Jewell and Caspar Morris to the obstetrical departments, the latter gentleman being transferred from the medical to the obstetrical at his own request.1

On the 2d of July, 1855, the period for the annual election of a chief medical officer, Dr. Robert K. Smith was selected by the guardians, and co-operated most efficiently with the clinical board, delivering in October a most excellent introductory, and participating in the clinical instructions communicated to the class. On the 21st of July, 1856, Dr. A. B. Campbell was elected chief resident physician. A remarkable change this year came over the board of guardians in reference to the house instruction. It is altogether foreign to my purpose to enter into any analysis of the instrumentalities employed to sway the opinions of these gentlemen, although they were quite patent, I presume, to any member of the medical organization connected with the institution. It is sufficient to say, that on the motion of a member, offered on the 22d of December, 1856, clinical instruction in the Philadelphia Hospital was abolished after the termination of the lectures then in progress. The reason adduced in justification of this act, was the failure of the clinic to meet its own expenses. The record stultified the allegation; and those who were cognizant of the fact could not but feel indignant at so audacious a falsification of the case. There were at that very time seventy-five students in attendance, a larger number than usually attended the hospitals either in this country or Europe.

On the 8th of June, 1857, Dr. Campbell resigned, and was succeeded by Dr. James McClintock, very shortly after which event the visiting members of the medical organization all resigned, several of the resident physicians withdrew from the house, and again the institution ceased to administer to the wants of the medical class of Philadelphia.

On the 5th of July, 1858, Dr. Robert K. Smith again became chief resident officer, and on the 19th of the same month, under the auspices of this new medical head, Mr. Reall, a member of the board of guardians, proposed to re-establish a board of clinical lecturers. The subject for a time was laid over, until the 11th of October, when the students of the different medical colleges of the

[In the copy of Dr. Agnew's lecture from which this is reprinted, the following is written in lead pencil: "This is an error certainly, at least, I have no recollection of such a request." Signed "Caspar Morris, June, 1875."]

city addressed a communication to the guardians, praying for the revival of medical instruction.

On the 22d of November they acceded to the request, and proceeded at once to ballot for gentlemen to discharge this duty. Drs. Joseph Carson, J. B. Biddle, J. Aitken Meigs and Samuel Dickson were elected lecturers on clinical medicine; Drs. John Neill, W. S. Halsey, Richard J. Levis and D. H. Agnew on clinical surgery; and Drs. R. A. F. Penrose and E. McClellan on obstetrics and diseases of women and children. Dr. Dickson's health not allowing him any increase in his labors, was compelled to decline serving, and in his place Dr. J. M. DaCosta was elected one of the physicians; and under this organization the hospital commenced again to discharge one of its legitimate functions to the community.

On the 4th of July, 1859, the old board of guardians, which for many years had been selected by popular vote, was abolished, and a new one, consisting of twelve members, appointed by the courts and Councils came into power. This organization, consisting of the most respectable and intelligent gentlemen in our community, men of enlarged liberal views, conjoined with superior practicable ability, after a careful survey of the field, entered on the work of reform. Among the subjects which earliest occupied their attention was the medical department of this institution. The result of these investigations was a return to the old system, dispensing with the office of chief resident, and placing the hospital in charge of a medical board, consisting of twelve members, to act as physicians, surgeons and obstetricians, and who were to visit the institution four times a week. The election for these officers took place on the 8th of August, 1859, at which Drs. J. L. Ludlow, William F. Maybury, Charles P. Tutt and Robert Lucket were selected to constitute a medical staff; Drs. S. D. Gross, Richard J. Levis, Robert Kenderdine and D. H. Agnew, a surgical staff; and Drs. R. A. F. Penrose, John Wiltbank, William D. Stroud and Lewis Harlow, an obstetrical staff. It was in August of this year that the professors of the Homeopathic College proposed in a communication addressed to the guardians, to take the entire charge of the medical departinent, and furnish all the medicines for the sick without any charge whatever.

On the 27th of December, 1859, the medical board underwent some changes, in consequence of questions connected with the

political state of the country, and which have since inaugurated a revolution of unparalleled magnitude, the issues of which, on the destinies of race, nation, and the world, no human mind can foresee. Dr. Lucket, espousing the southern view of the question, induced a large number of medical students to abandon the medical colleges of Philadelphia and enter the institutions of their own states. The doctor becoming the medical Moses of this exodus left his place in the board, to which Dr. J. M. DaCosta was elected in December, 1859. In the same month Dr. Wiltbank resigned, and to supply the vacancy Dr. George Ziegler was elected. Again on May 7, 1861, Dr. Maybury was compelled by the extent of his professional duties to withdraw from the board, to which place Dr. O. A. Judson was elected.

Since the new organization of the board of guardians, by which in a great measure this house has been rescued from the vortex of politics, its medical prosperity and popularity have been steadily increasing, until it may now be pronounced the great clinical school of the country. The change was not accomplished without a struggle. There is a class of persons who can only exist in the seething caldron of political agitation, and who cling to official places like the barnacles to a ship's bottom. Of such there were some who lost no opportunity to prefer charges of mismanagement, in order to shake the confidence of the public in the administration of the present organization.

On the 25th of June, 1860, it was stated in Common Council that a great increase had taken place in the mortality of the institution since the change in the medical system, and a committee was appointed to investigate the facts of the case.' In the report of these gentlemen it will be seen that instead of the mortality being increased it had been greatly diminished. They took the last year of the old board of guardians, which expired on July 1, 1859, and contrasted it with the first year of the present board, which terminated on July 1, 1860. By examination it appeared the year ending July, 1859, the average population of the house was 2,513, and the deaths for the same period were 657, or 26.15 per cent. of the average population. For the year ending July, 1860, the average population was 2,520, and the deaths for the same time were 589, or 23.30 per cent. of the average population.

1Journal of Common Council, from May to November, 1866, page 121.

This showed a decrease of 68 in the number of deaths, or 11 per cent. on the mortality of the previous year.

In the insane department, in 1859, with an average population of 400, there were 96 deaths, or 24 per cent. on the above average. In 1860, the average population was 425, and 72 deaths, or not quite 17 per cent. of the average population; a decrease of 38 per cent. in the mortality of the previous year. They go on further to state that it must be remembered that only a part of the population of the almshouse is under medical treatment, and that the proper basis to determine the mortality among the inmates should be taken from the hospital. For this purpose the committee took the last published report of the late chief resident of the former board for 1858. Its author declares during that period the institution shows a smaller inortality than had been known for many years. By that report, in the various wards of the hospital, children's asylum, and nursery, there were treated 5,335 cases of disease, of which number 548 died, or 10.29 per cent. The books of the present board showed 6,176 cases treated, and 478 deaths, or 7.74 per cent., exhibiting a decrease of 25 per cent. on the mortality of the former year. This, then, was a vindication of the wisdom of the guardians in establishing the present medical organization, and rested on a mathematical demonstration, which even its enemies dared not gainsay.

On the 10th of September, 1860, the medical board addressed the guardians on the propriety of throwing open the wards of the hospital for free clinical instruction. This proposition was considered from a liberal and intelligent standpoint, in its broader and more general bearings, and on the 24th of September, 1860, received their cordial sanction; and its doors have been opened to this time, and it is to be hoped through all time to come, its doors may never be closed against or a fee craved from those who enter its halls in search of that knowledge, which can alone render them qualified to discharge the functions of a divine art.

In the month of April, 1861, the guardians furnished another proof of the confidence which they reposed in the medical board by authorizing the construction of the present lecture room, which for elegance and convenience has no superior; and which was formally inaugurated on the 16th of October, 1861, in an able address by Dr. J. L. Ludlow, on "The Rise and Progress of Clinical Instruction.”

MUSEUM.

On the 25th of November, 1814, the first efforts were made to` establish a hospital museum. The board required every resident pupil to leave in the house a preparation made by himself. That the rule was enforced for a time there can be no doubt, for on the 26th of February, 1822, I find the acknowledgment of the following anatomical preparations: A corroded kidney, by J. T. Sharpless; a side view of the head, with the vessels injected, by J. M. Fox; a specimen showing the anatomy of scrotal hernia, by Edward L. DuBarry; and a fœtal preparation showing the vessels peculiar to circulation. Where are these now?

The 23d of November, 1840, Dr. Burden, one of the guardians, presented a resolution to fit up a room in the centre building of the hospital for a museum, which was to be placed under the charge of the apothecary, to whom all the morbid specimens were to be given for preservation. The first museum contemplated was evidently to be only a depository for normal anatomical specimens; this last may be considered as the inception of a pathological cabinet. There were three things which, of course, rendered it impracticable. First, the curator was to be the apothecary, who knew nothing of pathology; second, there were no provisions made for dissecting the specimens; and last, at this very period the subject of post-mortems was embarrassed by more formalism than would be necessary to ratify and induct an archbishop into his holy calling.

On the 10th of September, 1860, the present board of guardians, acting on the recommendation of the medical board, authorized the founding of a pathological museum, to which the writer was assigned as curator. For the perpetuation of this important undertaking an annual appropriation of two hundred dollars is made, which, if judiciously expended, will serve to preserve a large amount of pathological material. The work has begun ; already a considerable collection has been placed on the shelves of this museum, some of them quite unique of their kind, and all most valuable illustrations of morbid structure. Although much of this work has been done at considerable personal inconvenience, yet I assure you that it is with no ordinary feelings of personal pride and pleasure that I regard the association of my name with an enterprise which, if prosecuted with ordinary