REMINISCENCES OF THE PHILADELPHIA HOSPITAL,

AND REMARKS ON OLD-TIME DOCTORS

AND MEDICINE.

BY LEWIS P. BUSH, M.D.

MR. PRESIDENT AND FELLOW-MEMBERS OF THE ASSOCIATION OF EX-RESIDENT AND RESIDENT PHYSICIANS OF BLOCKLEY HOSPITAL: One year ago we met to talk over the scenes and incidents, "grave and gay," of the Blockley Hospital within the last half of the century; some fresh and strong in memory, others fading into the dim vista of a "long time ago." A few of 1837 still remain-how many of the years before, if any, I have no knowledge. Should the roll of 1836-37 be called, who could respond but Stillé and Elmer, and I presume Morris, the former of whom I am happy to find with us this evening. What shall we say of Frisby, Johnson, Fromberger, Gibson, Egé, Walker, Wallace and Boyer? They are not here-most of them, as I believe, gone beyond the sound of human call. Whether joyful or sorrowful, may I not spend a few moments in passing a simple tribute to the memory of several of them?

William P. Johnson, of Savannah, Georgia, was graduated in the University of Pennsylvania in 1836, settled in his native place, but afterward in Washington, D. C., where he became engaged in a large and successful practice, and became professor of obstetrics in the Washington College, which place he filled for twenty years. He died about the year 1880, broken down by the labors of his profession, and lamented by a large circle of friends, acquired by kind and unremitting professional attention.

Address made by Dr. Bush, of Wilmington, Delaware, at the dinner of the association of ex-resident physicians of the Philadelphia Hospital, December 4, 1888. Dr. Bush and Dr. Stillé were resident physicians in 1836, and are probably among the oldest, if not the oldest, living ex-residents.

Asa Frisby was a sober and solid Mississippian, who also was a graduate of the University of Pennsylvania in 1836; he was elected the same year to the hospital staff; he passed with us through the typhus period, of which both he and Johnson had an attack, the former severely, the latter lightly; and went to Natchez at the end of his service, where he died a few years afterwards of yellow fever.

John H. Fromberger was a graduate of the same school in 1835, and became an interne of Blockley; he settled in Delaware, was successful in obtaining a large practice, and died in Florida, where he had gone on account of ill health.

Charles Bell Gibson, son of professor William Gibson of the University of Pennsylvania, was graduated there in 1836, and was an interne of Blockley previous to and after his graduation; he removed to Richmond, was elected professor in the medical school of that city, and died at the early age of fifty. Of the remaining confrères of that company I have but little knowledge.

John F. H. Patterson, a graduate of the University of 1835, an interne of Blockley, a professor in the medical college, died about the age of 50-an energetic, earnest, bright man.

Joshua M. Wallace, brother of Ellerslie, a University student, graduate of 1836, a genial, whole-souled fellow, was an interne but for a short time, when he was transferred to the staff of the Pennsylvania Hospital; he died early of pneumonia.

It is unnecessary to go over the ground which was brought before us a year ago. As usual, in the checkered scenes of life, there were many things which we recalled with pleasure, growing out of our intercourse with each other; others with emotions. arising from what we considered a want of appreciation of what was due to us, for no doubt the most of the board esteemed us a parcel of fellows of no particular status, either in the medical or political world (and perhaps they were not far from wrong), while we, of course, thought ourselves of far more consequence than the most of them-elected as they were by either the whig or the loco-foco party-and who, we supposed, cared more for the monthly or quarterly dinner than anything else that pertained to the institution. I allude now to our sentiments after our election-of course previously we had treated them with profound respect. Altogether we have the confident conviction that we there laid up an amount of pathological and practical knowledge

which has served as a reserve during all the subsequent period of our lives. While we look back with due appreciation of what was gathered up at that time, we are far from acceding to the sentiment so charged, and not always unjustly, to that fragment of our race who have attained the three score and ten limit, "that the old times were better than the present; nor yet do I feel quite ready to subscribe to the dictum of a medical friend, "that we were born fifty years too soon." As for the future, it is wrapped up in an impenetrable scroll; and the reveries of those who assume to make out the progress of the coming century are vain and vapid—it is enough for us who can look back for more than half a century to admire with grateful and fervent hearts the wonderful progress of human ingenuity and research; the power of the human mind in compelling the acknowledgement of the rights of man; the elevation of the down-trodden at home. and abroad, and the increasing instability of tyrannical thrones.

Is it possible that the coming half century can offer more glorious exhibits to the wondering minds of its inheritors than the past has shown to us? But we are here as physicians, not merely as citizens of this great republic, from whose heights we overlook not only what is taking place immediately around us, but can take in from most favorable positions the aspect of the whole world panorama.

Long before the dawn of life upon any of those now present, our profession experienced the slow advance made by theory and empiricism, not only from ignoble, but also from noble minds in their earnest gropings after scientific truth and its application to the healing art. Foremost among the latter stands the "father of medicine," whose name shines forth brightly amidst the dim and obscure clouds of ignorance and superstition which enveloped the age of Hippocrates. It was a true philosophy which he inculcated; a philosophy founded upon observation and induction, rather than upon mere theories; but it is not now proposed to speak of that age, that we had over and over again from the lips of our venerable professor in the University, Dr. John Redman Coxe. Having passed the stormy days of 1845, requiescat in pace.

Let us come far down the stream of time towards the present century. We now meet with such men as Sydenham, Cullen, Huxham-strong, original thinkers, who used all the knowledge

they gathered to the best advantage, and left traces, not yet obliterated, upon the broad field of literature.

Misty and obscure enough were the notions even of those upon whom we still look back with a degree of reverence as being in the front rank of their contemporaries. Doubtless they themselves felt that great darkness surrounded them, and that their vision penetrated it but feebly; and that it was after all but imperfect experience and worse theory which they were obliged to promulgate.

When Dr. Samuel Jackson was asked why he did not publish another edition of his work on physiology, a work written in that graceful and pleasing style which marked all the productions of his elegant mind, he replied, "It is sufficient that I state my views in my lectures-they will last as long as they are worthy to be remembered." "Don't tell me," said John Hunter, "that my teachings last year were different from what you have just now heard these are my present opinions." Such men were true philosophers; they were aware of the imperfection of the deductions of their day; and were wide awake to scrutinize every new fact; and even peered longingly into the future for the developments which their minds but feebly anticipated. No one perhaps of Dr. Jackson's period felt more sensibly than he the dimness of the light of that period, or longed more earnestly for the evolution of more truth in medicine than he could command.

If we would judge of the men of those days, we must, if possible, come down from our advanced position, and take place among the fogs and obscurities which surrounded them; and putting on their spectacles, carefully scan the scene which would then present itself. For myself, a feeling of sadness comes over me when I reflect upon the disadvantages of the true philosophers in medicine of even half a century ago, and doubtless some of us will be the subjects of the same sympathetic sentiment by those who will live a century hence, when many of the works which have been built up with so much labor in our time, will have had written upon them "TEKEL."

But I have said that it is not a subject of regret to some of us, that we are not just now entering upon the stage of life. We have had the satisfaction, which the younger members of our profession can never fully appreciate, of watching the wonderful developments of science-we have seen the rise of theories and empiricisms, as each in turn called out its followers, "Ho, here's the

throne of truth!" We have seen the light of these false prophets, which was but little better than darkness, melt away into its own proper realm of utter obscurity; while we have also observed the chariot of truth slowly advancing, dimmed at times by the clouds of error, but again and again coming into brighter vision, as around it glowed the true light of scientific research.

We need but to revert to the student days of some of us, and consider what were the teachings and the notions regarding fevers which were advanced from the rostrum, where stood the fine form of Chapman, setting forth in beautiful style and language the varieties, causes, treatment, etc., of these diseases. In nothing was both teacher and student more perplexed than in these forms of disease. If you look into the treatises of those days, you will perceive how difficult it was to arrive at a diagnosis at all satisfactory. They brought before the reader all the theories from the days of Hippocrates down to their own times, and discussed them laboriously, and when they had arrived at the end of their travail, they brought forth only another theory.

Chapman divided his fevers into intermittent, remittent or bilious, and continued, which included synocha, synochus, and typhus. In Dr. Christison's arrangement we have primary fevers, synocha, synochus, mixed or nervous fever, and typhus or adynamic, and continued and intermittent. Is it surprising that the student should have been puzzled to vexation by an arrangement which afforded no standing point, nor any definite boundary at the ending, for, says Dr. Chapman, “as synocha passes by insensible shades into synochus, so the latter passes insensibly into typhus." With such a spectre as that before him, what wonder if the student should have been as much confounded as was Hamlet upon the appearance of the ghost of his father.

The treatment was always hampered by the idea of inflammation, no belief being entertained that such temperatures could exist without that basis, and as inflammation required depletion, emetics, venesection and purgatives were of course necessary. By various practitioners bleeding was resorted to in various degrees, from one to six pounds of blood at a dash. This was proposed as Dr. Chapman says, by Dr. Jackson, in his practice of medicine. I presume he means Dr. Jackson of Boston, as I am not aware that Dr. Samuel Jackson of Philadelphia, ever published a work on practice. All this was done under the impression that these