5. From the diffusion of medical knowledge among all classes of our citizens, by means of medical publications, and controversies, many people have been taught so much of the principles and practice of physic, as to be able to prescribe for themselves in the forming state of acute diseases, and thereby to prevent their fatal termination. It is to this self-acquired knowledge among the citizens of Philadelphia, that physicians are in part indebted for not being called out of their beds so frequently as in former years. There are few people who do not venture to administer laudanum in bowel complaints, and there are some persons in the city, who have cured the cynanche trachealis when it has occurred in the night, by vomits and bleeding, without the advice of a physician. The disuse of suppers is another cause why physicians enjoy more rest at night than formerly, for many of their midnight calls, were to relieve diseases brought on by that superfluous meal. 6. The dispensary instituted in our city, in the year 1786, for the medical relief of the poor, has assisted very much in promoting the empire of medicine over disease and death. Some lives have likewise been saved by the exertions of the humane society, by means of their printed directions to prevent sudden death; also, by the medical services which have lately been extended to out-patients, by order of the managers of the Pennsylvania hospital. 7thly and lastly. A change, favourable to successful practice in Philadelphia, has taken place in the conduct of physicians to their patients. A sick room has ceased to be the theatre of imposture in dress and manners, and prescriptions are no longer delivered with the pomp and authority of edicts. On the contrary, sick people are now instructed in the nature of their diseases, and informed of the names and design of their medicines, by which means faith and reason are made to co-operate in adding efficacy to them. Nor are patients left, as formerly, by their physicians, under the usual appearances of dissolution, without the aid of medicine. By thus disputing every inch of ground with death, many persons have been rescued from the grave, and lived, years afterwards, monuments of the power of the healing art. From a review of what has been effected within the last nine and thirty years, in lessening the mortality of many diseases, we are led to look forward with confidence and pleasure to the future achievements of our science. Could we lift the curtain of time which separates the year 1843 from our view, we should see cancers, pulmonary consumptions, apoplexies, palsies, epilepsy, and hydrophobia struck out of the list of mortal diseases, and many others which still retain an occasional power over life, rendered perfectly harmless, _provided_ the same number of discoveries and improvements shall be made in medicine in the intermediate years, that have been made since the year 1766.