had no clinics as a part of their required curriculum. Now it is impossible for a medical school without some clinical opportunities to exist.

I cannot illustrate the use of medical charities in their relation to medical education better than by giving a brief sketch of the practical work required of a medical student of to-day, all of which practical work is dependent upon medical charities.

A medical student, during at least the last two years of his course of instruction, is required to attend lectures on actual cases of disease or injury, witnessing surgical operations. In addition, he is taken into the wards of a hospital and instructed in diagnosis, treatment and the application of surgical dressings. He is practically instructed in the modern aseptic and antiseptic surgical technique. He is required to attend, under supervision, at least six cases of labor. If a student should get the full benefit of this practical course, he brings to his aid a certain experience even in his first case in private practice, he is able to avoid infection in his first surgical operation, and in his labor cases the element of danger is reduced to the minimum. The existence of medical charities alone renders this education possible.

Patients contributing thus to medical education receive, from their point of view, much more than they give. With all due respect for older members of the profession who have been for years engrossed in private practice and are almost of necessity unfamiliar with recent advances in pathology and therapeutics, it is not too much to say that their methods do not always give patients the benefit of modern science, although their clientèle may be among those amply able to secure the best medical attendance. On the other hand, the inmates of a pauper hospital have their cases investigated in the light of medical science as it is to-day, and are treated secundum artem. Of necessity this is so. A clinical teacher cannot sustain his position in a hospital unless he is fully abreast of the present state of medical science, which reduces accidents and errors in the practice of medicine, surgery, and obstetrics to the minimum. In the great pauper hospital of the city of New York, the world-renowned Bellevue, for many years practical politics has stopped short at the medical management. With an experience and observation of this institution extending over nearly forty years, I can not call to mind a medical or surgical requisition that has been dishonored or a well-founded

complaint of lack of care and attention to patients, even when requisitions called for supplies, remedies, instruments or apparatus of the most expensive kind. The same may be said of nearly every hospital and dispensary, public or private, in the large cities of the United States.

The great hospitals are the practical schools for the modern. "trained nurse." The internes are carefully selected by competitive examination, and they represent the flower of the younger members of the profession. When we bring these facts to mind, and remember, also, that even the smallest surgical operation, performed with proper precautions, involves a considerable expenditure for dressings, etc., which many in moderate circumstances are unable to buy, and which the practitioner whom they can afford to employ is unable to furnish, can we wonder that many who can pay small fees only, and must receive corresponding service, seek free treatment, which is of the highest grade? The statistics of the society of the Lying-in Hospital, which treats patients of the poorest class, in their filthy and squalid homes, under the most disadvantageous surroundings, show a mortality that is almost nil. Few physicians in private practice can show such a record. The actual expense of treatment in such cases, to say nothing of fees, is more than many of the working classes are able to pay.

I say nothing of abuse of medical charities in their relation to medical education, for I fail to see what and where the abuses are, if, indeed, they exist; and, looking at medical charities solely in their relations to medical education, their use and importance can hardly be overestimated. Medical charities are the foundation of medical education; and, while much is given in charity, much is received in return. There are heroes of war, who give up their lives on the field of battle for country and for principle, and medical heroes of peace, who brave the dangers and horrors of pestilence to save life; but the homeless, friendless, degraded and possibly criminal sick poor in the wards of a charity hospital, receiving aid and comfort in their extremity and contributing each one his modest share to the advancement of medical science, render even greater service to humanity. Whether a patient is restored to health and to his measure of happiness or succumbs to the inevitable, he does something to educate men for the exercise of the most beneficent and disinterested of professions; and this is the use of medical charities in their relation to medical education.

MEDICAL CHARITIES IN RELATION TO
RELIGIOUS SOCIETIES.

BY THE REV. DAVID H. GREER, D.D.

The subject which has been assigned to me is somewhat unique, and different from those which have been already considered. It is the subject of medical charity in connection with religion; and that is a phase of the subject which has not been discussed, and which perhaps is not usually discussed in the consideration of the subject itself. And yet without such discussion the consideration is incomplete; for religion is the rock whence charity has been hewn, medical charity and other the fountain or the source from which it has been derived. Charity is the offspring of religion, and of the Christian religion in particular. For the Christian religion taught, with strong stress and emphasis, the sacredness of human life, its transcendent worth and value, no matter how degraded or crippled or broken or weak or apparently unimportant the pauper, the slave, the child, the suffering, and the sick; and from that vivid sense of the value of human life we would naturally expect a charitable disposition to come to minister to human life, not only in its spiritual needs, but in its physical needs as well. And so, in fact, it did come. Charity is the offspring, and the legitimate offspring, of Christianity. That is not a theological statement, open to question: it is an historical statement, beyond question,- a statement of fact which every historical student knows and is familiar with. For while it is true, as Mr. Lecky tells us, that a few pagan examples of charity have indeed descended to us, it is also true that they are exceptional and few, and that, when Christianity appeared, charity became not the exception, but the rule, and was regarded, at least by the Christian world, as a "rudimentary virtue," to be generally exercised, as it was exercised and practised.

It was a Christian woman who established the first public hospital in the world. It was a Christian bishop who caused to be erected the first asylum for lepers in the world. It was a Christian monk who caused to be erected the first refuge for the blind. It was a Christian merchant who caused to be erected the first free dispen

sary. It was the Christian Council of Nicea that caused to be erected, or ordered to be erected, in every Christian city a public institution for the benefit of the poor.

The motive which inspired these and many other similar deeds and works was not always or wholly, as is sometimes alleged, the hope of winning another world and securing safety there by some largess and bountiful gift in this world, cleansing from all iniquities and all defilements here. That may have entered into the But, then, things are often mixed

motive, and doubtless did a little. in this world,- motives as well as other things; and even pills and drugs administered by some of you gentlemen are not always wholly medicinal,— that is, medicinal throughout, but are tinctured and coated with a little unmedicinal sweetness, just to make them palatable and more easy to take. So sometimes are motives, even the most disinterested, mixed with a little personal interestedness, just to make them more potential and easy to act. And the motive which inspired charitable ministration to human life in the early Christian world, while doubtless mixed up with a little post-mortem self-interestedness, making it more efficacious and active, was also in part, and in the main part, the impulse and the desire to minister to human life, its hurts, its wounds, its distresses, just for the sake of ministering to those distresses and those hurts, and helping and relieving that suffering human life which, in the light of Christian teaching, had been shown to be of such transcendent worth.

So it came to pass that charity at the first was associated with religion. So has it been ever since associated with religion, not only as its offspring, but also as its handmaid. And so has religion done its proper work in the world, its moral and spiritual work, contributing to righteousness by contributing to healthfulness, to holiness by wholeness, not only giving a tract, but also giving a treatment, and helping and healing the soul by helping and healing the body, making one well at times by making the other well. And that is what now, as never before in their history, all religious societies and Christian churches are doing. And just because they realize now as never before how close the connection is between the physical and the spiritual, the material and the moral, they are not only saying to the suffering and the sick, "Go and sin no more," but, in order that they may go and sin no more, "Take up your bed, and walk.”

And not only for the sake of religion and its work in the world

must medical charity, like other charity, be associated with it, but also for the sake of the charity and its work in the world. For, while the immediate aim of charity, and medical charity in particular, is to give to human life physical relief, it did so in the first place, and it does so now, even when it is not conscious of it; yet it does so because religion has shown that human life to be, even in its feeblest and most abortive form, of such important value and such transcendent worth. Let that sense of the worth and value of human life which religion gave and gives be separated from charity, and there will be in time no charity—the stream run out and dry-to minister to human life. That, however, has never been the case in Christendom, and never will be the case. Charity and religion are joined together in philosophy and in fact, each helping the other, and each enabling the other to do, in the most efficient way, its true and proper work.

But I must not forget that I am expected to say something about the abuse of charity in connection with religion. Well, it has been abused, very much abused. Shortly after the appearance of Christianity in the world the charity of the Christian Church became, as Mr. Lecky says again, so extensive and excessive that it made very many impostors; and, quoting from one of the writers of that period, he tells the story of a certain Jew who, pretending to be a convert to Christianity, had been repeatedly baptized in different Christian sects, and who had amassed a considerable fortune by the various charitable gifts held out as inducements to him, and which he had thus obtained. It reminds us of the stories told, and which no doubt are true,― some of them have been verified,— of certain well-to-do, if not wealthy, persons, who, leaving their carriages and coachmen at some convenient corner, have walked up to dispensary doors, and become temporarily converted to poverty for the sake of a free treatment there from some celebrated physician. Or of those other stories told, which again some of us have verified, of the way in which some persons have been temporarily converted to religion for the sake of some material aid, in the shape of the free lodging or the free supper, which they hoped thereby to secure.

Something like this, I presume, will always be the case as long ae human nature is what it is. Even in the time of the Founder of the Christian religion himself, we read of many persons who were drawn and attracted to him and followed him about for the sake of the