means annually approximately three weeks time, and a considerable outlay of cash for three days scientific refreshment.

Then too, there are professional interests that belong to certain parts of the United States that cannot well be taken up in a national organization. It has, therefore, come about that in various parts of the country, sectional societies have been formed to meet the special requirements that a national society could not be expected to cover.

In consideration of those men who feel that they cannot regularly attend the meetings of the larger association and who still hold in high regard professional interests and public welfare of their own section, and for the purpose of reducing, improving and systematizing our society work, the American Medical Associotion has now under consideration a plan for establishing seven or eight large branch associations, each to include a number of states, and all to be governed by constitutions and by-laws furnished by the parent association. In the far west the Rocky Mountain Inter-State Medical Society has, in a large measure, already covered the field, but in view of the facts already stated, and for reasons to be mentioned, the time has come in my judgment, for this association to seriously consider the advisability of including a larger territory and a broader line of work, in harmony with the proposed action of the American Medical Association.

man.

Between the eastern slope of the Rocky Mountains aud the Pacific Coast line lies a vast territory that includes thousands of miles of fertile soil, immense tracts of grazing lands, the greatest forests in the world, and mineral riches beyond the estimation of The development of the marvelous resources of this vast empire is but just begun, and it requires no prophetic vision for one familiar with the facts and the coexisting conditions to realize that within the next half century this region is certain to be peopled with millions of seekers of fortune, fame, health, and homes, who will expect and deserve from the medical profession every care, attention and protection that our science offers to the most favored of mankind.

Those who have witnessed or learned of the transformation that has been accomplished in the past fifty years, more particularly those who have experienced the hardships and trials incidental to the practice of medicine and surgery on the frontier and are now able to view the modern hospital structures and conveni

ences erected, it may be, upon the former site of log cabinssurely will not doubt any reasonable prediction as to the advancement and growth of our professional work during the next fifty

years.

We of the West need, therefore, not only to be prepared for our present labors but we must hold ourselves in readiness to assume the new and greater responsibilities that are certain to be thrust upon us in the near future. In this region, and at this time, this work of preparation for present and future duties, if it is to be most effective means an organization and combination of our forces, a personal and professional acquaintance with each other, a unity of purpose asaociated with deliberate and concerted action. Moreover we need to be self reliant.

In the past we have intuitively turned our eyes to the east for instruction and aid, and too often, it may be, we have bowed to the orders and authority of our eastern brethren in questions which they could not, from the nature of things, be as well quali fied to pass judgment upon, as we. In legislative and sanitary matters at least we should know our needs and be ready to secure them ourselves.

Only a few years ago we were without colleges, journals, hospitals, and laboratories, and with neither inclination or opportunity to carry on original researches ourselves or even impart such knowledge as we possessed to others, and the western surgeon's preparatory and post-graduate education was made to cost him more in time, money and effort than now seems necessary or wise. I mean no disrespect to our eastern brethren nor do I feel myself lacking in fraternal spirit, when I express the opinion that the time is not so far distant when we will be able to contribute our share of thought and knowledge in the advancement of our science, and that we will have builded colleges, laboratories, hospitals and established journals worthy of creditable recognition in any part of the world.

The Pacific Ocean on the west and the plains on the east, form barriers that prevent our close communication with others, and we must learn to face and solve the problems that confront us alone. To meet the conditions and accomplish these objects we need to form an association in which every state in this section shall be represented. It has been urged that there are already too many medical societies. This may be true, but if so, there is all

the more reason for us to be loyal to those who have a right to claim our allegiance.

The most important objects of this branch of the American Medical Association we cannot hope to accomplish in our state, county, national or international associations. For example, we would all welcome a reciprocity clause in our statutes that would permit the licensed practitioner of any of our states to be exempt from examination should he desire to practice his profession in any other state of this section. As a solid body we might reasonably hope to influence legislative action in this and other questions of interest to western men. Is it fair or just we should wait upon the slower action of our eastern friends? Laws and practices regarding sanitation and preventive medicine are easier to rightly formulate and execute in a new country, than to change or improve in an older country.

We need more hospitals and better ones. The management of these institutions should be inspired by a spirit of fairness, that will lead them to extend their peculiar conveniences and educational advantages beyond the favored few on the various staffs, to the general profession of this section so that no regular practitioner of this region shall be deprived of hospital privileges and advantages.

Our colleges need our support, and if we give them our united support as we can, and should, we will transform them into institutions that will deserve and may receive their full share of outside patronage,

We have some excellent journals, perhaps we have too many journals, but certainly none receive sufficient substantial support. A few good journals that would record all our best work and thought would merit and should command the support and cooperation of every well informed medical man in this western country. Personally I believe that one such journal should be under the control or our association. No one who visits regularly the hospitals of this and other countries will question the statement that, as a whole, the work done in our western institutions will conpare, not unfavorably, with that of any part of the world, and this work as well as ths ideas of the workers is worthy of record. The papers read in our societies may be lacking in fine spun theories, but as a rule they are the product of earnest, thoughtful, logical men, and I believe our journals should have