USA > New York > Old New York : or, Reminiscences of the past sixty years > Part 28
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The Bellevue Hospital may well be pronounced a noble rival to the finest and best-conducted charities in the world. As a school of practical medicine and surgery, its claims will be conceded by all ; and from my official connection with its affairs, for some years, I can testify to the disin- terested zeal and benevolence and devotion which dignify its medical and surgical Board, and clini-
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cal instructors. It is due to individual zeal and professional ardor to add that the great field of medical and surgical practice which the Bellevue Hospital presents, has recently led to the formation of a museum of pathological anatomy, by Dr. J. R. Wood, one of the clinical instructors.
But where am I to stop when I have entered upon a consideration of the humane and benevo- lent institutions of this metropolis ? the briefest notice of those alone which have been created, since the incorporation of the Historical Society, by legislative authority and individual liberality, would fill a volume. Some other occasions may be appropriated to so instructive an undertaking. Among her thousand claims to commendation, I consider the charities of this metropolitan city the noblest trophy she bears ; and as I am much in the habit of connecting with her various institu- tions the names and promoters of those beneficent foundations, I cannot separate the blessings which have been imparted to suffering mortals during the long career of the New York Hospital, the wisdom imparted by clinical instruction to the hosts of students who have resorted thither for some two or three generations, and the triumphs of skill which the professional literature of the country records, achieved by Bayley, Post, Hosack, Kissam, Seaman, Stringham, and Mott. Memoirs of these eminent professors of the art of healing have long
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RICHARD S. KISSAM.
been before the public. Yet I could have wished that some surgical friend had delineated, with more satisfaction than has yet been done, the great career, as an operative surgeon, of Richard S. Kissam. For thirty years he was one of the sur- gical faculty of the New York Hospital, a station he was solicited to accept, and displayed in his art resources of practical tact and original genius. He was emulous of surgical glory, and he obtained it. Our city had the honor of his birth ; he was one of the sons of the renowned lawyer, Benjamin Kissam, who had been the legal instructor of John Jay. Young Kissam received a classical educa- tion under Cutting, of Long Island, and was graduated M. D. at Edinburgh in 1787. Upon receiving the doctorate he travelled over the con- tinent, and made a visit to Zimmerman, who pre- sented him with a copy of his work on Solitude. Horace and Zimmerman were the two authors Kissam most delighted in. His long and triumph- ant career leaves no possibility of doubt as to the solidity of his pretensions. Society had little at- tractions for him ; he was absorbed in his profes- sion. During more than twenty years he was the most popular operator the city could boast, and he was often called the man of the people. His pro- fessional liberality to the afflicted poor was a strik- ing characteristic of his whole life ; while from the affluent he demanded a becoming return for his
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skill. He died in November, 1822, aged fifty-nine years.
There are due, by the inhabitants of this me- tropolis, many obligations to the administration of the New York Hospital, for their early and in- cessant efforts to mitigate the horrors, and alleviate the sufferings of the insane. The loudest calls of humanity are often awakened in cases of afflicted intellect, and the solicitude which has from time to time invoked new desires for their relief, has by this institution been crowned with results checr- ing to the philanthropist. In 1808 the governors of the hospital erected an edifice for the exclusive use of the insane, on grounds adjacent to the south wing of their city hospital, and Dr. Archibald Bruce was elected as physician. In 1820 the large and commodious institution at Blooming- dale, under their government, was opened for that special class of patients." This beautiful site, with its ample buildings, is eminently fitted for the benevolent design originally projected, and De Witt Clinton secured its perpetuity by legislative grants. Among the medical prescribers to this magnificent institution have been Hosack, Neilson, Bayley, Ogden, MacDonald, Pliny Earle, and Brown. To Dr. Earle the public arc obligated for valuable statistics and reports on mental alien-
* Hosack's Life of Clinton.
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ation. When justice is done in an historical ac- count of the Bloomingdale Asylum, the services of that prominent citizen, in acts of benevolence, the late Thomas Eddy, will be more entirely appre- ciated. He seized the first opportunity to enter into a correspondence with Samuel Tuke, of York, in England, Icarning of the success which, under moral management, had followed the treatment of the insane ; and in Knapp's Life of Eddy are to be found many incidents connected with the literary and professional intercourse of these two worthy disciples of Primitive Barclay. When abroad in Europe I found that the condition of lunatic asylums, and the treatment of those suffer- ing the tortures of a diseased mind, were subjects attracting great notice. The Report of the Inquiry instituted by Parliament was then just published, and vast abuses exposed, and I was prompted by more than a vacant curiosity to add personal facts to my reading, by the inspection of many institu- tions devoted to insanity, and the treatment adopt- ed by them. I dare not speak in commendation of the practice of Monro, at Bethlehem. I found more barbarity and indifference in the medical dis- cipline of those lamentable subjects of insanity in the establishments in Holland, than elsewhere. At the Bicêtre, in Paris, I was delighted with the fatherly care and medical tact of Pinel, now the acknowledged discoverer of the great benefits of
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moral management, but who, a short time before, was annoyed by the vituperations of the British press. At the retreat of Samuel Tuke, the benev- olent and philosophic Quaker, I found all verificd that his novel and impressive work related, and I was emboldened to write to Eddy, on the success of this important innovation on old prejudices which this institution presented. The result was, that, fortified by the most gratifying testimony, the writings of Tuke and the publications of the day, with verbal details by intelligent travellers whom Eddy consulted, the moral management found the strongest advocates among the members of the Hospital Board, and demonstrative proof has multiplied itself again and again, that while the doctor's art is often indispensable to restore to right reason, yet that, in an imposing variety of cases, disturbed intellects are rendered again healthy, not so much by the prescription of drugs, as by humane treatment, and that system of man- agement which the Retreat so advantageously en- forced. Thomas Eddy will ever be remembered as the active agent in this great measure in the New World. Pathology has not as yet yielded us any great light on the grave causes of mental aberration, and the knife of the dissector has often failed to trace altered structure in the most per- verted cases of lunacy. Hence we estimate at a still higher price the value of discipline, the exer-
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cise of the kindlier affections, and moral culture. When the adoption of these curative measures shall have become more general, we shall no longer hear of the flagellation of an infirm monarch, or of ponderous manacles and eternal night as arti- cles of the materia medica. Our countryman Rush has enlarged our storehouse of facts on the diseases of the mind ; and the treatise of Dr. Ray, of Rhode Island, has strengthened our philosophy on the analysis of intricate cases in juridical science.
With the bare mention of that newly-created charity, St. Luke's Hospital, now about to open its portals for the accommodation of the afflicted- an institution the offspring of Christian benevo- lence, aided by the outpouring liberality of our opulent citizens-with the further prospects we have before us of a Woman's Hospital, for the special relief of infirmities hitherto among the most disconsolate of human trials, and over which recent science has triumphed in the hands of Dr. Sims : with the cherished hopes derived from the success of our enlightened countryman, Dr. Howe, of Boston, that in due season even the forlorn idiot may be rescued, I reluctantly dismiss all further notice of the corporations of like benevolence which flourish in this metropolis. But it is the less necessary on this occasion to notice the pro- gress of humanity in this rapidly increasing city
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since the commencement of the Historical So- ciety's labors ; a partial estimate may be formed of the work that is actually done, and is doing among us, from the statement lately furnished by that accurate observer, Dr. Griscom .*
With facts of this import before us, who will gainsay the claims of the divine art of healing to that public recognition which is yielded to the highest and most solemn of the professional labors of life ? who that properly contemplates the du- ties, the objects, and the desires of the real physi-
* According to a tableau which I have compiled, says Dr. Griscom, chiefly from their own published statements, there are in this city devoted to the care of the sick poor, four general hos- pitals, five dispensaries, two eye and ear infirmaries, one lying-in asylum, three special hospitals (on Blackwell's and Randall's Islands), several orphan asylums and prison hospitals, besides other unenumerated charitable and penal establishments, where medical and surgical aid is rendered. In the institutions thus enumerated, there were treated in 1853, 151,449 cases of disease, of every variety. Devoted actively to the service of these pa- tients, we find recorded the names of 169 medical men. Esti- mating the professional service rendered these patients at what is denominated, in the last report of one of these institutions in true mercantile phrase, the "lowest market value " (which of ne- cessity varies in the several institutions, in consequence of the varied character of the cascs) we have an aggregate of $745,458. An analysis of the circumstances connected with these services, shows that of these 169 medical men, 36 are merely boarded and lodged at the expense of the institutions, or receive pay equiva- lent thereto, amounting in all to $6,552; 30 of them receive salaries varying from $200 to $1,500, in the aggregate $20,560; while the remaining 103 receive no compensation whatever. In
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cian, can prove reluctant in awarding to his re- sponsible calling merits not surpassed by those of any other human avocation ? Let the moralist and the philosopher give attention to the progress medical science has made during a period not longer than that of an ordinary human life ; in- vestigate the achievements which have marked the past thirty years ; learn in how many ways pesti- lence has been disarmed of half of her weapons ; individual disorders lessened in malignity or exter- timated ; hygiene fortified with new capabilities ; the principles of sanitary laws comprehended and applied ; individual life made happier and pro- longed ; the health of mighty populations im- proved, and the great numerical increase in lon- gevity. London is at the present day to be enumerated as first of the healthiest cities in the world ; and the statistics which have been given
addition to this, if we estimate the amount of private gratuitous advice which every medical man renders, in the emergencies of the sick poor, at the moderate rate of $100 per annum, the num- ber of practitioners in this city being about 900, we have a total sum of $90,000 to add to that before given, making a total of ser- vices rendered by the medical profession, in the year 1853, to the sick poor, in the city of New York, of $835,458, of which there is returned $27,112. In whatever light it may be viewed, the rendition of these services is simply the contribution of the medi- cal profession to the support of public charity, to the full amount mentioned ; it is so much saved to the tax-payers .- Anniversary Discourse before the New York Academy of Medicine, Nov. 22d, 1854, by JOHN H. GRISCOM, M. D.
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to the public by our distinguished countryman, Dr. Campbell F. Stewart," show us the grounds upon which life annuities may be granted to the greater advantage of the insurer, a ratio of improvement which Price, Morgan, and Finlaison, never antici- pated. In another work previously published, of elaborate exposition, and pregnant with instructive facts relative to vital statistics and hospitals, by the gentleman to whom I have just alluded, the able Dr. Stewart, we are furnished with still more striking views of the enlarged science compre- hended in the medical art, of the wide benevolence exercised by the French government for the pro- motion of healing knowledge and the deep inter- ests of humanity. "While affording a judicious and parental care to all its poor subjects," says Dr. Stewart, "it is towards the sick and infirm, how- ever, that the most benevolent attentions have been extended by the government, in establishing for their accommodation, and particularly for those of the capital, the most extensive and best organ- ized hospitals and houses of refuge that are to be met with anywhere in the world."+
The intimate connection between the healing art and religious sentiment is obvious throughout the history of both ; the charities of the Romish,
* Discoure before the New York Academy of Medicine.
¿ The Hospitals and Surgeons of Paris. By F. Campbell Stewart, M. D. New York : 8vo, 1843.
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REV. E. M. P. WELLS.
and the humane enterprises of the Protestant Church, are identificd with the divine system of faith, whose holy Author was sanctioned to the popular heart by miraculous healing. At the commencement of my professional career, and while yet a student, it was not uncommon to hear breathed over the process of vaccination a special form of prayer, invoking a blessing on this re- medial experiment, and thereby cxorcising the bitter animosity of its pertinacious opponents. In our own day this pious union of religious exercises with medical charities takes a broader range ; most of our hospitals and asylums enjoy the minis- trations of a chaplain, as in the case of the be- nign guardian of St. Stephen's House at Boston, that modern apostle with whom Paul would have loved to fraternize, the Rev. Dr. Wells. The exact period at which provision was made for such spiritual consolation for the afflicted in various in- stitutions of the States, I am unable to record. Pastoral duties and religious instruction seem to have been first regularly imparted in the charitable organizations of New York in 1810. They have become an integrant portion of the adjuvants to the afflicted ; and perhaps no official of this paro- chial function has ever longer or more faithfully dis- charged that responsible trust than John Stanford, D. D, the latcly deceased chaplain of the New York Hospital.
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How much then has been accomplished by the mental activity, the science, and the philanthropy of the medical faculty ? Had now this opulent city a proper sanitary commission duly organized, with our almost unequalled topographical advan- tages, we might boast of a population whose mor- tality might safely bc estimated at twenty-five or thirty per cent. less than is recorded of its present inhabitants. Sad, sad indeed, is the reflection, that responsible trusts are not always confided to competent officials. The trammels of party too often defeat the best designs, and incompetency usurps the seat of knowledge. How long we are to be doomed to witness this monstrous incongruity and suffer its penalties, time alone must show.
In taking a retrospective view of the progress of medical science during the past fifty or sixty years in New York, the instructors and practition- ers of the healing art have had many reasons for rejoicing. Our medical colleges have enhanced in power, and the means of enlightenment." The collateral branches of science are unfolded by more ample apparatus, and by experiments such as in former days were wholly beyond our reach. Our
* Now three in number :- The College of Physicians and Surgeons, founded in 1807, its present head, Dr. Coek ; the Uni- versity of the City of New York, founded in 1840, present head, Dr. Draper ; and the New York Medical College, founded in 1848, present head, Dr. Greene.
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medical annals are enriched with recorded evi- dences of great chirurgical skill, of novel and suc- cessful proofs of wise discrimination, and of genius happily demonstrated ; in the practical displays of clinical science, the writings of our authors have furnished lessons of instruction to the masters of the art abroad. Our medical and scientific literature is sought after with becoming deference by remote professors in foreign schools, and has the honor of translation for continental Europe. All this for a long season has been gratifying to indi- vidual pride, and flattering to our character as a rising people. Yet it is not to be concealed that imposture still holds its influence among us, and that, as a learned body, the medical profession is still disfigured by pretenders to its secrets ; that jarring elements still disturb its harmony, and that the public, scarcely to be presumed to be the best judges of the recondite qualifications of the disci- ples of healing, are still molested by the artifices of the designing and the effrontery of the igno- rant.
More than forty years ago I gave utterance to my opinion on the condition of the medical art in New York." The reasons for denunciation of
* " That almost every district of our country abounds with individuals who set up to exercise the duties of practitioners of medicine, need scarcely be stated; how great is the number of them, who from want of proper education and from habits of in-
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many occurrences then prevalent, were stronger than at the present day. The condition of affairs is ameliorated. Numerous agencies have been in operation since that period, which have corrected many abuses detrimental to public safety. Then we could not speak of a school of Pharmacy. The Indian doctors and the effete remnant of licentiates by a justice's court, thanks to a superintending Providence, now rest from their labors. Collegiate knowledge is more widely diffused, and he is an adventurous individual who now presumes to ap- proach the bedside without the clinical knowledge of hospitals. I shall never forget the tone of
dolence, are totally ignorant of the first principles of their pro- fession, and who degrade the noblest of studies into the meanest of arts, cannot have escaped the attention of any who at all re- gard the interests of society. That characters of this description do abound, not in this or that particular city or district, but are to be met with in almost every part of the country, is a fact which no one, we presume, will have the hardihood to deny. Though they differ from beasts of prey, inasmuch as these are most gen- crally found in the uninhabited wilds of the country, while those are most abundantly congregated in our largest and most popu- lous cities, yet they wage war with equal success as it regards the destruction of their objects. So frequently, indeed, do tlicy pre- sent themselves to our view as almost to have become domesti- cated and familiar with us, and to have lost that novelty which monsters in general possess. The inroads and depredations which they commit, bid defiance to all calculation ; whether they come in the natural shape of nostrum-mongers and venders of infallible cures, or whether they assume a peculiar grimace and affected sapience, their touch is equally pestilential."-American Medical and Philosophical Register, vol. iii.
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voice, the elocution which I heard proceed from the mouth of John Abernethy, when he told the boys (for he called all by that designation, though some were sixty years old), that they must judge for themselves of the truth of what he uttered by what they derived from hospital practice. "I was the first," said he, " who described fungous hæma- todes ; I have seen as yet but three cases, but the disease is distinctive, well marked, and cannot be mistaken by the clinical eyc ; yet," added he, "I meet practioners now and then, who tell me they have had twenty cascs. No dependence can be placed upon such observers. If they would but visit St. Thomas, I could convince them of their error, and expose their ignorance. These pests of the profession have no clinical experience, and magnify their stupidity by falsehood. Boys, the hospital is the college to build up the practitioner." If I were placed here to defend or advance the importance of bedside knowledge, I might cut the argument very short, by requesting the young dis- ciples of Æsculapius to sift the merits of the once great work of Cullen, the First Lines, and then rcad the Practice of Physic by Watson, of this our day : he would then be able to pronounce by which teacher he becomes best disciplined to fulfil the grave duties of healing the sick. I am not to overlook what the contributions of half a century have made to the noble science, and of which the
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illustrious Cullen could scarcely have possessed a glimpse ; but the theories of the one, and the clinical data of the other, may be looked at with scrutinizing judgment, to determine the inherent merits of refined theory, and that special wisdom on which the practical physician relies. It may be written as an axiom, You might as well create a practical navigator by residence in a sylvan retreat, as furnish a physician without hospital experience.
Nevertheless, it would be criminal to ignore the fact that the noble art with us still struggles with many difficulties ; and it is a glaring truth, that not the least of them has arisen in the vicissitudes of leg- islation. The few wholesome laws, which a century had brought forth, for the advancement of medi- cine and the protection of its rights, were by State authority, some ten or twelve years since, abro- gated, and, strange to add, the bill which accom- plished that nefarious measure was introduced into the chamber of the Senate by a partisan repre- sentative from this city. The distinguished presi- dent of our Historical Society, Lieut. Gov. Bradish, was then a member of the Senate. It is scarcely necessary to add that his cultivated mind recoilcd at the measure, and that his strenuous efforts were exerted to defeat the iniquitous law. There was no monopoly existing to absorb the rights of others that could justify such enactment. The colleges
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did no more than confer their usual honors, to dis- tinguish and reward merit ; they fostered rising talent, and held communion with mature expe- rience, with no other aim than to exalt excellence ; their very incorporation forbade their countenance of corrupt practices ; and with the principles ever inherent in disciplined minds, they disdaincd to mar the rank of professional worth. I have often had my credulity taxed to believe that in these enlightened days such hardihood could have been exhibited by the makers of our laws, and that too at the very seat of wisdom, where our special guardians of literature and science, the Hon. the Regents of the University, annually convene, and where, moreover, that long created association, the State Medical Society, with its many able mem- bers, are wont to exercise their chartered privi- leges for medical improvement.
It is almost superfluous to remark that the memorable act to which I have alluded was re- ceived by the Profession with emotions of sorrow and indignation. It was now seen that the noble art was again left unprotected by the representa- tives of the people, and consequently by the peo- ple themselves. It had thus found itself in the beginning of the city, but a revolving century had presented some relief ; its prospects had bright- ened, and the rights and immunities of the regular physician had been recognized, and approved laws
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had secured him against the tricks of the harlequin and the wiles of the over-reaching. The disci- plined medical man is not, however, the easiest to be disheartened. His study is human nature, and he comprehends its phases :
Intus et in cute novi.
He is familiar with hindrances, and in the exercise of his art has often prescribed for individual men- tal delusion, and can comprehend the sources of popular error. What is sporadic he knows may become epidemic.
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