ADDITIONAL REMINISCENCES OF THE PHILADEL

PHIA HOSPITAL.'

BY ALFRED STILLÉ, M.D.

MR. PRESIDENT AND GENTLEMEN:-I rise to respond to the toast you have heard read, but let me add, it is under compulsion— moral compulsion I mean, which is sometimes more constraining than physical force. Your committee of arrangements was good enough to say that my semi-centennial reminiscences of last year gave pleasure to the guests, and they founded thereon a suggestion that more of the same sort would be acceptable. But they probably forgot that there is a natural limit to such recollections; that they cannot be produced at will, and that between my friend and ancient colleague, Dr. Bush, and myself, the garner had been pretty thoroughly emptied. Indeed, it seems to me that any slight addition I might make to the picture will be flat and meaningless if torn from its original connections, just as a garment would be if removed from the body to which it belongs.

And yet all of you who have passed through the discipline of our great hospital, even recently, must have observed that besides the atmosphere of science and art, and besides the discipline and the comradeship, which together constituted its training as a professional school, and which cannot fail to shape and color your whole career, there are some others which cling to the memory and even to the senses, and are strangely powerful to resuscitate impressions long ago received and apparently extinct. Philosophers have contended that our sensations are most numerous and permanent, some when we receive them through the sight, and others through the hearing; but I am disposed to

1 Address made by Dr. Stillé at the association of the ex-residents of the Philadelphia Hospital, December 4, 1888, at the dinner given by them at the Bellevue Hotel, Philadelphia. Response to the toast, "The Residents of Auld Lang Syne."

think the olfactory sense retains longest of all the impressions made upon its organs.

It seems to me that the almshouse smell must be immortal, or can only "by annihilation die." It is, or was, a smell sui generis, for every hospital has its specific smell. Certainly it has no resemblance to the smell of rose, or violet, or lily, nor, on the other hand, is it borrowed of asafoetida or cacodyl. It is a smell that one may recognize as a familiar acquaintance in the prisons of Naples or in the Edinburg infirmary. The smell of a civil or military hospital has its characteristics, but the effluvium of a pauper almshouse hospital has a much intenser quality. It is compounded of the exhalations of the habitually great unwashed; of effluvia generated by the decay of the sick, and the decomposition of their excretions; of the stale or rotting food that has been accumulated surreptitiously and hidden away; of steam from the meat caldron and emanations from the bakehouse or the fresh bread; from the heaps of musty old boots and festering garments thrust out of sight and fermenting in unopened closets; and then, mingling with and overlaying all of these, a certain medicinal odor which may be traced to the accumulation of tinctures, and mixtures, and unguents, and plasters, upon the bedside tables of many patients. It is not what perfumers call a bouquet, which plays a gamut of delight upon the olfactory sense, but an acrid, fœtid, sickening, musty, fusty, and above all, frowsy smell, more complex in its combination than the most ingenious compound of the perfumer's art. It is the pervading genius loci, and never is to be encountered outside of the walls of a pauper hospital. You cannot sweeten it; you cannot altogether expel it.

"You may scrub, you may ventilate wards as you will,
But the smell of the almshouse will cling to them still."

It can "only by annihilation die;" by a fire that should consume the whole building. But the remedy is too costly.

No doubt in progress of time this odor has lost something of its acrimony, for during my service as a visiting physician (1866-72) its pungency had perceptibly declined. This improvement was immediately due to two members of the board of guardians. One was its president, John M. Whitall, a plain man of strong common sense, an expert in the art of ventilation, and a guardian, who, with some of his colleagues, kept the board

from plunging into the quagmire of politics. The other was Mr. Parker, an iconoclastic reformer, whose zeal sometimes outran his discretion, but whose efforts to reform were so persistent that he came to be felt as a thorn in the guardians' side. They could not tolerate his continual pricking, and when his term of service expired they took efficient means to prevent his re-appointment.

As everybody knows, one gets used to foul smells, and at last ceases to notice them. Indeed, some persons seem rather to thrive in a contaminated atmosphere. So it is said that scavengers and night-soil workers acquire an immunity to certain diseases. In like manner, the inhabitants of the Nile and the Mississippi basins are said to prefer the muddy water of those streams to clear and sparkling mountain brooks. But it does not follow that the ignorant and stupid and careless should be allowed to sacrifice either themselves or those who are under their care. I cannot doubt that the day will come when it shall no longer be thought any more consistent with humanity and benevolence that almshouse paupers and hospital patients and their physicians and attendants should breathe a noisome and pestilent air, than it now is to chain maniacs to their cell walls, or strap them in "tranquillizing chairs," as was not long ago the custom.

Looking back at the far distant period when I was a resident physician of the Philadelphia Hospital, I am as much surprised at the definite portraits in my memory of certain of the inmates of that time, as I am at the distinct impressions retained by my olfactory senses. Although I have seen scarcely any of them for half a century, I think that if I were a draughtsman, I could outline the faces and figures of many among them, beginning with steward Stockton, whose grave and weary, but benevolent features, were hardly ever lighted by a smile, and ending with the Captain," who reigned in the region of the dead, and enlivened his lugubrious occupation by frequent trials of strength with Bacchus, in which the man was uniformly worsted by the fiery god. It would seem that there must be some natural connection between dead-house men and spirits, for I remember that one winter, while I was a visiting physician, the river was full of ice, and the dead-house official of the time not clearly distinguishing between it and terra firma, plunged into the water and was drowned. His body was brought to the house the next day. It

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had a bright, ruddy color, and all the limbs were placed as if the man had died in the act of climbing. So life-like a corpse I never beheld.

Among the nurses, I most distinctly remember the matron of the children's hospital, where I lived. She was a quiet-spoken, motherly person; but the zeal of her office did not eat her up. She had a too wholesome dread of daring to have an opinion in the presence of the committee of the board. She had two acolytes, Nancy, the nurse, who nearly lost her sight by contagious ophthalmia, and afterwards entered the service of one of the physicians of the house and brought up all his children; and Jane (I think that was her name), who had that stupid, astonished good nature peculiar to some of her country-folk.

Then there was the big, burly, apoplectic looking head nurse of the male insane department. He enjoyed the monopoly of leeching and cupping all over the house. It shakes my faith in medicine to think what sanguinary floods we then believed it necessary to shed! This man ruled his own particular kingdom with an impartiality of severity most edifying to those who believed that maniacs are possessed with devils.

I think I can see old mother Hardy of the female venereal ward peering through the big, round glasses of her spectacles; a stern, yet kindly shepherdess of poor sheep that had gone astray, and found more thorns than flowers in the primrose paths of pleasure.

Ah well! these reminiscences are, I know, less interesting to you than to him who gathers them, for he was himself a part of them. They have been woven into his life, and none but himself can understand or thoroughly feel them.

And let me be allowed to say to my younger brothers, do not let the impressions of your hospital life ever grow dim. Recall them for the entertainment of your friends and for your own solace. Preserve them for the time when you, like myself, shall have rested from the more active and arduous labors of your profession; and then

[During the last few years the almshouse smell has almost disappeared, a result due to the earnest efforts of the governing board, the superintendent, and physicians-in-chief, aided by the medical board and the nurses' training school. The erection of improved water closets with proper sewer connections has had a most wholesome effect.

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.