PRESENTATION OF PORTRAIT OF DR. CHARLES SLOAN

BY DR. HENRY BARTON JACOBS

Mr. President, and Members of the Medical and Chirurgical Faculty of Maryland:

Ladies and Gentlemen: The late Mr. Frank Frick of Baltimore in disposing of his personal effects arranged that this portrait should come eventually into the possession of The Medical and Chirurgical Faculty of Maryland, and as it is the wish of his sister-in-law, Miss Lurman, to whom it was left for her life-time, that the Faculty now receive the portrait, I esteem myself most privileged in being selected in behalf of both Mr. Frick and Miss Lurman to present it, Mr. President, through you to The Medical and Chirurgical Faculty of Maryland, to be hung in the Frick Reading Room according to the injunction written on the back of the frame in Mr. Frick's own handwriting under date of February 1901; to wit:

"In the distribution of my personal effects, I desire this portrait of Dr. Charles Sloan to be presented in my name to The Medical and Chirurgical Faculty of Maryland to be placed in the Charles Frick Memorial Room."

In contemplating the portrait of this young man, we are taken back to the very beginnings of the old Faculty, and to renewed evidence of the dauntless courage and enthusiasm which the study of medicine has inspired in the minds of men, leading them to the utmost sacrifices, that knowledge of disease may be advanced and good to humanity be attained. Here we have before us the face of a young man who, no less than more recent examples, was a hero and a victim in the search for medical truth.

Dr. Charles Sloan was the son of a very prosperous, wealthy merchant and manufacturer of Baltimore, James Sloan, whose beautiful house stood on the site of the present postoffice on Battle Monument Square. Here in all the surroundings of luxury Charles was born on March 18, 1798, the very year in which the preliminary meeting for the incorporation of this Faculty was held. His two older brothers were James, Jr., and William. James was educated at Princeton College and studied law at the University of Maryland, but as he early fell a victim of tuberculosis, he was sent to Italy for his health where he remained a number of years perfecting himself in languages and literature, and cultivating a taste for writing. In 1817 he returned to Baltimore, but his health failed rapidly, and soon after publishing his attractive account of his "Rambles in Italy," he succumbed

at the age of 33 to the disease he had been fighting for a dozen or more years.

William, the second brother of Charles, studied medicine with Doctors Littleton and Donaldson of Baltimore and later graduated in Philadelphia in 1811. He was appointed surgeon of the 14th Regiment United States Infantry at the commencement of the War and continued on the northern frontier until peace was declared. Soon after his return to Baltimore he was elected one of the physicians of the City Dispensary, and in 1817 was appointed attending physician of the Almshouse. Here he served faithfully and successfully for the two following years until his death on April 7, 1819, at the age of 28 years.

Of Charles' early life and education we have little knowledge, save that he adopted medicine as his profession and became a doctor. He was born, as I have said, on March 18, 1798, and died in New Orleans where he had gone to study yellow fever, on November 15, 1821, in his twentyfourth year.

Yellow fever was the plague of the Eastern seacoast towns in the latter part of the eighteenth and early years of the nineteenth century. Baltimore did not escape. There was a severe epidemic in 1808, and another even more severe in 1819. In the latter year public sentiment became so aroused that greater knowledge of the disease should exist, that Mayor Edward Johnson issued a circular to the physicians of Baltimore requesting specific answers to certain inquiries relative to the place where first cases were noted; the cause to be ascribed to the disease; the nuisances that should be removed; and whether or not yellow fever was thought to be contagious. This circular was signed Edward Johnson, Mayor, and was dated Dec. 1, 1819. Numerous replies were received and these were published for the benefit of the Baltimore Second Dispensary in 1820 under the title "A Series of Letters and other Documents relating to the late Epidemic or Yellow Fever." The epidemic abated in the following year, 1820, but in the City of New Orleans beginning in 1818, a very severe. epidemic continued until 1822. I cannot but think it probable that Charles Sloan, just having graduated in medicine, should have been influenced by the call of Mayor Johnson for greater knowledge of the terrible disease to attempt a more satisfactory answer to his several inquiries than were contained in the published letters of the older physicians of the city. There had ceased to be an opportunity of study at home, but in New Orleans the epidemic was at its height, and hundreds of cases, even thousands, were to be seen and studied. So with the full enthusiasm of youth and stimulated by the ambition and desire to be of real assistance to his fellow creatures, he goes to New Orleans, despite, we can well imagine, the remonstrances of parents and sisters who have already been called upon to mourn the sad loss of the two elder boys.

Communication with New Orleans at this time was practically solely by sea. The packets, Clio and Temperance, made trips back and forth when cargoes were obtained. Nearly a month was required for news of one city to reach the other. What was the nature of Charles Sloan's studies on his arrival in New Orleans, what lines of investigation he pursued, we may never know; that he hesitated not to put himself in intimate contact with yellow fever we do know, for on November 15, 1821, he died of the disease he had gone to study, not yet 24 years old, a young life full of promise voluntarily sacrificed that medicine might be advanced and the lot of humanity bettered. How similar is this sacrifice on the altar of the yellow fever to those later more conspicuous and happily more beneficial sacrifices of Walter Reed and his gallant band of heroes, Lazaer, Agramonte, and all the others!

After the tragedy of his death, we may well imagine with what affection and care this portrait of the young martyr was held in the great house on Monument Square. Finally it came into the possession of his sister, Mary, who married the Honorable William Frick, Judge of the Superior Court of Baltimore. She in turn gave it to her son, Frank Frick, who now through me presents it to the Faculty. That it should hang in the Charles Frick Memorial Room is most appropriate. Charles Frick, the brother of Frank Frick, was the nephew of Charles Sloan, and in all probability was named Charles in memory of his young uncle, whose life was so brief, and end so tragic, both victims to dread disease-one a student of yellow fever at 24-the other, in relief of a poor sufferer of diphtheria at 37.

In bequeathing this portrait to the Faculty, Mr. Frank Frick has added another token of the interest he felt in his life-time in medicine, and of his desire to benefit the profession through this State Society. The first gifts of Mr. Frick, and his brother, Mr. William F. Frick, came at a period in the Faculty's history when they were of such importance that almost the very life of the Society was dependent upon them; indeed without these gifts it is extremely doubtful if Doctor Osler would have been able to put that reviving spirit into the old Faculty which he was so fortunate in doing. Members of the Faculty can never cease to be thankful for the stimulus given by these gentlemen in establishing the Frick Library and the Charles Frick Memorial Reading Room in memory of their brother-and no matter what may be the subsequent history in respect to these foundations, assuredly these two names, the Frick Library and the Frick Reading Room will always be maintained.

As a matter of history of the Sloan family it may be interesting to add that the second sister of Charles Sloan, Elizabeth, married Dr. John Buckler of Baltimore, and so became the mother of Drs. Riggin and Thomas Buckler, and grandmother of the present generation of Bucklers.

Just a word in conclusion about the picture itself. It is an excellent example of early American portraiture, done by Rembrandt Peale prior to 1821, probably in 1819 or 1820, some time before Charles Sloan went to New Orleans. It represents in a simple but strong manner the attractive face of the young physician, and is a portrait to be prized most highly in the interesting gallery of portraits which adorn the walls of this building. Rembrandt Peale was one of the more distinguished of the early painters of the country, to whom, as to Copley, Gilbert Stuart, Thomas Sully, and his father, Charles Wilson Peale, we owe today tributes of praise and thanksgiving for handing down to us so many of the faces of our distinguished men of the past. Rembrandt Peale was born in Bucks County, Pa., in 1778. He studied under Benjamin West in London, afterwards in Paris, then returned to America, and established a Museum in Baltimore which until comparatively recent times was still standing. We may have other examples of his work on these walls, but I do not recall any other, so from this point of view we should be very glad to have this portrait in the collection-a fine portrait of a most interesting and courageous young physician who died that others might live-an added testimony of the generosity of one of the Faculty's most esteemed benefactors.

THE CHRONIC PATIENT

NEW METHODS OF EXAMINATION LEADING TO BETTER UNDERSTANDING AND TREATMENT OF THESE CASES

BY JOEL E. GOLDTHWAIT, M.D.

Boston, Massachusetts

The honor which you have conferred upon me in asking me to address you at this meeting made it difficult to select a subject that would be worthy of the occasion, and the one announced was chosen as perhaps representing the most needed line of discussion for us practitioners today.

The chronic patient represents a great challenge to us and since so many of the acute diseases are being eliminated by better understanding of the rules of general hygiene, the chronic patient is occupying an increasingly large place. Unless we, as physicians, are able to give these cases the relief which they seek, the drift will be even more to the irregular schools of medical thought or treatment than it is today.

The general lack of interest which the average physician has for the chronic patient is undoubtedly due to the lack of understanding which he has received either from his Medical School training or from the textbooks of the day. It is hoped that in this discussion tonight, methods of study may be suggested that will represent a basis of interest to you all in this type of patient which, if followed, will, I am sure, lead to relief in many of your cases and give you a sense of satisfaction not often rightly felt in the acute work.

An experience of over thirty years spent largely with the chronic patient, has led me more and more to feel that very few of the so-called chronic diseases cannot be controlled with the knowledge as it is possessed today and that those remaining not now controlled will, ultimately, be controlled as our knowledge of the basic elements of structure and physiology become better understood. It is this type of knowledge which we especially need with the chronic patient and the examinations of this type of patient as they are commonly being made today, unless they go further than they usually do, lead to harm rather than good in many of the cases. Unless something is done with the elaborate examinations which are being made, other than to report the negative findings, not only is the patient harmed by the common hopeless or indifferent prognosis given, but our profession is rendering itself liable to great ridicule. No one can have had much to do with any clinic where chronic patients are received, without meeting