence of Alcohol in the Causation of Insanity." In the Section of Physiology the seat of the formation of urea in the body was discussed by Professor Gamgee. Sleep and Hypnotism were discussed by Preyer, Brown-Séquard, Prof. Bowditch, of Boston, Dr. Beard, of New York, and others. Prof. Preyer opened the discussion, and in addition to elaborating his own theory of hypnotism, illustrated it by experiments upon fowls, guinea-pigs, and men. His short historical account of hypnotism was very interesting, and included a biographical sketch of Dr. Braid, the Manchester physician, who was the first man in Europe to give the subject anything like a scientific investigation.

In Obstetric Medicine, the Address by William Playfair on "The Teaching of Obstetric Medicine" was a very masterly one, showing that the teachings in this department should be more thorough than they are wont to be. Among the many valuable papers discussed in the Section of Diseases of Women, was one by your honorable delegate, Dr. M. A. Pallen, of New York, on "The Etiology and Treatment of Lacerations of the Cervix Uteri." The paper attracted considerable interest, and the discussion was very lively. Dr. Sims spoke and sustained the points developed by the essayist. From the English point of view, there seemed to be a want of knowledge upon this common affection and operation, both of which are so well understood by the profession in America. There was also a discussion upon "Uterine Hæmostatics," and Sir Spencer Wells opened the very

interesting subject of "The Removal of Uterine Tumors by Abdominal Section."

In closing, I would call your attention to the ceremony of conferring the Honorary Degrees. This I know will interest you as well as it did me, for among those honored at this ceremony were two of the beloved sons of America. It was a beautiful and ennobling sight to behold those venerable and venerated twelve disciples of Esculapius robed in scarlet, and crowned with silver locks, seated around the Chancellor of the great University in that classic senate chamber of Cambridge which, times without number, had been used for similar impressive occasions. As each of the candidates for the degree arose and was introduced by the Public Orator to receive upon their honored and stately heads still further honors at the hands of the Vice-Chancellor of the University of Cambridge, in his scarlet and ermine robe, how one thrilled with the solemnity and grandeur of the mo ment! Prominent among them was Brown-Séquard, whom the two great nations of America and France claim in common, as their son; but over-towering all in grandeur, pride, and dignity, arose the stately and upright form of our venerated Gross, a perfect Jove in appearance as well as skill. With what delight the orator named his deeds in a voice of thunder.

"Trans fluctus Atlanticos, trans Oceanum non jam ut antea dissociabilem, patriæ nostræ ad portus nuper advectus est vir venerabilis, quem inter fratres nostros Transatlanticos scientiæ Chirurgica quasi alterum Nestorem nominare ausim. Ergo libenter quasi fraterno amore hodie salutamus, civitatis bene ominati nominis civem, Chirurgiæ Professorem Philadelphiensem, Samuelem D. Gross."

This was the only meeting of any medical body that I had the pleasure of attending as delegate. I visited, however, by invitation, many of the large hospitals of London, and was highly pleased by their scrupulous neatness and cleanliness, and the great care given to hygienic arrangements. In Paris, I showed before the Academy of Medicine what I had already shown the British Medical Association, and visited a few of the hospitals. But how great the contrast to those of London! Here ventilation and other hygienic arrangements were far from perfect, and I must confess that I found the hospitals in a most unsightly and impure condition. I also visited Berlin, but of my visit to either France or Germany, I have nothing of general interest to report, except what has already been made known by medical

literature.

On motion, the Association adjourned until 10 A. M. on Wednesday.