Page:American Medical Biographies - Kelly, Burrage.djvu/633

JANEWAY later vice-president of Rutgers College, was a man of robust intellect and great moral earnestness. His mother was a New Yorker of New England stock, who died while he was a boy.

His school and college life were passed in New Brunswick, where he received from Rutgers College the degree of A. B. in 1860, and later the A. M. He did not take special honors in college and showed a very wholesome fondness for outdoor sports and practical jokes. The career of a physician, as he had watched his father's arduous days, did not attract him, and he begged permission to enter business in New York. His father was wiser and, with confidence that his talents would develop best in medicine, begged him to try. The first year of the old curriculum at the College of Physicians and Surgeons, New York City, with its grind of didactic teaching, and its lack of contact with objective facts except in the dissecting room, gave him no enthusiasm for the profession. Then came the experience of a hospital, where he could sec real sick people and do real things to help them, and his love for the work grew apace. This experience was brought by the Civil War, in which, during 1862 and 1863, he served as medical cadet in the army hospital at Newark, N. J., under his cousin, Dr. John H. Janeway, U. S. A. From that time on the study of medicine absorbed his every energy of mind and body. He completed his course and graduated in 1864, and immediately entered Bellevue Hospital, where he served on the house staff for two years. In those days the first service of an interne was the charge of the small-pox hospital on Blackwell's Island, where a visiting physician rarely came, and education was laboriously won in the bearing of heavy responsibility, alone.

In 1866, soon after the completion of his hospital service, he was appointed curator of Bellevue Hospital, a position he held until 1872, when he became visiting physician. Those six years laid the firm foundation of his later achievements. He literally lived in the dead-house, in spite of the remonstrances of friends, who thought he was throwing away all his opportunities for acquiring a practice. Virchow's work was just coming into prominence, and he mastered medical German in order that he might follow it at first hand. Stimulated by it, he, with Francis Delafield, who became the other great teacher and consultant of his time in New York City, and the brilliant J. W. Southack, his particular friend, who died young, conducted systematic autopsies for the first time in New York City. Through them he learned to know the lesions of disease as the greatest clinicians, and none but the greatest, have known them in the past, and as few will ever know them in the future, now that pathology has become a separate field of investigation. Through them he also came to recognize the pitfalls that await the diagnostician and to know the limitations of his methods, where he might be bold in the certainty of observed fact, where cautious in the dangers of interpretation. Few men, I believe, have ever so completely exemplified Virchow's dictum that the physician must, above all, think anatomically. The almost uncanny skill with which, in later life, Dr. Janeway would sometimes solve a difficult diagnostic problem by a few simple observations, and which made men say that he could see inside a patient, was but the result of a mind stored to the full with accurate visual memories of almost every known lesion that can affect the internal organs.

Pathology was never for him an end in itself, but always the final chapter in the history of a case of disease. When, in 1872, he received the coveted post of visiting physician, he still frequented the autopsy room, and throughout his whole life he would cancel any other engagement to see the post-mortem on a patient he had observed. He obtained many autopsies on private patients, and later, as commissioner of health, he often incurred the risk of physical violence in order to confirm by section his suspicion of the existence of such dangerous diseases as hemorrhagic smallpox or typhus fever. He left no permanent contributions to pathological theory, but his contribution to making pathological anatomy the basis of clinical diagnosis in the United States was conspicuous. The "Pathological Reports of Autopsies performed in Bellevue Hospital" (Bellevue and Charity Hospital Reports, 1870) and the "Proceedings of the New York Pathological Society" from 1868 to 1878, attest his activity during this period.

From 1868 to 1872 he was a visiting physician to Charity Hospital. During 1870 he gave up some months at the urgent request of the Commissioners of Public Charities to live there as chief of staff, in order to root out the corruption known to exist, and he accomplished it successfully and fearlessly. This was his first public service. A far more important one followed in 1875, when he was appointed commissioner of health of the City of New York, serving until 1881. He thus acquired a large interest in and knowledge of