Nestor of the American Medico-Psychological Association, Dr. George Cook, later of Brigham Hall, Canandaigua, Dr. J. M. Cleveland, the builder of the Hudson River Hospital, Dr. A. O. Kellogg, Dr. T. R. Beck and others. He remained here until his removal to Michigan in 1858 to assume charge of the completion and opening of the Michigan Asylum for the Insane at Kalamazoo. Here he found a hospital for the insane, liberally planned, which had been ten years in building and which had been destroyed by fire before it was completed. His first mission was to complete this building by placing before the legislature the needs of the State. He possessed a happy faculty of interesting the members of the medical profession in the humanitarian aspects of the work, and also the members of the legislature and State officers generally in the public duty of taking care of all the insane of the State irrespective of the duration of their mental disease. He believed that as long as patients have mental disease they need the care which is given to the sick and should not from mistaken ideas of economy be returned to county receptacles or almshouses, but should continue in organized hospitals under the skilled care of the State. By a consistent advocacy of these principles he beheld the asylum at Kalamazoo grow to a large institution, and also saw established a second institution at Pontiac and a third at Traverse, in the location and building of which he was personally interested.

He had a charm of personality which attracted all who came in contact with him and endeared his patients to him. He was a ready writer and his letters to his friends or to his former patients and their friends were models of the epistolary art, now fast disappearing. He took infinite pains in his letters to the friends of patients to relieve their anxiety and to give them confidence in the institution. He had rare ability as a medical man and was extremely able in the treatment of mental disease. His keenness of observation and the care with which he studied his cases are well shown in his famous paper on neurasthenia which formed the supplement to one of his biennial reports to the legislature. It was the first paper of any importance written upon a topic which since then has received so much attention. It was republished in Volume XXV of the JOURNAL OF INSANITY, page 445, and is a classic worthy of a place with the writing of Brigham, Bell, Ray, Kirkbride or Gray.

After a service of twenty years his health, always delicate, failed utterly and his valuable services were lost to the State in great part. His influence, however, continued a mighty force to the day of his death. Earnest, devoted, philanthropic and unselfish, he worked for the good of humanity and had a rich reward in the appreciation of his friends, neighbors and fellow citizens in the State of his residence.

AMERICAN ASSOCIATION OF CLINICAL RESEARCH.-In view of the increasing and intelligent interest which is being shown in clinical studies in psychiatry we believe many of our readers will be glad to take an active part in the formation of an association to promote clinical research. The following letter has been sent to many clinicians and we are happy to be able to forward the interests of the movement by bringing it to the attention of the readers of the JOURNAL.

Dear Doctor: A meeting of physicians and surgeons interested in scientific clinical research is called for Wednesday, October 27, 1909, at John Ware Hall, Boston Medical Library, No. 8 Fenway, Boston, Mass. The meeting will come to order at 10 a. m., and carry its sessions through Wednesday, and, if necessary, through Thursday and Friday.

The object of the meeting is: First, to establish an American Association of Clinical Research; secondly, to establish clinical research on an incontrovertible scientific basis in hospitals; and thirdly, to institute an "American Journal of Clinical Research," in which the work of members of the American Association and of others doing clinical research work in a scientific manner shall be published.

You and your friends are herewith cordially invited to participate in this meeting and in the proposed movement of scientific clinical research.

This invitation is extended to all physicians and surgeons whose interest goes beyond the immediate case work of ordinary clinical societies; and it is hoped that the invitation will be accepted by all medical practitioners, irrespective of their present medical affiliations, who can appreciate the necessity for establishing on an incontrovertible scientific basis the certainties and limitations of the present practice of medicine and surgery before attempting to add to the already large and cumbersome field of medicine.

The American Association of Clinical Research is not intended to disturb the present medical affiliations of its members nor to interfere in the very least with the duties they owe and the privileges they enjoy by virtue of their affiliation with any existing national medical body.

The American Association of Clinical Research is to take cognizance of the fact that the clinic requires cold facts and conclusive methods, and upon

these fundamental requirements, the structure and the work of the American Association of Clinical Research are to be built.

It is of the utmost scientific importance to establish conclusively all that is at present true in medicine and surgery, and only upon such proved knowledge, to base any further advancement. The clinic deals with clinical entities and not, like the laboratories, with parts as entities. Therefore, clinical research differs, and must differ, from experimental laboratory researches. Clinical research must consider clinical entities, and when considering parts, it must consider them only as parts and not as wholes. All that subserves the object of obtaining and investigating clinical facts and principles belongs to clinical research and the laboratory is a part of the means of clinical research, but only a part.

The crux of the matter appears to be that experimental laboratory proof is not sufficient clinical proof. In order to advance in an irresistible line, clinical research must be based on a conclusive form or method of clinical proof. In experimental proof, we dislocate a part from a whole and attempt to prove the whole from the part, as though a dislocated part could always prove the whole. Or, we attempt to prove facts in one species by facts in another species, as though the two species were identical. For instance, the experiments made on animals to elucidate certain elements of fever bring out a fact of almost insurmountable difference between man and the lower animals, the fact that man has associated with the nakedness of his body a highly perfected power for regulating his temperature, a highly developed vasomotor system and a vast array of sweat glands, a characteristic complex of things which apparently no other species of animal life presents. Experiments made on animals to prove febrile or other clinical phenomena in man, may be suggestive, but for obvious reasons cannot be conclusive. To prove observations in man, the observations must be made on man and not on animals. But observations on man even are not necessarily conclusive. Individual observations on man cannot be conclusive, because the same experience cannot be repeated, and when we prove by numbers, we compare similar but not identical experiences. Analogy is not conclusive proof. Identity alone is conclusive proof; but since, in medicine, identical experiences cannot be repeated, we must provide simultaneous identical experiences in order to have proof by identity. Clinical proof is conclusively established when all observations and experiments are made conjointly by at least two competent men, preferably of opposite ideas, at the same time. Conjoined critical observation and experiment, at the bedside and in the laboratory, as may be required, furnish simultaneous identical experiences, the proof proceeding on the principle that a whole can be proved only by the whole and not by dislocated parts.

These and other weighty questions await your assistance for a necessary solution. The benefit that will accrue, both to medicine in particular and to the medical profession and humanity at large in general, from a satisfactory establishment of scientific clinical research, can be easily surmised. Come prepared, yourself and your friends, to give to this matter your

mature convictions and your personal assistance. Only from a critical interchange of critically acquired opinions, can we hope for clearness and for the clarification of the medical atmosphere now charged with confusion and indifference.

Your communication, indicating your interest and your expectation of being present at the meeting in Boston on October 27, next, is eagerly awaited, and on receipt of the expression of your interest, further developments will be communicated to you personally in due time.

Please address your communications at the earliest possible date directly to James Krauss, M. D., 419 Boylston Street, Boston, Mass.

Yours fraternally,

JAMES KRAUSS, M. D.,

Chairman Committee American Association Clinical Research.

DEATH OF DR. B. D. EASTMAN.-Dr. B. D. Eastman, the first medical superintendent of the State Insane Asylum, at Topeka, Kansas, and earlier of the State Hospital, Worcester, Mass., died of heart disease at his home in Topeka, Kansas, on Saturday morning, September II, in the seventy-fourth year of his age.

Dr. Eastman opened the hospital at Topeka, in 1879, and continued at its head for eighteen years with the exception of two short intervals when the institution came under the baleful control of party politics.

The new State hospital at Worcester was built under his supervision and largely after his plans. He was for many years an active member of the American Medico-Psychological Association, but for some time his health has prevented his attendance at its meetings. A notice of Dr. Eastman's life and work will appear in a subsequent number of the JOURNAL.

Death of Dr. W. W. IRELAND.-Dr. Ireland who was well known through his contributions to the literature of psychiatry, and will be personally remembered by many of our readers, died at his home in Musselburgh, Scotland, May 17 last, at the age of seventy-seven. Dr. Ireland had a long, interesting and varied career. The son of an Edinburgh publisher, he was educated in the university of that city and in Paris, and shortly before the outbreak of the Indian mutiny joined the Bengal Horse Artillery as assistant surgeon. He was present at the siege of Delhi and attended the present Lord Roberts, then a lieutenant, when he was wounded. After seven months active service Dr. Ireland was

shot in the eye, the bullet passing out behind the ear. At the same time another ball struck him in the shoulder and lodged in the back being subsequently removed by the surgeon. It was a year before he could leave his bed and not until three years had passed was he able to undertake the voyage home. It was ten years before he was able to engage in the work of his profession. In 1861 Dr. Ireland wrote The History of the Siege of Delhi, this was followed by two works Studies of a Wandering Observer and Randolph Methyl, a tale of Indian life.

When he resumed professional work he took up the study of mental diseases and shortly was appointed superintendent of the Larbert Institution for Imbecile Children. He was much interested in studies in heredity and two of his works are based upon studies in this field: Through the Ivory Gate and The Blot on the Brain. In 1877 he published a work on Idiocy and Imbecility and in 1900 one on Mental Affections in Children.

Notwithstanding the handicap to his early professional career resulting from his wound and the resulting blindness in one eye, Dr. Ireland did during the subsequent years of his life a vast amount of work and gained the warm esteem of a large circle of professional friends. He was not one who repined over his misfortunes and met whatever came to him with a serene and confident mind. He said of himself near the close of his life at the jubilee of his M. D., at Edinburgh, that: "He was not one of those who were in doubt as to life being worth living; he would gladly live his life over again, and he had found that his worst experiences had always taught him something."