Medicine, page 915, Dr. William S. Thayer of Johns Hopkins University called attention to the wonderful progress made by medicine during the last century. First came vaccination; then anatomy and physiology were placed upon a scientific basis; exact methods of diagnosis followed; the theory of cellular pathology came into existence; bacteriology came and made surgery safe and placed prophylaxis on a sound foundation; and today the problem of immunity is uppermost and is a natural consequence of the scientific thought going before. All this goes to prove that medicine is fast leaving the empirical and becoming truly scientific. This necessitates the placing of the profession upon higher educational ground. It can not continue to be scientific unless our ranks are filled with men well grounded in the fundamentals of pure science. The unfit should be weeded out before they become a part of us. It should be made easy for men of brains and ability to enter our profession, and difficult for all others. Progressive medicine largely depends upon the progressive doctor, and the keynote to progress is preparation.

Our ranks, therefore, should be filled with men thoroughly trained, brave, ambitious, intense, loyal, and, in addition to this, possessing those rare qualities of head and heart that are found in the makeup of perfect manhood. For character has a deeper foundation than that of mere training and association. It comes somewhere out of the dim and unknown past. The man who stands head and shoulders above his fellow men is bigger because he was born bigger. No man has ever won great things unless created great in the fineness of his brain, the intensity of his nature, the clearness of his perception, and the force of his application. And so it is men of character as well as of training that we want to fill the ranks of progressive medicine.

Progress in medicine has always depended upon hard work and intense application; it will continue to be so in the future. The element of chance or luck has no place in progressive medicine. The so-called accidental discoveries in medicine are always made by those engaged in laborious study and investigation. A successful career is a constant stimulation to beginners, and in the profession

of medicine there are guiding lights of genius to keep one off the rocks of failure; but the study of any successful life accentuates the truism that genius is nine-tenths hard work. Inspiration waits upon application, and, like a fairy godmother, illumination dances before the plodding way of the hard worker. Progressive medicine never hurries, never lags, never rests, because there is no rest in science. "Science always progresses. Like the stars we must go on, unhasting, unresting, always at work."

There is one word that is directly responsible for all the advances in medicine during the past centuries. It has been called by Professor Osler the "master word." Through a little one, the master word becomes large in meaning. The stupid man it will make bright, the bright man brilliant, and the brilliant man steady. To the youth it brings hope, to the middle-aged confidence, to the aged repose. With it Virchow smote the rock, and the waters of progress gushed out; while in the hands of Pasteur it proved a very talisman to open to us a new heaven in medicine and a new earth in surgery. Not only has it been the touchstone of progress, but it is the measure of success in everyday life. And the master word is "work."

The necessity of preparation is emphasized in every department of life and nowhere more than in the medical profession-because to every individual there comes at some time the unexpected and full testing of his powers, and if he is found wanting he falls deservedly into the rear of the column in disgrace, and is rarely heard from again. When some great event crowns the life of an individual it is often remarked that but for this he would have remained unknown and that it was a lucky accident that made him famous. If this "accident" ever happens it comes as an exception to the rule that behind the opportunity lay the lifelong preparation which fitted for the seizure of the supreme moment.

Do you wish to play an important part in the future of progressive medicine? You must begin and complete your preparation while you still have youth and its attendant vigor and capacity for work-before you have passed the meridian of life and begin the descent-while the sun is still shining on your back. Old me

chanics often become indispensable to their employers, it is true, on account of their general knowledge of the business in which they are engaged and because they can always do good work with the tools they learned to use in their younger days. And, as a matter of fact, old men have made many great discoveries, but it is mainly to young men that the world owes those steps across the boundary of the unknown, which constitute landmarks in the development of knowledge.

A word, therefore, to the younger practitioners of this association, whose activities will wax, not wane, with the growing years of the century which has opened so auspiciously for the progress of medical science. You have entered upon a noble heritage, made by no efforts of your own, but by the generations of men who have unselfishly sought to do their best for suffering mankind. On your shoulders their mantle has fallen. Much has been done; much remains to do.

A way has been opened, and to the possibilities in the scientific development of medicine there seems to be no end. Act well your part, and thus the nearer approach the great ideal so beautifully expressed by Robert Louis Stevenson:

"There are men and classes of men that stand above the common herd; the soldier, the sailor and the shepherd not unfrequently; the artist rarely; still more rarely the clergyman; the physician almost as a rule. He is the flower of our civilization, and when that stage of men is done with, and only remembered to be marveled at in history, he will be thought to have shared as little as any in the defects of the period and most notably exhibited the virtues of the race. Generosity he has, such as is possible to those who practice an art, never to those who drive a trade; discretion, tested by a hundred secrets; tact, tried by a thousand embarrassments, and, what are more important, Herculean cheerfulness and courage. So it is that he brings air and cheer into the sick-room and often enough, though not as often as he wishes, brings healing."

But it does not follow that your attainment of this high ideal will receive public recognition. You can not all work in the blaze of the noonday sun, or even in the glare of the electric light. Like

the ideal wife of whom Plutarch speaks, the best doctor is often the one of whom the public hears least. To you, the silent workers in the ranks, in villages and country districts, in the slums of our cities, in the mining camp and factory towns, in the homes of the rich and in the hovels of the poor-to you is given the harder task of illustrating in your lives the old Hippocratic standards of learning, of sagacity, of humanity and probity of learning, that you may apply in your practice the best that is known in our art, so that to all everywhere skilled succor may come in the hour of urgent need; of a humanity that will show in your daily life tenderness and consideration to the weak, infinite pity to the suffering and a broad charity to all; of a probity that will make you under all circumstances true to yourselves, true to your high calling and true to your fellow men.

And, indeed, these words are applicable to us all, for this association has very few old men. True, some of its members were born sixty, seventy, eighty and even ninety years ago, yet by constantly keeping the company of young men, mingling with them in their studies and rejoicing with them in their success, their noble minds stand out of reach of the body's decay. How old is a man? The weight of years may bow his back and the touch of time may tinge his hair with white, and yet he need not age in spirit. The man or woman who cherishes the ideals of youth, who nurtures these ideals through the years, their hopes, their dreams, their loves, may hold on to youth even until the sun dips down into the silent waters.

The springtime of life is the age of hope and aspiration. The youth speculates in futures and his dreams lead him whither ambition points the way. His eye is set upon the day-star of his dreams. passes on to the stage of action and achievement, and then to the age of reminiscence, when the thoughts turn backward to the years of accomplishment.

Ie

The sunset of life is the richest period of human existence; the period when our memories recall the panorama of years, with all its varied incidents, all its sunlight and its shadows. Happy indeed is he who feels at such a time the peace and satisfaction which come as the fruitage of years well spent.

THE SUNSHINE AND SHADOW IN MEDICAL

ENDEAVOR.

JOSEPH D. BRYANT, M. D., NEW YORK CITY.

Justice to myself, and a proper consideration for those whose faith or curiosity has prompted them to be present on this occasion, impels me to say at the outset, that I have been not a little troubled to select a topic that might suitably meet expectations and at the same time afford an excuse for my presence. I might, perhaps, with a faint trace of propriety, lighten each of these contingencies with the guileless claim that neither you nor I can be regarded entirely responsible for a crisis which has been fostered for a considerable time, and is now launched by those who are charged with the success of the occasion. However this may be, a reasonable fidelity to those who have so implicitly trusted us, should beget praiseworthy patience in you, and a degree of commendable brevity in me that benefits your present comfort and the character of the topic under consideration."

The theme of the evening as already announced is somewhat euphonious, but quite suited, as it seemed to me, for an occasion of this kind; one healthful in all respects, dignified by character and learning, and adorned by beauty and grace.

In order that there may be no suspicion in the minds of any, that the topic of our choice is intentionally clothed in a garb of mysticism, I hasten at once to say that the expression, "The Sunshine and Shadow" has no hidden meaning, but is chiefly employed on this occasion to express in a metaphoric and more agreeable, but in no less emphatic way, the well recognized results of our profession, in the long struggle for the relief of human affliction. The glorious sunshine of medical achievements is reflected in the happy faces and glad manners of the patients and their friends, also in the gratified expression of the otherwise imperturbable demeanor of the experienced medical attendants.