The musings of a physician who served the community for over six decades
367 Topics
Downtown A discussion about downtown area in Philadelphia and connections from today with its historical past.
West of Broad A collection of articles about the area west of Broad Street, Philadelphia, Pennsylvania.
Delaware (State of) Originally the "lower counties" of Pennsylvania, and thus one of three Quaker colonies founded by William Penn, Delaware has developed its own set of traditions and history.
Religious Philadelphia William Penn wanted a colony with religious freedom. A considerable number, if not the majority, of American religious denominations were founded in this city. The main misconception about religious Philadelphia is that it is Quaker-dominated. But the broader misconception is that it is not Quaker-dominated.
Particular Sights to See:Center City Taxi drivers tell tourists that Center City is a "shining city on a hill". During the Industrial Era, the city almost urbanized out to the county line, and then retreated. Right now, the urban center is surrounded by a semi-deserted ring of former factories.
Philadelphia's Middle Urban Ring Philadelphia grew rapidly for seventy years after the Civil War, then gradually lost population. Skyscrapers drain population upwards, suburbs beckon outwards. The result: a ring around center city, mixed prosperous and dilapidated. Future in doubt.
Historical Motor Excursion North of Philadelphia The narrow waist of New Jersey was the upper border of William Penn's vast land holdings, and the outer edge of Quaker influence. In 1776-77, Lord Howe made this strip the main highway of his attempt to subjugate the Colonies.
Land Tour Around Delaware Bay Start in Philadelphia, take two days to tour around Delaware Bay. Down the New Jersey side to Cape May, ferry over to Lewes, tour up to Dover and New Castle, visit Winterthur, Longwood Gardens, Brandywine Battlefield and art museum, then back to Philadelphia. Try it!
Tourist Trips Around Philadelphia and the Quaker Colonies The states of Pennsylvania, Delaware, and southern New Jersey all belonged to William Penn the Quaker. He was the largest private landholder in American history. Using explicit directions, comprehensive touring of the Quaker Colonies takes seven full days. Local residents would need a couple dozen one-day trips to get up to speed.
Touring Philadelphia's Western Regions Philadelpia County had two hundred farms in 1950, but is now thickly settled in all directions. Western regions along the Schuylkill are still spread out somewhat; with many historic estates.
Up the King's High Way New Jersey has a narrow waistline, with New York harbor at one end, and Delaware Bay on the other. Traffic and history travelled the Kings Highway along this path between New York and Philadelphia.
Arch Street: from Sixth to Second When the large meeting house at Fourth and Arch was built, many Quakers moved their houses to the area. At that time, "North of Market" implied the Quaker region of town.
Up Market Street to Sixth and Walnut Millions of eye patients have been asked to read the passage from Franklin's autobiography, "I walked up Market Street, etc." which is commonly printed on eye-test cards. Here's your chance to do it.
Sixth and Walnut over to Broad and Sansom In 1751, the Pennsylvania Hospital at 8th and Spruce was 'way out in the country. Now it is in the center of a city, but the area still remains dominated by medical institutions.
Montgomery and Bucks Counties The Philadelphia metropolitan region has five Pennsylvania counties, four New Jersey counties, one northern county in the state of Delaware. Here are the four Pennsylvania suburban ones.
Northern Overland Escape Path of the Philadelphia Tories 1 of 1 (16) Grievances provoking the American Revolutionary War left many Philadelphians unprovoked. Loyalists often fled to Canada, especially Kingston, Ontario. Decades later the flow of dissidents reversed, Canadian anti-royalists taking refuge south of the border.
City Hall to Chestnut Hill There are lots of ways to go from City Hall to Chestnut Hill, including the train from Suburban Station, or from 11th and Market. This tour imagines your driving your car out the Ben Franklin Parkway to Kelly Drive, and then up the Wissahickon.
Philadelphia Reflections is a history of the area around Philadelphia, PA
... William Penn's Quaker Colonies
plus medicine, economics and politics ... nearly 4,000 articles in all
Philadelphia Reflections now has a companion tour book! Buy it on Amazon
Philadelphia Revelations
Try the search box to the left if you don't see what you're looking for on this page.
George R. Fisher, III, M.D.
Obituary
George R. Fisher, III, M.D.
Age: 97 of Philadelphia, formerly of Haddonfield
Dr. George Ross Fisher of Philadelphia died on March 9, 2023, surrounded by his loving family.
Born in 1925 in Erie, Pennsylvania, to two teachers, George and Margaret Fisher, he grew up in Pittsburgh, later attending The Lawrenceville School and Yale University (graduating early because of the war). He was very proud of the fact that he was the only person who ever graduated from Yale with a Bachelor of Science in English Literature. He attended Columbia University’s College of Physicians and Surgeons where he met the love of his life, fellow medical student, and future renowned Philadelphia radiologist Mary Stuart Blakely. While dating, they entertained themselves by dressing up in evening attire and crashing fancy Manhattan weddings. They married in 1950 and were each other’s true loves, mutual admirers, and life partners until Mary Stuart passed away in 2006. A Columbia faculty member wrote of him, “This young man’s personality is way off the beaten track, and cannot be evaluated by the customary methods.”
After training at the Pennsylvania Hospital in Philadelphia where he was Chief Resident in Medicine, and spending a year at the NIH, he opened a practice in Endocrinology on Spruce Street where he practiced for sixty years. He also consulted regularly for the employees of Strawbridge and Clothier as well as the Hospital for the Mentally Retarded at Stockley, Delaware. He was beloved by his patients, his guiding philosophy being the adage, “Listen to your patient – he’s telling you his diagnosis.” His patients also told him their stories which gave him an education in all things Philadelphia, the city he passionately loved and which he went on to chronicle in this online blog. Many of these blogs were adapted into a history-oriented tour book, Philadelphia Revelations: Twenty Tours of the Delaware Valley.
He was a true Renaissance Man, interested in everything and everyone, remembering everything he read or heard in complete detail, and endowed with a penetrating intellect which cut to the heart of whatever was being discussed, whether it be medicine, history, literature, economics, investments, politics, science or even lawn care for his home in Haddonfield, NJ where he and his wife raised their four children. He was an “early adopter.” Memories of his children from the 1960s include being taken to visit his colleagues working on the UNIVAC computer at Penn; the air-mail version of the London Economist on the dining room table; and his work on developing a proprietary medical office software using Fortran. His dedication to patients and to his profession extended to his many years representing Pennsylvania to the American Medical Association.
After retiring from his practice in 2003, he started his pioneering “just-in-time” Ross & Perry publishing company, which printed more than 300 new and reprint titles, ranging from Flight Manual for the SR-71 Blackbird Spy Plane (his best seller!) to Terse Verse, a collection of a hundred mostly humorous haikus. He authored four books. In 2013 at age 88, he ran as a Republican for New Jersey Assemblyman for the 6th district (he lost).
A gregarious extrovert, he loved meeting his fellow Philadelphians well into his nineties at the Shakespeare Society, the Global Interdependence Center, the College of Physicians, the Right Angle Club, the Union League, the Haddonfield 65 Club, and the Franklin Inn. He faithfully attended Quaker Meeting in Haddonfield NJ for over 60 years. Later in life he was fortunate to be joined in his life, travels, and adventures by his dear friend Dr. Janice Gordon.
He passed away peacefully, held in the Light and surrounded by his family as they sang to him and read aloud the love letters that he and his wife penned throughout their courtship. In addition to his children – George, Miriam, Margaret, and Stuart – he leaves his three children-in-law, eight grandchildren, three great-grandchildren, and his younger brother, John.
A memorial service, followed by a reception, will be held at the Friends Meeting in Haddonfield New Jersey on April 1 at one in the afternoon. Memorial contributions may be sent to Haddonfield Friends Meeting, 47 Friends Avenue, Haddonfield, NJ 08033.
Proposed to the Annual Dinner of the Franklin Inn Club, 16 January 2009:
p>In the century after Benjamin Franklin, one of the most diversely creative Americans was S. Weir Mitchell. Like Franklin, he was an empirical scientist. But whereas Franklin went in the direction of homely philosophy, diplomacy, and urban institutions, Mitchell shot off into practical and theoretical medicine and was the first president of the American Neurological Association. He wrote several historical novels, some juvenile literature, and 440 pages of collected poems; as well as the penetrating case studies, essays, and books he contributed to medicine.
The year after Mitchell helped found The Franklin Inn Club, 1902, a painting of him was commissioned, by John Singer Sargent. The world’s leading social portraitist was 47; his subject was 74. Sargent fretted over the beard, and muttered, “I mustn’t make him look like a goat.†Mitchell’s thin, silvery beard nonetheless looks like an afterthought, brushed over his clothing. Mitchell’s left-hand rests awkwardly on a book standing vertically, index finger inserted, holding a place. His light blue eyes look watery and accusing as if from eyestrain combined with irritability at keeping still for this arrogant young Englishman. When the painter finished he exclaimed, “At least it is a Sargent.†To which the sitter replied, “Yes, and it is of S. Weir Mitchell.â€
Mitchell’s own fame dated from experience as a surgeon in the Civil War and a book on gunshot wounds, a classic still used by the French in World War I. If he was active today, editorial writers would be quoting Mitchell on whether or not post-traumatic stress disorder should qualify a warrior for the Purple Heart. He also generated monographs on rattlesnake poison, and on relations among nurses, physicians, and patients. Most famously, his “Rest Cure†for depressed patients was adopted in Europe, and some of its features remain in practice today in Japan and China.
We may see Weir Mitchell, then, as one of the great medical figures between the first surgical anesthesia and the eminence of Sigmund Freud. But where exactly fit him? Critics of the Rest Cure might say that he came to embody the title of a short story he wrote during the Civil War 'Autobiography of a Quack. It is easy to concede that he may have been a strange duck; but I should also insist that he was a pioneer in experimental physiology, studying carefully how things happen in the human body and mind.
That said, I wonder about the title of his classic book on the treatment of hysteria and neurasthenia, which went through eight editions before his death in 1914. Its title is Fat and Blood. Something seems wrong there. He believed that neuralgic conditions of all kinds were treatable by managing ratios between blood and fat. His theory figured centrally in the Rest Cure, which required four to eight weeks of seclusion, away from family and intellectual work, in the care of a nurse who bathed, dressed, and massaged the patient, while a doctor occasionally prescribed electricity and dietetics, and studied weight gain, which would be evidence of improvement. (This, after all, was the age of Lillian Russell, no slender beauty; and of William Howard Taft, who at peak weighed 335 pounds.) We may be allowed skepticism regarding features of Mitchell’s treatment: about seclusion, because we are ultra-sociable; about rest and no-use-of-hands, because our age is hyperactive; about massage, which we believe yields only a transient “feel-good†effect; about electricity, which we think useful only in careful shock doses; and about exotic pharmaceuticals such as the glycerin that Mitchell valued, which was specially extracted from bull’s testicles.
If we read the short story by Charlotte Perkins Gilman, The Yellow Wallpaper, we may get an even darker view of the Rest Cure. This utopian feminist and prolific writer suffered postpartum depression after her first daughter was born, and for it, she undertook Mitchell’s treatment. In her story, a secluded woman obsesses with the sickly color and creepy patterns of the wallpaper and imagines them hiding a woman who wants to get out. She goes mad and rips the paper off the wall to let the tortured prisoner free. In reality, Gilman ignored Mitchell’s advice against resuming intellectual activity, and flung herself back into it for the rewards of “joy and growth and service.â€
Perhaps Gilman’s reputation as a feminist contributes to Mitchell’s as a misogynist. But that charge I believe is wrong. He had many woman friends, and many female patients adored him '" all without scandal. He may have erred in treatment, but his very focus on conditions suffered by educated women was novel in his time. Women were subject to hysteria (which in male doctor language appeared to mean restless, bitchy women), and neurasthenia (which implied more docile, pleasing women). Both kinds might endure headaches, fatigue, anxiety, loss of appetite and motivation, and even suicidal thoughts. [Nowadays, simply “depression.â€] But then neurasthenia was taken as ordinary for women, meaning affluent urban women, and certainly not freed slave women. Men, of course, were also subject to such vapors, which they should treat with a stiff upper lip, or to ulcers and heart attacks, which Mitchell also wished to cure and prevent. These stress-produced conditions, as early as 1869, were traced to competitive capitalism. Americans were thought especially prone to neurasthenia, and when William James suffered it, he called it “Americanitis.â€
Weir Mitchell’s advance was to approach the condition experimentally and pragmatically. At that time, mental illness was associated with the madhouse. Instead, he considered it as common and treatable. His chief distorting error, surely, was an excess of empiricism, in trying to base every distress and its cure in bodily function. He nonetheless appreciated psychodynamics, and many anecdotes attest to his high appreciation for women and his sensitivity to them. His net contribution was major: Mitchell domesticated mental illness, so to speak, and laid some of the bases for modern psychosomatic medicine.
For an attentive physician and engaging conversationalist, I wish we could still find Weir Mitchell, a short distance west of our Inn at 1524 Walnut Street. To his office at home came numerous patients, who were admitted by a male servant in a red vest and swallowtail coat. It was an easy walk for Weir, of course, to come here to Camac Street, for the kind of conversations with J. William White and others that he cherished: unpredictable, wide-ranging, based on frontiers of knowledge; open to controversy, and hospitable to disagreement, far beyond the norms of Philadelphia society.
Although we cannot host our founder in fact, let us thank him warmly for starting up the Franklin Inn, and together toast his spirit: to S. Weir Mitchell!
Theodore Friend
Sources:
1. published: Ernest Earnest, S. Weir Mitchell, Novelist and Physician (Philadelphia, University of Pennsylvania Press, 1950)
2. web/Wikipedia/Google/ Google Images:
Charlotte Perkins Gilman
S. Weir Mitchell
Neurasthenia
Rest Cure
John Singer Sargent
Elaine Showalter (selections from The Female Malady)
A special meeting of the Kappa Lambda was convened this afternoon by order of the President, Dr. Otto, at the request of Drs. Bache, Bond, and Wood for the purpose of settling and closing the concerns of the institution ....
Resolved that the Secretary be requested to transfer to the College of Physicians, for safe keeping, With the consent of that body, Journal of Proceedings and other manuscript documents of the Kappa Lambda Society to be deposited in the Archives of the College ....
Philosophical Hall
February l Sth 1835, 3 1/2 PM
.... Resolved that from and after the termination of this meeting the Kappa Lambda Society of Philadelphia be held to be dissolved.
Resolved that the foregoing minutes of the present meeting be now read, which being done, they are unanimously approved.
On Motion adjourned sine die.
Henry Bond, Secy,
WITH these resolutions, the Philadelphia branch of the Kappa Lambda Society of Hippocrates transferred its organizational records to the College of Physicians of Philadelphia and then dissolved itself.
What was the Kappa Lambda Society of Hippocrates?
An elitist clique dedicated to the advancement of its membership?
A secret fraternal order?
A scientific society that published one of America's most important medical journals?
A society for the moral reform of medicine?
A society for reviving the Hippocratic Oath?
A society dedicated to the replacement of Hippocratic ethics with
Thomas Percival's
code of medical ethics?
A medical society that served as the prototype for the American Medical Association?
A failure from which the founders of the AMA learned how not to organize a national medical organization?
Seal of the Philadelphia chapter of the Kappa Lambda Society
The answer that seems to emerge from the books, ledgers, and correspondence that the Philadelphia branch of Kappa Lambda transferred to the College of Physicians of Philadelphia 1835 is that the Philadelphia chapter was all of the above. Yet the only three scholars who have written about the society -- Chauncey Leake (1922), Lee Van Antwerp (l945), Philip van Ingen (1945) -- have tended to view it as only some of the above, casting Kappa Lambda as either "elf" or more commonly, as Van Antwerp marks, as an "ogre".
Samuel Jackson, M.D.
The Kappa Lambda Society began as a secret fraternal order whose members swore a version of the Hippocratic Oath, pledged to upload the honor of the medical profession, and promised to keep the existence of the society a secret. The earliest known records of the society are from Lexington, Kentucky, and date from 1820. But, as Van Ingen has suggested, the history of society is considerably older. What appears to have happened in Lexington was that, in 1820, Dr. Samuel Brown (1769-1830), as professor of medicine, became head of the local chapter of Kappa Lambda. Under his leadership, this chapter committed itself to the moral reform of American medicine and took as its objective the idea of having American doctors pledge themselves to adhere to the code of conduct that Dr. Thomas Percival (1740-1804) had published in 1803 under the title Medical Ethics. To implement these reforms the Lexington chapter of the Kappa Lambda Society of Hippocrates published the first American edition of Percival's code of ethics, Extracts from Medical Ethics or A Code of Institutes and Precepts, Adapted to the Professional Conducts of Physicians & Surgeons in Private or General Practice (1821),and sought to establish new chapters of Kappa Lambda, whose members would pledge to adhere to the standards of conduct delineated in Percival's code.
When Dr. Brown went forth to spread the new Perivalean gospel, he found willing adherents in Philadelphia, where Samuel Jackson and seven other physicians (Franklin Bache, J.H.Gordon, Thomas Harris, Thomas T. Hewson, Hugh L. Hodge, Charlie D. Meigs, and Rene' La Roche)agreed to found a chapter. The Philadelphia constitution required all members to adhere to Percival's code of medical ethics and designated several members as "Guardians" with "the duty of preserving concord among all the members of the society, by arbitrating in all disputes referred to them, and prescribing the kind of reparation to be made .... (and) report(ing) ... whatever they may deem derogatory to its dignity and usefulness, in the misconduct of its members." The Philadelphia chapter of Kappa Lambda was thus to be a self-policing medical community that would abide by laws (stated in Percival's Medical Ethics) and that had guardians to police and enforce these laws.
Philadelphia may have been the only chapter of Kappa Lambda to take Dr. Brown's commitment to a self-policing moral community seriously. His ideas had been awkwardly juxtaposed on top of the original conception of Kappa Lambda as a secret fraternal order. The Philadelphia struggled with this fundamental tension in drafting their constitution. At the core of the old fraternal order was a secret oath passed down from society to society. Philadelphians were initiated into the society with the following oath:
You (swear/affirm) that you will endeavor to exalt the character of the Medical Profession by a life of virtue and honor--that you will keep the secrets, guard the reputations and advance the interest of the Society and of each of its members; and that you will never encourage anyone to devote himself to the Study of Medicine whose leaning, talents, and honorable qualities are not such as to render him respectable in his Profession, and worthy to be distinguished as a member of this society.
Whatever the original intent of this oath, its fraternal aspects--"advanc[ing] the interests ... of each of (the) members" and excluded from the profession, or at least from its higher ranks, anyone insufficiently virtuous, honorable, learned, or talented to be elected to Kappa Lambda--seem more prominent than its moral commitments.
Each chapter, moreover, was free to develop its own initiation ceremony. The Philadelphians used the ceremony to put a reformist spin on the oath. The following words were to be pronounced by Philadelphia initiates immediately after they read the oath:
The venerable Hippocrates of Cos may be considered as the remote founder of this society and the considered as the remote founder of this Society and the {oath/affirmation} which you have taken is in substance the same as that administered to its members. The influence of this society on the morals and professional demeanor of the physicians of that period is attested to by the most respectable authorities.
Believing that the state of the Profession in this country so imperiously calls for reformation & knowing that we have not that rank and influence in the community, to which as members of a liberal profession we are entitled, we have determined under a solemn sense of duty to associate on just principles for the purpose of elevating the character of our Vocation.
In other words, the oath was simply a ritual reminder of a historical reform movement. One could no longer reform medicine by excluding the unworthy, however, because "unworthy brethren" had already been admitted to the profession and had “humbled†the profession through their “sinister conduct.†The Problem facing the new Hippocrates, the Kappa Lambda, was reforming an already corrupt profession that problem could only b resolved by teaching the profession t associate on "just principles"(i.e., Percival's principles of Medical Ethics).
The need for "just" and benevolent principles of association is restated in the Preamble to the Philadelphia chapter's constitution, to which very member affixed their signature upon joining the organization.
As the bonds of all associations and confederacies by which their parts are firmly and permanently linked together, must be the eternal principles of benevolence and justice-we the undersigned-professing to follow implicitly, desirous of rigidly applying, these principles to our particular situation; uninfluenced by motive of personal ambition, disclaiming any right or wish to infringe on social compact, assume any power, delegate any authority which is incompatible with the religion we profess, the laws of our country or the fair and honourable advancement of our fellow citizen:--do hereby unite and pledge ourselves to be governed by the following constitution, and the laws which may afterwards be framed under it. Nor can we ever be unmindful, that our present efforts, directed to the support of the dignity, and extension of the usefulness of the medical profession, will more readily meet with their successful fulfillment in the encouragement of virtue and science, the pure lights of which must eventually dispel the mists of immorality and ignorance. To this end, we are to engraft medical ethics on moral precept, and sedulously cherish that friendly feeling and courteous conduct, in our professional and social intercourse, which can alone confer happiness on individuals, and promote the welfare of mankind.
With the words "uninfluenced by personal ambition ... [and] disclaiming any right or wish to infringe on ... the fair and honourable advancement of our fellow citizens" the Philadelphia chapter explicitly annulled the self-serving clauses of the traditional Kappa Lambda oath; indeed, by "engraft[ing Percival's] medical ethics on [Hippocratic] moral precept," they had effectively consigned the oath to a purely ceremonial function. The Philadelphia was thus continuing along the path taken by Samuel Brown (who beamed upon the Philadelphia branch and lauded its work), converting a vaguely Hippocratic elitist fraternal order into a society seriously committed to reforming American medicine.
The Philadelphia broke entirely new ground on another issue. Citizens of a city that was the center of the American science, the Philadelphia quite naturally wedded the two distinct ideas of scientific and moral reform into a single progressive union: pledging themselves to "the encouragement" of both "virtue and science" and to dispelling "the mists" of both "immorality and ignorance." Article V of the Philadelphia chapter's constitution made it morally obligatory for "Every member ... to contribute any practical fact, discovery, or view, which, in his opinion, will tend to the improvement of the profession, and the amelioration of the condition of the sick and infirm."
John Bell, M.D.
Such statements must have been intuitively obvious to the founding members of the Philadelphia chapter. When Samuel Jackson(l787-1872), who is generally credited with writing the constitution, formed the chapter in 1822, he was already professor of material medical at the Philadelphia College of Pharmacy and a member of the American Philosophical Society; by the time the constitution was formally enacted in 1825, he had become professor of the institutes of medicine at the University of Pennsylvania. A year later Franklin Bache (1792-1864) became a professor of chemistry at the Franklin Institute. Similar career patterns are evident in most of the other founding members; Hugh L. Hodge(l836-1881) was a lecturer on the principles of Surgery at the Medical Institute of Philadelphia, and went on to become a professor of obstetrics at the University of Pennsylvania; Charles D. Meigs (1792-1869 had been a member of the Academy of Natural Sciences of Philadelphia, became a member of the American Philosophical Society, and went on to become a professor of obstetrics at the Jefferson Medical College; Rene' la Roche(1795-1872) was a member of the Academy of Natural Sciences and, shortly after the constitution was approved, became a member of the American Philosophical Society.
The Philadelphia' fervor to reform medicine and to advance medical science clashed with the secret fraternal inclinations of traditional Kappa Lambda chapters. First, there was the issue of Percival's Medical Ethics. In 1823, following the precedent set by Dr. Brown, the Philadelphians published 500 copies of a newly revised editions of Percival' code, sending them to older chapters in Baltimore, Lexington, and New York, and distributing three copies to each member of the Philadelphia chapter(who appear to have used the extra copies to recruit new members). A new member, John Bell (1796-1872), was instructed to publish a copy of the Philadelphia edition of Extracts from the Medical Ethics of Percival in the National Gazette. He would later chair a subcommittee that revised and published yet another edition of the Extracts in 1826. As a member of a society committed to abiding by Percival's code, dedicated to disseminating its ideals, and seeking to recruit like-minded physicians, the Philadelphians thought it was perfectly natural to continuously revise and publish new editions of Percival. Yet publication was a disturbingly public activity for a supposedly secret society like Kappa Lambda.
Even more disturbing to the already established non-reform chapters of Kappa Lambda was the Philadelphia chapter's attempt to encourage scientific research by American physicians through The North American Medical and Surgical Journal. A regularly published journal was an event more public enterprise than the sporadic publication of revised editions of Percival's code. The New York chapter was instantly hostile to the idea, demanding that the existence of the Kappa Lambda society be kept secret. The District of Columbia chapter was concerned with the question of secrecy and wrote to the Philadelphia chapter to "ascertain particularly" whether in light of the "Journal which is to be proposed ... you intend to make public the existence of the KL societies generally." The journal's editors (Drs. Hodge, Bache, Meigs, Benjamin Homer Coates, and LaRoche) did not initially acknowledge the relationship between the journal and society. In February 1827, however, Dr. Meigs proposed that the Philadelphia chapter rescind its pledge of secrecy. The proposition was formally accepted by the membership in June. In meantime, the editors of The North American Medical and Surgical Journal announced that the Journal was supported by the Kappa Lambda Society.
Removing the Philadelphia Chapter from behind the shroud of secrecy was problematic. The older fraternal societies had never accepted Dr. Brown's reformist agenda and resisted it at every tum. A move vexatious challenge to publicity was the central reformist tenet of voluntary self-policing. It was one thing for members to volunteer to submit their personal and professional conduct to the private scrutiny and possible censure of their peers within the confidential confines of a secret society, it was quite another to voluntarily expose themselves to possible public censure. It took over two years to settle this question, when, in 1830, it was decided that all meetings would be opened to the public--except those involving inquiries into the conduct of the membership. This compromise in place, it was officially decided in June 1830 to announce the existence of the Philadelphia chapter of Kappa Lambda. By this time, however, the tide of public opinion had begun to tum against Kappa Lambda; all chapters were swamped in the backwash of a scandal over the conduct of the older non-reform New York chapter.
An anonymous letter to the Medical Society of the State of New York had revealed not only the existence of a "Secret Medical Association" operating in city , but the content of its secret oath, and the names of all its members--which included all the attending physicians and surgeons at the New York City Dispensary, the New York Hospital( except for one, ) and the Lying-in Hospital (except for two). The simple fact that a preponderance of members in the upper echelons of New York were members of a secret society prompted suspicions of favoritism. The Medical Society convened a Special Committee to Investigate a Secret Medical Association. The secret oath of the New York chapter of Kappa Lambda (a pre-reform chapter, founded around 1819) confirmed the Special Committee's worst suspicions.
I-do solemnly promise, that by all proper means, J will promote the professional respectability and welfare of the members of this association and vindicate their characters when unjustly assailed, and that J will not demand any pecuniary acknowledgment for such instruction as it may be convenient for me to afford to the son of an indigent member, as may be in the opinion of the society qualified by his previous educations,
and talents, and moral character, to become a respectable and useful member of the profession, but I will afford such instruction gratuitously, in conjunction with the members of the society.
This oath, the Special Committee observed, acknowledge that the members of the society were pledged "to promote the professional respectability and welfare ... of each other." Moreover, when the Special Committee asked the members of the New York chapter what they had done as an Association for the cause of science and the honor of the profession, the New Yorkers could not cite any significant achievements. Consequently, on the evidence of the oath and the pattern of appointments at New York hospitals, the Special Committee concluded that members of Kappa Lambda had in fact created "an unjust monopoly of the emoluments and honors of the profession.: They had evoked the name "Hippocrates" simply to put a patina of honor and a veneer of venerability on the shameless pursuit of personal advantage. The Special Committee reprimanded all members of "the Secret Association" and advised any man of character to resign.
Title Page of Volume I
Prior to June 1830 the Philadelphia chapter of Kappa Lambda had been doing quite well. Beginning with a small group of eight initiates, it had rapidly enrolled many prominent physicians, ultimately initiating ninety-eight members--with seventy dues-paying members residing in Philadelphia. The North American Medical and Surgical Journal was generally regarded as one of America's leading medical periodicals. Meetings were well attended; some drew crowds of over forty members. Yet, after word of the Special Committee report reached Philadelphia, attendance fell below the minimal quorum required by Kappa Lambda's Constitution. The Only meeting that had a quorum large enough to conduct business was that of 5 February 1835, when ten members assembled to dissolve the chapter. Samuel Jackson resigned on the first word of the scandal, but many members simply ceased to pay their dues. Without the membership dues to sustain it, The North American Medical and Surgical Journal was discontinued.
It mattered little that no one had ever accused the members of the Philadelphia chapter of monopolizing emoluments and honors; it mattered even less than the Philadelphia chapter's constitution forbade favoritism concerning any member, or that it had tried to become a public society, or even that, in striking contrast to the New York chapter, it had made contributions to medical science by publishing a major medical journal and Percival's Medical Ethics. The Philadelphia chapter was still a society, and the Special Committee had argued that secrecy corrupted any society, no matter how noble its initial intent. The stigma attached to Kappa Lambda was so deep that as late as 1858, when the New York chapter of Kappa Lambda sent an openly-declared member as its representative to a national meeting of the AMA, his credentials were rejected.
The Story of Kappa is more than a quaint tale, for as Chauncey Leake has correctly observed: "the same forces[that] were at work in establishing the American Medical Association in 1847, and in passing its elaborate code of ethics." The Philadelphia "forces" exerted their influence at the end of a national medical convention that had been convened in New York in 1846 to set national standards for medical education. After two days of discussions, the conferees were unable to reach any consensus. The Meeting was about to dissolve in failure when hoping to salvage something from the failed convention, Isaac Hayes(l796-1879), former secretary of the Philadelphia chapter of Kappa Lambda, proposed that the convention reconvenes in Philadelphia the next year to create a national medical society dedicated to reforming American medicine--ethically as well as educationally. The convention delegates endorsed Dr. Hays' proposal and put him in charge of making arrangements for the 1847 Philadelphia convention. They also established a committee to draft national code of medical ethics. Chairing this committee was John Bell, who had chaired the 1826 Kappa Lambda Committee to revise Percival's Medical Ethics; Dr. Hays, who had been secretary and editor for the 1826 Kappa Lambda committee, played the same role for the 1846 code-drafting committee, The third Philadelphian on this committee, Governor Emerson (1796-1874), was also an alumnus of the Philadelphia chapter of Kappa Lambda.
The American Medical Association and its code of ethics were, as Leake suggests, an extension of the ideas and ideas that originated in the Philadelphia chapter of Kappa Lambda. Yet the failure of Kappa Lambda had taught the Philadelphians some important lessons. Kappa Lambda had been secret, fraternal, and exclusive; by contrast, the AMA was to be public, political, and inclusive--a grand public alliance of all the forces of reform and of all the hospitals, medical schools, and medical societies in America. Kappa Lambda had been founded on a gentlemanly version of the Hippocratic Oath. Chastened by their experience with corrupt versions of the Oath, the former Kappa Lambda eschewed any mention of Hippocrates of his oath in AMA Code of Ethics. The new AMA Code of Ethics, like the old Kappa Lambda code, was based on Percival ethics that called 0 physicians "to obey the calls of the sick," to treat every patient skillfully, attentively, faithfully, tenderly, but firmly while tempering medical authority with a spirit of equality. Moreover, "every case committed to the charge of a physician" would "be treated with attention, steadiness, and humanity"; every patient would be entitled to confidentially, delicacy and discretion. Yet the new AMA code of ethics required even more of physicians that the older Percival codes: having once been crucified on charges on selfishness and monopolization, the former Kappa Lambdans obligated physicians to self-sacrifice on behalf of their patients and the public. They required physicians to recognize "poverty ... as presenting valid claims for gratuitous services," and to pledge that "when pestilence prevails" it is their "duty to face the danger, and to continue their labors for the alleviation of suffering, even at the jeopardy of their own lives. "
The grand moral vision of the former Kappa Lambda energized the American Medical Association and made it the preeminent moral and political voice of American medicine. In the twentieth century, as the Kappa Lambda's reformist vision lost its vigor, the tale of Kappa Lambda became the stuff of scholarly debate=most scholars have tended to dismiss it as an idiosyncratic and ultimately unimportant chapter in the history of American medicine. Yet it seemed to me, as I surveyed the records that the Kappa Lambdans had turned over to the College of Physicians of Philadelphia, that 1997 was an appropriate time to reassess its legacy. For in wrestling with the task of developing formal standards of medical ethics that could serve as the basic of professional self-policing, in obligating American physicians to serve the interests of the public as well as their willingness to put the care of their patients ahead of their own financial interests and physical safety, the Kappa Lambda had formulated very high ideals for American medicine. Looking back on these ideals on the sesquicentennial of the founding of the American Medical Association and its Code of Ethics one is still struck by the grandeur of their moral vision--and also by the thought that the prominent role ethics still plays in American medicine is ultimately the heritage of the Philadelphia chapter of Kappa Lambda.
Although we have had Judges for thousands of years, it's only one of the three branches of American government, and the last to be adopted, even in rudimentary form. Perhaps the framers felt the legal profession could handle the matter without much specification, just as at least so far, we have no cabinet minister or separate department for Medicine, in spite of its coming close to twenty percent of the national budget. At least it is certain that the award of a cabinet seat does not relate to the size of its national cost. The main function of the Supreme Court seems to be to enforce the Constitution on the elected branches, and the main rule is to limit the federal branches to making war and levying taxes. That's under constant attack, but at least it's the theory. An invisible rule is to avoid non-federal rules; we rejected the League of Nations, and essentially ignore the United Nations. The surest way to defeat a law is to say the Europeans have one like it.
This seems to be partly a human jealousy, quite similar to the way the federal government constantly seeks to invade the territory the Constitution gives to state legislatures. One of the central attractions of Roman citizenship was the set of rights afforded the citizens, and definitely not afforded to other people. St. Paul made good use of the rights of a Roman citizen, available to those who could announce civis Romani sum . These were, however, the exclusive gift of the Roman Senate, which for a long time Emperors feared to tamper with.
Chip Kelly of the Right Angle Club points out that Hammurabi intended the right of a tooth for a tooth and an eye for an eye as a limitation of rights. If someone offended you or your family, you were definitely not entitled to overreact by massacring his whole tribe but limited to exact equality of the punishment to fit the crime. An eye for an eye, tooth for a tooth -- and no more.
Somewhere, there may be a reasoned argument for natural rights or divine rights, but outside the French Revolution, it is a little hard to find anything but legal rights, as consistent rights which society, in general, has decided to give you. That's somehow related to the concept of extending those rights to everyone, which everyone would want to have for himself. Anything more restricted than that is not a human right, it is political favoritism. It may even be much of the reason the French and English rejected the European Union.
A cynic might say that an inalienable right is one which is impossible to bargain for. It will only be conferred if you are willing to die for it in a war which you win. When it comes down to it, that is the reason professional soldiers regard religious wars as the very worst kind and may just be a driving force behind the First Amendment.
The Right Angle Club was recently highly entertained by a talk by Richard Karschner about the hay day of Willow Grove Park. Mr. Karschner appeared before the club in full uniform of the Marine Marching Band with medals and quickly demonstrated an immersion in this topic that must have taken a lifetime to perfect. He put on a virtuoso performance, a prepared speech perfectly timed to an automated slideshow, which was in turn in perfect synchrony with an automated musical background, exactly tailored to fit the momentary subjects. He concluded with a brilliant brief solo on the cornet (trumpet), using double and triple tongue-ing. To some of us who remember some futile struggling with the trumpet in our high school marching bands, the skill demonstrated was certainly impressive.
Music Pavilion
To go back a moment in time, the trolley car was the main method of public transportation in the last half of the 19th Century, blanketing the cities of America and their suburbs, and connecting to the trolley lines of other cities through an interurban network. Somewhere the idea developed of building Amusement Parks out at the far end of suburbs, to attract riders into using the trolleys for more than just commuting; there may have been as many as seventy or eighty such permanent circus grounds in America at one time, with more elaborate attractions that could be managed by traveling circuses. Philadelphia had several such trolley parks, notably Woodside Park in Fairmount Park, serviced by the "Park Trolley". But in 1896 Willow Grove was created on the edge of Abington, far more elaborate than any others, at the intersection of Old York Road and Easton Pike (Rte 611). Its terminal could hold as many as a hundred trolleys at once; the ride from Center City Philadelphia took 70 minutes and cost 15 cents. The area had mineral springs and had long been a favored vacation spot. Horace Trumbauer designed four or five of the buildings, and the Park eventually included a lake with rental boat rides, an arboretum, amusement rides, restaurants, a fun house, silent movie theaters, rodeos, roller coasters, a picnic park, and even an artificial mountain with a slow scenic ride up but a rip-roaring fast descent. By far the most central feature of Willow Grove was the 4000-seat music center, dominated by John Philip Sousa and his band giving four performances a day. Other musical performers were Victor Herbert, Walter Damrosch, Arthur Pryor ("The Whistler and His Dog"). Many of the ideas of Willow Grove are now to be found in the modernized form at Disneyland, but for twenty-five years music under the direction of John Philip Sousa was really the central unifying feature.
John Philip Sousa
It's generally held the arrival of radio broadcasting caused the decline of Willow Grove, although "The March King's" immense energy declined toward the end, as he began to enjoy being a multimillionaire. The composition of marches was in fact only a minor part of his musical output, which included among other things 16 full-length Broadway musicals. He was a national champion trap-shooter and a horseman of some note. One arm became nearly useless to him after a fall from his horse. Meyer Davis took over in the last few years, but a major fire pretty well finished the place off just in time to be buffeted by the 1929 crash. There was an attempted resurgence in 1933, but circumstances which made Willow Grove a successful "Virtuoso Solo" just couldn't withstand the competition of the automobile and television, and the land was finally broken up and sold for $3 million in 1976. Remnants of the gilded past are now scattered around the Willow Grove Shopping Mall, for those who wish to renew fond memories from their childhood. Or perhaps their grandparent's childhood.
When writing to a good friend and fellow naturalist about his exploits in American Conchology, the Philadelphia Entomologist Thomas Say assured his friend that "INSECTS are the great objects of my attention. I hope to be able to renounce everything else and attend to them only." And so he did, writing one of the most important books on the study of North American insects. Say's American Entomology transformed the study of American Natural History from the pastime of science-oriented gentlemen, into a legitimate scientific field.
Thomas Say was born on June 27th, 1787 into a respectable Quaker family, the same summer when men from the newly independent states were meeting for the Constitutional Convention. His father, Benjamin Say, a "fighting Quaker" during the revolutionary war, was a well-established pharmacist and apothecary. His mother was a descendant of the famous naturalist, John Bartram of Bartram Gardens in Kingessing. Say seems to have inherited the naturalist gene, and collected butterflies for his great uncle, William Bartram, as a young boy. Into adulthood, he remained uninterested in all subjects save Natural History.
Say's father, skeptical about his son's obsessive interest in bugs, attempted to set him up in the pharmacy business as a partner with a family friend and fellow naturalist, John Speakman. Unfortunately, both men were more interested in Natural History than business; their partnership failed miserably, leaving Say completely broke but with plenty of time to devote to his passion, Natural History.
This passion contributed to the founding of the Academy of Natural Sciences. Meeting in the houses of local naturalists, and even in Say and Speakman's chemist shop, a small group of young men set out to create an institution where they could collect, share and legitimate the study of Natural History. With Say present at the founding meetings, the Academy of Natural Sciences was established to stop the exportation of scientific research to Europe and establish an American scientific community. Patriotic fervor was particularly notable during the year of the Academy's founding, 1812.
The Academy's progress took a brief hiatus that summer to put a stop to what the new Americans viewed as threats to the young country's independence. Say joined the army and survived its bullets. By the end of the war, and with American economic independence intact, the Naturalists now continued their mission of establishing American intellectual independence. Elected the Conservator of the Academy, Say devoted his life to the maintenance and study of its collections. He is said to have lived in the rooms of the Academy on bread and milk (with an occasional chop or egg) and to have slept under the skeleton of a horse. Notoriously frugal, spending only 6 cents on food every day, Say bemoaned the hassle and expense of dining. He would rather be studying the wings of mosquitoes than wasting time with fancy dining.
During these early days of the United States, Thomas Say was quickly cast as a key member of America's varied and extensive expeditions to discover its largely unknown country. His first was a trip with fellow Academy members to Florida in 1817, a journey cut short by the threat of unfriendly local indigenous tribes. The group did manage to capture a few important species; Thomas Say wrote to a friend that Florida while "not flowing with milk and honey," was "abounding in insects which are unknown."
In 1819, Say was appointed head zoologist for the expedition of Major Long to the Rocky Mountains, where Say discovered and named not only insects, but animals as well, including the Columba fasciata Say, or fan-tailed pigeon. Several years later, in 1823, Say accompanied Long once again, this time on an expedition to the head of the St. Peter's River.
Back in Philadelphia, Thomas Say worked tirelessly to deepen the Academy's intellectual work, publishing many articles for the Academy's Journal on both entomology and conchology. He was also involved with the American Philosophical Society and became professor of Natural Sciences at the University of Pennsylvania. During this busy time, Say also managed to socialize among Philadelphia's upper crust, and is noted as having attended Caspar Wistar's weekly "soirees."
Papilio Glacus from American Entymology
His urban life did not last, however; Say found himself swept westward in a great tide of social idealism. Robert Owen, a Scottish social reformer, moved to the United States in hopes of establishing a community based on the principles of cooperation, brotherly love, and universal education through the absence of competition, and religious motives. Having purchased the property of the German "Harmonists" in Indiana, Owen persuaded nearly 1,000 people of varying background to help establish a Utopian society. Although Say had a strong democratic spirit, he was perhaps most interested in the move West for what it might offer him in the way of scientific discovery.
In 1826, with both MacClure and Owen, Thomas Say sailed down the Ohio River on what was called the "Boatload of Knowledge," a small ship carrying East Coast intellectuals to their Indiana paradise. Say was put in charge of the operation and named captain of the ship, perhaps due to his experience in the army more than a decade before. It was also on this boat ride to Indiana that Say met his future wife, Lucy Way Sistare, a prospective schoolteacher at New Harmony.
Despite this drastic move, Say remained much more concerned with his study of Natural History than any particular ideological movement, a fortunate enough attitude given the community's short life; after only two years the New Harmony project evaporated because of lack of organization and internal feuds between Owen and his various followers. Say was nevertheless able to use the move out West to his advantage and took part on an expedition to Mexico with William MacClure.
Although voices from the East Coast, and particularly the Academy, called him back, Say stayed in Indiana, publishing his two most famous works, American Entomology and American Conchology. He used illustrations composed over the years by young Titian Peale, son of Say's portraitist, Charles Wilson Peale, as well as Charles Alexandre Lesueur. Lucy Say, his wife, also helped to color the plates for their publication. These two works, and particularly American Entomology were praised abroad as real works of science and as proof the United States had "serious" scientists.
Say experienced relative peace and quiet during his final years in Indiana, a quiet spent in vigorous study of Natural History. However, after years of ill-health, of putting off food for study and his own well-being for that of others, Say died at the young age of 49 in 1834. He was buried at New Harmony, the grave marked with an epitaph capturing his unique passion for the Natural World:
Botany of nature, even from a child,
He saw her presence in the trackless wild;
To him the shell, the insect and the flower,
Were bright and cherished embers of her power.
In her, he saw a spirit life divine,
And worshiped like a Pilgrim at the shrine.
109 Volumes
Philadephia: America's Capital, 1774-1800 The Continental Congress met in Philadelphia from 1774 to 1788. Next, the new republic had its capital here from 1790 to 1800. Thoroughly Quaker Philadelphia was in the center of the founding twenty-five years when, and where, the enduring political institutions of America emerged.
Philadelphia: Decline and Fall (1900-2060) The world's richest industrial city in 1900, was defeated and dejected by 1950. Why? Digby Baltzell blamed it on the Quakers. Others blame the Erie Canal, and Andrew Jackson, or maybe Martin van Buren. Some say the city-county consolidation of 1858. Others blame the unions. We rather favor the decline of family business and the rise of the modern corporation in its place.
Originally the "lower counties" of Pennsylvania, and thus one of three Quaker colonies founded by William Penn, Delaware has developed its own set of traditions and history.
Start in Philadelphia, take two days to tour around Delaware Bay. Down the New Jersey side to Cape May, ferry over to Lewes, tour up to Dover and New Castle, visit Winterthur, Longwood Gardens, Brandywine Battlefield and art museum, then back to Philadelphia. Try it!
Millions of eye patients have been asked to read the passage from Franklin's autobiography, "I walked up Market Street, etc." which is commonly printed on eye-test cards. Here's your chance to do it.
In 1751, the Pennsylvania Hospital at 8th and Spruce was 'way out in the country. Now it is in the center of a city, but the area still remains dominated by medical institutions.
Grievances provoking the American Revolutionary War left many Philadelphians unprovoked. Loyalists often fled to Canada, especially Kingston, Ontario. Decades later the flow of dissidents reversed, Canadian anti-royalists taking refuge south of the border.
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