their senses and appetites, and which all other persons, including the resident physicians, were as strictly forbidden to enter as were Adam and Eve to return to the garden of Eden. One of the residents it seems, not having the fear of the guardians before his eyes, had the audacity to enter the sacred precincts and appropriate a few peaches and roses. A mighty clamor followed, only to be compared to the outburst of Mr. Squeer's wrath when Oliver asked for "more." I do not remember what the upshot was, but certainly not "the brown paper parcel full of groans" which was the net result of the English school boy's flogging. My impression is that a special edict was issued against trespass upon paradise, and signed with the vermilion pencil of the great Mogul of Blockley almshouse.

In those days the residents boarded at the steward's table; the meals were always good, and on Sundays and on the days when the board of guardians met, they seemed to us both sumptuous and abundant. On Sunday, when everything and everybody is later than usual, it happened that the residents were not always punctual to the dinner hour; but the president of the board and some of his colleagues, who were not apt to be behindhand at the feast, were so annoyed by the young men's unpunctuality, that they issued an ukase proclaiming that all the residents who did not arrive within a certain time should be denied a passage through the gates in the yard fences, and be thereby compelled to reach the steward's quarters by passing through the paupers' outwards. This indignity was hotly resented, and one summer day a resident physician, being detained by his duties, found the yard door closed between him and his dinner, and was told that he must reach the steward's apartments through the paupers' wards. After parleying for some time, and then sending a request to the president of the board to permit his passage, which was denied, he retreated a little, and with a rush, kicked the door open, and made his way to the dining-room, where he reported to the president of the board what he had done. This gentleman was so amazed that he made no reply, and the combative resident was never called to account for taking the law into his own hands.

As I have said already, I had special charge of the children's asylum, and lodged in it. It was a very interesting field for me from a humanitarian as well as a medical point of view. A hundred or more children were sheltered there on their way to the

early grave to which most of them were destined. Illegitimate and other outcasts formed the majority, and ophthalmia, that curse of children's asylums, made of them a blear-eyed, puny crowd, most pitiable to see. I soon became convinced of the causes that. produced the crippling and mortality of these outcasts and waifs. I pointed out to the committee of the board how the disease was disseminated by the children washing in the same basins and using the same towels, and how it was maintained by their having no shaded places for exercise in the open air, and also by the insufficient food permitted them; for if the soup which they received one day was nutritious, the meat of which the soup had been made, and which formed their dinner on the following day, must necessarily be nearly devoid of nutriment. But, of course, the committee on the children's asylum and the guardians knew better than I, and at the time, at least, nothing was done to correct this wrong. In my day Dr. Joseph Pancoast was the attending physician of the children's asylum, and it is pleasant to me to recall the cordial relations which I there began with him.

I might digress here to speak of my colleagues in the hospital, and of some of those who immediately preceded or followed me. The list of them as I remember it was the following: Asa Frisby, of Mississippi; Thomas J. Turpin, of Maryland; John H. Fromberger, Robert R. Porter, and Louis P. Bush, of Delaware; William Elmer, of New Jersey; William P. Johnston, of Georgia, and later, of Washington, D. C.; Robert Morris, Benjamin Stillé, Joshua M. Wallace, Henry S. Patterson, Charles Bell Gibson, Edmund C. Evans, Charles N. Egé, and John B. Biddle, of Philadelphia; and Joseph Walker, of Bermuda.

Of these there survive only Dr. Bush, Dr. Elmer, and Dr. Morris. The last never became a practitioner, and after a few years pursued literary rather than medical studies; but Dr. Bush was long a leading practitioner of his native town; and Dr. Elmer, of Bridgeton, N. J., and the surrounding region. Of the rest, Johnston, Wallace, Gibson, Patterson and Biddle obtained distinction as teachers of medicine, and the others were successful in practice. I have never doubted that they all owed their success in a very large measure to two of the gentlemen who were then attending physicians to the hospital, and I, for my own part, am happy to recognize my share of this standing debt. These two physicians were William Woods Gerhard and Caspar

Wistar Pennock. Both had studied in Europe with great distinction, and had enjoyed unusual opportunities for clinical study at home and abroad.

Dr. Pennock by his experiments upon the physiological action and sounds of the heart, and by his clinical researches in cardiac disease, preceded other American physicians in this field, and inspired with his own noble enthusiasm all who became his pupils. No nobler, purer, more unselfish man ever lived; but he was lost to medicine many years before his death by the steady progress of a disease of the spinal marrow. His colleague, Dr. Gerhard, had been a resident physician of the almshouse hospital while it was still in the centre of the city, and the great clinical school of Philadelphia. In its wards he made numerous important investigations, and among them experiments on the endermic action and absorption of medicines. Thence he went to Paris well accoutred for the study of clinical medecine under Louis; and among other fruits of his Parisian studies he contributed largely to the pathology of tubercular meningitis.

His familiarity with typhoid fever gained in Paris, and with typhus fever which he studied in Great Britain, prepared him for a thorough investigation of them on his return to this country, and especially for becoming the historian of the epidemic of typhus, which furnished hundreds of patients to the Philadelphia Hospital in 1836. In spite of the extreme contagiousness of the disease, and the great mortality which kept everyone busy with examinations post-mortem, the enthusiasm of master and pupils knew no bounds. The history of this epidemic was afterwards published by Drs. Gerhard and Pennock, and to this day remains the earliest, as well as one of the most perfect and original demonstrations of the specific differences between typhus and typhoid fever.

Dr. Gerhard's bedside instruction in physical diagnosis was also followed with zeal, and happy did his pupils esteem themselves in having as a teacher one who had drawn his knowledge from the very fountain head in Paris. For in those days there was a far greater gulf than now fixed between those whose knowledge had been gained abroad and those whose education had been domestic only.

At that time also, and through Dr. Gerhard's skill, a radical reform occurred in the treatment of mania-a-potu and delirium tremens. Indeed, to him and to the wards of the Philadelphia

Hospital is due the abandonment of the murderous use of opium in those affections and the substitution for it of well seasoned food and alcohol, generally in the form of porter. He was enabled to prove that both the primary and the secondary effects of drunkenness tend to terminate in cure, and that they ought never to be fatal in uncomplicated cases.

Among the patients who came periodically under his care for such effects of intemperance was a certain M.D., a man of good education and some wit, who was so charmed by the new method that he exhaled his pleasure in the following doggerel verses.

THE WONDERFUL BOOK,

OR JIM CROW, DAVY CROCKETT, AND MAJOR JACK DOWNING SWEPT FROM THE READING
WORLD IN A BLAZE OF SCIENCE BY A. C. DRAPER, M.D

Ye knights of the lancet for knowledge prepare ;
A brother of talents and learning most rare
Has determined no longer his fingers to crook,
But enlighten the world with a wonderful book.
Six months is the time he has wisely assigned
To usher to light this great birth of his mind ;
Some granny bookseller accoucheur will act,
As deliv'ring a doctor requires much tact.

In a fit of the horrors the book was begot,
That from mania-a-potu will rescue each sot,
And save almshouse doctors the trouble and care
Of prescribing for those mania fills with despair.

And who can dilate on disease of the Cells
Like him who so oft in their solitude dwells,
And worships fair science within their bare walls,
Unmindful of home or his patients' loud calls?
Ye men of cold water, avaunt! quit the field !
To brandy and porter he'll force you to yield ;
And as to the swill you have christened hop tea,
With the stomach he swears it will never agree.

'Bout hops he is certain you're sadly at fault;
'Twere better to brew them at once with good malt,
The prescription no patient would ever bewail
If it came in the shape of good Albany ale.
Should the doctor once more for humanity's sake
Get blue, on his system more lessons to take,
It is hoped the physician who 'tends to his case,
To cure him with brandy the chance will embrace.

And who, to teach others, such perils would court,
Treating life as a thing only given for sport?
Not one out of twenty his studies would try,
Not one in a thousand for science would die.

When he's quite convalescent and home would retreat,
Never try to regale him with tea made of meat;

For nought to his stomach affords such relief

As a bottle of porter and a pound of good beef.

And the names of the doctors who please him will grace

In letters of gold his book's learned preface ;

Prescribers who value a medical fame

Must feed him with brandy to get a good name.

At the period of which I am speaking blood-letting was still in vogue. The absurd theories of Broussais were still dominant, and the "hand-over-hand bleedings" of Bouill I soon afterwards witnessed in Paris. I may truly say that when I think of bloodletting at the Philadelphia Hospital fifty years ago, I shudderhorresco referens. Adults were bled in all manner of diseases by venesection, cups and leeches, and even the miserable cachectic children did not escape the bloody sacrifice. I have seen a chronic lunatic strapped in a so-called "tranquillizing chair" and bled ad deliquium. To this day I have on my own person a scar that attests my own ignorance and the presumption of one of my equally ignorant colleagues, who bled me for some trifling ephemeral fever that did not even confine me to bed. From the beginning of my own private practice in 1841 to the present day, I have not practised venesection a dozen times.

The management of the insane department at the time of my service was as devoid of medical knowledge and humanity as was possible, and there, as also in institutions that falsely laid claim to being pioneers in the humanitarian treatment of the insane, cruel repression took the place of rational and humane management. I have still vividly in my memory pictures of raving maniacs in straight-jackets strapped to their bedsteads or bound to massive chairs, while bladders of ice were applied to their shorn scalps. I still see before me the narrow shelterless yards of the hospital filled with a mingled crowd of gibbering lunatics, many of them wearing leather muffs, while others wandered in melancholy vacuity around their narrow prison-with nothing to occupy, nothing to amuse, nothing to improve them.